Friday, May 17, 2013

With Respect to Prescription Drugs the Medical Profession is Not Policing Itself - And Sending Out an Open Invitation for Government Regulation

Just Another in a Long List of Ways the U. S. Health Care System is Broken

Because the Medicare prescription drug coverage requires public disclosure of how much and what type of medicines doctors are prescribing, it is now possible to determine exactly which medicines are being prescribed.  The results according to a Washington Post and ProPublica report are that some physicians are prescribing massive amounts of dangerous and sometimes ineffective medication.

Medicare Part D in 2010
  • 27.5M
    Beneficiaries with Part D Claims
  • 1.1B
    Prescriptions (Including Refills)
  • $77.7B
    Retail Price of All Prescriptions
  • 1.7M
    Number of Prescribers

An analysis of four years of Medicare prescription records shows that some doctors and other health professionals across the country prescribe large quantities of drugs that are potentially harmful, disorienting or addictive for their patients. Federal officials have done little to detect or deter these hazardous prescribing patterns.

Now the charge that the Feds have done nothing to regulate in this area is a meaningless one, because the Feds do not have the authority or mission to do that.

But officials at the Centers for Medicare and Medicaid Services say the job of monitoring prescribing falls to the private health plans that administer the program, not the government. Congress never intended for CMS to second-guess doctors — and didn’t give it that authority, officials said.

“CMS’s payments don’t go to physicians, don’t go to pharmacies. They go to plans, which is how our oversight framework has been established,” Jonathan Blum, the agency’s director of Medicare, said in an interview. The philosophy “really has been to defer to physicians” about whether a drug is medically necessary, he said.

Also it is unclear why this problem of prescriptions is happening.  It may be a differences of opinion within the medical community, it may be ignorance on the part of doctors, or it may be the marketing efforts of the drug companies which provide huge benefits to physicians who prescribe a lot of a certain drug. 

No one, surely absolutely no one, wants the Federal government to engage in massive regulation of who should get prescription drugs and in what dosage.   The medical profession itself is supposed to be self-regulating, and it should be since only the profession has the technical knowledge and enforcement power to do so.

But contrary to conservative claims that the government is regulatory active, regulation in the United States happens only after terrible abuses in the private sector.  So the message to the medical profession is clear and loud.  Clean up your own act, do it now and do it well, unless of course you want government officials second guessing your every move.

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