Opinion

Stories I’d like to see

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

Steven Brill
Jan 8, 2013 13:09 UTC

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.

Ad technolology that may threaten newspapers; winners and losers of the fiscal cliff

Steven Brill
Nov 20, 2012 12:51 UTC

1. Another threat to newspapers’ business models?

This article in the New York Times last Friday and this one in the National Journal pinpoint two important developments in the media business that could collide to pose yet another threat to the financial viability of journalism.

The Times article describes the rise of “programmatic advertising,” in which new online tracking technologies allow an advertiser to follow a consumer whose profile fits the advertiser’s targeted demographics wherever the consumer goes online rather than just make an educated guess about the websites that consumer is most likely to visit.

Before programmatic advertising, if an upscale restaurant chain decided that its best prospects were well-to-do men who live in major metropolitan areas and travel a lot, it might buy ads in the business sections of high-end newspapers or on business travel sites. Now the restaurant chain can follow those targeted people to any website they visit. It doesn’t have to buy ads on the sites where the target is most likely to be found but can instead simply bid on an electronic ad exchange to buy the cheapest ad that will reach someone with those demographics no matter where he or she goes (a gossip site, for example).

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