Ozark
member
Reged: 12/14/05
Posts: 4012
Loc: out in the woods
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We've talked about the state of American medicine before, and I don't pretend to be an expert. I just want to put a little more personal experience here and see what you all think.
I mentioned before that my mom passed away in a nursing home here on Aug. 13. She was 93 and had developed senile dementia.
She was hospitalized for a few days in June with pneumonia, which they were able to clear up. I talked before about the outrageous charges that were made to Medicare and her insurance on that deal - including the ambulance company that doubled its' bill after they found out she had health insurance.
For these 2 1/2 months since she's been gone, I've been getting more copies of medical bills every day - they're all piling on now that she's dead, and most all of it is fraudulent. This stuff is still coming.
I visited mom every other day and talked with her nurses and doctor frequently. I know what care she was getting.
The nursing home doctor is an osteopath - he's about as much of a doctor as I am, in my opinion. After mom got back from the hospital in June he was visiting her once a week in the nursing home. In July he took a blood test and sent it off to verify that she still had low blood potassium (pernicious anemia). She did, and he continued her once-a-month vitamin B-12 injection.
Other than that, mom was taking a generic blood pressure pill that she'd been taking for 40 years. She wasn't getting any other medication or medical care.
I've got copies of bills now for FORTY-SIX lab tests that have been billed and paid for by her insurance company - performed on different dates from June and up to and including the day she died at 6 a.m. The "referring physician" is the house osteopath - the guy doing the billing is a pathologist I've never heard of.
All the lab charges are under $25 each, so I'd guess those low amounts fly under some oversight radar. But there are FORTY-FIVE of them that never happened! I'd guess the osteopath and the pathologist are in cahoots, and when someone at the home dies, well, this is what they do and the osteopath gets a kickback.
In June, the nursing home suggested that Hospice start visiting mom, and I was glad they did. The Hospice nurse visits that nursing home every Tuesday and she had several other patients to see there. She was very nice to mom, talked to her for a few minutes and made sure she was comfortable, and called me with a report every couple of weeks. That IS a nice service, and I'm sure not complaining about that.
But today I got a copy of how much Hospice billed Medicare "A" for about 6 brief nursing visits, and maybe 3 phone calls to me. MEDICARE PAID $5235.45 FOR THAT!
No, I'm not gonna blow the whistle on anybody. It wouldn't do any good, and it would make me enemies here in town. But - THIS STUFF IS GOING ON ALL OVER THE COUNTRY, multiplied by many thousands of times. Dang it, this is why medical costs and insurance are so high and Medicare is in trouble.
The whole health-care system is so fraud-ridden and full of overcharges, there's just no fixing it.
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Liberty
member
Reged: 12/14/05
Posts: 5796
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let me add to that, only in the field of medicine do we see technological advances leading to higher prices, and the answer is simple, deep pockets, deep government pockets and government regulation that is so protective promising treatments die on the regulatory vine.
Helliberal wants Medicare for all, imagine the consequences of that
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Hellbender
member
Reged: 12/14/05
Posts: 3416
Loc: Taney County
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And as long as you tell us nothing is accomplished, except to get some irrelevant reply from Rosie.
I would at least take it too Blunt.
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A government survey has shown that 91% of illegal immigrants come to this country so that they can see their own doctor.
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Whackattack
member
Reged: 12/14/05
Posts: 2554
Loc: Farmington, Mo
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Give me names, I'll drop the dime.
You can sit around and biatch about it, but if you are unwilling to rat out the guilty Sonsabitches taking everyone else to the cleaners, then you may as well see if they will give you a cut.
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Liberty
member
Reged: 12/14/05
Posts: 5796
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"irrelevant reply from Rosie"--Helliberal
I know it bugs you, as it does all liberals, to be reminded of their own words that signify their own stupidity
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Hellbender
member
Reged: 12/14/05
Posts: 3416
Loc: Taney County
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Quote:
Liberty said:
let me add to that, only in the field of medicine do we see technological advances leading to higher prices, and the answer is simple, deep pockets, deep government pockets and government regulation that is so protective promising treatments die on the regulatory vine.
Helliberal wants Medicare for all, imagine the consequences of that
This is irrelavent to Ozarks post concerning fraud, focus Rosie, focus.
