patrick.net

Ironman's "logic."

We shouldn't have schools, becasue students sometimes cheat.

We shouldn't have capitalism becasue corruption happens under a capitalist system.

We shouldn't have weapons, becasue weapons are only used to kill.

We shouldn't have countries, becasue wars are usually started by countries, unless it's a civil war, and even then often.

I guess you get where I'm going with this.

The truth is fraud can be watched. Especially as systems of payment are standardized with appropriate precautions taken. Put some engineers and "AI" on the problem and it can be lowered down to a very low level. Probably by having patients fill out some online form describing what they are having done and why. Seems like an easy problem to solve in the digital age. Various red flags can be used to identify doctors that need to be watched more closely, and even that can be done by computers, contacting patients asking them to go online and fill something out, and so on.

Considering the state of the VA, do we really need single payer. Exclude the illegals at least.

Ironman says

U.S. jury on Friday found a Florida eye doctor guilty of defrauding Medicare by as much as $105 million by using false claims, including charging for eye tests of blind patients, according to a federal court document.

Florida ground zero for Medicare and Medicaid fraud

marcus says

Seems like an easy problem to solve in the digital age.

Just like it should be easy to get rid of uunderperforming teachers. Yet it is not

People benefit from status quo and once entrenched is difficult to reform

MMR says

Florida ground zero for Medicare and Medicaid fraud

This has been widely reported for years: "Medicare fraud - estimated now to total about $60 billion a year - has become one of, if not the most profitable, crimes in America." The combination of the fee-for-service model and infinite subsidies has produced huge amounts of waste, fraud, and abuse, and lethal consequences.

Imagine if schoolteachers had to incur close to $1 million in startup costs, plus overhead of $100k/year, but they could make it all back and more by assigning more kids to detention and referring them for ADHD drugs on a fee for service basis. Almost inevitably, you'd see some entrepreneurial teachers putting as many kids as possible in detention and on drugs, while idealistic teachers who try to do right would struggle to make ends meet, might even be driven out of the high cost areas. Similar events have actually happened involving judges in Pennsylvania sentencing kids to juvenile detention in exchange for kickbacks, and Florida is notorious for drugging kids in juvenile detention. In SF and other high cost areas, we see honest doctors driven out, while entrepreneurial doctors cash in.

This.

PeopleUnited says

It isn't that he underestimated his own popularity, it is that he underestimated the UNPOPULARITY of the rest of the field. Even Obama underestimated the unpopularity of Clinton and essentially handed the election to Trump by endorsing her.

How so, MrMrs Junior?
joeyjojojunior says

Except that he is enriching himself more directly through the Presidency than any other politician in history. He's not even hiding it

joeyjojojunior says

PeopleUnited says

But it does mean that his motives are likely more towards the sacrificial side of the spectrum than personal gain. The fact that he doesn't resign and go back to his own private jet and private life is evidence that he cares more about doing what is right than he cares about leading a cushy life.

Except that he is enriching himself more directly through the Presidency than any other politician in history. He's not even hiding it.

I don't think Trump needs any more money, but if you are to indict him, where is the evidence?

BlueSardine says

This.

PeopleUnited says

It isn't that he underestimated his own popularity, it is that he underestimated the UNPOPULARITY of the rest of the field. Even Obama underestimated the unpopularity of Clinton and essentially handed the election to Trump by endorsing her.

So you agree that had Obama endorsed Bernie we would now have just finished the first 100 days of the Sanders administration.

I actually think single payer is a great idea. Bernie Sanders should sponsor everyone's medical care. He has the magic socialist pixie dust to sprinkle over everything to make it free.

Alternatively we could just bring all our troops home, close all our foreign military bases and use the savings to pay for free VA based health care to all Americans.

curious2 says

he combination of the fee-for-service model and infinite subsidies has produced huge amounts of waste, fraud, and abuse, and lethal consequences.

