ACC SVP of Advocacy Jim Fasules and I had a fascinating meeting with Newt Gingrich last week. I had called him about setting up a time to talk about ACC’s expanding opportunities to use our science-based tools and clinical registries to improve outcomes, quality and system effectiveness.

Our purpose in having this meeting was simply to be on Newt’s radar screen as he meets with so many other constituencies about transformational health care and innovative use of health IT. He needs to appreciate what NCDR, the PINNACLE Registry, and our appropriate use criteria tools are capable of contributing to improving quality and reducing unnecessary spending. I think we succeeded. The last time I talked with him, I was able to scratch the surface of these opportunities but not get into detail, so this was an important follow-up.

We also talked about the Administration’s Medicare cuts to cardiology physician practice viability. In his view they should first stop “paying the crooks” in health care who are costing the system much more than the entire cost of physician services. By crooks, he of course means the insurance companies — just kidding! Poor insurance companies get the brunt of a lot of criticism, and sometimes unfairly.

No, the crooks he refers to are those real criminals who produce the enormous fraud, waste and abuse in the federal health care system. Health care is one-sixth of the nation’s economy (17 percent of the GDP, or $2.4 trillion), and likely to grow to at least $4.3 trillion and 20 percent of the GDP in 2017. It’s estimated that at least 10 percent of what the federal government spends is wasted on overt fraud — I’m talking about mafia-like activities that get away with  billing for services for deceased beneficiaries, billions in procurement payments for services and supplies never issued, and the like. Every administration talks about this reality, and nobody seems to succeed in doing anything about it. It’s easier to cut physicians it appears. Newt thinks that overt fraud reform could save between 10 and 20 percent of the total Medicare and Medicaid budget. Sounds better than the 2010 Medicare Rule to me.

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