Weatherford Democrat

Viewpoints

September 7, 2012

COLUMN: Who pays for healthcare?

— Last week the Star-Telegram carried another article on the abuse of federally funded healthcare in Texas. Last month, it was revealed Texas had authorized and spent more on Medicaid children’s dental orthodontic than as all the other 49 states combined. Last week, it was revealed Texas paid out more Medicare home healthcare dollars than any other state, including California, which has about 10 million more people. No other state even came close to Texas in spending per person.

Both Medicare and Medicaid are largely funded by the federal government, but the plans are administered by each state. As a result of this latest self-inflicted wound, Medicare is considering suspending new applications in Texas for home healthcare. Texas has squandered billions of tax payer dollars for fraudulent or unnecessary care.

If my readers can’t relate to these huge sums, I will give an example of home healthcare right here in Weatherford. Around the end of January 2012, my wife slipped in the tub and tore ligaments in her leg. After one day in the hospital and five days in a rehab center, she came home. We asked for help bathing and any physical therapy required. What ensued was amazing. In five weeks, my wife received 11 visits at home from a physical therapist and eight from an occupational therapist. Additionally, we received seven visits from a skilled nursing tech, who just took my wife’s blood pressure. And to be fair my wife did receive 12 visits from an aid/home healthcare tech to assist with bathing, which was all we originally wanted.

I recently received Medicare’s statement for these home visits. Medicare had been charged $250 for each physical therapy, $250 for each occupational therapy, $200 for each blood pressure check, and $120 for each bath assist. The total amount charged for five weeks of home therapy was $7,604.37, of which Medicare paid $4,719.09.

The main purpose of home healthcare is to reduce cost by keeping people in their homes as long as possible. If our home healthcare saved money, I would like someone to explain it to me. For the $7,604 my Tricare and Medicare paid, my wife could have spent those five weeks in the most luxurious nursing home in Dallas or Fort Worth. I can’t believe it cost $250 for a 10-to-15 minute physical therapy. Or $200 for a five minute visit to take a blood pressure reading; the need for which we never discovered. The only reasonable charge was the $120 charged for each bath assist, which is all we really needed.

If these charges aren’t enough to convince people Texas is terribly mismanaging publicly funded healthcare, keep in mind we stopped all home healthcare after five weeks, we could have continued for weeks or months longer.

Why haven’t I seen our governor or state attorney general start an audit and investigation of the Texas agencies that administers these tax payer funded programs? Why aren’t the newspaper headlines demanding immediate action to stop this flagrant fraud and abuse? Republicans are always claiming that government can be made more efficient, well, here’s a perfect opportunity to put up or shut up.

Part of the President’s Affordable Healthcare Law will greatly reduce this kind of waste when implemented. It’s the part of the law Republicans always describe as a raid on Medicare.

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