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Medicare Bills Rise As Records Turn Electronic

timothy posted about 2 years ago | from the wealthy-donors-doing-just-fine dept.

Government 294

theodp writes "As part of the economic stimulus program, the Obama administration put into effect a Bush-era incentive program that provides tens of billions of dollars for physicians and hospitals that make the switch to electronic records, using systems like Athenahealth [note: video advertisement] (which made U.S. CTO Todd Park a wealthy man). The goal was not only to improve efficiency and patient safety, but also to reduce health care costs. But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care. Hospitals received $1 billion more in Medicare reimbursements in 2010 than they did five years earlier, at least in part by changing the billing codes they assign to patients in emergency rooms, according to a NY Times analysis. There are also fears that features which can be used to automatically generate detailed patient histories and clone examination findings for multiple patients make it too easy to give the appearance that more thorough exams were conducted than perhaps were. Critics say the abuses are widespread. 'It's like doping and bicycling,' said Dr. Donald W. Simborg. 'Everybody knows it's going on.'"

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294 comments

Sounds like... (2, Informative)

fustakrakich (1673220) | about 2 years ago | (#41422997)

Mission Accomplished!

Medicare fraud is not new (5, Interesting)

bit trollent (824666) | about 2 years ago | (#41423005)

Medicare fraud is not new. It existed way before electronic records.

Florida's governor, Rick Scott's company committed medicare fraud way before electronic records were introduced.

Electronic records should make it easier to detect medicare fraud, as statistical analysis is much easier with computerized systems.

Re:Medicare fraud is not new (2)

sjames (1099) | about 2 years ago | (#41423537)

The problem here isn't exactly fraud, it's that the 'optimization' of billing codes allows them to go right up to the line but not over. It's the closest thing to fraud there is without actually being illegal.

Re:Medicare fraud is not new (5, Informative)

russotto (537200) | about 2 years ago | (#41423697)

Because the whole system is idiotic. It's not like doctors and hospitals have prices for (non-emergency) procedures, tell you what those prices are in advance, tell you what the procedures they will be performing on before in advance, and get agreement on price before doing anything. They don't even do so much as give you an estimate.

No, instead, assuming an insured patient, they do an exam and get a flat fee from you. Then depending on what they did during the exam, they bill for everything they did (according to the standard set of codes) at some totally fictitious rate that maybe one sucker in a million pays. The insurance company or Medicare then looks at what they did (according to the codes), ignores completely the amount they charged, and pays them whatever they, the insurance company or Medicare, feels like paying. So basically, a doctor who doesn't code the most expensive codes he can based on what he did is leaving money on the table for no reason.

Re:Medicare fraud is not new (2)

TheRealMindChild (743925) | about 2 years ago | (#41423743)

The cost may be, in some part, from welfare fraud, however, I my personal experience is, they contract a service company now to their paperwork needs. They no longer do it in house with low paid employees. Also, now when your records need to be transferred, they CAN charge an "administrative fee" to do so.

This is silly (5, Interesting)

rsilvergun (571051) | about 2 years ago | (#41423017)

it's already been established that moving to electronic records helps track Medicare fraud. Yes, the system has a lot of gaps, but electronic tracking reduces them. If that wasn't true companies wouldn't use electronic purchasing systems to track expenditures, and the spreadsheet would just be an interesting foot note in computer history...

I gotta ask (since I'm far too lazy to read the article): Is this a lame attack on the existing administration?

Is this a lame attack on the current admin.... (2)

RL78 (1968236) | about 2 years ago | (#41423319)

The story being a NYT article, I don't think you can cry spin on this one.

Re:Is this a lame attack on the current admin.... (2)

rsilvergun (571051) | about 2 years ago | (#41423609)

I don't think that counts for much any more. Pretty much all mainstream and big media is conservative on Economics any more. Some are liberal on a few social issues (Gay Marriage, Abortion, etc), but on economics they don't stray too far from Supply Side Economics. I attribute this to the fact that the owners (Rupport Murdoch et al) are very conservative, and if you want to stay employed you don't tick off the boss man...

