The Obamacare website Healthcare.gov has been grabbing all the headlines lately, but another aspect of the Affordable Care Act (ACA) may come under increased scrutiny in the weeks and months ahead: Electronic Health Records (EHR). The ACA requires medical providers to transition to electronic record keeping by 2015. In addition to increasing privacy concerns over the systems, the financial benefits of EHR are less clear after reports in January that the RAND Corporation had backed off from an optimistic $81 billion annual savings predicted in a 2005 report. The New York Times reported that:
...evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services. Health care spending has risen $800 billion since the first report was issued, according to federal figures...
With savings from EHR in question, a recent report by the Government Accountability Office (GAO) may raise concerns about incentive payments through Medicare to medical providers for the EHR transition. Healthcare providers and hospitals were paid $6.3 billion in 2012 alone, up from $2.3 billion in 2011. Participation in the program by eligible providers approximately tripled from 2011 to 2012 matching the increase in incentive payments. However, the GAO reports that not quite "half of eligible hospitals and less than a third of eligible professionals received Medicare EHR incentive payments for 2012," so participation is far from universal.
While the maximum incentive payment to a hospital in 2012 was $4.7 million, the median amount was $1.4 million. The median payment to individual health care professionals was $18,000.
The Department of Health and Human Services released a statement today saying that gay spouses are now eligible for key Medicare benefits. The announcement is presented as "guidance" for "implementing Supreme Court’s decision on the Defense of Marriage Act."
A recent audit by the Office of the Inspector General for Health and Human Services found that in four out of five cases when elective surgeries were cancelled for one reason or another, Medicare still paid even though the claims submitted by the hospitals failed the "reasonable and necessary" standard.
The bankrupt city of Detroit may have found a way out of its health care woes for its retired city workers: shifting the costs to taxpayers nationwide via Obamacare. If Detroit and other struggling municipalities follow through, the result could be a "huge cost" to taxpayers. The New York Times has the story:
The recent news on the economy, in general, and deficits, in particular, has been encouraging. Seems the clumsy blend of tax increases and reduced spending – aka the sequester – brought in more revenue and reduced spending. Funny how that works.
Earlier this month, President Obama released his fiscal year 2014 budget, which calls for $1.1 trillion in higher taxes over the next decade, cuts of $400 billion from Medicare and Medicaid, and alterations to Social Security’s benefit rate worth about $130 billion.
Robert Samuelson's fine column in the Washington Post, “America the retirement home,” argues that “The budget debate’s central reality is that federal retirement programs, led by Social Security and Medicare, are crowding out most other government spending,” and that this is endangering the other important functions of government, including defense:
It’s an old basketball adage that teams that apply a full-court press don’t like to be pressed themselves. They like to force the action, not have it forced on them. In a similar vein, those who seek to centralized power by spearheading the passage of new federal laws generally don’t like to obey those laws themselves. Laws are something for other people to dutifully obey — less important people.
Wisconsin congressman Paul Ryan knocked President Barack Obama for "shadowbox[ing] a straw man" in his inaugural address. Speaking Tuesday morning on the Laura Ingraham Radio Show to guest host Raymond Arroyo, Ryan responded to Obama's statement that Medicare, Medicaid, and Social Security "do not make us a nation of takers, they free us to take the risks that make this country great."
Ryan called Obama's insinuation that he and other reform-minded Republicans consider recipients of these benefits "takers" a "switcheroo."
Among the many items bundled into the fiscal cliff fix there was another delay in implementing cuts to physician payments for Medicare services. It wasn't hard, though. Congress has had plenty of practice handling what is called the "doc fix," since it has been doing it almost routinely for the last decade.
Journalist Bob Woodward explained this morning on CBS that "there's a civil war in the Democratic party":
"There's a civil war in the Democratic party," said Woodward. "You had Nancy Pelosi on, saying, oh, we're not going to change the eligibility age for Medicare. And down at the White House they very much want to do that."
One problem with the unearned income Medicare contribution tax is the name Congress chose for it, which is a triple misnomer. The income that will be subject to the tax isn’t unearned -- it is earned by savers who receive market rewards for delaying consumption and providing funds to finance business investment.