Should George W. Bush assume the presidency, he has vowed to "slash back" Medicare regulations, WebMD.com reports. During the presidential debates, Bush pointed to the "132,000-page document bureaucracy" which WebMD called the "central exhibit in the philosophical drive toward greater Medicare privatization." Bush said during the debates, "The idea of supporting a federally controlled, 132,000 page document bureaucracy as being ... the only compassionate source of care for seniors is just not my vision." But the Health Care Financing Administration, which runs Medicare, contests the assertion that Medicare's rules are "voluminous," arguing that the number is highly inflated. In a July letter to Sen. Bill Frist (R-Tenn.), Nancy-Ann Min DeParle of HCFA noted that there were only 35,000 pages of "Medicare statutes, regulations, and program manuals."
HCFA Demands Recount
According to HCFA, Mayo Foundation President Dr. Robert Waller first "tossed out" the number of 132,000 pages several years ago in a Washington Times editorial, but DeParle said that Mayo had counted "documents that cannot fairly be characterized as part of the Medicare regulatory framework," and included "virtually every piece of paper relating in any way to Medicare." DeParle also said that it was "exaggerating Medicare's burden to suggest that physicians had to be aware of every regulatory preamble, cost dispute review board decision, and carrier newsletter produced by private-sector contractors." However, Frist said in a letter to DeParle in May that the Mayo estimate "may even actually understate the volume of (Medicare) regulations," as the number did not include new rules and requirements. DeParle responded to GOP criticism that Medicare is a "creaking, bureaucratic, and oppressive dinosaur in the age of MRIs," by saying that HCFA is "actively tackling the question of Medicare's burden on doctors," including the internal development of two systems to evaluate each new Medicare policy (Martin, WebMD.com, 12/1).