That said, it's tough to say. But I think it's been pointed out that electronic billing gives the pencil pushers enough data to figure out where they could be billing but aren't. But in 2010 [cbsnews.com] alone $4 billion was recovered. But was that due to better tracking, a strong willingness on the part of the current Administration to stop fraud, or blind dumb luck?

Re:Is this a lame attack on the current admin.... (1, Flamebait)

clarkkent09 (1104833) | about 2 years ago | (#41423709)

Pretty much all mainstream and big media is conservative on Economics any more.
 
It may seem that way but only if your own views are slightly to the left of Lenin. The reality is that the mainstream media is still Keynesian, i.e. in favor of heavy government intervention. NYT still has the discredited loon Krugman as their economics expert for God's sake, how supply side is that? The only real pro-capitalism program that I know of is Stossel on Fox Business channel and that's hardly mainstream media.

Re:Is this a lame attack on the current admin.... (1)

amiga3D (567632) | about 2 years ago | (#41423865)

I think the Times used to worship President Obama but now they think he's far too conservative. They'd really like someone along the lines of Nancy Pelosi or Cynthia McKinney.

Re:Is this a lame attack on the current admin.... (1, Insightful)

feedayeen (1322473) | about 2 years ago | (#41423965)

You lose credibility when you call the largest television news network, owned by the largest media company, non-mainstream.

Re:Is this a lame attack on the current admin.... (1)

SomeKDEUser (1243392) | about a year ago | (#41424007)

Interesting... I cannot tell whether you are making a joke or not.

In case you are not, you might want to stop drinking the kool-aid.

Re:Is this a lame attack on the current admin.... (2)

RL78 (1968236) | about 2 years ago | (#41423809)

Rupert Murdoch owns the New York Post, not the Times.

Re:This is silly (1)

kelemvor4 (1980226) | about 2 years ago | (#41423411)

it's already been established that moving to electronic records helps track Medicare fraud. Yes, the system has a lot of gaps, but electronic tracking reduces them. If that wasn't true companies wouldn't use electronic purchasing systems to track expenditures, and the spreadsheet would just be an interesting foot note in computer history...

True, but as organizations such as anonymous and other hacker groups frequently show us they also help make fraud easier. It's very much a double edged sword.

I gotta ask (since I'm far too lazy to read the article): Is this a lame attack on the existing administration?

I didn't get that impression. They mention the Obama and Bush administrations together since both were pushing electronic records. I think if it were a political attack, you wouldn't see dubya's name on it.

Re:This is silly (1)

Shavano (2541114) | about 2 years ago | (#41423573)

it's already been established that moving to electronic records helps track Medicare fraud. Yes, the system has a lot of gaps, but electronic tracking reduces them. If that wasn't true companies wouldn't use electronic purchasing systems to track expenditures, and the spreadsheet would just be an interesting foot note in computer history... I gotta ask (since I'm far too lazy to read the article): Is this a lame attack on the existing administration?

Making billing and payment systems electronic reduces processing costs. That's the primary driver of the multi-industry-wide push to do all that electronically. It's really expensive to have humans transcribe things and add up columns of numbers.

Re:This is silly (1)

gtall (79522) | about 2 years ago | (#41423593)

No, it isn't an attack. Doctors and hospitals find that with medical records, upping the codes for service in their favor is made easier. Hence, the government and insurance companies pay more.

It isn't clear how to go about fixing this. There's no way the government could have enough monitors to make sure doctors and hospitals are honest. Maybe they could use statistics. That has its own problems, what is the baseline. And baselines would change across the country. Spot checks might work if backed up by proper law enforcement. Upping the codes is not against the law though, so we'd need new laws. Compensating whistle blowers might also help a bit.

