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Nothing sets the blood to boil like
the notion that doctors, hospitals and HMOs are taking
everyone's insurance premiums and illegally lining their pockets
with them. (Everyone knows that pockets are being lined, but
one hopes that at least most of it is legal.)
Indeed, it is extremely attractive
to suppose that there's so much health care fraud in the land, that
all we have to do is root it out, and our health care crisis will be
solved. And this is the notion that has been advanced by federal
regulators over the past several years.
While there is indeed too much
health care fraud, and while vigorous efforts are indicated to put a
stop to it, there are two major problems with the anti-fraud efforts the
government has now launched. First, the idea that there's enough
fraud out there to make their anti-fraud efforts a primary means of solving
the health care crisis is patently absurd. Second, federal
anti-fraud efforts threaten to become a particularly heavy-handed
weapon for controlling physicians' behavior, and preventing them
from doing what's really best for their patients - in other words,
for covertly rationing health care.
As part of our mission to help you
understand and survive the American health care system, YourDoctorintheFamily.com
examines
the anti-fraud efforts of
the federal government. We show you why your doctor (if he's
smart) is looking over his shoulder before making even the simplest
of medical decisions, and if there's any question of a conflict with the
feds, is giving the feds' needs at least as much priority as
yours.
We describe
the Regulatory Speed Trap,
a time-tested means for regulators to change federal policy (and
thus to change the behavior of a particular segment of society)
without the fuss and muss of public debate, lobbying, or
legislation. We show the implications of the HIPAA
legislation (Health Insurance Portability and Accountability Act of
1996), and show how it has given the fraud fighters sweeping (and
for doctors, frightening) new powers in rooting out health care
fraud. And we describe the first case study, the PATH
audit (Physicians at Teaching Hospitals), that shows just how
these sweeping new powers will be used.
We show why
doctors (even the innocent ones) are growing deathly afraid of the
feds. And while you may think doctors have it coming (and
maybe they do), perhaps you ought to consider the implications to
yourself when you need that doctor to fight for your rights within
our health care system. Hmmm?
Don't thank us. It's what we do.
We're your
on-line guide to understanding and
surviving the American health care system.
YourDoctorintheFamily.com
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