That’s No Fire, Just a Vacant Lot by Pat Conrad MD


7/13/15: Pres. Obama said in his press conference that Medicare is not in “crisis.”

From U.S. News & World Report: “As Medicare enrollment numbers have climbed, the costs have as well. In 1967, the program’s first full year of operations, Medicare spending was $4.6 billion; in 2014, it reached nearly $600 billion, or 14 percent of the federal budget.”

Did you think our race to become a national mausoleum would be efficient? “Nearly $60 billion in Medicare funds distributed in 2014 that were meant to reimburse doctors for the care they gave older Americans were doled out to practices with dubious addresses or delivered to medical providers who had been given disciplinary actions … [these] findings were concerning to members of Congress because they showed an increase in improper payments of more than $10 billion – or 20 percent – from 2013, despite reforms put in place beginning five years ago as a result of President Barack Obama’s health care law, the Affordable Care Act.” Check my math, but is that an error rate of 10%? Some of the erroneous payments were sent to addresses which are actually vacant lots, or burger joints.

About 15 years ago, before the Bush-Obama arsonists threw gas on the Medicare budget bonfire, I was in a new fledgling family practice clinic. One day I got a check from Medicare for a modest sum, on behalf of a patient I had never seen, for work that I did not do, in a practice location I had not visited in almost 2 years. I couldn’t shred that sucker fast enough.

CMS is a bad entity with a benevolent title. The “disciplinary actions” referenced above might include actual fraud, but they might also include some poor internist who got a dash-025-who-gives-a-damn modifier wrong. Reports like this that highlight bad results will only result in more pressure on the hapless medical community. Big government invites fraud the way a porch light attracts mosquitoes, and that is not going to change. Trying to reform this Medicare will never be curative, but only palliative at best. Doctors sold out their profession a half-century ago, and are now as hooked on the junk as entitled seniors and their elected representatives who will gladly destroy the nation before considering any real reform of this awful program.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “That’s No Fire, Just a Vacant Lot by Pat Conrad MD

  1. Hart
    August 8, 2015 at 2:24 pm

    Well I guess I am one of those entitled seniors—–but gee whiz I did want to live. Did not want to get health care needy. Now the thing is I am a health care professional and what I see from some of the providers is scary. I tried to get a smigen of prevention but had to wait until I was very ill. In fact, called my insurance co. stated that these people in this state were going to let me die and that I needed to go to Va. where at least my son’s could bury me. The rep wanted to know if that would be a permanent move. I replied that burial usually was. I did go back to my home town Drs (well respected), got the order for what I had needed for 4 years.

    It really does not matter, we the non government retirees are in trouble. The congress/house etc. add to the drain…….don’t get me started.

  2. Elwood L Schmidt, MD
    August 6, 2015 at 6:33 pm

    I resent Dr. Conrad’s comment that we older physician’s sold out to Medicare. We were loud and often in our protestations against the program as then constituted. We didn’t sell out. We were rolled over.

    Elwood L Schmidt, MD

    • Pat
      August 6, 2015 at 11:34 pm

      Dr. Schmidt, as a group, physicians in 1965 certainly did sell out. That was the time to refuse, to force your local hospitals to not bill Medicare, to educate your patients, to band together in local medical societies and state medical associations; that was the time to say no, I will not take ready government cash for just a few rules. The majority of physicians in that day were good, principled people who could not see that flipping the switch to work primarily for a government rather than for the patient would lead to this morass we cannot crawl out of. I’ve read the history of that joke “House of Medicine”, the AMA’s response to Medicare’s passage, and how they turned on a dime to embrace it. Why didn’t the AMA then call for a revolt? Who refused to take government coin in 1965, or in 1972 when this garbage was first declared financially unsupported, or in the early 1980’s with the onset of DRG’s? You might have been one of the minority voices, but most of the docs of that day had their heads so buried in hard work that they did not recognize – and did not think of – their soon-defunct ethics being used to turn them into government agents. Yes it’s easy for me to use hindsight, but that doesn’t change the timeline. And yes, most of us are now swirling in this drain because a very bad idea was not halted before it became too big to fail.
      Pat Conrad, MD

  3. August 6, 2015 at 11:54 am

    Actually, the statistics which just came out about a month ago show that Medicare costs have expanded, but only half as much as projected. Somebody is doing a good job managing costs.

    Make no mistake, I, too, despise the evils of overmanagement. There is, however, a point where management slides over into overmanagement, and that is the point where the costs rise only to pay managers’ salaries and office staves, when the increase can provably be nothing other than paying for more administration.

  4. Steve O'
    August 3, 2015 at 9:35 am

    Only about 20% of Medicare payments go to evil doctors. The other 80% go to nice corporations and such. It’s gonna be hard when they go after them nice guys.

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