Proper coding != fraud (5, Interesting)

Anonymous Coward | about 2 years ago | (#41423041)

It's not clear to me that medicare providers changing their coding is the same as fraud. If a doctor was coding for a 10 minute E&M (evaluation and management) but was actually spending 20 minutes with the patient, then it's totally reasonable for them to change their coding. If EMRs are making it more obvious that the practice users are mis-coding, then this is at worst an unintended side-effect of the EMRs.

(Full disclosure, I work for a company that builds EMR systems.)

Re:Proper coding != fraud (4, Informative)

salesgeek (263995) | about 2 years ago | (#41423133)

The issue is changing from an E&M to an intensive care E&M. Same procedure, higher payout. Same goes for taking a common tests that are bundled and breaking them into smaller component tests. A few wears ago I met with an Ausie founder of a startup that was talking about how revolutionary their software was that would optimize billing codes to ensure maximum revenue per procedure by basically scanning a billing batch and re-coding it using more lucrative codes for the same procedures. I waked on doing any development for them.

Re:Proper coding != fraud (1)

plover (150551) | about 2 years ago | (#41423305)

I think that the electronic records are probably making it easier for physicians to bill more accurately, not necessarily more "lucratively". Electronic recordkeeping doesn't turn otherwise honest people into fraudsters overnight. So I don't see the increase in billing as tied to an increase in fraud.

Now, the Australian company you declined to work for, they seem like the kinds of scum who hospital administrators might hire to commit wholesale fraud. That obviously would give rise to increased billing rates. If there's still a sliver of justice in the world, they'll go to jail for falsifying records.

Re:Proper coding != fraud (4, Interesting)

salesgeek (263995) | about 2 years ago | (#41423451)

Now, the Australian company you declined to work for, they seem like the kinds of scum who hospital administrators might hire to commit wholesale fraud. That obviously would give rise to increased billing rates. If there's still a sliver of justice in the world, they'll go to jail for falsifying records.

Both the company providing the service and people enriched by using that service need to be held accountable.

Re:Proper coding != fraud (1)

kelemvor4 (1980226) | about 2 years ago | (#41423427)

optimize billing codes to ensure maximum revenue per procedure by basically scanning a billing batch and re-coding it using more lucrative codes for the same procedures.

Sounds to me like the coding system need to be revamped to remove the duplications if possible.

Re:Proper coding != fraud (0)

Shavano (2541114) | about 2 years ago | (#41423599)

The issue is changing from an E&M to an intensive care E&M. Same procedure, higher payout. Same goes for taking a common tests that are bundled and breaking them into smaller component tests. A few wears ago I met with an Ausie founder of a startup that was talking about how revolutionary their software was that would optimize billing codes to ensure maximum revenue per procedure by basically scanning a billing batch and re-coding it using more lucrative codes for the same procedures. I waked on doing any development for them.

If that's what they're doing it's easily detectable. Somebody at Medicare should be looking at the billing records and saying, "It can't be right for every procedure to be billed at the highest possible code when they're a regular full-service hospital. These people are cheating us and I have a red phone on my desk to the Department of Justice Prosecutor's office."

Re:Proper coding != fraud (2)

Sir_Sri (199544) | about 2 years ago | (#41423223)

It would seem like a benefit of the system that you can actually get paid for the work you did, rather than being narrowly restricted to a handful of codes and having to 'pick the closest', where you go from say a 25% error on paper to 10% electronically that's good.

Obviously there will be fraud - even in a fully nationalized healthcare system doctors still try and find ways to get more money for the same work. It's management and oversights job to prevent it, and the more tools they have to find it, the better. It's the same problem with any workers, if you pay them by the hour they try and find a way to take more hours at a higher rate, if you pay per procedure they try and find a way to do more (or more expensive) procedures, if you pay them a salary they do the minimum necessary to qualify for yearly promotions and why do anymore when you get paid the same either way?

As hard as we try to hold doctors to a higher ethical standard than the average person (and pay them well for it) they are as greedy as the rest of us.

Re:Proper coding != fraud (0)

Anonymous Coward | about 2 years ago | (#41423233)

Disclosure: I also work for a company that develops EHR systems.

