Editor’s Note: Every independent expert who has examined Medicare’s “competitive bidding” program for home medical equipment has determined that it will fail. Hundreds of economists, including Nobel laureates, and researchers working under a National Science Foundation grant and the Congressional Budget Office have all reached a similar conclusion. HHS/CMS has been deaf to the science community and pursued their own deeply flawed plan. Now the human toll is starting to be felt. The article below explains why Congress must pass H.R. 6490 – The Medicare DMEPOS Market Pricing Program Act of 2012.
MIAMI (CBS4) – Medicare was one of the most fought over issues of the presidential election.
The big question remains what further changes will be made to keep it from going broke.
Already some changes are hurting some Medicare patients and small businesses. It’s a major struggle between President Barrack Obama and the Republican Leadership of Congress: How to balance the budget without slashing millions of dollars worth of critical social-service programs like Medicare.
Caught in the middle of this increasingly bitter national debate is Hollywood Medicare recipient Frank Triassi.
“I think they should all get together and do the right thing and work together instead of knocking each other. It’s not helping anybody else out there what they’re doing,” said Triassi.
The 70-year old retired salesman from New York has got 10 grandchildren. He relies on the monthly oxygen tanks he gets through Medicare to stay alive since.
“I only have one lung,” said Triassi.
Because of the way Medicare is now limiting payments for supplies like oxygen, other commonly needed medical equipment and diabetes medications, Frank said he’s not getting the kind of care he expected.
He said he’s run out of oxygen several times in the past few months.
“I think it sucks, I think Medicare has to push a little bit do people a lot better than they are doing,” said Triassi.
So what happened?
Back in 2003 Congress changed the way Medicare worked. To trim a growing deficit and stop billions of dollars in fraud, it started a test of competitive bidding.
Miami and Ft. Lauderdale were among the cities selected at test sites.
The winners were basically the big companies that offered the lowest prices. But the savings also came with unexpected costs. Some insiders told CBS4 Chief Consumer Investigator Al Sunshine the winning companies essentially agreed to provide supplies for less than they paid for them.
Former Congressman Ron Klein of Palm Beach remembers the pressure to eliminate fraud and cut costs almost a decade ago.
“The pricing of this was out of control. And as everybody understands, Medicare is under a lot of pressure to find ways to save money. There’s a lot of fraud in the system,” said Klein.
Recent congressional testimony claimed the change saved Medicare some $202 million dollars or about 42% savings for medical supplies alone.
“Normally competitive bidding has saved the taxpayer a lot of money for a long time,” said U.S. Senator Bill Nelson.
But some industry insiders disagree.
Rob Brant used to own Aventura’s City Medical Service. He claims the competitive bidding process forced him out of business.
“Unfortunately with the Medicare competitive bidding program, the rates were too low. I couldn’t afford to keep my full-time respiratory therapist and my staff and service the patients like we’ve done for the past 14-years,” said Brant.
Some critics say current cuts for life-saving medical supplies like Triassi’s oxygen are putting patients’ lives at risk.
Jorge Huerta supplied Triassi’s oxygen tanks through Medicare.
“They found a way to stop the fraud (but) they went from one extreme to the other. There is no in-between. You know the patients aren’t being able to get the service they were able to get before, they’re not being able to get the home medical equipment they got before, they’re going back to their doctors, they’re going back to rehab centers and nursing homes and they’re being ignored,” said Huerta.
“I’m just a number, it’s all about money,” said Triassi who worries that the problems he’s having with Medicare today could get even worse in the future for a whole new generation of aging baby boomers.
“It’s going to be a disaster for them. It’s going to be a disaster for them because they’re not going to get no help. You can’t get it now. They sure as hell ain’t going to get it later. Some golden years it is. You can’t get nobody to, nobody to help you. They don’t want, don’t want to hear. They always pass it over to somebody else,” said Triassi.
Because of the success of the competitive bidding program, it’s set to be expanded nationwide over the next few years.
The debate on how to trim Medicare without hurting critically ill patients is expected to dominate Congress for a long time to come.