patrick.net

curious2 says

Laughing in greed, with blood dripping from their teeth and sinews and umbilical cords hanging from their mouths, they snarl their appreciation for the mandatory insurance that enables them to disguise the hideous cost as a "benefit."

Raw afterbirth is supposed to be good eatin'. Maybe they should start stocking the surgical suites with fromage and wine, as long as the docs don't eat the babies and charge for that, too.

"Plano’s Baylor hospital faces hard questions after claims against former neurosurgeon"

It will be interesting to see how this story plays in Texas, where Karl Rove and GW Bush surfed to power on "tort reform." California has it too. It certainly has not reduced costs; to the contrary, the effect is to align the financial incentives all one way: do more billable procedures, without regard to risks. Thanks to malpractice insurance with community rating, the most unscrupulous operators offload their costs onto more careful practitioners, who cannot compete and are driven out of business.

Yeah, don't even get started on dental chains whose business model is to hire indebted recent graduates and push unneeded procedures.

Procedures like filing down a 15yo girl's healthy natural teeth and installing crowns.

"Yes, you do need braces"

I awoke early this morning, to michelle obama scaling the side of our house with a pitchfork.

elliemae says

Unnecessary equipment ordered for patients.

Obligatory:

Automan Empire says

Yeah, don't even get started on dental chains whose business model is to hire indebted recent graduates and push unneeded procedures.

Procedures like filing down a 15yo girl's healthy natural teeth and installing crowns.

In the heyday of Medi-Cal dentistry, the clinics in L.A. would send buses to the ghetto and engage in "capping" i.e. they would pay cash to the "patients" to drive them to the clinics for dental procedures to be billed to the state. It was eventually outlawed, but still, the patients were used as identity shills for billing purposes to tap the state funding. A few graduates became rapid millionaires by engaging their families in their practices with Medi-Cal fraud. Some were caught, others not. Like it or not, foreign graduates primed to exploit the idiot American welfare system were frequent offenders.

If you create a money spigot, there is always a genius who finds the most direct route to tap it come hell or high water, ethics or patient care out the window, it is why our insurance system and medical billing are crippled.

errc says

I awoke early this morning, to michelle obama scaling the side of our house with a pitchfork.

Michelle's fondest ambition is to scale Everest without oxygen and only a pitchfork. She will twerk decapitate her Sherpa on the summit.

I spent all morning stringing slab bacon from the gutters like christmas lights to keep that deviant muslin witch from making her way atop the roof.

sbh says

Automan Empire says

Yeah, don't even get started on dental chains whose business model is to hire indebted recent graduates and push unneeded procedures.

Root planing is one such, and some hygienists are super pushy. The industry standard schedule for dental care they want to impose is akin to changing your engine oil every month. And even the receptionists feign insult when they aren't allowed to force appointments upon you. Going on an "as needed" basis is as frowned upon as fully paying off credit card balances each month. We aren't supposed to think for ourselves.

This is true, but one of the reasons is also that compensations for routine preventative care are negligible, don't cover office overhead and are bankruptcy bait, so the incentive is the "bill up" for survival if nothing else.

But again, that is part of the "broken" system where incentives and practices are awry.

"Consumer group urges hospitals to stop 'unethical' health screenings... "It is exploitative to promote and provide medically non-beneficial testing through the use of misleading and fear-mongering advertisements in order to generate medically unnecessary but profitable referrals to the institutions partnered with HealthFair," said Dr. Michael Carome, director of Public Citizen’s Health Research Group." Public Citizen highlighted HealthFair’s cardiovascular screening package, which includes taking pictures of the heart, measuring electrical activity and looking for blockages in arteries, among other tests."

"The healthcare industry has frequently been criticized for poor security practices in recent months. In April, the FBI issued a warning to healthcare providers regarding potential security weaknesses, and several security reports have highlighted the same threats.

According to a recent report from BitSight Technologies, healthcare and pharmaceutical companies have the lowest security performances when compared to the finance, utility and retail sectors.
***
The [latest reported] breach, which is believed to have originated from a Chinese hacker ring, resulted in stolen personal data from nearly 4.5 million patients who were treated within [a] hospital chain over the last five years."

If you've got insurance you can get treatment you don't need. But even if you have cash, you can't get much desperately needed treatment without insurance.

I know I'm missing something, we just had healthcare reform for Christ sakes!

