Lax over­sight

Modern Healthcare - - Opinions Letters -

Re­gard­ing teach­ing med­i­cal stu­dents about Medi­care and Med­i­caid fraud ( Mod­ern Physi­cian, Oct. 25):

I am an ac­tive med­i­cal stu­dent lob­by­ist and this topic has been of con­cern to me for some time. But, more im­por­tant, I am concerned with the lack of over­sight by the govern­ment re­gard­ing how much each per­son en­rolled in Medi­care and Med­i­caid is con­sum­ing. I have seen more than one pa­tient visit two dif­fer­ent hos­pi­tals and get the ex­act same workup. This to me is fraud and this is why the govern­ment is bad at health­care. If we want to con­tinue car­ing for the poor and el­derly, some­one needs to monitor how much peo­ple are con­sum­ing.

One way this could have been ad­dressed is by the govern­ment in­sti­tut­ing their own elec­tronic med­i­cal records for Medi­care and Med­i­caid pa­tients and not just pay­ing doc­tors and hos­pi­tals to adopt their own. The govern­ment could col­lect good qual­ity data on epi­demi­ol­ogy, and we could have some sense of what peo­ple were get­ting sick from and what needs to be ad­dressed for the pop­u­la­tion as a whole.

But of course, they go the con­vo­luted route, try to “re­form” health­care and as a re­sult, end up with more doc­tors re­fus­ing to see pa­tients on Medi­care and Med­i­caid be­cause they sim­ply can­not sus­tain their prac­tice and pay their em­ploy­ees with this kind of sub­par pay­ment sys­tem. So your ar­ti­cle asks if we know about fraud. We do. But I’m con­vinced con­sump­tion with­out over­sight is the real cul­prit and will drown any hopes for a ra­tio­nal health­care sys­tem in the fu­ture.

Molly Maloof Med­i­cal stu­dent Uni­ver­sity of Illi­nois Col­lege of Medicine

Peo­ria

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