That was the other point: seems like a fee for service problem as much as an inability to quickly root out fraud.

curious2 says

. In SF and other high cost areas, we see honest doctors driven out, while entrepreneurial doctors cash in.

SF quite pricy but I do think a slightly more entrepreneurial approach is good for primary care. Think that current system of waiting 6 wks for appointments and having to take half day off for primary care appointment is an abomination.

Ironman says

A U.S. jury on Friday found a Florida eye doctor guilty of defrauding Medicare by as much as $105 million by using false claims, including charging for eye tests of blind patients, according to a federal court document.

The ophthalmologist, Salomon Melgen, is also part of a separate corruption case in which prosecutors say he bribed U.S. Senator Bob Menendez, a Democrat from New Jersey. (It pays to have friends in high places)

Federal prosecutors in that case say Melgen contributed $700,000 to political committees that helped the senator win re-election in 2012.

The eye doctor was found guilty on 67 counts of federal health care fraud against him, according a verdict sheet filed in U.S. District Court. The Palm Beach Post newspaper reported that Melgen was originally charged with 77 counts, but not all made it to the 12-member jury.

Melgen, 62, was accused of fraudulently taking as much as $105 million from Medicare. Prosecutors say he gave patient...

FOR THE RECORD @Ironman

This incident is an indictment of the current system of government subsidization of people who use private health care organizations for their care. The current system favors large organizations and crooked individuals and limits competition in the healthcare marketplace by putting onerous rules on any doctor or facility that wants to get access to patients on medicare and medicaid. I think if every medicare and medicaid patient instead was enrolled/subsidized to use the VA for health care the fraud waste and abuse would be eliminated all together for people in those programs. The problem with the current system is that a for profit Healthcare industrial complex is sucking at the teat of big governments just like the Military Indrustrial Complex.

iPig says

Nope, I'm not going to address a wall of text. Every single one of your points is invalid.

CBOEtrader says

Its clear you don't want to have an intellectually honest conversation. You willfully misinterpret, then change the topic to semantics based on your misinterpretations. This is called trolling. No one does this to you.

You are indeed a lost soul.

@CBOEtrader you are correct sir. iPig is the biggest troll on this site. Just look at his number of posts, and consider that most of them are exactly what you describe above.

iPig is nominated king of the trolls. All hail the pig.

Ironman says

Ironman says

Prosecutors say he gave patients unneeded tests and treatments from 2008 to 2013

Oops.... so @Marcus, why do you think this scam went on for 5 YEARS before it was caught, since EVERYTHING is computerized??

I don't believe that things are nearly as "computerized" as you may think. IT's fairly early in the evolution of this.

https://en.wikipedia.org/wiki/Electronic_health_record

And whether medicare gets expanded or not, I believe they will find solutions to monitoring and catching fraud. The biggest problem would probably be tests that don't really need to be done. For this they can come up with protocols, as I'm sure some countries already have. OR simply lower the profitability of a lot of the tests, down to where they are done for their utility, not for the profit they bring.

Our entire system has far too much profit incentive built in to it. With only one major payer for health services, policies can be implemented to correct this.

MMR says

marcus says

Seems like an easy problem to solve in the digital age.

Just like it should be easy to get rid of uunderperforming teachers. Yet it is not

You're beyond clueless on this subject.

But I get that your intention is to troll, not to show off your ignorance.

MMR says

entrepreneurial [vs] current system of waiting 6 wks for appointments and having to take half day off for primary care appointment

I agree if by "entrepreneurial" you mean evening and weekend appointments and housecalls, but in practice we see more unnecssary and injurious tests including diagnostic radiation with no benefit. Patients brag about having the "best" insurance (meaning it covers the most things) and the "best" doctors (meaning they drive the fanciest cars) and feel valued, but they receive "no proven benefits" and are probably worse off. Some doctors get illegal kickbacks in exchange for ordering unnecessary tests, while others own (legally) shares in the testing labs. The Kaisers' empire combines ostensibly "non-profit" hospitals (so they pay no tax) with expressly for-profit labs located inside the hospitals.

