Medicare

washington -- Mitt Romney twice emphasized his unique business background when he and eight other Republican presidential candidates faced off in a debate last week in Iowa. "I've spent the last, as I've told you, 25 years in the private sector," former Massachusetts Gov. Romney declared at one point. "I understand why jobs come and why jobs go. I've done business in 20 countries."

WASHINGTON - Doctors, nurses and social workers from across the country, 107 in all, were charged in what federal officials in Washington called a "nationwide takedown" of medical professionals accused of fraudulently billing Medicare out of nearly half a billion dollars. The amount of bogus Medicare claims, totaling about $452 million, was the highest in a single raid in the history of a federal strike force combating rising fraud in the medical industry, according to the Justice Department.

A whistle-blower lawsuit by two former University of California employees alleges that the university's five medical centers--at UCLA, UC Irvine, UC San Diego, UC San Francisco and UC Davis--billed the government for millions of dollars in fraudulent insurance claims.

Re "Fix Social Security, now," Editorial, April 25 It's hard to take this editorial seriously because it fails to talk about the Social Security payroll tax holiday enacted in 2010. If you want to fix Social Security, the first thing you need to look at is rolling back this tax break. With every extension of the payroll tax holiday, the prospect that Congress will ever restore the tax to its statutory 6.2% of covered income becomes increasingly remote. In case you haven't figured it out yet, this is the tax that funds Social Security, so it should be no surprise that Social Security will run into trouble if we don't pay it in full.

Medicare's new prescription benefit will cover sexual performance drugs, like Viagra, in addition to medications for such ailments as high blood pressure and heart disease, program officials confirmed Monday. The move into what some consider "lifestyle" -- rather than life-saving -- pharmaceuticals is being criticized by conservatives, who see it as an unnecessary frill for a program that already is projected to cost at least $400 billion over its first decade.

The 1.4 million California seniors who belong to Medicare HMOs are getting more bang for their buck this year, reversing a two-year period during which benefits had eroded, according to a new study released today. "We're finally seeing some good news," says Dr. Mark Smith, president of the California Healthcare Foundation, an Oakland-based philanthropic group that along with Consumers Union produces the annual survey. "The past two years haven't been easy for seniors."

Lipitor is the most prescribed name-brand drug in America - nearly 3.5 million people take it every day to control their cholesterol. Since the statin entered the market in 1997, it's earned New York-based pharmaceutical giant Pfizer Inc. $81 billion, making it the best-selling prescription drug of all time, according to IMS Health, a Danbury, Conn.-based healthcare information company. So when Lipitor's patent protection came to an end Nov. 30 and a generic alternative became available, an awful lot of patients had a decision to make: Should they stick with the drug they knew or switch to something less expensive?

Doubling down on a controversial campaign issue, the GOP-led House approved a 2013 budget that would cut taxes for the wealthy, revamp Medicare and slash federal spending in a vote that will define the Republican Party this election year and beyond. Thursday's 228-191 party-line vote comes as a heated debate is playing out in Congress and the campaign trail, where Mitt Romney has embraced the proposal in sharp contrast to President Obama's approach to budgeting. No Democrats voted for the measure, but 10 Republicans voted against it - more than last year.

Medicare, the nation's medical safety net for seniors, on Wednesday announced it would extend its coverage for obesity screening and "intensive behavioral therapy," ensuring that roughly 30% of the 42 million people insured by the program can undertake a weight-loss program supervised by their doctor. The decision by the federal government to cover face-to-face doctor visits as an aid to weight loss is likely to prod private insurers, many of whom have been reluctant to cover medically supervised obesity treatments, to follow suit.

Medicare is like Humpty Dumpty. If the Republicans push it, we will never be able to put it together again! BOB MORGAN Van Nuys

Healthcare companies are tripping over themselves to profit from a flood of government contracts for treating the poor and disabled, and a family-run company in Long Beach with nearly $5 billion in revenue is trying to stay ahead of the pack. Amid the growing competition,Molina Healthcare Inc.is facing new hurdles. It has lost two key state contracts in Ohio and Missouri and its shares have tumbled 23% in recent weeks. J. Mario Molina, the company's 53-year-old chief executive, said that these are temporary setbacks and that the company remains in expansion mode.

