And Germany.
Is that not the role of the opposition party? It is an attempt to show what they would do if they were in power, and forces the party currently in power to show their face by rejecting the proposal. I know the US system is a bit different from parliamentary democracies, but the principle would seem to be essentially the same…
I know people have gone to prison for Medicare fraud - but for simple differences on medical opinions? I think you would be doing everyone a favor by documenting that.
For you and @KathyPartdeux
Here’s a doctor who in good faith did something which he felt was necessary to help a patient. He billed Medicare, and Medicare disagreed with his clinical judgement. Now he’s going to jail.
There are two ways he could have stayed out of jail. One - not treat the patient. Two - do it for free, not billing Medicare. I tell the doctors I advise to take their choice. Not many of them take door number two, and I can’t blame them.
Read the article. Medicare is deciding whether or not to allow services based on the cost of those services, regardless of what the physician and patient think is appropriate. Just like a commercial insurer does.
There are thousands of cases where doctors and hospitals settle rather than fighting it out in court, because a lost case will bankrupt them.
“On June 5, Sandesh Rajaram Patil, 51, a former cardiologist at Saint Joseph’s Hospital in London, Ky., pleaded guilty to making false statements in connection with the placement of cardiac stents, according to the U.S. Attorney for the Eastern District of Kentucky. He accepted a prison term of 30 to 37 months.”
Uh - no- he falsified the degree of obstruction to get payment.
This is the point where he bravely runs away.
[ETA: or conflates admitted fraud with a “medical decision” because he can’t cite evidence of the latter – better?]
[Second ETA: L_J called me out later on in the thread for withdrawing the post to do a full edit, claiming I was the one running away. Someone flagged that comment, but for the record I took his advice and did a partial edit]
Yes, and having spoken to doctors who faced the exact same situation, I believe Dr. Patil was doing what he thought was the right thing for his patients. He was not performing unnecessary procedures on healthy patients, which is my definition of “fraud”.
Medicare has determined that unless you have X amount of blockage, the procedure is not medically necessary and billing for it is a crime. If that is not criminalizing difference of medical opinion, I do not know what is.
When you commit fraud - you commit fraud. And there’s nothing there assessing whether he put patients at risk due to unnecessary surgery that brought in hundreds of thousands of dollars.’ They didn’t say trying to bill was a crime - but falsifying records was fraud.
He didn’t say the standard was wrong- he said I’m guilty.
Here’s something else that Medicare For All will push along smartly…
http://www.academyhealth.org/blog/2016-03/medicare-payment-cuts-hospital-closures-and-patient-harm
Of course, this may not be a bad thing. After all, those hicks voted for Trump, maybe they deserve this.
Hid it for a full edit, but you’re right – the original should stand. Usually you run away when asked for a cite, but on some occasions you try something dishonest like this (before moving on to something else due to lack of further citations to support your first bogus point).
I’m not denying he committed a crime. I’m saying that the law* under which he was convicted is wrong.
- The Medicare determination of when a stent is required/not required is not contained in any statute. It is administratively determined. I use the term “law” therefore only in a theoretical sense.
If you’re not denying he committed a crime- why use it as an example.
Hey, all I know is that the guys who helped him file those claims didn’t go to prison.
Good thing the Secretary of HHS does not get to define “dishonest” I guess.
Because this is as far as I can tell a good doctor, doing what he thought was the right thing for the health of patients who were really sick. This is not some storefront clinic billing millions for bogus tests.
I meet with many such doctors every year. And like I said upthread, Medicare for all will be good for my income. For their patients, maybe not so much.
That tyrant isn’t like the benevolent CEOS of for-profit insurers, who would never dream of going after anyone for fraud.
Poor rural people are high on their list of priorities, too – far ahead of shareholders and executives.
OK, now it’s your turn to cite. Show me a case where an insurance company has brought criminal charges against a hospital or physician for billing errors or irregularities.
And show me a case where a rural hospital has closed because commercial insurance reimbursement is too low.
That first article you linked puts a lot of blame on states that didn’t expand medicaid and cuts in medicare spending that are (in part, if nothing else) driven by congress cutting its budget. Expanding medicare with Medicare For All would seem to be a big push directly against both of those things.
I said “go after” – private companies usually do this via civil lawsuit as their priority is recouping money for shareholders. The government has different priorities.
Going into a meeting, but here’s one example from 30 seconds on Google:
I’m sure I could find more. As for rural hospitals, contraction of government programmes (combined with some private insurers’ policies) seems to be the problem:
But please, more of your post-hoc argument blaming it on ACA.