I miss Turtledove, who commented in detail about the methods hospital corporations use to stifle genuinely entrepreneurial competition. SF has the most restrictive zoning I've seen anywhere, there's basically nothing medical on a weekend evening except the hospital emergency rooms, which are (by their own account) the most expensive places in town. If doctors are required to maintain hospital admitting privileges, for example, the hospital can make an offer they can't refuse: either sell the practice to the hospital corporation, or face trumped up allegations to lose the necessary admitting privileges.

PeopleUnited says

Alternatively we could just bring all our troops home, close all our foreign military bases and use the savings to pay for free VA based health care to all Americans.

We wouldn't even need to close the bases: we could simply quit starting unnecessary and undeclared wars, e.g. Iraq, Libya, and Syria, and southeast Asia. We could have provided universal VA care for everyone at a lower cost than what we've spent there. In fact, if the Iraq war had been managed competently, we could have done both. Instead, we pursued an Orwellian strategy to maintain scarcity and internal power differentials by destroying surplus production in a way that most of the population found psychologically acceptable. It's both sad and amazing to see what people accept when hypnotized by NATO MSM.

curious2 says

PeopleUnited says

Alternatively we could just bring all our troops home, close all our foreign military bases and use the savings to pay for free VA based health care to all Americans.

We wouldn't even need to close the bases: we could simply quit starting unnecessary and undeclared wars, e.g. Iraq, Libya, and Syria, and southeast Asia. We could have provided universal VA care for everyone at a lower cost than what we've spent there. In fact, if the Iraq war had been managed competently, we could have done both. Instead, we pursued an Orwellian strategy to maintain scarcity and internal power differentials by destroying surplus production in a way that most of the population found psychologically acceptable. It's sad and amazing to see what people accept when hypnotized by NATO MSM.

Sounds like a good start to me. Why do we let them get away with it (policies of endless war)?

jazz music says

Blurtman says

It's all shit.

You should have seen the higher positioned songs, most of them are rap, with that gratuitous ebonics and use of nigga to signal cult belonging. Do you realize that people are buying these songs and that's what makes them high on the list?

What were the parents of the early 60s saying when Elvis was gyrating his hips?

PeopleUnited says

Why do we let them get away with it (policies of endless war)?

Manufacturing Consent.

BlueSardine says

How so, MrMrs Junior?

joeyjojojunior says

Except that he is enriching himself more directly through the Presidency than any other politician in history. He's not even hiding it

PeopleUnited says

I don't think Trump needs any more money, but if you are to indict him, where is the evidence?

http://www.nbcnews.com/politics/white-house/trump-s-mar-lago-travel-triggers-cost-ethics-concerns-n743541

And then there's the "coincidence" that Ivanka gets 3 lucrative trademarks in China on the day that Daddy met with the Chinese.

http://www.latimes.com/business/la-fi-ivanka-trump-brand-20170418-story.html

Do I need to continue? That's in the first 100 days.

They are funds well spent to have a happy healthy president.
You want trump making bad decisions while in a bad white house mood? Remember the white house is a step down in quality living for him.

Ironman says

joeyjojojunior says

http://www.nbcnews.com/politics/white-house/trump-s-mar-lago-travel-triggers-cost-ethics-concerns-n743541

Ahhh, the opinion of ONE guy... that's it... Case settled..

joeyjojojunior says

Do I need to continue?

Please do, I'll get some more popcorn.

He's supposedly going to mar a lago every weekend for privacy of conversations. The price absolutely seems wasteful as fuck. Is suggest leaving the entourage in DC. If trump wants to jet off to FL, let him foot his own bill.

MMR says

What were the parents of the early 60s saying when Elvis was gyrating his hips?

I understand that POV, but there are seemingly quite a few young people who long for better music, if you read Youtube comments. I have a few millennial friends who long for the music of the 60's and 70's.

