Heritage Foundation Leadership for America

Only in Medicare can lawmakers have more say than a doctor over medical procedures.

But that's exactly the case with the Great Society program, health-care expert Walton Francis explained at a briefing for Capitol Hill staffers sponsored by The Heritage Foundation.

"It's a government-run program in the truest sense of the word," Francis said during the Oct. 6 briefing. "You can't change anything without an act from Congress."

Because of this inability to easily adapt, Francis said, Medicare has had some cases of fraud that are so silly they almost belong on a sit-com. Like the one where Medicare covered a rising easy chair for those with back pain. The problem, though, Francis said, is that the easy chair essentially was a high-grade La-Z-Boy that had little, if any, medical value. And it took years before Congress could fix the problem.

"Medicare paid for this because private insurers laughed at it," Francis said.

But some changes are not so funny. Take bone density scanning. Imaging techniques to measure bone density were developed in the 1980s. But the process of getting it approved through Medicare’s regulatory system took seven years without any results. It got to the point where Congress had to step in and pass a law requiring Medicare to cover it. Medicare patients finally had access to this service in 1998.

This can’t continue anymore. We need real Medicare reform. Now.

For more information or to receive an e-mail version of “Medicare Maladies,” contact medicaremaladies@heritage.org or call Heritage Media Services at (202) 675-1761.