Fraud, Abuse, and the Medicare Industrial Complex

Blade Runners (Ridley Scott's great science fiction move Blade Runner was based on Philip K Dick's short story "Do Androids Dream of Electric Sheep". However the title "Blade Runner" was purchased from a novel about the future of medicine under a bureaucratic state that tries to dictate health care. In this dystopia "blade runners" are agents that deliver illegal drugs to patients in need--scenario a lot more likely today than when Blade Runner was written.)   Blade Runner: A Movie, by William S. Burroughs "In this futuristic screenplay vision of a strife-and-disease-plagued America in 1999, Burroughs finds the cure for a decaying civilization in the medicine practiced by underground physicians and surgeons. These heroic healers, in turn, are aided by 'blade runners,' teenagers who smuggle banned surgical instruments past the watchful eyes of fascistic police. ..." review from Amazon             Back to NCPA Debate Home Page

A Practicing Physician's View by Lawrence R. Huntoon, M.D., Ph.D. , President Assoc. of American Physicians and Surgeons Presented at the Heritage Foundation March 1, 2000 Ladies and gentlemen, you know we're in big trouble in medicine today in this country when there's a code not only for flatulence, but one for the guy standing downwind as well. I'm not making this up. If you look in the ICD-9 diagnosis coding book that Medicare requires physicians to use, you'll find a code for almost everything that can happen to a person. There's a code for injury due to legal intervention by gas (particularly appropriate if you happen to live in Waco, Texas), a code for injury that occurs while riding an animal that collides with another animal, a code for injury from being pecked by a bird, a code for injury from prolonged weightlessness, and a code for injury due to a fall from a spacecraft, flagpole, or commode. There's even a code for a person who has been sucked into a jet engine. Now think about that. Why would you need a code for a person who has been sucked into a jet engine? Yes, there is a code for almost everything.... everything except for the plague that is so well entrenched in our great nation today - Government Dependency Illness. There is no code for that. Indeed, the sad fact is that many people today don't want to be cured of this disease. Many have willingly traded their freedom and liberty for government-provided security, however false and precarious that may be. But I'm not here today to talk about Government Dependency Illness and the loss of freedom and liberty that accompanies socialized medicine. I am here to talk about a serious crisis that affects both patients and physicians. Unlike the fictitious "crises" of the socialists, we have a real crisis today in this country and it's the HCFA/Medicare bureaucracy itself. This abusive and tyrannical HCFA bureaucracy has created a Frankenstein monster with an insatiable appetite for physician time and one which obstructs, impedes, and interferes with every aspect of the practice of medicine today. If you have any doubt about this, consider the fact that there are only about 17,000 pages of IRS regulations, whereas there are more than 111,000 pages of Medicare regulations. ... Last but not least, I want to address the current fraud-and-abuse situation. What I intend to show is that HCFA operates no differently than the mob or the KGB. The former Soviet KGB had a slogan that HCFA seems to have fully embraced, and that is: "Show me the man, and I'll show you his crime." That is where physicians are today with this HCFA/Medicare bureaucracy. The rules are so numerous and complex that any physician in this country could be singled out at any time and found to be in violation of some Medicare rule, regulation, or guideline. In fact, we have learned that some government agents have even hidden behind a one-way mirror at a public meeting to see which doctors are making negative comments about the HCFA/Medicare bureaucracy. The practice of one such physician was targeted (coincidentally?) for a "Hit" - a "Hit" being defined as a bureaucratic action that kills the practice. Lest we forget, we must remind ourselves that this is the United States of America, not Communist China. Yet we are also aware of armed government raids conducted in hospitals and private physician offices for the purpose of conducting "Medicare audits." In February of last year, 37 armed flak-jacketed agents carried out a Medicare raid in a 72-bed hospital in Eastern Tennessee. Can you imagine being a patient in that little hospital and seeing this invading army stomping into the hospital, trampling through sterile areas, forcing employees into a small room and holding them hostage? Or how about the doctor's office in West Virginia where three armed federal agents invaded and held everyone at gunpoint, including the physician, his wife, patients, and children? Most people have no idea that this is the way that the government is treating physicians today in this country. The practice of medicine has been criminalized by our own government. Moreover, if you are a physician, you can count on the HCFA/Medicare bureaucracy treating you as guilty until proven innocent. What a totally unAmerican concept of justice! I submit to you that even accused murderers and rapists are treated better than physicians in that at least if you are accused of murder or rape, you are entitled to the presumption of innocence until proven guilty. But HCFA goes even farther into the realm of pure abuse and uses this guilty-until-proven-innocent mode of operation to extract money from physicians, hospitals and medical schools. Because of the presumption of guilt and the six-figure cost of defending oneself from charges of healthcare fraud, HCFA frequently offers to settle for double damages in return for not pursuing treble damages and prison time for the physician. What a deal! When the mob does this, it's called extortion or protection money. When HCFA does it, it's called Operation Restore Trust or some other similar euphemistic name. ... Pamphlet No. 1073, May, 2000. See full article at AAPSonline.org.