Are we getting the shaft or being stiffed?

Guess what? While Grandma is getting run over by a reindeer, Grandpa is getting a penis pump for Christmas paid for by…drum roll…♪♫ ♪ Medicare…you know, government insurance! In other words, while Grandpa is getting stiffed, we (collectively) are getting the shaft. I just heard about this yesterday on talk radio as I was on my way to work (so I can pay my Medicare tax). I had to do a little data collection, but take a look at this:

As of December 22, 2011, 3 senators are in their 80s, 21 are in their 70s, 38 are in their 60s, 29 are in their 50s, and 9 are in their 40s.

The median age of currently serving Senators is 62 years Wikipedia-Senators

As of December 21, 2011 the average age of members of the U.S. House of Representatives is 58. Wikipedia-Representatives

According to WebMD,  research, published in the August 2003 issue of Annals of Internal Medicine, shows that ED (erectile dysfunction) is common among older men and sexual function sharply decreases after age 50.

Please note that the article below states, “Quarter-Billion Taxpayer Dollars…”, not million…as if! Now why exactly are we, the American people paying for penis pumps? After you have an opportunity to read the article below, I would really like to hear how you feel about government spending your hard-earned tax dollars on penis pumps!

A really good read on Rockin’ the Purple‘s blog: I want health CARE; I don’t want health INSURANCE!

Quarter-Billion Taxpayer Dollars Spent on Penis Pumps

December 6, 2011

According to data collected by the Centers for Medicare and Medicaid Services (CMS), Medicare has spent more than $240 million of taxpayer money on penis pumps for elderly men over the past decade, and will surpass a quarter of a billion dollars this year for costs since 2001.

The cost to taxpayers for the pumps more than quadrupled during that period, from a low of $11 million in 2001 to a high of more than $47 million in 2010. And these represent only the costs for external devices, technically classified as “Male Vacuum Erection Systems,” not implantable devices or oral drugs such as Viagra.

Easy to Qualify

In order to obtain a pump, according to CMS’s Local Coverage Determination (LCD) revised in October this year, the “patient’s medical record must contain sufficient documentation of the patient’s medical condition to substantiate the necessity for the type and quantity of items ordered,” noting erectile dysfunction (ED) can “commonly occur in men in the Medicare age group.”

The National Institutes of Health previously estimated between 15 percent and 25 percent of 65-year-old men experience ED on a long-term basis, which the LCD notes may be caused by “diabetes, other endocrine abnormalities, vascular abnormalities, trauma, neurogenic, psychogenic, side effects of many medications, and other causes.” The Cleveland Clinic also points to “psychological factors, such as stress, depression, and performance anxiety” as possible causes.

If a medical exam and history shows a senior on Medicare meets the relevant threshold—a diagnosis of ED—he becomes eligible for a wide range of options under the Medicare Prosthetic benefit. Treatment Options covered by Medicare include “oral medications, pharmacological injections, intra-urethral suppositories, vacuum erection devices, and implantable penile pumps.”

But are these devices really “medically necessary”? Health Care News contacted CMS to ask whether they have audited the medical files to determine medical necessity. CMS has not provided a response at the time of publication.

Rising Incidence of Fraud

One area of concern for CMS is the rise in fraud in relation to the pump devices. Earlier this year an Illinois man pled guilty to collecting more than $2 million from Medicare in a fraudulent operation where he repackaged $26 items from adult websites and sold them to seniors as medical devices, charging Medicare $284 apiece.

Device fraud has become an increasingly common way for criminals bilk the taxpayers. Durable medical equipment (DME) is widely perceived as a “high risk” area for fraud, according to a spokesman for the HHS Office of the Inspector General.  And a report released last month by CMS found the error and improper payment rate for DME was above 60 percent, whereas no other area even entered double digits.

Questionable Medical Need

Given the questionable medical need for this technology’s utilization and the significant percentage of improper DME payments, John Nothdurft, director of government relations for The Heartland Institute, questions whether it is prudent for Medicare to continue to pay for penis pumps.

“At a time when the federal government borrows 43 cents of every dollar it spends, do we really need to be spending money on this? I doubt you need a ‘Super Committee’ to realize that this is the epitome of wasteful spending,” Nothdurft said.

In prior reports of Medicare’s trustees, the program’s actuary projected Medicare has $36.8 trillion in unfunded liabilities. And according to their 2011 report, Medicare spending is expected to grow from 3.6 percent of U.S. gross domestic product (GDP) in 2010 to roughly 10.7 percent of GDP in 2085.