Hospitals Lie to Exceed Already High Pricing Limits
|January 24, 2014||Posted by Staff under Health|
This 2014 excerpt of The New York Times, Jan 23, is by Julie Creswell and Reed Abelson.
This month, the Justice Department said it had joined eight separate whistle-blower lawsuits against Health Management Associates, a for-profit hospital (H.M.A.), in six states. The lawsuits describe a wide-ranging strategy that relied on a mix of financial incentives and threats in an attempt to inflate the company’s payments from Medicare and Medicaid by admitting patients like an infant whose temperature was a normal 98.7 degrees for a “fever.”
Federal regulators have multiple investigations into admissions, procedures, and billings at many hospital systems, including the country’s largest, HCA. Community Health Systems, the Franklin, Tenn., company from which H.M.A. hired its former chief executive in 2008, faces similar accusations that it inappropriately increased admissions.
Like their Wall Street bank counterparts, the mega-hospital systems, with billions of dollars in revenue, are more challenging to regulate.
Many settlements run only into the tens of millions of dollars. That’s a corporate slap on the wrist.
H.M.A. also faces shareholder lawsuits and a federal securities investigation. A former executive was indicted late last year on an obstruction charge related to these investigations.
Ed. Notes: Yawn. Hospitals lie, like these hospital chains, to charge too much in the sense over the legal limit. Yet almost everybody involved in medical car charges too much in the sense of more than a fair return for service: private ambulances, local government “emergency” response, doctors, specialists with their tests, pharmaceuticals, they all take as much as they can get.
The greed got its start with doctors and their licenses keeping out competitors, such as doctors from a different jurisdiction, or from an unconventional field such as chiropractors, and different treatment such as vitamins (however useful), which the AMA tried to get listed as medicines needing prescriptions. The solution to that is to let competition back in. Abolish licensing. Instead, require doctors and any sort of healer to post their won/lost record. Since as many people are healed by placebos and by traditional cures as by mainstream medicine, and the medical establishment is the third leading cause of death, the absence of licensing can not do any harm, not as long as potential patients are fully informed by all healers of any stripe by declaring their success rate.
With easier entry into the field for newcomers, and with prestige earned not by conformity to norms but by actual healing, the cost of true health care will fall. And it will fall even further if the populace gets healthier. What will help everyone get healthier are (a) a healthier environment and (b) metro regions friendlier to pedestrians and cyclists. Both a cleaner environment and a compact, car-free urban region follow from geonomics, from turning land values into common wealth. Once the populace gets healthy, perhaps the greedy can visit health practitioners to heal themselves and learn some more sociable mental values.