When word came down that Medicare would be cutting reimbursement by 5.4 percent in 2024, some physicians no doubt felt an understandable wave of anxiety. “How will we manage with the new payment cut?” they’d wonder. And then, on another level, they’d probably also wonder, “Are these endless cuts necessary? Aren’t there other, less vital programs that could be cut first, rather than sight-saving surgery?” It turns out, these surgeons are probably right.

At the end of 2023, Kentucky Senator Rand Paul assembled his annual list of wasteful government spending and, as usual, you have to laugh to keep from crying. Here’s a look at some of the highlights which show that if wasteful spending were curtailed just a little bit, it might give physicians a little more reimbursement breathing room.

In one example of waste, the government lost around $180 million worth of equipment because they couldn’t store it properly. One instance involved 80 military turbine engines ($1.1 million each) that were left to fall apart outside, rather than being housed in a building. The second saw 135 hydraulic transmissions ($12.6 million total) in leaky containers outside, sitting in pools of standing water and oil.¹ In the third instance, $68.2 million worth of tank treads went to seed by being allowed to sit out in the elements rather than a shed.

The government also seems to love giving drugs to animals to come to conclusions that we pretty much knew already. In one such insightful study, researchers gave monkeys meth in the morning and then tracked their sleep habits. It wouldn't be that bad if it didn’t cost the National Institutes of Health $12 million dollars in grant money.¹ Spoiler alert: Substituting meth for an Egg McMuffin every day affects your sleep.

In other news, do you think the Medicare system could use $400.6 milion? It could? OK, because that's how much has been sitting in the Presidential Election Campaign Fund account (funded by that little checkbox on your tax return where you can donate $3). Since 2008, no major party’s candidate has accepted any funds from it. So it’s just sitting there.¹ Though these funds obviously couldn’t be accessed to help Medicare's budget, they are an example of how adept the government is at wasting hundreds of millions of dollars.

Before you think we got away from 2023 without funding any animal gambling research—think again. Researchers can’t seem to get enough of gambling animals. It’s their monkey meth. A couple of years ago, it was slot-machine-loving pigeons, this year, it’s high-rolling monkeys. As described in the report, two  rhesus macaques had part of their skull removed to allow researchers to inject a tracer into their brain that allowed the study doctors to monitor neural activity. The monkeys then gambled between options they saw on screens with different risk/reward values. It turns out, monkeys choose the high-risk/high-reward option more than 70 percent of the time, and it only cost us $3.7 million to learn.¹ 

Let's hope that, in 2024, the government takes some of its gambling animal money and puts it toward physician reimbursement instead. The payouts are much better for everyone.

— Walter Bethke
Editor in Chief

^{1. The Festivus Report: 2023. https://www.hsgac.senate.gov/wp-content/uploads/Festivus-2023.pdf. Accessed January 21, 2024.}