Reagan killed the middle class, exploded the deficit, and sold out America. We'd all be twice as rich if Reagan were never president. The facts are indisputable.

www.youtube.com/embed/z5CCRI1vdwE

www.youtube.com/embed/CTa8H6vAMyQ

www.youtube.com/embed/534YLXIKT1E

Reagan was a lying sack of shit who created all the economic problems that we still face today. Anyone who worships Reagan is morally bankrupt.

Ironman says

So, @Marcus, you think computerized Medicare billing records are the SAME as electronic health records??

REALLY??

Folks, you can't make this shit up...

The only thing that qualifies for the "you can't make this shit up" here is that I'm willing to argue with you.

I'm not an expert on the subject at all, but common sense would suggest that the networks, systems, EHRs, and databases that are out there in health care are extremely immature compared to what they will be even a decade from now. This is partly based on what I've heard from people in the industry.

And yes, cross referencing health records against billing would be only one off the top of my head way that monitoring medicare fraud by taking advantage of continued digitization of everything in health care. The amount of money that can be made (and will be made) by IT people helping the government get medicare fraud under control boggles the mind.

You haven't made a single argument as to why medicare can not or will not put downward pressure on health care costs in the future. In fact, the demographics of the baby boom guarantee it will happen for reasons that even you should be capable of understanding.

http://observer.com/2016/05/what-digital-innovation-in-healthcare-will-look-like/

https://hbr.org/2016/02/speeding-up-the-digitization-of-american-health-care

http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/healthcares-digital-future

The proportion of American hospitals with an electronic health record has grown eight-fold in recent years, from 9% in 2008 to 76% in 2014. For physicians, the comparable increase has been from 17% to 51%.

Stop with the Technophilia. This has little to do with carbon copy vs. electronic.

If Congress actually began policing medicare fraud, private hospitals would have big league problems paying big dividends to investors and million dollar salaries to management.

The C-Diff to Private Hospital to Private Nursing Home to Private Hospital again is a cash machine roller coaster.

Lashkar_i_Trumpi says

This has little to do with carbon copy vs. electronic.

Yes of course, I can totally imagine AI or at least "smart" automated systems reading a bunch of carbon copies looking for billing that's not justified.

joeyjojojunior says

BlueSardine says

How so, MrMrs Junior?


joeyjojojunior says

Except that he is enriching himself more directly through the Presidency than any other politician in history. He's not even hiding it

PeopleUnited says

I don't think Trump needs any more money, but if you are to indict him, where is the evidence?

http://www.nbcnews.com/politics/white-house/trump-s-mar-lago-travel-triggers-cost-ethics-concerns-n743541

And then there's the "coincidenc...

So your evidence that Trump and his family continue to run successful businesses while simultaneously serving in the White House means what exactly? What would make you happy? Would you rather he sold his company (for a profit no doubt) to the highest bidder? I don't think even that would satisfy you.

Dan8267 says

Reagan...created all the economic problems that we still face today.

I agree with you. Reagan was the start down our current neo-con path that every president since him has followed, including Clinton and Obama. This is why Trump won, and why Bernie would have won. The people are pissed at neo-cons.

iPig says

Obama switched from a policy of bringing back body bags to a policy of targeted strikes of high profile terrorist leaders. Although there are still innocent casualties, they are lower by an entire order of magnitude or more. Furthermore American servicemen are also safer by far more than an entire order of magnitude. Obama was far superior, incomprehensibly superior to Bush.

Props to you iPig. You paint a rosy picture of Obama on defense. However, the devil is in the details.

iPig says

the rise of the Al Qaeda and ISIS resistance in Iraq,

Even if you want to blame Bush/American involvement in Iraq for the rise of Al Qaeda and ISIS in Iraq, it became Obama's responsibility when he took over. He called ISIS the JV team and let them become an international terrorist threat. He failed to recognize the problem of ISIS/Islam and consequently failed to act decisively to prevent the ISIS movement from becoming a regional and global force.

