While I am a big proponent of a single-payer system that could be implemented by allowing everyone to enroll in Medicare, this does not mean that Medicare is perfect. In fact, there is a lot of waste that could be eliminated in it but has not been.
ProPublica has a new report out that says that Medicare’s policies are such that it does not make much difference in cost to low-income patients if they are given high cost name-brand prescription drugs or their much cheaper generic equivalents. This enables drug companies to market their brands directly to consumers as if they are more effective and results in patients demanding those brands from their doctors who find it is less of a hassle just to give them what they want.
Meanwhile the companies also woo doctors with incentives to give those drugs. The net result is that more money is spent than necessary, most of it as a result of actions by just a few medical practitioners.
ProPublica analyzed the prescribing habits of 1.6 million practitioners nationwide and found that a tiny fraction of them are having an outsized impact on spending in Medicare’s massive drug program.
Just 913 internists, family medicine and general practice physicians cost taxpayers an extra $300 million in 2011 alone by disproportionately choosing name-brand drugs. These doctors each wrote at least 5,000 prescriptions that year, including refills, and ranked among the program’s most prolific prescribers.
Many of these physicians also have accepted thousands of dollars in promotional or consulting fees from drug companies, records show.
Many of the 900-plus primary care doctors who favored name brands shared another trait: Financial ties to the companies whose pills they prescribe.
Since 2009, 48 percent of them have received at least $1,000 for speaking, consulting and other promotional purposes, according to data ProPublica compiled from company web sites. Eleven have accepted $100,000 or more, the data show.
Medicare could ask Congress for authority to forbid doctors from prescribing name-brand drugs if equivalent generics are available but it has not done so. The Veteran’s Administration and even private insurers like Kaiser Permanente have such policies in place.