There are a couple of caveats to this particular link. One, this was a case filed in 2006, While George W. Bush was President, and probably wasn't paying attention to the out of control portion of our federal behemoth that launched this particular witch hunt in which doctors who were engaged in the business of saving peoples lives became identified as public enemies began. Two, it was for actions taken by those doctors during the calendar years of 2001 through 2006. That being said, it is a symptom of our overzealous and quite frankly wrongheaded bureaucracy that has been put on steroids, and will soon threaten the health and well being of every American Citizen. The link is from The Morning Journal, a regional newspaper serving Northern Ohio, about 40 miles west of Cleveland.
You can read the article in its entirety by clicking here.
EMH Regional Medical Center and the North Ohio Heart Center have agreed to pay the federal government $4.4 million to settle allegations that between 2001 and 2006, EMH and NOHC performed unnecessary cardiac procedures on Medicare patients.In the settlement, which was announced by the Justice Department yesterday, EMH will pay about $3.9 million, while NOHC will pay $51,870.
The federal government alleged that EMH and NOHC performed angioplasty and stent placement procedures on patients who had heart disease, but did not need them. The patients’ blood vessels were not closed off enough to require that kind of procedure.
“Billing Medicare for cardiac procedures that are not necessary or appropriate contributes to the soaring costs of health care and puts patients at risk. Today’s settlement evidences the Department of Justice’s efforts both to protect public funds and safeguard Medicare beneficiaries,” Stuart F. Delery, principal deputy assistant attorney general of the Justice Department’s Civil Division said in a statement.
You may have noticed as I did, that the allegations of wrong doing were not made by a person with a degree, or any actual knowledge of medicine. These allegations of malfeasance were leveled by a bureaucrat who's sole interest was in saving the federal government money. Indeed, there was no doubt as to whether the individuals receiving the care had heart disease, only whether or not they were sick enough to undergo the procedures proscribed by the medical professional. The doctors said yes, and the politicians said no. In my estimation, were it me with heart disease, I'd rather the doctors be making the determination as to what was necessary, having attended medical school and all. Buried in the article was this quote, spoken by Steven M. Dettelbach, a U.S. Attorney working in Cleveland:
“Patient health and taxpayer dollars have to come before greed.”
This is what's coming, whenever the government wants to save a few bucks, they'll just accuse some poor doctor somewhere of amputations in order to pad their Obamacare billable hours, hold a news conference that they're going to crack down, and then sue some poor doc for not waiting for someone to get sick enough to have the procedure that could have saved his or her life. I don't know at what stage of heart disease a stent is most effective, or if angioplasty is warranted prior to a blockage becoming greater than 100%, 95%, or even 30%. I am humble enough to know that I should listen to the expertise of another person, like for instance, a Heart Specialist. My gripe here is that in this case, it was a couple of people with law degrees and some appointed authority who have interjected themselves into that decision, and even went the extra mile to paint the care givers with the dirty end of the stick in the process. It may be possible that by performing the procedures earlier than the attorneys thought cost effective, those patients may have had their lives extended and quality of life vastly improved far more than if they had waited for conditions to deteriorate further south. I can't help but notice also that the paper didn't bother to find out, or in any way ask the patients how they were feeling. No studies pointing to the efficacy of any heart procedures being ineffective when applied too early were cited at all. There must be evidence somewhere that either proves or disproves the government's case, or at least supports their claims or provides evidence against them. In fact, it would appear that the only person lazier than the bureaucrats in this case was the reporter writing the article.
Here's the most pernicious part of the article:
The resolution is part of the government’s emphasis on fighting health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, secretary of the Department of Health and Human Services in May 2009. The partnership between the two departments has focused reduce and prevent Medicare and Medicaid financial fraud. One of the most powerful tools is the False Claims Act, which the Justice Department has used to recover more than $10.1 billion since January 2009. The total recoveries in False Claims Act cases since January 2009 are over $13.8 billion.
Every time the Democrats talk about where they're going to save us money in the budget, our good friends fraud, theft, and waste, come out to play. It's as if during the rest of the time, fraud, theft, and waste, are O.K. If it were so easy to prevent fraud, eliminate waste, and catch thieves, why wouldn't that be a priority all the time, rather than just as a campaign talking point during election seasons? Putting that aside for just the moment, there is something else wrong here.
