Medicare Reform: It's the Price-Fixing, Stupid

The National Health Expenditure projection is expected to increase by 6.3% annually from 2009 through 2019, but no one in the government or the media wants to talk about the root cause of the increase.  There are two parts to the problem: who is paying for medical care and who is setting the prices. The first part of reform is getting Medicare out of the price-fixing business.  Medicare sets the reimbursement rates on approximately 7,800 procedures and services physicians perform in the form of Current Procedural Terminology (CPT) codes.  These CPT codes include everything from a normal office visit to hip replacement surgery.  The American Medical Association (AMA) developed the system and updates and publishes the CPT codes annually.  All private commercial health insurance companies use Medicare rates as a base.  They set their reimbursement rate for the CPT codes as a multiple, usually 110 to 140%, of Medicare's reimbursement rate.  By law,...(Read Full Article)

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