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The Medicare data dump: How the government gave physicians the finger

Jordan Grumet, MD
Health Policy
April 29, 2014
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According to a study by Jackson Healthcare, the percentage rate of U.S. physician compensation is among the lowest of western nations.  In 2011, physicians’ salaries compromised 8.6 percent of the nation’s total health care costs.  This is in comparison to 15 percent in Germany, 11 percent in France, and 11.6 percent in Australia.  Detractors point to the fact that although the percentages speak for themselves, if you look at the total number of dollars (per capita health spending in the U.S. is double that of the average for the twelve other OECD countries), physicians are still compensated quite well.  Either way, in our bloated costly system, physician services are comparatively already discounted.

So it was with great pomp and circumstances, as well as consternation from various physician sources, that the government released data for all payments made by Medicare to physicians in the year 2012.   Lauded as a win for transparency, the administration argued that making such information public would lead to a reduction in fraud, greater research into healthcare costs, and empower citizen investigators to crack the code of our overwrought system.

In reality, the so called “data dump” was exactly just that.  The information didn’t account for the percentage of each physician’s practice as Medicare versus private insurance.  There was no recognition of pass-through costs (medications, chemotherapy, etc.).  There was no adjustment for range or severity of illness of each physicians patient population.

Besides physicians, it is unclear that this information will really interest anyone.  The government already knows who are the largest Medicare billers; they were privy to the information previously.  The public is so overwhelmed with the ACA, surgical report cards, physician rating sites, and the like, it is unclear that they will take the time or have the expertise to actually interpret the data.

Previous studies suggest that patients could give a hoot about such information.  And even if they could, finding a doctor who takes their insurance and hasn’t been narrowed out of a network is hard enough.

I can assume that the only real reasoning to release such information was to send physicians a clear and unmistakable message.  We are being told not so subtly that we are being watched: “Get on board with what is happening, or there will be consequences.”

That’s right.  Our government just flipped us the bird.

Jordan Grumet is an internal medicine physician and founder, CrisisMD.  He blogs at In My Humble Opinion.

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The Medicare data dump: How the government gave physicians the finger
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