Then there's ABIM and mandatory continuing medical "education":

"Videos and study sessions sold to help doctors prepare for re-certification exams often featured instructors saying physicians would never see a particular condition or use a certain diagnostic technique, but they needed to review it because it would be on the test. “Exam questions often are not relevant to physicians’ practice,” Teirstein says. “The questions are often out-dated. Most of the studying is done to learn the best answer for the test, which is very often not the current best practice.”
***
In January 2014, when the ABIM issued a series of new requirements for maintaining certification—that would have generated all new fees—Teirstein and his colleagues declared “enough.” They recently formed a new recertification organization called the “National Board of Physicians and Surgeons.”
***
The group’s fees are much, much lower than those charged by the ABIM. And its board and management—all top names in medicine—work for free."

In other words, the financial tsunami of Obamneycare has unleashed predictable waves of venality, but also a backlash (which the article calls a "civil war") in both the profession and the public at large. Instead of reforming health care, the legislation mandated its worst and most wasteful attributes, so now the last best hope of reform falls to unpaid volunteers.

Ceffer says

paper mill

I call it insurance mill but paper mill is probably appropriate also

I wonder what/if insurance companies are allowed to own labs and testing facilities.

Insurance Companies own the labs, they jack up your labs' rates, then use the new higher rates to justify raising premiums on the insurance side.

thunderlips11 says

Insurance Companies own the labs, they jack up your labs' rates, then use the new higher rates to justify raising premiums on the insurance side.

Yes, I got Disliked for pointing that out, but it's very common and it goes beyond labs. Insurance corporations and hospital corporations are merging, in order to shift revenue from one pocket to the other. The parent corporation raises fees at the hospital subsidiary in order to shift profits to the (unregulated) hospital side and away from the (slightly regulated) insurance side; as an added bonus, they can overcharge "out of network" and uninsured patients more than ever. Also, even "non-profit" hospitals that pay no tax may house for profit labs, with myriad opportunities for stock, options, and other revenue sharing incentives. This is a major factor driving unnecessary and injurious tests, including radiation that has nearly zero actual cost but can be billed for hundreds or even thousands of dollars. The typical Obamneycare enthusiast would rather roll his eyes than open them, so he sees either nothing or a dizzyingly skewed worldview.

No need to worry anymore. The IRS just decided to start auditing government spending and use the waste collected to pay off the national debt!

MMR says

Prime Healthcare Associates

Looks like the DCHS Prime sale fell through....It's pretty much a done deal that those hospitals will have to declare bankruptcy.

http://www.healthcarefinancenews.com/news/report-prime-backing-out-daughters-charity-deal

While I don't like to call a billionaire a victim, especially one who has a spotty track record, Prime was the best candidate to keep the hospital open and honor the pension agreements of the SEIU workers. Instead of agreeing to 5-7 years running the hospital the way it was running (hemorrhaging money) she asked them to do that for 10 years. Prime Healthcare would be required to operate the hospitals as they are now, despite the fact that they are losing more than $10 million a month. "[The Daughters chain] would lose nearly $3 billion over the 10 years the conditions are in effect. Conditions dictate operations far beyond the scope of what is typical, including service offerings, financial reporting, governance, staffing levels, on-call coverage, seismic compliance and insurance contracts."

......One thing that isn't going to happen, Collis said, is Harris applying less stringent terms to any other buyer of the Daughters' chain. The best a buyer could hope for, he said, is that the attorney general might provide some relief down the road.

Translation: Prime was the best offer available, even if they would have cut some of the safety net operations of the hospital to stay afloat.....now the hospital will crash and burn and it will be interesting to see what effect that will have on the pensions of the SEIU rank-and-file.

http://www.latimes.com/opinion/opinion-la/la-ol-prime-daughters-of-charity-kamala-harris-20150310-story.html#page=1

This article represents essentially the first time Prem Reddy was ever spoken about in a positive light in the LA Times.

Update: Even before they start in on fraudulent admissions, "Hospitals grab at least $1 billion in extra fees for emergency room visits"

"The former chief financial officer of a California hospital and four other people have been charged in a series of health care kickback schemes that generated nearly $600 million in fraudulent billings for spinal surgeries, prosecutors said on Tuesday.
***
The hospital's former owner, Michael Drobot, pleaded guilty last year to taking part in the scheme and is cooperating in the investigation....

Former California state Senator Ron Calderon was indicted last year on charges that he accepted $100,000 in bribes from Drobot to preserve a loophole in the law that allowed companies he controlled to charge more for hardware used in spinal surgeries."