During a previous life, I was a retail manager for some of America's largest retailing firms. I managed stores in urban areas, down town U.S.A., or more precisely, just out of down town areas. One of the things that I have seen was a scam where dentists would pull the teeth of drug addicts out one at a time, bill Medicaid, and give the addict a 28 day prescription for two pain killers with pretty decent street value. One pill for if the pain was normal, and another pill for if the pain was unbearable. That's fraud.
That's the kind of thing we all expect to be ended when our U.S. attorneys are charged by the President to put an end to the abuse we tax payers are expected to tolerate. Finding that and proving it however is not so easy as our officials are telling us. Instead, we are watching them label as butchers, doctors who are actually doing their level best to save the lives of their patients, which some day may actually be us. I do not want to wait for angioplasty to be administered with a blockage of 57% of my artery, if my doctor tells me that 40% would be better suited for saving my life and improving on my life's quality. I want my doctor, who actually went to medical school, to make that determination without any fear of reprisal from a trained monkey known as a bureaucrat.
There is a reason why bearing false witness against your neighbor made the top ten in commandments. The damage done has reprisals far beyond the lie told. Calling doctors crooks every time they step out of the approved line for administering cost effective medical advice will cost lives and happiness galore. yes this case is from before Obamacare became law, but guess what. We have just granted these very same bureaucrats an increased level of authority, power, and privilege over our lives and the decisions of those charged with helping us to keep them. During his campaign for this sink hole of a law, Barack Obama stated that those in the medical profession routinely performed unnecessary surgeries and amputations when simple inexpensive options would have sufficed. I don't remember the exact quote, but this story is clearly the foreshadowing of things to come. That vision ain't pretty.
Comment
Comment by Pamela Harper on January 8, 2013 at 3:57pm Right on Gail & Debrajoe, right on!!! ;>)
Comment by Debrajoe Smith-Beatty on January 8, 2013 at 10:34am John I want to remind you that welfare benefits are more clostly than Social Security and Medicare benefits. Benefits to illegal immigrants are costing Americans billions every year. So get off of the soap box and 1. Cut all benefits to illegals 2. reduce the benefits to welfare and make welfare not attractive. Then you can talk about medicare.
Comment by John Wiseman on January 8, 2013 at 10:29am @ Delilah Bankhead, thank you for continuing to make my point. There is a misconception suffered by people in terms how an economy works. The belief that there is some magic solution out there, which will allow one group of Americans to get their free stuff provided by the government, while not costing all of the citizens something, both planned and unintended. There are no solutions, only trade offs. Everything comes with its cost.
yes, it is possible for us to pay for the health care of every American Citizen. The trade off is that either it will bankrupt the country, or we will pay for it with a greatly diminished quality of care. Medicare, as wonderful as the reviews for that particular service have been over the years from its participants, is out of money, and has been bleeding our society dry for decades. I am not saying scrap it, on the contrary, I am saying fix it. The problem with Obamacare is that he has copied it, hit the enlarge feature on the Xerox machine, and added a few thousand complications as well. The trade off will be the complete collapse of the insurance industry, which contrary to your assertion, does not receive a dime in subsidization, a greatly diminished quality of care, rationing of resources, assets, and treatment, high unemployment, and the bankrupting of our nation. That's a bad trade.
Time and time again, I will listen as people eloquently state that our government needs to stop spending money, and then they'll advocate for an increase in the spending of those programs that they hold dear. Medicare and Social Security alone now top out somewhere North of our annual revenues. The fact of the matter is simple, there is no way to balance our budget without doing something about those expenditures.
In New York in 1975, a person could check into a hospital, have major surgery, receive post operative care, and see his surgeon for follow up care for a grand total of $300. The series of governmental policies put into law since that time have inflated the cost of the health care commodity beyond all recognition. The law forcing employer sponsored health plans was a small step in that progression. Forcing insurance companies to pay a bribe to be allowed to do business in individual states was another. Allowing States to exclude any insurers that they felt unworthy of paying the bribe and thereby limiting competition was another. I could go on for a good long while here, but I think you should probably get the point by now. The real problem is that further government policy to mitigate the dire circumstances created by previous government policy will not solve anything, it will only serve to do more damage. If history has taught us anything, it has done an ample job of showing us that.
