CNN on Medicare Fraud--Ethics is on the Line!

[Gene Scarborough]

[Gene Scarborough]

I have personal knowledge of an individual in Accra, the capital of Ghana, and the cost for a heart procedure to unblock (70%) a Coronary Artery = $1,500!!!!

This happened in an African Country with the good fortune to have modern Doctors well-trained in the same heart surgery skills and techniques we use in the US to save lives.

What would that procedure cost in the US????

$15,000 / $150,000???

It probably depends on the location, but it is obvious something is wrong with the cost of healthcare in the US. Add to it the fraud exposed above and you have a more wise route which needs to be taken here as opposed to the Republicans just cutting the devil out of Public Services at taxpayer expense. It's not as simple as Federal Budget Cuts and has to do with the Ethics of Healthcare, I think.

[Ed Pettibone]

Gene S: This happened in an African Country!

Ed: And Gene If I where a betting man, I would bet they do not have malpractice insurance in that African country and that the nurses make considerably less than your wife does. You do have an interesting point but as is you custom you grossly over simplify the issue.

[KeithE]

The US health care costs are twice the rest of the industrilized world. Fraud plays a role, but our lack of cost controls, procedure controls and malpractice control work together to cause overtreatment by Doctors. Why not do a marginally-needed test if I'm paid more for so doing (in our fee-for-services model) and at the same time the Doctor covers his rear end from malpractice claims.

Real TORT REFORM is needed for sure.

PROTOCOLS and PRICE CONTROLS of best practices would help as well. (Those who think we can shop around for best costs don't realise that that takes time and money)

But real independent ACCOUNTABILITY is want is needed most (which comes at a price, but that price need not double the legitimate medical costs). Over-treatments and fraud can be ferreted out. To be best that ACCOUNTABILITY should be rotational so that collusions can be minimized. Think about collecting the offerings at church; good practice is that two be involved.

Dr. Tim Johnson's book is outstanding! It is only available as a Kindle Book right now.

[Mrs Haruo]

Medicare fraud must be a major industry. Because of injuries sustained during military service, I get my medical care through the Veteran's Administration. Because of research I have done on line, and some surveys I have answered in hopes of finding more information about medical issues I am facing, my name is now on the list for a bunch of telemarketers who want to provide me with testing supplies and set me up with a power chair "at no cost to me!" I must get at least one call a day, but as soon as I tell them I am not on medicaid or medicare, they hang up quick.

[Ed Pettibone]

[Gene Scarborough]

I think most medical students graduate with stars in their eyes that it is a road to "get rich quick." They work a hard schedule, but within 3-5 years too many have a palace where they live with high dollars / membership at the country club / another home or timeshare in the mountains and at the beach. My wife works with Physical Therapists who take elaborate and expensive vacations twice a year.

In days gone by before the complexities of today, the good Doctor was willing to practice and go to homes, if necessary. Most were General Practitioners where today they all want to specialize. The good old caring medicine of yesteryear is practiced by nurse-practitioners. Outside major physical issues like heart attack and stroke, the studies show that people usually get well in 3-5 days whether medicine is applied or not. So much for taking your child to the Dr. at the first cough! They just infect each other more.

Our problems are 3-fold = patients / doctors / ambulance-chasing lawyers. Patients expect a magic pill for everything instead of rest, plenty of fluids, trusting the body to heal naturally. Doctors expect to get well off more than to help people get well. Lawyers have them all scared and greedy patients have never read the details of any prescription medicine = bell shaped curve where the majority get better from it, but a small percentage have a negative impact. That's not lawsuit territory, it's just the facts of life so if good results don't happen in a few days, see the Dr. again rather than suing him. He is not God, for goodness sakes!

As usual, we think in America money solves anything. It does not cure death and we all must die so let's get real. The Hippocratic Oath says nothing about getting rich. It is all about doing no harm intentionally.

[Gene Scarborough]

Ed---

I was in a hurry yesterday and had no time for specific answers for you. Here they are:

1) You accuse me of oversimplitying---I think you over-complexify and nit-pick any answers to death = chill out a little more, man!
2) You wisely cite the likely absense of ambulance-chasing lawyers in Africa = without question too many lawyers are bad for any society's healthl!
3) Regardless of wages in any area of society, the same percentage seems to go to food / rent / transportation / etc. Higher wages seem to never make one rich.

Here is an example of too much legal interference: My father died a few years ago in Georgia. We went to get the house deed correct with only mother's name---to find out the GA Legislature had quietly put in new "required wording" of any deed after a certain date. They meant exactly the same as the old words, but no anyone dying must pay a Lawyer for a "new deed" with "new words meaning the same" to comply with a "new law" put in by legislators with too many law degrees and the will to do Colonoscopy exams on Georgia's citizens without a medical liscense.

I think we may have a good lawsuit here!!!!!!!

[Ed Pettibone]

[Gene Scarborough]

Chill out, Ed, or I'll have to crank my big diesel powered chipping machine and pay you a visit!!!!

The only way I will be able to be so precisely precise is if this format is changed so I don't have to copy / paste / answer as you constantly do. I think that takes too much time and space.

Remember, many people glance at this---and too much nit-picking just turns them off as it does me.

In the interest of smooth flowing dialogue, let's just not spend so much time nit-picking. This is not Theology 101 where each word must be so precisely defined in such special ways no one can understand it.

[Ed Pettibone]

[Mrs Haruo]

I would love to see less nit picking and cud chewing here too--but I guess that is theology-- and current events.

