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Reflectin on fraud and abuse in healthcare
Fraud and Abuse in the U.S. Health Care System
Fraud and Abuse in the U.S. Health Care System
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Summary of “The American Healthcare Paradox” “The American Health Care Paradox” focuses on health care and how the United States is suffering compared to their peer countries. The United States has spent billions of dollars in health care and the problem is still growing. The government is responsible for not following or ignoring the issue that we suffered with, in today’s society the healthcare system is failing drastically. The health care system has been a problem for several decades now, even though it seems that things are getting better it’s not.
Although the US is technologically advanced and has some of the highest caliber medical professionals in the world, compared to many other industrialized countries, it has one of the lowest outcomes in regards to quality of care. Moreover, it has some of the highest overall medical costs (Panning, 2014). In the US, low quality care and high costs have resulted in fragmentation of the healthcare delivery system. Fragmentation of services often results in patient experiences that are poor, with less than desired
Annotated Bibliography: Medicare Fraud and Abuse Carolann Stanek University of Mary Annotated Bibliography: DiSantostefano, J. (2013). Medicare Fraud and Abuse Issues. Journal for Nurse Practitioners, 9(1), 61-63. doi:10.1016/j.nurpra.2012.11.014
Most people in the state of Alabama are aware of the HealthSouth scandal due to former Alabama Governor Don Siegelman being convicted of crimes of bribery, and honest services fraud along with former CEO Richard Scrushy. The HealthSouth fraud case was also one of the first fraud cases tried under the Sarbanes Oxley Act of 2002. HealthSouth officers were cooking-books and shell games trying to mask the fraud that was occurring by acquiring companies, overstating cash balances, falsifying financial statements earnings releases as well as annual reports. The fraud also involved booking the accounts receivable amounts as income instead of collectable income, fictitious fixed assets such as office equipment, recording the sale of shares in another
In 2013, California physician Daniel J. Stone wrote an article for the Los Angeles Times titled “Our Big Appetite for Healthcare.” Stone wrote this article because he wants people informed about the growing addiction that people in Southern California have for healthcare. He outlines how the problem is bad for both doctors and patients. By publishing this article, the Los Angeles Times hopes to have people more knowledgeable about the reality of overusing healthcare. Stone uses two persuasive strategies to interest readers.
In addition to the dismay of many healthcare professionals, patients, and citizens who are uninsured, several flaws about the current healthcare system show the necessity for reform. The three flaws that exacerbate the current healthcare crisis are: the tax code and tax breaks, the lack of preventable care and adequate care of chronic diseases, and administrative costs. A single payer, universal healthcare system can resolve the major flaws of the
For the past 40 years health care spending has consistently grown faster than the economy. The reasons for the higher levels of spending on health care in America are not totally understood but include higher costs of treatment in the U.S. health care system, including rates of reimbursement for doctors and other health care providers; higher prices for hospital stays and prescription drugs; increased use of medical technology; a lack of reliable comparative information on medical outcomes, quality of care, and cost; and increased prevalence of risk factors such as obesity that can lead to expensive chronic
The American health system has been controlled by private, all-for-profit companies who couldn’t care less about the health of a human, but are more worried about maximizing their dollars. If the Affordable Care Act is repealed, or “done away with”, tens of millions of Americans will be without adequate health insurance. This is exactly what Americans
Medicare fraud is a very common occurrence in the United States. However, there are whistleblowers who are working hard to stop Medicare fraud. The vast majority of people who report Medicare fraud are healthcare professionals. This includes people such as ambulance drivers, physicians, nursing home workers, hospice workers and nurses. There have been some changes recently to the United States whistleblower laws.
Here is a short clip of an article from the Washington Post which exposes how medicare is corrupt and is an easy target for fraud. …in a Los Angeles courtroom, Bonilla described the workings of a peculiar fraud scheme that — starting in the mid-1990s — became one of the great success stories in American crime. The
Americans also spend about 36% more on drugs than the next highest paying countries (Japan and Canada) even though our life expectancy is nowhere near the longest. The number one spot belonging to Japan, and the U.S. coming in at 31. The amount we spend on private healthcare could easily be decreased, and routed towards public healthcare virtually reducing our extra costs to
The United States is the only Western nation that does not authorize free health services to its people. The cost of healthcare to the uninsured is beyond prohibitive, and insurance plans are far more captivated with profit costs, rather
As Bernie Sanders once said, “Health care must be recognized as a right, not a privilege.” Most developed countries choose to live by this quote while the United States of America chooses to go against it. Universal health care has benefits on multiple levels, whether it’s a single individual or the people in a whole. The U.S is one of the few developed countries that doesn’t offer universal health care to their people, yet the U.S spends more than seventeen percent of their GDP on health insurance. Many people believe that universal health care is a simple one solution problem, but the truth is that there are multiple forms of universal health care that provide all citizens with the health insurance they need.
Health care should not be considered a political argument in America; it is a matter of basic human rights. Something that many people seem to forget is that the US is the only industrialized western nation that lacks a universal health care system. The National Health Care Disparities Report, as well as author and health care worker Nicholas Conley and Physicians for a National Health Program (PNHP), strongly suggest that the US needs a universal health care system. The most secure solution for many problems in America, such as wasted spending on a flawed non-universal health care system and 46.8 million Americans being uninsured, is to organize a national health care program in the US that covers all citizens for medical necessities.
Sicko is an American documentary by Michael Moore which explores the status of health care in America. In my opinion, he has presented a clear-cut viewpoint that American health care is not producing results. Nearly half a hundred million Americans, according to Sicko, are not insured while the rest, who are insured, are often sufferers of insurance company deceit and also red tape. Additionally, Sicko mentions that the United States health care system is placed 37th out of 191 by the W.H.O. with definite health measures, like the neonate death and life probability, equivalent to countries with quite less financial wealth. Interviews are carried out with individuals who supposed they had sufficient coverage but were deprived of care.