Health insurance giant WellPoint Inc. reported an 8% drop in first-quarter profit, reflecting lower membership and higher costs. The nation's second-largest health insurer, after UnitedHealth Group Inc., runs Anthem Blue Cross in California and plans in 13 other states. It reported net income of $856.5 million, or $2.53 a share, for the three months ended March 31, compared to net of $926.6 million, or $2.44 a share, a year ago. Revenue grew 4% to $15.42 billion in the quarter.

WASHINGTON - The nation's Social Security and Medicare programs are sliding closer to insolvency, the federal government warned in a new report underscoring the fiscal challenges facing the two mammoth retirement programs as baby boomers begin to retire. Medicare, which will provide health insurance to more than 50 million elderly and disabled Americans this year, is expected to start operating in the red in its largest fund in 2024, according to the annual assessment by the trustees charged with overseeing the programs.

OK, so Social Security is going to be in trouble in, oh, 2033. And Medicare?  Uh oh, 2024. Hmmm. Let's see. That's close but probably OK on Social Security; not so good on Medicare (especially with my -- how to put this? -- non-vegan lifestyle). What? You weren't thinking the same thing? Tell me you didn't read The Times' article Tuesday and then do the math, trying to figure out if the two safety-net programs will be around long enough for you? Because that's what it's all about.  Tea party types like to harrumph about the debt their kids and grandkids are going to have to shoulder.

WASHINGTON -- The nation's Social Security and Medicare programs are sliding closer to insolvency, the federal government warned Monday in a new report underscoring the fiscal challenges facing the two mammoth retirement programs as baby boomers begin to retire. Medicare, which is expected to provide health insurance to more than 50 million elderly and disabled Americans this year, is expected to start operating in the red in its largest fund in 2024, according to the annual assessment by the trustees charged with overseeing the programs.

My wife and I arrived as legal immigrants from Canada four years ago at the age of 63 to be closer to our three children. Having lived in Canada most of our lives, we never contributed to Medicare. Right now I am self-employed and have a small-business health plan through Kaiser. The premiums have escalated from $450 per month to $1,228 per month, with a very high deductible. I am afraid we may have to return to Canada, where we enjoyed free health care. I am sure that many parents who join their children in the U.S. are in the same situation and would like to know what other options are available.

At last count, the bills I racked up for two years of heavy-duty medical care (hospitalization, surgery, nursing, drugs) came to $2 million. If it weren't for Medicare, my life would only have been saved at the cost of bankrupting my family. As it turned out, Medicare, with a reasonably priced supplementary insurance policy, has paid all the costs except for a modest co-pay for pharmaceuticals. What a relief that I didn't have to worry about the financial side of my illness or fear that my coverage would max out or that my deductibles would be overwhelming.

Medicare agreed to settle a dispute with about 2,200 hospitals nationwide over a decade-long error in reimbursement rates, offering what could amount to a $3-billion infusion to hospitals already bracing for funding cuts under the federal healthcare law. More than 200 California hospitals are included in three similar agreements reached April 5, and they stand to share a total of more than $310 million. For instance, Cedars-Sinai Medical Center said it would receive $14.3 million and Long Beach Memorial Medical Center said it was due about $6 million.

California is beginning the process of shifting 1.1 million of the state's sickest and poorest patients into managed care, which healthcare officials say will cut costs and improve treatment. The move is part of a broader state plan to continue moving residents with publicly funded health coverage into managed care, prompting concerns among critics who fear that patients could lose their current doctors. State officials announced Wednesday that Los Angeles, Orange, San Diego and San Mateo will be the first counties to provide managed care to the patients, who are enrolled in both the federally run Medicare and the state-federal Medi-Cal program.