Improper Payments the Focus of Obama's Speech

President Obama, in his Wednesday, March 10th, 2010 speech in St. Louis, Missouri, unfortunately chose to focus on Medicare inefficiencies and the estimated $100 billion dollars in 2009 improper payments as the main means to cost control and a way to pay for his proposed reform efforts.




Worse, he chose to laud the Recovery Audit Contractors (RACs) as potential saviors of healthcare and a major source of cost savings in his healthcare reform proposals.

The Improper Payments Elimination and Recovery Act (originally introduced in 2009) is designed to introduce RAC-style auditors to other, high-cost areas of government spending, like military defense and education.

When, in fact, the problem is not mainly inefficiencies in payment but the system itself: fee-for-service creates incentives to overutilize, overspend and overtreat.

Obama's health care reform has been appropriately criticized as health care financing reform.

An outcomes-based system for medical payments is years away and the transition is likely to be gradual and phased-in.

America has the highest health care 'unit prices' in the world but a middling rank in total outcomes (#34).

Rather than cast auditors as heroes (which, by contrast, paints doctors, hospitals and physical therapists as villains) let's put our efforts into accelerating the transition to real health care reform - outcomes.

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Improper Payments the Focus of Obama's Speech

Reviewed by Merlyn Rosell
Published : 2010-03-14T08:31:00-07:00
Rating : 4.5