Healthcare industry “experts,” and there are many, never cease to offer their opinions on how to improve the system. Healthcare costs have spiraled, and everyone seems to be blaming everyone else. Politicians love the debate. They can remain above the fray. After all, they get healthcare for free!
Healthcare insurance form with calculator
For the rest of us poor souls who pay premiums, co-pays, pharmaceutical costs and for supplies “not part of your plan,” healthcare as an industry often seems sicker than we are. Where does all of the money go? We maintain that it goes down the drain of bad ethics. I also feel that the healthcare debate, as massive as it is should start and end with good ethical practices.
One example of many:
The Associated Press just released an article (April 25, 2017) entitled: “Prosecutors: Doctor’s practice stole millions from Medicare,” about a South Florida doctor with connections to a crooked politician, who has managed to steal more than $100 million from Medicare.
Life for a man who took the oath to save lives
His name is Dr. Salomon Melgen, and he is 62. From 2008 to 2013, he managed to rip off Medicaid for $105 million. Think about that for a second. Think about all of the truly sick people that much money could have helped. He now has 76 counts of fraud against him and if most of them stick, he is looking at a life sentence.
How do you steal so much money? By having a large base of elderly patients who may not fully understand English, and then telling them they need a whole slew of meaningless tests and questionable treatments. He is after all, a doctor.
The good doctor’s lawyers have painted a picture of him as kind and compassionate man who “never gave up on his patients.” There’s a good reason for that. The longer he didn’t give up, the more money he made. In fact, he even prescribed tests and treatments for patients who had a glass eyes! I’m sure they tested perfectly. Prosecutors have stated that his office was almost specifically set up to scam Medicare. In fact, working out of his location, Dr. Salomon Melgen set a record of sorts in 2012, he received more money from Medicare than any other doctor in the country! He’s an Ophthalmologist!
However, the case does not end there. The good doctor decided to dabble in politics. For example, he tried to bribe Democratic U.S. Sen. Bob Menendez, who has denied any wrongdoing. That trial, a separate deal altogether, is scheduled for the fall. The doctor was a friend of former Florida Democratic Governor. Lawton Chiles. He gave money to the Chiles campaign – and miraculously – he was appointed him to the state medical board.
From his association with Chiles, he met Menendez and lavished gifts and bribes on the senator. Why? Because Menendez allegedly helped Melgen in terms of visa disputes with the Dominican government.
Unending bad ethics
Part of our healthcare challenge is how we view our system and its providers. I refuse to come out with the usual caveats about how “99.9%” of our physicians, nurses, administrators, etc. are hard-working and ethically upright people. Truth is, we don’t know. Anyone who has ever “negotiated” an outrageous medical bill, and that’s many of us, knows that there are all kinds of costs that are questionable. Up to, and including, tissues for $200 a box.
If a system exists where there are few checks and balances, and an almost opaque billing scenario separating patients from their providers, how do we ever fully know anything? How many Dr. Salomon Melgen’s are out there, and how many politicians are influenced by their money? Frankly, we don’t know that either.
Melgen is extreme, I agree. $105 million is a huge scam. But what of offices that might take “just a touch,” one million or a few hundred thousand here and there? How many of those are out there? We don’t know.
This scandal is about Medicare fraud. What do we get when insurance fraud is added into the equation? How many billions are stolen annually? We don’t know that either.
Unless the healthcare community finally gets serious about ethics, whether Trumpcare, Obamacare or any other cute word we wish to give it, the results will remain the same. Higher costs, more fraud and more influence.
