Tuesday, April 7, 2009

Medicare: An Interesting Number

Now that I have been over 65 for a while and now that many of my friends are also, I read the paper in today's NEJM on the hospitalization of Medicare recipients with some surprise. The NEJM paper states that there were 13 million Medicare participants enrolled who were hospitalized in the year between 1 October 2003 and 30 September 2004. If one goes to the Medicare Site and look at the Medicare Trustee Report for that period one sees that there were:

"In 2004, 41.7 million people were covered by Medicare: 35.4 million aged 65 and older, and 6.3 million disabled. Total benefits paid in 2004 were $303 billion. Income was $318 billion, expenditures were $309 billion, and assets held in special issue U.S. Treasury securities grew to $289 billion."

This means that 32% of the Medicare participants were hospitalized at least once. That is one in three. That means that of the fifty or so friends in that age who I know and see somewhat frequently, enough so that if they were hospitalized I most likely would know, more than 16 of them should have been hospitalized! I can only think of one, and that one has been a chronic one for years. A closer look shows that of the 41 million only 34 million were 65 and older so it even gets worse, that is 38%! I wonder where all these sick old people are hiding out? The map in the paper shows a story which may or may not be correct. Clearly it reflects the data, no question there, but it may also reflect another tale. The picture is shown below from NEJM:



















The question is, does the lack of higher hospitalizations in the low states reflect healthier people, or have the sicker people moved, and why? There is still the lingering question as to where all these chronically ill people are. They are hospitalized not just seeing a physician. Just some food for thought. There are times when these numbers really get confusing....I will look for the old people like me this week when I go to New Hampshire to work the farm, they are probably out tilling the soil!