Robert Powell has been a journalist covering personal finance issues for more than 20 years, writing and editing for publications such as The Wall Street Journal, the Financial Times, and Mutual Fund Market News.



BOSTON (MarketWatch) -- Is Rod Stewart eligible for Medicare? If so, he might want to look at a map that details how much Medicare spends on its enrollees by state. It tells a story and then some.

Not surprisingly, Medicare spends vastly different amounts to care for its enrollees depending on where they live, and growth rates vary dramatically across U.S. states and regions, according to the map on Kaiser Health News' Web site, based on research by the Dartmouth Atlas Project at the Dartmouth Institute for Health Policy & Clinical Practice.

On average, Medicare spent $8,304 per enrollee in 2006, up from $5,110 in 1992, according to the map.

Overall, Medicare spent the most per enrollee in the following states: New York, $9,564; New Jersey, $9,551; Louisiana, $9,401; Florida, $9,379; Massachusetts, $9,379; and Texas, $9,361. And Medicare spent the least per enrollee in sparsely populated states such as North Dakota, $6,108; South Dakota, $6,253; and Montana, $6,340.

So what are some of the takeaways?

If you have designs on committing fraud against Medicare should you move to a state where Medicare spends the most per enrollee? Yes and no. Yes, because that's where the elderly and disabled are found. No, because the Medicare Fraud Task Force is likely to catch you. Consider: The feds last week arrested more than 30 suspects and were seeking others in a major Medicare fraud bust in -- you guessed it -- New York, Louisiana, Boston and Houston.

By the way, the Wall Street Journal reported that some $60 billion of the $800 billion spent annually on Medicare and Medicaid is lost to fraud. The good news is that the government's special antifraud teams have recovered some of that money: They've produced 293 indictments for Medicare claims totaling $680 million since 2007.


But what if you're Joe Medicare Beneficiary? What should you make of the map? Should you move to a state where Medicare spends more or less? "I don't believe you can really draw any conclusion from these statistics," said Chris Cooper, president of Chris Cooper & Company and ElderCare Advocates.

Medicare uses private insurance companies to administer the Medicare program. "That's why we get so many different prices for the same services in different locations in the U.S.," Cooper said. "If the price was set in Washington, D.C., it could be too high or too low."

What's more, he said different areas of the country have different health-care outcomes. "This is because of the socio-economic make up of the Medicare beneficiaries in a given region," he said. He said that lower-income elders have more heart and lung diseases. They smoke and eat poorly, he said. Also, some diseases, including heart disease, stroke and obesity are more concentrated in some states than others.

So what's the upshot of all this? I've got two thoughts: One, we should all join the battle to stop Medicare fraud. Imagine saving the $60 billion per year lost to fraud. That could certainly help bring down health-care costs.

And two, our poor lifestyle choices haven't helped matters. Maybe it's time to wage war on smoking, drinking and cussing. Maybe Rod Stewart could be our spokesman.