About what is wrong with our medical system. She posted this on her blog and I’m wholeheartedly in agreement. Been a fan of hers since reading Nickle and Dimed.
But I wish someone would just come right out and say it, that the real problem is the hospitals, billing companies and insurance companies. When all three are for-profit you know things are going to go seriously wrong. This is why a single payer health insurance system would be such a good idea in the United States. But of course the lobbyists for the hospitals, billing companies and insurance companies will never let the cash cow run dry.
I know of one egregious example of a billing company on the take. They’re getting pretty big and will remain nameless however I’ll tell the story using pseudonyms. We’ll call the doctor Dr. Justice, and the billing company Profit, Inc.
At the time I was working at the state AG’s office. Seems Dr. Justice got into a little trouble with the Internal Revenue Service. So to make up the difference, he started upcoding all his patient visits. In some cases he’d seen as many as a dozen patients in an hour. Where he went wrong is that he started upcoding Medicare patients. Alarm bells went off in our Medicare Fraud Unit.
After getting his billing data we noted that the curves on both his IRS payments and his upcoding coincided nicely. Ok, there’s motive.
We brought in executives from Profit, Inc. as well as their I.T. director and requested data from them, only to be stymied. So I as the I.T. director for the AG’s office layed into their I.T. director. A couple of days later we had all the information we wanted.
The billing company not only knew he was upcoding, they encouraged it. Of course in the meeting they couldn’t admit that, but that didn’t matter at all since the data told the true story. We found out that in some instances they’d warned Dr. Justice in writing that his patient load and upcoding were going to become an issue. But in those same memos they encouraged him to keep on upcoding.
So now Dr. Justice has been convicted of Medicare fraud and will be doing a stint in Club Fed. Profit, Inc. is still under federal investigation.
Now comes the true irony. We needed someone to manage our CVRS systems so gathered resumes, scored them, and then brought in the top four candidate. Who should one of the candidates be but the I.T. director from Profit, Inc. And guess who we hired.
Turns out my suspicions about Profit, Inc. were dead on. It’s a company so bent on profit that they completely screwed one of their own partners.
This is what is wrong with medicine in the United States. Too many hands in the pie.
And is even more scary. Peter Rost paints a very dismal picture of the United States being controlled by greed. But that is precisely what is going on. We’ve allowed the New Robber Barrons control of our lives, of our right to life, liberty and the pursuit of happiness.
We need to clamp down on corporations more today than we ever did in the past. Corporations in the United States are all about short term profit. Japanese companies use to be the antithesis of that but western influence has pretty much ruined that. Now that I think about it, citizens of all G8 nations are firmly under the thumb of corporate interests.
The question is, how do we throw off this yoke?
I for one would be more likely to incorporate if I didn’t have to worry about health care, and didn’t have to pay what I consider onerous minimum taxes to the state I live in. And I’d be more likely to hire employees for that business. But for now I won’t do anything because the current scheme doesn’t support how I’d like to run a business.
But maybe if we could change the health care paradigm we might actually see increased economic benefit. Alas, I’ll be long dead before that happens.