Medical Student Concerned Over Bidding Program’s Lack of Concern for Patient Care

I write to express my concern over Medicare DMEPOS Competitive Bidding Program both as an employee of a locally owned durable medical equipment company in Cleveland, Ohio and as an incoming medical student at one of the nation’s elite medical schools. Having worked with my company during Medicare’s first attempt at creating a bidding process and having followed the progress that has been made in establishing new rules and procedures for the second round, I must admit that I am profoundly disappointed. The second round of bidding is shaping up to be just as confusing and have as little transparency as the first round. The implementation of this competitive bidding program threatens to tarnish Medicare’s rich history as a protector and advocate of patient care. From studying the proposed program, the policy seems to be guided more by personal agendas of politicians and bureaucrats than true appreciation for the fiduciary implications and inevitable impact on patient care. Competitive bidding as well as Medicare’s 36 month oxygen cap makes absolutely no sense from a medical perspective and the potential monetary savings of the program pale in comparisons to other loopholes in Medicare funding such as the prescription drug benefit that provided massive windfalls to the pharmaceutical companies. Further, the data used to trump up the charges of the potential savings was compiled in much the same way of Atul Gawande’s recently published article in the New Yorker “The Cost Condumdrum”. The program savings were extrapolated from limited data on limited procedure codes in select parts of the country, selected primarily because they were outliers in the extreme. They by no means constitute a representative sample from which to base a national program. Healthcare policies need to be guided by sound evidence based science, and the competitive bidding program fails to meet the criteria to be considered either medically or economically beneficial. As a future doctor, I am very concerned.

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