PeopleUnited says

So your evidence that Trump and his family continue to run successful businesses while simultaneously serving in the White House means what exactly? What would make you happy? Would you rather he sold his company (for a profit no doubt) to the highest bidder? I don't think even that would satisfy you.

No, my evidence is that Trump is purposely forcing the US Government to spend hundreds of millions of dollars on businesses owned by Trump. That is the definition of using the Presidency to enrich himself. No other President in US history has done anything resembling this level of behavior.

And we haven't even started on the quid pro quo with China to enrich Ivanka. Basing US foreign policy to funnel $$ to his family.

It is truly unprecedented. Or unpresidented, as Trump would write.

joeyjojojunior says

PeopleUnited says

So your evidence that Trump and his family continue to run successful businesses while simultaneously serving in the White House means what exactly? What would make you happy? Would you rather he sold his company (for a profit no doubt) to the highest bidder? I don't think even that would satisfy you.

No, my evidence is that Trump is purposely forcing the US Government to spend hundreds of millions of dollars on businesses owned by Trump. That is the definition of using the Presidency to enrich himself. No other President in US history has done anything resembling this level of behavior.

And we haven't even started on the quid pro quo with China to enrich Ivanka. Basing US foreign policy to funnel $$ to his family.

It is truly unprecedented. Or unpresidented, as Trump would write.

So lets examine the situation with a parallel. I work for Acme company. They pay for me to eat lunch. I chose to eat lunch at my favorite restaurant (I happen to own it). Am I therefore guilty of forcing my employer to support my business? I guess so. Big deal. Trump is just choosing to patronize his favorite businesses. The fact that they happen to be owned by him might be unprecedented but it certainly isn't unethical. He has the prerogative to do so, and America has the prerogative to judge him for it. I simply don't think it fair to judge a man for doing exactly what he did before he was president, patronizing his own businesses.

PeopleUnited says

So lets examine the situation with a parallel. I work for Acme company. They pay for me to eat lunch. I chose to eat lunch at my favorite restaurant (I happen to own it). Am I therefore guilty of forcing my employer to support my business? I guess so. Big deal. Trump is just choosing to patronize his favorite businesses. The fact that they happen to be owned by him might be unprecedented but it certainly isn't unethical. He has the prerogative to do so, and America has the prerogative to judge him for it. I simply don't think it fair to judge a man for doing exactly what he did before he was president, patronizing his own businesses.

What company pays you to eat lunch?? And yes, most companies have strict conflicts of interest policies to avoid this type of situation. Very few large companies would allow a purchasing manager to hire a company owned by an employee to do contracting work.

It IS a big deal. We elected a huge snake oil salesman and he is using his position to take money from you and me and put it into his pockets. Obviously it doesn't bother you because you are part of the Trump cult. But that doesn't make it any less of a big deal.

Meh, nothing by Taylor Swift.

tr6 says

Obamacare is a "heritage foundation" disaster passed by Obama.

The only reason why Republican can't repeal it because it's pretty much what they would have passed in the first place.

CBOEtrader says

Go look at wealth disparity, workforce participation %, number of people on food stamps, % of population in poverty, and real wages... then compare that to the price of a home or food or gas or HEALTHCARE OR COLLEGE. The net result of Obama's policies hurt the poor and helped the rich.

More accurate to say that Obama was not single handedly able to reverse these strong trends which continued during his Presidency. These trends can all be placed at the foot of both parties, especially the republicans.

But you're completely right, Obama wasn't able to do much to prevent it from getting worse. I wonder why ?

Dan8267 says

Reagan killed the middle class, exploded the deficit, and sold out America. We'd all be twice as rich if Reagan were never president. The facts are indisputable.

Reagan took economy out of recession, won the cold war, turned everything around. But you liberal pinheads will never give him credit, and he's dead so he doesn't care what you think of him. He was one of the greatest presidents this country had.

Honey, the videos I posted show actual evidence. Your baseless rewriting of history carries no weight. Reagan was a loser who betrayed the American people, and they are still suffering from his inept policies.