Too Many Zeros

I have tried to understand the goal of the competitive bid. The problem that CMS and our industry faces should be identified as “where will the money come from?”

Recently CMS released a report titled “National Health Expenditure Projections 2006-2016.” When I reviewed this report, I found it to be rather discouraging. CMS has predicted that by 2016, the cost for health care in the United States will double. In 2016, it is estimated this cost will rise to $4.1 trillion.

In this country to visualize a trillion, the number is followed by 12 zeros. (In Great Britain, it is followed by 18 zeros.) The figure shows we will be spending 20 cents of every dollar just for health care. That is one-fifth of the cost of keeping the United States running!

I do not know where all those dollars are going to come from. Add to this that in the year 2016, we will still have the great debt created by the current wars in which the country is engaged.

Is there any good in this report? It does not appear so. In 2005, consumers had to live with 27 percent of their income allocated to health care. CMS predicts that when the figures for 2006 are all recorded, that figure will drop to 26 percent of income, and by 2016, the number could drop to 25 percent. CMS said this shows how expenses will be reduced.

To me, these figures are outrageous. When we see how much less it costs for health care in other countries, then I really become very concerned.

Where will all this money come from?

Can our country sustain such expenditures, pay off the gigantic national debt (which, as I write this article, stands at $8.8 trillion, or about $29,357 per citizen) and still remain the leader and the most important economy in the world, or will we find our position and power rapidly diminishing?

Litigious Times

We live in a very interesting time. The United States has always been a law-abiding nation. This is what has made us so strong.

However, there always will be some people who step out of the norm and look for ways to make a quick buck. The percentage of HME providers who do this is very small, but because home health is so important, when something untoward happens it makes the front pages of the local papers.

The cost of providing health care has risen to heights never imagined, and at the rate it is growing, it will soon be the most expensive service our government offers. Social Security, Medicare, Medicaid — all need many, many dollars.

I have been trying to comprehend where the dollars go. I study various financial articles and industry journals, and I listen to everyone on the tube explaining the whys and reasons.

I find two major contributors. The first is greed, which happens at almost every step on the health care ladder. Everyone involved wants more, but soon the sources of money will dry up.

Added to greed is the second evil, litigation.

Ours has become a litigious society. I read that there are more lawyers in the United States than anywhere else.

To cover themselves, physicians and hospitals have to do every test possible for their patients, even though they are aware that these are not really necessary. This costs money.

I see ads on TV offering to represent you and sue “if.” (If: a supposition or speculation.)

What can we do? If we all set an example and rid the HME industry of those very few providers who have been found being dishonest, this will be a big step forward.

Accreditation is finally being recognized. Therefore, if every HME provider is obliged to earn accreditation in order to do business with Medicare, then accreditation will have teeth.

When a provider is found doing something dishonest, the accreditation can be suspended until the error has been corrected. If a provider proves to be constantly bad, the accreditation can be revoked. Without accreditation, the provider should not be allowed to service the community.

Accreditation with teeth must be the law. As Thomas Fuller stated, “Law cannot persuade where it cannot punish.”

Sheldon “Shelly” Prial is based in Melbourne, Fla., with Prial Consulting and also serves as the director of government relations for Atlanta-based Graham-Field Health Products. In 1987, he founded the Homecare Providers Co-Op, now part of The VGM Group. He can be reached by e-mail at [email protected] or by phone at 877/553-5127.