Now costing more than
$500 billion per year, Medicare is central to the United States’ fiscal predicament. For this complicated problem, there are many complicated proposed solutions. But what if we try something simple, like journalism?
In essence, that is the argument that Dow Jones, publisher of the Wall Street Journal, is pressing in a federal court in Jacksonville, Fla. Dow Jones is asking District
Judge Marcia Morales Howard to lift a 1979 court order that exempted from the Freedom of Information Act all provider-specific data on Medicare payments. Arguments ended in August, and a ruling could come at any time.
Thanks to the 33-year-old injunction, the press and the public cannot examine the treatments individual physicians billed to Medicare or — most important — how much Medicare paid for them. Yet this is a matter of obvious public concern, given that Medicare made
$28.8 billion in improper payments in 2011, according to a Government Accountability Office report last February.
Media coverage could be a powerful weapon against waste, fraud and abuse, Dow Jones argues — plausibly, given the Journal’s recent work.
In 2009, Dow Jones and the nonprofit Center for Public Integrity sued the Department of Health and Human Services for access to its database of physician fee-for-service claims. HHS resisted but ultimately agreed to supply a small portion of its information in return for a fee and a promise not to reveal individual physicians’ names.
Even with those limitations, the Journal
produced articles in 2010 and 2011 do enting many millions of dollars’ worth of excessive spinal*fusion surgery, questionable prostate-cancer treatments and dubious billing for home health-care services.
More irregularities might turn up if all journalists could comb through Medicare’s records using data-mining techniques. And imagine how many irregularities would be deterred if providers knew that they might be named and shamed.