Let there be light on health spending

Foes of Obamacare often frame such health reforms as “redistribution” schemes. They take money from hardworking Americans and give it to the presumably undeserving.

My conservative friends are right that a lot of health reform is about redistribution. What they get wrong are the arrows on the real redistribution chart.

Health care reform is beginning to divert the money, all right, but from the medical-industrial complex back to the pockets of we who pay for health care. Repeat. We pay for medical care directly, through taxes and through insurance premiums.

There are reasons Americans have been spending twice the “rich country” average for health care while leaving millions uncovered and enjoying no better medical outcomes. For one, health care business interests pay our elected officials, in both parties, to keep the public tied to their treatment and drug treadmills — and in the dark about what these things are costing.

Fascinating new data from Medicare show why we need more government in health care. They spell out how much individual doctors made off the program in 2012. In one case, an ophthalmologist in Florida, now under criminal investigation, billed Medicare for $21 million. That’s one eye doctor in one year!

Some 100 doctors reaped a total of $610 million in Medicare money. About 2 percent of the Medicare doctors, meanwhile, took in $15 billion, according to a New York Times analysis.

The American Medical Association, the doctors’ lobbying group, didn’t want this information released. It took a federal judge to rule that the public could see it.

Government officials now have leads to look into Medicare fraud. Private insurers can investigate which doctors are overprescribing. And patients can check to see whether their doctor sends everyone with a headache for a CT scan. In addition to being expensive, CT scans expose people to high doses of radiation.

Too much medicine can pose a great danger, especially to older people. Drugs have their side effects, and there can be significant risk in surgery. Studies have shown an excessive use of stents in heart patients, for example.

The AMA argues with some reason that the data may be misunderstood. Some billing may include assistants under a doctor’s supervision. Of course, many elderly patients have eye issues, and an eye specialist in Florida might be treating a lot of them.

But rather than suppress the data, let defenders of certain practices explain them.

A crowning achievement of the Affordable Care Act is the Independent Payment Advisory Board. This group’s job is to change payment schedules to curb ineffective or unnecessarily expensive spending in federal health programs.

More than a dozen Republican senators tried to kill the board via the spectacularly titled Health Care Bureaucrats Elimination Act.

As one of the leaders, Sen. John Cornyn of Texas, put it, the board places power over seniors’ health care “in the hands of politically appointed Washington bureaucrats.”

Yeah, let’s take power away from “unelected, unaccountable bureaucrats,” as the bill called them, and keep it in the hands of elected Washington politicians accountable only to the business interests filling their coffers.

The drug-makers’ lobby, the hospital lobby and the doctors’ lobby were all against the Independent Payment Advisory Board for obvious reasons. Dramatists on the right immediately labeled it a “death panel.”

That Congress can overrule any board decision is conveniently ignored. The real threat of the independent panel is this: It would shed light on the massive waste and fraud siphoning off taxpayer dollars.

A free flow of information about where health care dollars are going offers a lighted path to restrain the growth in federal spending. Taxpayers should note which politicians favor the dark.

Froma Harrop is a Providence Journal columnist. She can be reached at fharrop@gmail.com.

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