4est_4est_Gump
Run Forrest! RUN!
- Joined
- Sep 19, 2011
- Posts
- 89,007
http://spectator.org/archives/2013/01/17/quentin-tarantino-stars-in-oba/printThe other day, The American Spectator’s David Catron wrote an eye-opening piece — this one here “A Pimp for Obamacare Feels the Pain.”
In which Catron, a professional in the health care revenue business, tells the tale of an anonymous but vociferous liberal doctor who was one of a handful out there in blogland supporting Obamacare.
The crux? Here’s Catron:
And then?Among them was an ER physician who writes under the nom de plume “Shadowfax.” This particular “docblogger” stands out in my memory because he was peculiarly uninformed about the nuances of the issue and yet utterly dismissive of anyone, including other physicians, who attempted to make him understand that he would one day regret advocating an increased government role in medicine. I occasionally crossed swords with him myself, but it was an exercise in futility. Like most soi disant progressives, this self-satisfied sawbones couldn’t imagine that he might be on the wrong side of this or any other issue.
“Shadowfax” as the liberal doctor billed himself, hasThis unshakable belief in his own infallibility regarding government-administered health care was partly due to his hopelessly naïve view of Medicare, which he called “the most successful government program ever.” Never mind that this “success” had produced a $38 trillion unfunded liability, it was somehow “more efficient than private insurance.” Imagine my surprise, then, when I looked at the byline for this scathing piece bemoaning the depredations of that very program. The outraged author of “Medicare made the rules and now punishes doctors for following them” is none other than the redoubtable Shadowfax.
…finally discovered what I and others told him years ago: Medicare rules are, as he apparently now realizes, “arbitrary and disconnected from reality.” He has also noticed that, when a physician runs afoul of these bureaucratic vagaries, the government is the judge, jury, and executioner. The immediate cause of his disillusionment is Medicare’s trick of performing a superficial audit of a doctor’s billing practices and, based on a hopelessly flawed statistical sampling method, accuses him of fraud.
Shadowfax querulously explains: “You get a letter from the Medicare … telling you that you’ve been reviewed, found guilty of upcoding, and this finding, based on a handful of charts, is extrapolated back several years.” The term “upcoding” is industry jargon indicating that a provider has submitted a claim using codes that produce inappropriately high payment. It’s rarely done deliberately, assuming it has actually occurred, but that doesn’t matter. “The result is a large demand for reparations, usually in the mid-to-high six figures. The physician group can either write a check or lawyer up and argue it chart by chart.”