[Gene Scarborough]

Ed---

You are the thorn in my glutinous maximus.

Whether it matters or not to you, it does to me. Long ago in the world of Pastoral Care / Psychology I learned: It it matters, it matters. If you don't care, then go away.

I can do without your arrogant Yankee judging.

CLAR???????

[Ed Pettibone]

[Dave Roberts]

One thing about American medical costs that is left out of this. All of us who have insurance or who pay our bills are also taxed (without representation) to cover doctor's and hospital's bills for nonpaying patients. So if fifteen people come to the ER during the night to be treated because they cannot be turned away but also cannot pay, and I show up with a cut to be stitched, my cost will be $1,500 for a $100 procedure because the hospital has to recoup its losses for the 15 non-paying patients who preceded me. Delberate fraud is a completely different subject, and there is enough of that in geriatric mills to go around.

[Mrs Haruo]

Back to my calls from the "We do the paperwork for you" mills. I didn't necessarily mean those folks do fraud so much as there is a lot of waste in that industry. They get reimbursed from Medicaid/Medicare for services/supplies they bill for which are not always actually delivered to the patient. The patient gets this stuff in the mail for free, and there is opportunity for a lot of waste there. I had this argument with my first husband who had full drug coverage from his employer, and many of his health problems were self-inflicted. I tried to explain to him that SOMEONE was paying for his medication, even if it wasn't coming out of his pockets. When we changed to a pharmacy that showed the retail price on the sales slip even if we weren't having to pay it, it really opened his eyes to what a pickle he would be in if he lost his medical coverage.

[Ed Pettibone]

[Dave Roberts]

Nursing homes plus doctor's offices that do nothing but Medicare and Medicaid.

[Ed Pettibone]

[Dave Roberts]

Ed, such medical practices primarily seem to exist in the poorest parts of urban areas.

[Gene Scarborough]

Why don't we just admit, the primary problem with American medicine is that it has turned into a big expensive business. You cross the border into Canada and buy the same meds for 1/10 the cost! Many folks within a few hours drive of the Canadian border are now chartering buses to gamble at the casinos / buy their meds / return home having spent less than if they had gone to that American pharmacy.

Doctors and Lawyers seem to have a liscense to steal when they graduate. The prices have little to do with the relative value of what they do.

Insurance companies try to settle all cases out of court so a good ambulance-chasing lawyer just has to file a brief to get something!!! How's that for productive!! Actually, the un-insured get all their medical teatment for real costs--which most can barely afford to pay in parcels over the next year.

Here's another good one: Blue Cross / Blue Shield was formed by Doctors whose widows had lost money over patients they had treated without being fully paid. So-o-o-o-o---they formed an insurance company which pays them promptly off the multitude of premiums collected. Who knows what the "take" is for the insurance companies who all hope to clear more than they pay out just to stay in business. I do know some hospitalization insurance agents make a full year's premium as commssion before any claims are even made by their new client!

You do the math.

[Ed Pettibone]

[quote="Gene Scarborough"]Why don't we just admit, the primary problem with American medicine is that it has turned into a big expensive business. You cross the border into Canada and buy the same meds for 1/10 the cost! Many folks within a few hours drive of the Canadian border are now chartering buses to gamble at the casinos / buy their meds / return home having spent less than if they had gone to that American pharmacy.

Ed: What do you mean turned into ? It started as a big expensive business. And I know some of those folk who take those buses and will admit buying meds it is a nice excuse to make the trip.

Doctors and Lawyers seem to have a liscense to steal when they graduate. The prices have little to do with the relative value of what they do.

Ed: How about Tree surgeons and auto mechanics both of whom spend a lot less time in school. And a few preachers are over paid.

Insurance companies try to settle all cases out of court so a good ambulance-chasing lawyer just has to file a brief to get something!!! How's that for productive!! Actually, the un-insured get all their medical teatment for real costs--which most can barely afford to pay in parcels over the next year.

Ed: What? neither of the statements above make sense.

Here's another good one: Blue Cross / Blue Shield was formed by Doctors whose widows had lost money over patients they had treated without being fully paid. So-o-o-o-o---they formed an insurance company which pays them promptly off the multitude of premiums collected. Who knows what the "take" is for the insurance companies who all hope to clear more than they pay out just to stay in business. I do know some hospitalization insurance agents make a full year's premium as commssion before any claims are even made by their new client!

Ed: So Gene are you suggesting that should you die, folk who owe you for you tree service shouldn't have to pay you wife or offspring, what is owed?

[Gene Scarborough]

Goodness, Ed, we love to pick the nit!!!

Certainly, people should pay what they owe an estate. There is also room for compassionate care without the full bucks to pay for the services. It's called minisry!

I have heard of old time doctors who, during the Depression, were paid in chickens and pigs. See if anyone will settle for that today! When was the last time a Dr. made a house call or got patients into the examination room within 10 minutes of their coming in.

Anytime you wait in line for help it is to make sure the store / Dr. office / corporate phone center is always packed with paying customers. So where is the compassion for helping people no matter what you do????

[Ed Pettibone]

[Gene Scarborough]

Folks---please note----Ed and I are on the same beam here----almost!

Ed is the master of being just enough different to keep it going and going and going. I like him despite our regional differences.

What a beautiful story of the Dr. making a house call. Again, I remind us that too much doctoring is as bad as too little. The stats show that, just like with mental counseling---60% get better / 20% get worse / 20% show no change---whether treated or not!!!