Not fraud
The example that I gave may not be fraud, but it certainly can be considered waste and in many cases that hurts the taxpayer more than outright fraud cases at VA and could be considered gross malfeasance . Incompetent and inept oversight and leadership was not even mentioned here. that is an entirely different story.
As a resident, I worked extra shifts covering the VA ER. The whole "service connected" disability thing is a scam. Thirty percent service connected for lack of a uterus is a real thing. The more trips to the ER you have, the sicker you are and the easier it is to get approval for increased percentage of service connection. So, lots of unnecessary drop ins by the frequent flyers with vague neurologic complaints. I caught so many of them in lies using techniques of distraction that I learned from neurology friends. I know a CRNA who is a veteran and he was going to the VA after work for a check up to try and increase his service connection percentage. For the final 30 minutes of work, he wore gloves that had lidocaine cream inside them so that he could claim diabetic peripheral neuropathy and he could effortlessly pass the hand numbness evaluation portion of the physical exam. They could prick his hands with anything sharp and he didn't flinch. I knew a VA anesthesiologist who would work many OR days never changing into scrubs. Literally did nothing all day.
Similar story, I once showed up to a VA only to discover our inpatient chemo unit was unable to give chemo that day because “all the chemo trained nurses scheduled to work today are pregnant.”
I definitely saw surgeons doing that - “supervising” a resident then operating somewhere else at the same time. Another thing I saw was being clocked in at the VA then going a few blocks over to do sketchy workers comp evals in an unrelated private facility. I also had low level admins at the VA direct us to change patient statuses to make it look like they weren’t admitted anymore, in an effort to meet some discharge metrics by playing a shell game.
Just for clarification, you think it is a coincidence that the #1 service connected disability happens to be a condition that is 100% based on patient reported symptoms with zero objective measurement?
This is exactly what will happen if we get nationalized care. All of you that think “medicare for all” is the answer will get this instead.
That's insane, but at the same time I really do understand it. Those who are opposed to capitalism don't understand that is what has made America what it is today. Capitalism provides the incentive for advancement and it provides the incentive for us to work harder and more efficiently.
Modern Healthcare reimbursement is not true capitalism in its current forum.
Correct. I never understood the usap “partnership” model after the buyout. The partners still give up 20% to private equity forever. So the more the partners worked. The more private equity gets a 20% cut of the extra work you do.
No capitalist system would pay me 600k a year to “supervise” experienced CRNAs doing routine surgery. Careful what you wish for.
Maybe. In some sense we live in a revived microcosm of healthcare capitalism with the hospitals giving stipends and supply and demand driving prices (well beyond whatever the arbitrary anti capitalist reimbursement levels are). So in a way the current system really is working on a supply and demand level, especially since the system could select for independent CRNAs.
How much do you think you should be paid for that? Free? 1/2 price? 1/3 price?
Independent crnas want the same money as docs. That’s the goal. It’s no longer how much cheaper crnas are. The aana no longer promotes cost savings
The ultimate goal is to get us all working for the government anyway in the next 15 years or so. How else can you explain the reimbursement rate decrease in the last 20 years. I mean it is horrendous. A friend of mine is a general dentist. She charges 300 for a simple extraction. Medicaid/Medicare reimburses 45 dollars. You cant even get your tire on your car mounted and balanced for 45 dollars. And they wonder why dentists don't accept govt payors.
A more ominous goal is for those in power to get us all working for private equity... with private equity taking all the government money while pretending that they're making things "efficient".
Nah, the powers that be don't care about pvt equity either. They'll throw them a bone to make it look l ike they do but they dont. How else can you explain the death blow they passed when they abolished surprise billing. That was the industry cash cow. They want them gone too.
That just shows the insurance lobby is more powerful than medical private equity robber barons, not that politicians aren’t perfectly happy to sell out to anyone and everyone with money to spread around.
Why do you guys think I defend usap all the time in the Colorado lawsuit. That ftc lady was in way over her head and over step her authority forcing usap to give up Colorado. Because United healthcare lobbied her to death. For as smart as she is on paper. She’s dumb as rocks how medicine works.
