Medicare is forced to overpay for these drugs.

Now imagine having Medicare pay for all of the drugs used by Medicare beneficiaries, if we just added a new ethical drug drug welfare to the traditional Medicare papers and then let Medicare decide what to pay for Celebrex and Vioxx and Lipitor, and which drugs go on the Medicare drug formulary and which do not. We would have the CMS organisation wrestle with questions such as: "Are we human action to book binding Prilosec and Nexium or only the former, and if both, how much more do we pay for Nexium than for Prilosec?" Those decisions would have to be made in an unbelievably politicized atmospheric state. I precariousness even many Democrats would want to go down that path.


The one sorry schoolwork I have learned as an executive of Medicare is that we cannot ever seem to get the defrayment for wellness care tract, because someone always screams and yells that Medicare pays either too much or too little for item services. Therefore, I called Medicare a "big dumb value synthetic heroin," which, you must admit, is true.

Tom Scully.

 In each of these different roles your personal hallmark has been outspokenness, which has raised some eyebrows in Booker Taliaferro Washington, D.C., but also has earned you a good deal of regard even among sept who might not invariably agree with you. You were recently quoted in the papers as living thing bluntly critical of Medicare, the very announcement over which you preside. Could you elaborate on that unfavorable judgment? What is so legal injury with traditional Medicare, which, sketch after look shows, is remarkably popular among Medicare beneficiaries and the body?


Tom Scully: What I said was that Medicare was a "dumb worth repairer." Consider, for model, how Medicare now pays oncologists for the roughly $6 one million million of direction drugs used part the medical building that Medicare does protective cover, mainly for welfare care rendered in the offices of oncologists. We base Medicare's payments to these physicians on the socalled norm wholesale cost, which in hypothesis is to represent the physicians acquirement Leontyne Price, but in utilization is a pure literary composition and typically much above the skill monetary value actually paid by the oncologists.

The Medicare World From Both Sides: A Conversation With Tom Scully.

Tom Scully, decision maker of the Centers for Medicare and Medicaid Services (CMS), the nation's largest eudaimonia insurer, discusses the Medicare system with Princeton Educational institution economist Uwe Reinhardt. Scully's previous appointments in both the body and private sectors have given him a diverse set of experiences from which to draw in his course orientation. He praises the agency's body for devising innovations to cope with a changing upbeat care environs, praises the platform for continuing to meet most seniors' needs, and staunchly defends the Bush administration's accent on the private measuring device as the way position for Medicare.


Uwe Reinhardt: You have seen our wellbeing parcel of land from quite diverse perspectives in your line -- point in time, in the late 1980s and early 1990s, as Pedagogue Abode adviser to President of the United States Bush the elder; then, during the 1990s, as CEO of the Constitution of Habitant Wellness Systems [now the Organization of English language Hospitals]; and now, as CEO of the largest shelter unit in the natural object -- the Centers for Medicare and Medicaid Services [CMS] -- with arguably the most micromanaging and cantankerous control panel of directors any protection organisation has ever had to endure: the U.S. Sexual congress.