Sifting the Medicare Data

Thursday, April 10, 2014

March 21: Speaker of the House Rep. Nancy Pelosi (D-CA) carries the gavel that was used when Medicare was passed by the House in the 1960s. (Chip Somodevilla/Getty)

Thanks to a Wall Street Journal lawsuit, Medicare released details on how much individual doctors were reimbursed for the year 2012 in a searchable database.  Melinda Beck, health reporter for the Journal, talks about what we've learned so far from the Medicare data. What are consumers and doctors finding out about patient care and billing practices?  Call in and share your findings at 212-433-9692, that's 212-433-WNYC.



Melinda Beck

Comments [13]

@Ed from Larchmont re; abortion. Do you have multiple head injuries that have not been diagnosed because your mother had an abortion and wished she had another one which she named Ed? Sorry for the harsh response, but it seems your response is based solely upon opinion. Have you read or heard of Freakonomics for an example? I suggest that all the extensive data and studies compiled (particularly on abortion and lower crime rates) are based less like your opinion and based on extensive research. I didn't go to college and grew up working poor and yet I know the concept of 'correlation is not causation.' And sir that works for both sides. They may be wrong, I may be, Melinda Blick may be, but your remarks indicate that you know the answer. Ed from Larchmont for Vice President under the Paul Ryan ticket.

Apr. 11 2014 04:08 AM
fedupwithcorpwelfare from upper manhattan

To Robert in NYC, first comment: the important piece you glossed over is that these specialists who look in on you and charge Medicare $200-300 are only getting reimbursed. If you cared to explore who they are, you will find out they are indeed connected to your case. Please, $37? After spending 12 years in training and having an s-load of debt, while all their college colleagues are already making million dollar bonuses on Wall St? I think the culprit here, if we're hunting culprits, is the insurance companies. I could go on and on about that, and the corporate welfare our current healthcare system is providing, but will let someone else take the honor.

Apr. 10 2014 06:40 PM
Ed from Larchmont

We can work around the edges and cut costs on this or that, but the problem is so large it's not going to change, unfortunately, the trend of the whole situation. We used to have a wonderful healthcare system.

Apr. 10 2014 11:26 AM
Ed from Larchmont

We're an aging society because of abortion, we're just watching the system fail because of not enough young people. We blew it.

Apr. 10 2014 11:23 AM
Robert from NYC

Another goody in hospital is the constant coming around to take chest x-rays when you're not even there for lung problems. Why must they take two a day? Can your lungs become ill within the 6 hours from the first to the second x-ray or from one day to the next? If so you got it in the hospital, whatever it is!

Apr. 10 2014 11:22 AM

A massive congratulations is in order to this experienced and articulate reporter Melinda Beck, the WSJ, and yes, Murdoch, for reminding us what journalism is, and how valuable it can be to consumers and pundits alike!

Apr. 10 2014 11:20 AM
Alice L Knopf from 10021

Lucentis is for the eye. Avastin is off label and has cardiac side effects. I willot take Avaston.

Apr. 10 2014 11:19 AM
Van from Manhattan

I am a physician in NYC. I want to express that pharmaceutical claims are based on data. Health centers and doctors, on the other hand, often make anecdotal statements. The drug companies as evil and medical centers and doctors are victims is overblown and all medical players need to play evidence based medicine

Apr. 10 2014 11:19 AM
gerald lebowitz from Queens

When I began taking Medicare patients as a psychologist 25 years ago, reimbursement was over $125/session. Today it is under $90. My rent, utilities etc haven't gone down. This is why fewer people take Medicare, and why there is such a speed up in doctors offices.

Apr. 10 2014 11:17 AM
Robert from NYC

My favorite are the drs who come into your hospital room, are very pleasant but who you have no idea who they are or where they came from. They smile say hello introduce themselves (hame only) don't say who they are or why they're there, ask how you feel then leave. Two months later the statement comes from Medicare and there are all these Drs who you don't know have billed your account usually $200-$300 and get paid $37.14 or some such figure. LOL. What the hell is that!!!
I think I'll go buy some scrubs, go to some hospital, visit patients as Dr so-and-so and bill Medicare. What do you think? LMAO. Actually, I don't have the coglioni to do that.

Apr. 10 2014 11:16 AM
Christine from Yorktown

Too many unnecessary tests. All to CYA and up the costs. And re-doing tests instead of looking at the previous MRI etc. It's nuts. I note that they often use scare tactics on my elderly parents to get more testing noting that without this that and the other test, "we might miss something". I have little trust in the medical industry. It's all about teh money.

Apr. 10 2014 11:14 AM
Robert from NYC

I always wondered why my ophthalmologist received full payment charged from medicare and my vascular surgeon go practically nothing! I wonder why--but sure as hell am happy he does--my vascular surgeon even accepts medicare with the amounts they pay him. I noticed that anesthegiologists also get full payment billed! Strange policies Medicare pays.

Apr. 10 2014 11:06 AM
Joe Mirsky from Pompton Lakes NJ

From The Way We Were section of my book Ornamentally Incorrect, third edition, Luxe et Veritas

The Doctor is In

An October 26, 1923 article in the Literary Digest titled Do We Pay Doctors Too Much quotes an editorial in American Medicine (New York). In brackets are figures adjusted for 13.4X inflation to 2012.

“It has been determined repeatedly in the courts and rather generally accepted, too, that $20 [268] per hour is satisfactory remuneration for the average medical man;…$10 [134] a fair examination fee, which ordinarily does not require over thirty minutes; and $5 [67] for ordinary treatments which do not require over fifteen minutes. However, many specialists charge $25 [335] for an examination and $10 to $15 [134-201] for treatments.”

The editorial was about a paper by Dr. Louis I. Harris, director of the Bureau of Preventable Diseases of the New York City Health Department.

“It seems that Dr. Harris was trying to make the "high class" physician realize his responsibilities to the middle and poorer class of patient who can and is perfectly willing to pay a moderate fee, but who is being driven to such substitutes as the Cornell Clinic and the Life Extension Institute because of private office fees which he can not meet.”

The Life Extension Institute offered examinations only at low cost, the Cornell Clinic (now Weill Cornell Community Clinic) offered low or no cost medical treatment.

Copyright © 2013 Joseph MIrsky

Apr. 10 2014 10:59 AM

Leave a Comment

Email addresses are required but never displayed.

Get the WNYC Morning Brief in your inbox.
We'll send you our top 5 stories every day, plus breaking news and weather.