Medicare Concerns

This week, the Washington Post has an excellent series examining some of the problematic issues that exist within the Medicare program and efforts to ensure that it provides quality care. 

The first article concerned wasteful spending that occurs when Medicare fails to hold accountable those health care organizations that provide poor care.

For a year, The Washington Post crisscrossed the country to examine the economics of Medicare and how it monitors the quality of its services -- reviewing thousands of documents and interviewing hundreds of researchers, regulators and patients. Medicare is highly valued by 42 million elderly and disabled members, but it wastes an enormous amount of money on inefficient medicine, the examination found.

The second article concerns JCAHO's role in accediting various health care facilities. 

. . . . the joint commission's practices raise questions about potential conflicts of interest and the rigor of its hospital surveys. It operates a thriving subsidiary that charges hospitals thousands of dollars for coaching on how to pass its reviews. About 99 percent of the hospitals reviewed by the joint commission win accreditation, and in recent years it has missed glaring examples of poor care in which patients have been injured or killed . . . .

The third article examines problems with the close relationship that Quality Improvement Organizations (QIOs) have established with a number of those health care organizations that it should be monitoring.

By law, QIOs, which are dominated by doctors and health executives, operate in secrecy with little oversight or accountability. Consumers say they are difficult to contact and rarely uphold complaints. At the same time, the number of sanctions QIOs recommend against doctors each year has dwindled from hundreds to a few.

All three articles provide a good overview with some of the problematic issues facing Medicare and attempts to reform some of its practices. [bm]