Comment by Gail E. Engelhardt on January 8, 2013 at 8:05am @Delilah Bankhead - Apparently, you are unaware that Seniors are not the problem. We are not the "comrades" as you call us. Most seniors would rather not be on the government healthcare program called Medicare, but we are not given that choice. I was told if I wanted to try and get private health insurance, I would be penalized for not going on medicare and the cost of private insurance would be astranomical because of my age, and I'm in fairly good health. You are allowing the government to pit americans against one another. Just wait until you are 65 and see what you private insurance premiums go to when you are no longer able to work or when companies no longer want to hire you. We do, however, know that there is lots of fraud going on in Medicare by a few and there is greed by many bureaucrats. I am a Tea Party director in my area, and you need to understand the facts before you start putting the blame on others.
We are all in this together, and we are all (or should be) looking to work at getting our freedoms and liberties back and protected from tyrannts. WE should be holding our legislators feet to the fire on doing what our Constitution states, and not fighting or calling others names who are on your side as well. The Federal government should be getting out of the business of Healthcare, Education, Environmental Protection, Energy Resources, and limit themselves to only what our Constitution states and nothing more. Get rid of the Fed and get out of the United Nations. Fairtax or a Flat Tax based on consumption would be better than the mirade of taxing regulations of the IRS. Our government would save billions of dollars if they would just let the States and the Private sector handle what isn't the business of the Federal Government's to govern over.
Comment by John Wiseman on January 7, 2013 at 7:47pm @Delilah Bankhead, that's what's known as a straw man argument. Of course we're for saving money. Let's save tax payer money by getting the government completely out of the medical insurance subsidy business, and return it to the private sector where it belongs in the first place. The evil that occurs, which is the government taking over the whole ball of wax under the guise of providing it for free, and then cutting costs by denying care is the exact point that I was making here. The insane rate at which health care costs are rising in the first, second, third, and last place is a direct result of bad government policy. The answer is not more government in order to somewhat mitigate the damage done by previous bad intervention into the private sector, but to eliminate such interventions.
Please say hello to your comrades at the central committee offices for me though.
Comment by Melissa Bryant on January 7, 2013 at 4:49pm Was that dental office in Chicago area? Our dentist office was in same building as the associated insurance agent (they had another dental office but same dentist so they could say there were two offices). They went to employers and sold them on dental insurance that was only $45/employee/month with no co-pay required. It sounded good so they got a lot of employers to sign up. Their scam was not doing any work and spreading the care out over many many visits. You could not schedule more than one visit per month. It took 1 year to get a root canal (I went in right when I broke my tooth.) I could hear other patients EVERY time I was in (which was once a month) why can't you do something now? It was very sad. I eventually lost the tooth.
Comment by Pamela Harper on January 7, 2013 at 3:59pm Doug, I kept getting AARP's mailings after repeated refusals. I finally started filling up their postage paid envelopes with all kinds of folded papers or anything that would make the mail more bulky & costly. I also told them that I did not support them, Obama, or their socialized medicine. I've heard that some people fill the envelopes w/rocks & gravels. Bottom line, they finally stopped sending me any mail. I also ask them why they think I would want to do business w/anyone that doesn't understand what NO means!!
Comment by Doug Nicholson on January 7, 2013 at 3:28pm My apologies, folks. The link I posted below is WRONG! It should be:
Comment by Doug Nicholson on January 7, 2013 at 3:24pm I dropped my AARP membership at the beginning of the push for Odumbocare. There was an article in their magazine about how terrible the Veterans Administration was and how patients were dying while waiting for treatment at VA hospitals, etc. In the very same magazine was an article promoting Odumbocare! I concluded they must be insane.
A GREAT truly conservative alternative to them is The Association of Mature American Citizens (AMAC).
Comment by Ralph Roshto on January 7, 2013 at 3:00pm I'm sure the AMA is now saying to itself, "Whoa, what is this $hit!" They supported this Tyrant, and now they are surprised that the snake they held up...bit them.
Same with AARP... They are about to find out how much that 'free' obamacare costs.
It's a shame that both of these organizations don't encourage the second amendment.
I do. And though I am of age to join AARP, and I keep getting their literature, I always return it in their postage-paid envelope with a red felt marker of 'no communists' on it.
How far do we have to sink before we overthrow our own government?
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