Medicare meddling, the guns of Westchester, and Al Gore’s payday

By Steven Brill
January 8, 2013

1)   Fiscal cliff Medicare meddling:

According to this report in the New York Times, last-minute negotiations on the fiscal cliff included new congressionally imposed limits on what Medicare will pay for “nonemergency ambulance transportation of kidney dialysis patients” and “would reduce Medicare payments … for stereotactic radiosurgery, complete course of treatment of cranial lesion(s) consisting of one session that is multi-source Cobalt-60 based.’”

Yes, Congress really does get that far down in the weeds when it comes to dictating how Medicare doles out more than $500 billion a year. This includes, for example, overseeing the payments Medicare allows, by state, for designated categories of ambulance rides (“critical,” “emergency,” “air evacuation,” etc.).

There are two obvious stories here: What scandalous overpayments or abuses in those nonemergency kidney dialysis ambulance trips triggered this intervention, and who in Congress pushed for it? Similarly, what’s the story behind those Cobalt-60 treatments?

Beyond that, either of those tidbits would be a good lead-in for a broader story about the more typical type of congressional intervention when it comes to Medicare. Members of Congress on both sides of the aisle habitually succumb to lobbyists in ways that keep Medicare costs far higher than they need to be. For example, except in a few regions of the country, Medicare is not allowed to conduct competitive bidding for medical equipment ranging from canes to wheelchairs to oxygen supplies. The result is billions in overpayments every year, with Medicare paying more per cane to buy tens of thousands of canes than you would pay to buy them one at a time at Wal-Mart. At a time when Medicare cuts are center stage in the ongoing deficit debate, why not try to identify the cost of this congressional meddling?

2)   Surprise! Gannett makes news for its journalism:

Two weeks ago a Westchester, New York–based daily newspaper, the Journal News ignited a firestorm by publishing a map showing the locations of all those in the communities it covers who had received handgun permits. Those who clicked on the electronic version of the map on the Journal News website were shown the names and addresses of all the permit holders.

“We felt sharing information about gun permits in our area was important in the aftermath of the Newtown shootings,” publisher Janet Hasson told Reuters.

But supporters of gun rights complained that the permit holders had been singled out as bad guys even though they had done exactly what gun control advocates support – comply with a screening and registration process. FoxNews.com quoted an “ex-burglar” as saying that having a list of households that have guns would have made his job easier because he would know which places to avoid.

The reaction to the story became so heated that by last week the Journal News had posted armed guards outside its office.

The paper’s unusual project gave new context to the issue of whether disseminating information that is legally available to the pubic – in this case, records of gun permits – can become invasive of privacy when digital technology allows it to be made so accessible that it is arguably too public. But there’s another angle I’m waiting for a media reporter to explore: how the controversy generated by this local paper contrasts with the culture of its corporate parent.

The Journal News is part of the Gannett newspaper chain of 82 dailies. Many of those papers have distinguished histories as the journalistic pillars of their communities. But in recent years, Gannett has become a conservative company that eschews controversy; to the extent it has been in the news in the past few years, the reports have been about the business reverses and accompanying rounds of layoffs and furloughs it has suffered amid the general decline of the newspaper business. Although Gannett has recently received some good press for increasing revenue by charging for its websites’ content, the news has still been about Gannett’s business, not its journalism. Yet now, Gannett, through the Journal News, has stepped front and center into America’s highly charged post-Newtown debate over guns.

So far, although the Journal News’s publisher has publicly supported her editor’s decision to publish the gun permit story and website map, I haven’t come across any statements one way or another from Gannett’s corporate officers. I would love to see a story about how the company is handling this.

For starters, did anyone at the Journal News check with the home office before running the story, or even offer a heads-up in advance of what those involved had to know would be a firestorm of controversy? What policies are in place, if any, for how the parent company deals with locally generated controversy?

In the aftermath of the story, gun rights supporters have tried to organize a boycott of not only Journal News advertisers but of all of Gannett’s newspapers and even its 23 television outlets. How is Gannett trying to deal with that? Is the apparent silence so far from headquarters part of the strategy? Does America’s most prominent newspaper chain have a media strategy that includes ducking the press?

