In the first study of its kind, a group of health policy experts has determined the amount of money that Medicare has overpaid private insurance companies under the Medicare Advantage program and its predecessors over the past 27 years and come up with a startling figure: $282.6 billion in excess payments, most of them over the past eight years.

That’s wasted money that should have been spent on improving patient care, shoring up Medicare’s trust fund or reducing the federal deficit, the researchers say.

The findings appear in an article by Drs. Ida Hellander, Steffie Woolhandler and David Himmelstein titled “Medicare overpayments to private plans, 1985-2012.” The article was released online today and is forthcoming in the International Journal of Health Services.

[…]

Private Medicare plans – previously referred to as Medicare HMOs and now called Medicare Advantage plans – have been in existence for about three decades. Such plans, most of them for-profit, currently cover about 27 percent of Medicare enrollees and have been growing at a fast clip. UnitedHealth and Humana are among the largest players in this market, and together operate about one-third of such plans.

Medicare pays these privately run plans a set “premium” per enrollee for hospital and physician services (averaging $10,123 in 2012) based on a prediction of how costly the enrollee’s care will be.

The authors find that private insurers have exploited loopholes to garner overpayments above and beyond what it costs them to care for their enrollees. For instance, Medicare gives private insurers a full premium for each enrollee, even for those who get most of their care for free at the Veterans Health Administration.

[…]

“We’ve long known that Medicare has been paying private insurers more than if their enrollees had stayed in traditional fee-for-service Medicare, but no one has assessed the full extent of these overpayments,” said Dr. Ida Hellander, lead author of the study. “Nor has anyone systematically examined the many ways that private insurers have gamed the system to maximize their bottom line at taxpayers’ expense.”

“In 2012 alone, private insurers are being overpaid $34.1 billion, or $2,526 per Medicare Advantage enrollee,” Hellander said.

Co-author Dr. Steffie Woolhandler said: “It’s clear that having Medicare Advantage programs compete with Medicare doesn’t save us money. In fact the opposite is the case. The private plans only add waste, and the aggregate waste is staggering – enough to be a significant drag on the economy.

(Source: sarahlee310)

mohandasgandhi:

Last summer, a drunk Arizona police officer named Robb Gary Evans drove himself to a bar, flashed his badge to avoid paying cover at the door, and then walked up behind a woman, put his hand up her skirt, and ran his fingers over her genitals. A jury convicted him of sexual abuse, a felony with a maximum sentence of 2 and a half years in prison, and Evans was fired from the police force after an internal investigation.

Nevertheless, Arizona trial Judge Jacqueline Hatch, who was appointed to the bench by Gov. Jan Brewer (R-AZ), decided that Evans’ actions did not warrant jail time — sentencing him probation and 100 hours of community service. Evans also will not have to register as a sex offender. Yet, while Judge Hatch apparently did not view the disgraced former cop’s actions as particularly serious, she had some very harsh words for the woman he assaulted:

Bad things can happen in bars, Hatch told the victim, adding that other people might be more intoxicated than she was.

“If you wouldn’t have been there that night, none of this would have happened to you,” Hatch said.

Hatch told the victim and the defendant that no one would be happy with the sentence she gave, but that finding an appropriate sentence was her duty.

“I hope you look at what you’ve been through and try to take something positive out of it,” Hatch said to the victim in court. “You learned a lesson about friendship and you learned a lesson about vulnerability.”

Hatch said that the victim was not to blame in the case, but that all women must be vigilant against becoming victims.

“When you blame others, you give up your power to change,” Hatch said that her mother used to say.

The victim, who has not been identified by the press, called for Judge Hatch to apologize for her offensive comments, adding that if she had not been at the bar to be assaulted by Evans, “it probably would have happened to someone else.”

“There is a special place in hell for women who don’t help other women.” - Madeleine Albright, Former U.S. Secretary of State

(via sarahlee310)

Hillsborough County Sheriff David Gee has ordered the Orient Road Jail, a 1,700 bed prison in Tampa, emptied, relocating some inmates to another nearby prison and releasing others on bond. The entire facility has been transformed into a one-stop booking, detention, and bond-issuance center capable of handling large numbers of arrests, which begs the question: will Tampa police keep demonstrators on a short leash?

Sheriff Gee says no, but also indicated in a letter posted on a county website that his department would have very little tolerance for anything more than chanting and holding up signs:

To the agitators and anarchists who want only to bring a dark cloud to this event, let me be clear: criminal activity and civil disturbances will not be tolerated and enforcement actions will be swift.

(Source: sarahlee310)

Look, Ryan hasn’t “crunched the numbers”; he has just scribbled some stuff down, without checking at all to see if it makes sense. He asserts that he can cut taxes without net loss of revenue by closing unspecified loopholes; he asserts that he can cut discretionary spending to levels not seen since Calvin Coolidge, without saying how; he asserts that he can convert Medicare to a voucher system, with much lower spending than now projected, without even a hint of how this is supposed to work. This is just a fantasy, not a serious policy proposal.

So why does Saletan believe otherwise? Has he crunched the numbers himself? Of course not. What he’s doing – and what the whole Beltway media crowd has done – is to slot Ryan into a role someone is supposed to be playing in their political play, that of the thoughtful, serious conservative wonk. In reality, Ryan is nothing like that; he’s a hard-core conservative, with a voting record as far right as Michelle Bachman’s, who has shown no competence at all on the numbers thing.

What Ryan is good at is exploiting the willful gullibility of the Beltway media, using a soft-focus style to play into their desire to have a conservative wonk they can say nice things about. And apparently the trick still works.

(Source: sarahlee310)