'Dual Eligibles' Collecting from Medicare and Medicaid

Medicare is on track to go bust in less than 15 years, and Medicaid isn't expected to survive past that point either.

The reason is simple math - we are giving out more than we're taking in. That's bad enough, but to find out that money is being wasted is too much to take. The Wall Street Journal is pointing out a growing troubling trendnearly ten million Americans take home benefits from both Medicare - a program for the elderly - and Medicaid - a program for the poor. This apparently has been an ongoing problem since the programs were created back in 1965, but the number has skyrocketed since 2000 - up 30%.

In 2009 Medicare spent about $500 billion on its members, and Medicaid nearly $400 billion. But $300 billion of those taxpayer dollars went to "dual eligibles." That's one third of annual spending of these programs.

Breaking it down even further, those that belong to both programs make up about 16% of Medicare enrollees, but more than a quarter of its spending. And while the percentage of Medicaid members is relatively the same, they account for nearly 40% of their services. Again, this spending is your money. Another downside of this, because it's nothing new, is that Medicare and Medicaid are constantly trying to pass the buck between each other. Often times neither steps up to the plate to cover the costs, which can raise the costs for everyone. For example, nursing home residents make up a major portion of these "dual eligibiles," and nursing homes know how to work the system.

If one of these patients is sent from the hospital to a nursing home, they're reimbursed $422 dollars a day for 100 days. After that the daily rate drops to $172 dollars. So nursing homes routinely send "dual eligible" patients back and forth to the hospital to keep the higher reimbursement rate - accounting for nearly one million hospital admissions of these patients in one year - nearly half being unnecessary. Those avoidable hospitalizations cost taxpayers more than $3 billion in 2005 alone. We've often pointed out in this column that cutting spending doesn't necessarily mean layoffs, or benefits cuts, or other important programs being eliminated. It means streamlining business in Washington, being on the government dole with one program should be enough to take care of those Americans that need help.

If we stop the overlap and waste, it's amazing the difference we'd see in our bottom line.

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