Similarly, who is making what decisions, on what basis, about how Gannett’s flagship national newspaper, USA Today, is covering the Journal News controversy? USA Today ran this straight news story last week, but I’m wondering what extra levels of review, if any, it got before it was published.

3)   The Al Jazeera buyout of Current:

Can’t some reporter get more details on how the $500 million Al Jazeera is reportedly paying for Current is actually getting split up among the owners? How can it be possible, as has been reported, that former Vice President Al Gore stands to get $100 million because he had a 20 percent interest in news and talk channel Current.

Assuming Gore didn’t put any money up in the first place, wasn’t his equity payable only after the real investors got their money out (with some interest, I assume) off the top? In other words, if, say, $300 million had been invested in Current over its six years of losses (including expensive contracts to people like former anchor Keith Olbermann), then the investors would first get that $300 million back, plus, let’s say, $30 million in interest. That would leave $170 million, of which Gore would receive his reported 20 percent, or $34 million. Still not bad for a colossal business failure, but I do wish the reporting on stuff like this was a bit more sophisticated.

One more angle on the Current deal: What’s going to happen with Olbermann’s $70 million suit against Current and the counterclaim brought by Current against him? (I wrote about it  last August, noting all the juicy charges in the dueling court papers.) Al Jazeera’s owner, the government of Qatar, doesn’t seem to care much about writing big checks. So did the buyers agree to pick up that potential, albeit dubious, liability from Gore and company? And will they now just write a check to get rid of Olbermann, making the Al Jazeera deal not only a booby prize bonanza for Gore but for Olbermann, too?

PHOTO: Handguns turned in are seen during a gun buyback event in Bridgeport, Connecticut, in the wake of the shootings at Sandy Hook Elementary School December 28, 2012. REUTERS/ Michelle McLoughlin

4 comments

We welcome comments that advance the story through relevant opinion, anecdotes, links and data. If you see a comment that you believe is irrelevant or inappropriate, you can flag it to our editors by using the report abuse links. Views expressed in the comments do not represent those of Reuters. For more information on our comment policy, see http://blogs.reuters.com/fulldisclosure/2010/09/27/toward-a-more-thoughtful-conversation-on-stories/

“FoxNews.com quoted an “ex-burglar” as saying that having a list of households that have guns would have made his job easier because he would know which places to avoid.”

Faux News at it again. The best way to get your house burglarized is to let it be know that you have handguns at your house. Burglars simply wait until you aren’t home. Anything else gets pennies on the dollar when fenced, but stolen, now untraceable, handguns are the most valuable thing in the world in the criminal marketplace.

Posted by QuietThinker | Report as abusive

Paragraph 4 in the first item is way off base. Competitive bidding for durable medical equipment in Medicare is now well underway nearly everywhere — in 91 metropolitan statistical areas in addition to the first 9 market areas. Medicare will be announced steep reimbursement cuts in just a few weeks. Lobbyists have NOT stopped this bidding program NOR were they able to amend its most significant flaws, such as allowing nonbinding, unsecured bids, most recently described in the Math Trek blog at Science News. Durable medical equipment is one of the smallest sectors in Medicare (1.39 percent of total spending) and spending growth in that sector is virtually flat in spite of increasing demand, according to the new NHE data. Finally, comparing the cost of providing prescribed medical equipment and educating Medicare beneficiaries about their use in their homes with what one would pay at “Walmart” for the equipment alone is apples and oranges, at best. Mr. Brill, please freshen up your research skills.

Posted by Michael54 | Report as abusive

I suggest the following from the Wall Street Journal for additional perspective on Competitive Bidding.

http://online.wsj.com/article/SB10001424 052970204740904577193224024421442.html

Posted by spaige | Report as abusive

Great article .Thank you so much for your generosity.

http://www.medicarealabama.com/

Posted by vanessap | Report as abusive