MEDICARE: HCFA Y2K Efforts, Reform Questioned
A USA Today editorial states that "the Health Care Financing Administration, which oversees Medicare, should be charging the Y2K problem at warp speed. Instead, it has barely hitched the oxen to the cart. Indeed, Congress' General Accounting Office recently concluded that 'it is highly unlikely that all Medicare systems will be compliant on time to ensure the delivery of uninterrupted benefits and services into the year 2000.'" Pointing out that HCFA is woefully behind schedule, the editorial argues that "the problem isn't just that Y2K is an albatross. The problem is that agencies have ignored the hanging carcass for so long. Most agencies also say they are well on the way to fixing the problem. You can only hope they say so with more authority than the happy-face overseers at HCFA."
It's All Good
In an "Opposing View" column, HCFA Administrator Nancy-Ann Min DeParle writes that "Medicare beneficiaries need not worry: They'll receive health care services come Jan. 1, 2000, as they have for the past 33 years." She writes that because Medicare pays the bills but does not provide medical services, "[e]ven in a worst-case scenario, no year 2000 glitches will keep Medicare's 38 million beneficiaries from needed care." DeParle argues that HCFA faces "unique challenges" because it depends on computer systems that "are controlled and operated by more than 60 private insurance companies," but asserts that the agency "has steadily increased the time and resources devoted to this essential mission" by delaying certain programs, establishing a "war room," hiring additional programmers, receiving additional funding and "reaching out to hospitals, doctors and other health care providers, urging them to check their own computers for year 2000 compliance" (11/2).
An editorial in yesterday's Washington Post alleged that the Medicare reforms that were to have kept the program solvent "have mostly fallen pretty flat" for several reasons: "they had only incidentally to do with health care reform," as "ideological statements at Medicare's expense, or political favors to particular health care interest groups, or both." The Post singled out medical savings accounts for purporting to encourage "freedom from a supposedly burdensome and inefficient government program, which [they] then hel[p] to make more so" by drawing the healthiest beneficiaries out of traditional Medicare. Discounting one of the "current tenets of reform ... that managed care can produce the same results as traditional fee-for-service medicine at lower cost," the editorial argued that the Breaux-Thomas Medicare advisory panel "needs to decide how best to divide the modest benefit of managed care between patients and the Treasury, which is to say, between recipients and taxpayers." The editorial concluded, "Medicare turns out to be -- surprise -- already a pretty efficient provider of health care and not as easy to improve upon as some of its current critics would suggest. There are no magic, easy answers to the mismatch between prospective revenues and costs" (11/1).
What About The Seniors?
In other Medicare news this weekend, the Arizona Daily Star reported yesterday that despite the state's efforts to educate seniors about the new Medicare+Choice options, "[t]he grab bag of coverage options with alphabet names -- HMOs, PPOs, PSOs and MSAs, along with plain old vanilla 'fee for service' Medicare -- is sure to confuse even the most astute senior" (Erikson, 11/1). The Minneapolis Star Tribune reported that the Minnesota Board on Aging has been swamped with "questions regarding plan changes and plan terminations. Most people are confused. Change always generates some confusion, and Medicare can be especially confusing for a lot of people," according to Sandy Miller, coordinator for the board's health insurance counseling program (Howatt, 11/1).