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.
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.