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guccimamma · Oct 29th, 2009, 02:47 PM

and the government wants to run our health insurance? you'd think they want to clean up the current mess before embarking on another program.

1NutMeg · Oct 29th, 2009, 10:39 PM

I read an interesting article related to this the other day. http://www.msnbc.msn.com/id/33480141...h-health_care/

22% of healthcare waste is due to fraud- that's $200 Billion a year! I'm in healthcare and deal with Medicare and Medicaid and this shocked me. It truly is such a broken system. So many unnecessary tests and procedures are done in the name of "defensive medicine" because so many doctors don't want to be slapped with a lawsuit. The incentives for anyone all across the board are perverse.

lorihmatthews · Oct 31st, 2009, 03:51 PM

Originally Posted by 1NutMeg

So many unnecessary tests and procedures are done in the name of "defensive medicine" because so many doctors don't want to be slapped with a lawsuit. The incentives for anyone all across the board are perverse.

Oh, this drives me up the freakin' wall. My parents, who are both 71, are blessed with excellent health insurance. IMO their doctors run all kinds of tests and procedures just because they're well insured and the doctors know they will get paid. My parents are of the generation where you don't questions what about doctors say, so they just go along with everything.

I'm often asking them, "Why are you getting this test done? Why are you getting that procedure done?" They just shrug their shoulders and say the doctors told them they were routine and/or preventative. They are constantly at doctors' offices.

shanam · Nov 2nd, 2009, 11:12 AM

^^^ you are so right lori. I have noticed this to be especially true when it comes to physical therapy. There comes a point where no amount of therapy is going to change a degenerative condition or something that is just going to take time to heal, but because Medicare does not monitor this... the elderly go through what can sometimes be painful an it won't make any difference.

BigPurseSue · Nov 4th, 2009, 01:54 AM

Originally Posted by shanam

^^^ you are so right lori. I have noticed this to be especially true when it comes to physical therapy. There comes a point where no amount of therapy is going to change a degenerative condition or something that is just going to take time to heal, but because Medicare does not monitor this... the elderly go through what can sometimes be painful an it won't make any difference.

Funny you should mention this because I was just talking about this the other day with my elderly mom. She mentioned that several of her elderly friends--all 80-plus--were in physical therapy for something or other and it was all kind of foolish and didn't help them one bit.

I've been reading a lot lately how certain routine medical tests are nonsense for the over-80 crowd. Like colonoscopies and mammograms. But doctors keep ordering them anyhow because they're cash cows. Fortunately mom is a cynic and refuses to undergo major tests her doctors pressure her to have when she doesn't have symptoms.

one fifty · Nov 5th, 2009, 12:34 AM

Quote:

I've been reading a lot lately how certain routine medical tests are nonsense for the over-80 crowd. Like colonoscopies and mammograms. But doctors keep ordering them anyhow because they're cash cows

Really? usually the family doc orders these and it is the radiology place that benefits from the mammograms, and the gastroenterologist who does the $5k colonoscopies. the family doc is paid way less than the radiologist and the GI doc and isn't cashing in on ordering anything.

barcreperie · Nov 5th, 2009, 07:07 AM

Originally Posted by one fifty

Really? usually the family doc orders these and it is the radiology place that benefits from the mammograms, and the gastroenterologist who does the $5k colonoscopies. the family doc is paid way less than the radiologist and the GI doc and isn't cashing in on ordering anything.

Even when the work is 'sent out', it doesn't always mean that the ordering doc isn't profiting from it. Several of my friends/relatives who are general or specialized docs own part or all of the labs and diagnostic clinics they refer to. It's a tangled financial web.

shanam · Nov 5th, 2009, 11:48 AM

Originally Posted by barcreperie

Even when the work is 'sent out', it doesn't always mean that the ordering doc isn't profiting from it. Several of my friends/relatives who are general or specialized docs own part or all of the labs and diagnostic clinics they refer to. It's a tangled financial web.

Wow, I neve even thought of that aspect. How right you are.

~Fabulousity~ · Nov 5th, 2009, 12:55 PM

I remember watching a story on Dateline or 20/20 about a podiatrist(I think) who was billing medicare for visits he had not made and procedures he had not performed. All of his patients were elderly and because he was nice to them they would even lie and say he had seen them when he hadn't. If i'm remembering correctly he was found out when someone red flagged what he billed in one month and this caused them to look more closely at what he had been billing. Very sad how people take advantage of the elderly.

Oct 29th, 2009, 02:47 PM	#16
guccimamma guccimamma Joined: Aug 2006 Location: Wooo Hooo! Posts: 4,233	and the government wants to run our health insurance? you'd think they want to clean up the current mess before embarking on another program.
	__________________ "is it too early for a cocktail?"

Oct 29th, 2009, 10:39 PM	#17
1NutMeg Engaged! 11/13/2009 Joined: Dec 2008 Location: Ohio Posts: 506	I read an interesting article related to this the other day. http://www.msnbc.msn.com/id/33480141...h-health_care/ 22% of healthcare waste is due to fraud- that's $200 Billion a year! I'm in healthcare and deal with Medicare and Medicaid and this shocked me. It truly is such a broken system. So many unnecessary tests and procedures are done in the name of "defensive medicine" because so many doctors don't want to be slapped with a lawsuit. The incentives for anyone all across the board are perverse.
	__________________

Nov 2nd, 2009, 11:12 AM	#19
shanam OP 60 is the new 40 LOL Joined: Aug 2006 Location: Connecticut Posts: 1,568	^^^ you are so right lori. I have noticed this to be especially true when it comes to physical therapy. There comes a point where no amount of therapy is going to change a degenerative condition or something that is just going to take time to heal, but because Medicare does not monitor this... the elderly go through what can sometimes be painful an it won't make any difference.
	__________________ MY VERY BEST GIRL SO VERY DEARLY LOVED. FOREVER MISSING YOU 09 jan 09

Nov 5th, 2009, 12:55 PM	#24
~Fabulousity~ Member Joined: Jan 2006 Posts: 12,946	I remember watching a story on Dateline or 20/20 about a podiatrist(I think) who was billing medicare for visits he had not made and procedures he had not performed. All of his patients were elderly and because he was nice to them they would even lie and say he had seen them when he hadn't. If i'm remembering correctly he was found out when someone red flagged what he billed in one month and this caused them to look more closely at what he had been billing. Very sad how people take advantage of the elderly.
~Fabulousity~ Member Joined: Jan 2006 Posts: 12,946

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