The news that a small percentage of the country's physicians collected billions of dollars from
The Obama administration released details Wednesday on $77 billion worth of payments made in 2012 by Medicare Part B, which pays for doctors and other healthcare professionals. Part B is financed mainly by the government, so taxpayers have a keen interest in the program's financial integrity. The new data, however, reveal some alarmingly large payouts. For example, more than a dozen physicians each collected more than $10 million from Medicare in 2012, and thousands of specialists in four disciplines — three cancer-related fields and ophthalmology — averaged more than $300,000.
It's risky to leap to conclusions just from the numbers, given that the payments may include reimbursements for expensive drugs that doctors provided or services by multiple members of a team. Yet the concentration of payments — a mere 2% of the doctors participating in the program took in almost a quarter of the fees — exemplifies the problem with Medicare's "fee for service" payment system. This system ignores the value and effectiveness of the care provided, paying attention only to how many treatments are rendered. That gives doctors an incentive to provide the most expensive and intensive forms of care, not necessarily the treatments that work best.