No Hellbender doesn't want everyone under Medicare, but I know if I explained again, my position today, under todays climate, you still wouldn't get it.
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A government survey has shown that 91% of illegal immigrants come to this country so that they can see their own doctor.
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Liberty
member
Reged: 12/14/05
Posts: 5796
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carving out yet another position until you find one I won't knock yer ass to the dirt from
such a damn typical liberal retreat
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Ozark
member
Reged: 12/14/05
Posts: 4012
Loc: out in the woods
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Quote:
Whackattack said:
You can sit around and biatch about it, but if you are unwilling to rat out the guilty Sonsabitches taking everyone else to the cleaners, then you may as well see if they will give you a cut.
Yep, you're right. Ratting them out would be the right thing to do.
I've been fighting uphill battles for the "right thing" all my life. I've always, always, been the nail that sticks up highest and gets pounded down.
This nursing home is the best one around here, they do a lot of good for a lot of people. It's a family operation - the nursing home director's wife is the head nurse there, and his brother is the home's doctor.
Those people are also the big frogs in the puddle of a 2000-member Baptist church here in town. They practically run the place, and they're very well liked. They're good people in that way - but I learned a long time ago to keep my billfold pocket buttoned when I'm around "church people".
Now, I could blow the whistle and get an investigation started. That would be in the news, and probably even on the TV news - and I doubt much would come of it. There'd be a fuss about it for a while, and they'd get a fine - maybe.
But a lot of the businesses and people I deal with around here would decide I'm an absolute a-hole. That church would be having prayer meetings, trying to get me damned right away.
Bottom line is, this kind of fraud didn't cost me anything directly. It costs us all, indirectly - because it rips off Medicare and makes health insurance premiums higher.
If an "excellent" nursing home like this one is pulling this chit, I think it's going on all over the country. Thousands and thousands of health providers are doing the same thing, or worse, and it needs to be fixed on a national scale or not at all.
The rules need to be changed so this can't be done, because people, generally, aren't going to complain when it's the government and insurance companies getting ripped off.
And I'm not either.
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Hellbender
member
Reged: 12/14/05
Posts: 3416
Loc: Taney County
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Quote:
The rules need to be changed so this can't be done, because people, generally, aren't going to complain when it's the government and insurance companies getting ripped off.
Isn't it rules and laws that are being broken, what good would more do if everyone just sits back?
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A government survey has shown that 91% of illegal immigrants come to this country so that they can see their own doctor.
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Ozark
member
Reged: 12/14/05
Posts: 4012
Loc: out in the woods
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Quote:
Hellbender said:
what good would more do if everyone just sits back?
Dead people have done a lot of voting in this country. Apparently, they run up a lot of medical bills too.
The system relies on the honesty (ha!) of health care providers. They bill insurance companies and Medicare, and the bills get paid out of those bottomless pockets.
Most LIVE patients aren't in a position to know what medical services they've actually received, and DEAD patients sure aren't going to know. It's a situation just made for fraud, and I'm sure it's going on everywhere.
Letting health care providers bill Medicare for whatever "procedures" they claim to have done is like putting a drug addict in charge of a pharmacy.
Most people wouldn't care enough about Medicare and insurance companies being ripped off to even talk about it like we are here. There's NO incentive for me to cause a big stink by saying my mom didn't receive services, when two doctors and a nursing home are prepared to swear she did receive them.
This kind of fraud became inevitable when government and insurance companies got involved in medicine years ago. If it wasn't for that, medical charges would be a small fraction of what they are now - and people like me wouldn't stand for fraud and overcharges if we had to pay out-of-pocket.
Because of government interference, the health care system is broken - and it's going to get a lot worse if government takes it all over.
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Hellbender
member
Reged: 12/14/05
Posts: 3416
Loc: Taney County
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Quote:
Most LIVE patients aren't in a position to know what medical procedures they've actually received, and DEAD patients sure aren't going to know. It's a situation just made for fraud, and I'm sure it's going on everywhere.
And apparently its well protected by silence.
Sorry but while I understand the undertones that can occur, I've lived most of my life in towns a lot smaller than the one I think you're referring to and I can't buy the reasoning behind your silence. 
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A government survey has shown that 91% of illegal immigrants come to this country so that they can see their own doctor.
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