This article is clearly targeted FUD designed to scare the masses by tying electronic medical records in with already controversial topics such as the ACA (Obamacare). EHR systems implement tracking and statistical analysis features that allow a much closer analysis of billing trends. This article reads as if billing fraud didn't exist before EHRs - this is absurdly false.

What many EHR systems DO offer is the ability to calculate when physicians should bill at a higher code level. This results in higher bills than what was seen pre-EHR because way back when, physicians would commonly underbill to avoid costly Medicare audits. EHRs are giving physicians the confidence and support that they need to justify billing at a higher code level in circumstances that warrant it.

tl;dr: More Slashdot FUD scaremongering. Par for the course.

Re:Proper coding != fraud (1)

sjames (1099) | about 2 years ago | (#41423549)

The problem is that the 'underbilling' is still costing patients four times what healthcare costs anywhere in the civilized world.

Re:Proper coding != fraud (4, Insightful)

ColdWetDog (752185) | about 2 years ago | (#41423751)

Different problem (a real problem but a different problem).

The big issue here is how the billing codes are set up for physician encounters. You determine the code (and hence the charge) with a laundry list of things - how many issues you covered in your interview, how many parts of the body you examined, how much extra detail you went into (family history, smoking history and the like).

Then you get brownie points for medical complexity.

So, you add all of this up and you get your E&M code (Evaluation and Management). Now, in the olden days you had to manually keep track of how many 'points' you were wracking up. Amazingly enough, computers can add! So the program keeps track of all the little points and thus can maximize the code. Extra bonus points for the program 'helpfully' pointing out a few things you might have missed (did you ask about smoking? Vaccines?) - you can then go back and do them (or at least say that you did) and up code.

The other problem is cut and paste - you can take the Past Medical History of the patient and copy it from one encounter to another. Now, that seems perfectly reasonable - you WANT to know this stuff, it's important and that's why you take the time to write it down. However, you don't need to go through a 45 minute interview with the patient ever time you see them - but that's what the billing codes assumed you did. Now Medicare has decided if you copied the old data that's "fraud".

Basically, you have a clumsy, prehistoric system for coding physician encounters that has been computerized without much thought as to what happens after the fact.

One of my favorite aphorisms in this arena is "Computerizing chaos yields computerized chaos."

maybe not... (0)

Anonymous Coward | about 2 years ago | (#41423053)

and it might be that instead of fraud, we are better able to document what we do instead of down coding for fear of getting a medicare audit. We finally can prove that we do all the work they say we don't.

There's a problem on both ends (5, Insightful)

rickyb (898092) | about 2 years ago | (#41423063)

Yes, some physicians will abuse the system. Some will do so willingly, while others will do so out of ignorance. However, many physicians at large academic medical centers (also known as "residents"), are not taught how to code and bill at all until they reach independent practice. This leads to very bad habits and often to underbilling quite significantly for their services. They all do the work, but don't appreciate the importance of recording and documenting the work for billing purposes, leaving money on the table. This impacts primary care most of all, where margins are very slim, and many physicians are struggling to remain solvent. EMRs actually take care of the coding and billing far more efficiently and accurately than the physicians themselves. But as the saying goes, "garbage-in, garbage-out." The coding is only as accurate as the physician documentation. The vast majority of physicians do not intentionally document erroneously to inflate billing - once the error is pointed out to them, they are more than willing to fix it. And for those physicians who are maliciously abusing the system, there's no better solution than EMRs to record and track this behavior.

The real fraud... (4, Insightful)

OldSport (2677879) | about 2 years ago | (#41423077)

...is how much health care costs in the first place.

Re:The real fraud... (5, Insightful)

Deathlizard (115856) | about 2 years ago | (#41423393)

The Real Fraud is how much health care costs in the first place.

The main reason for that is simple. Insurance and Litigation

1) You Need Insurance to get healthcare, because healthcare costs too much.
2) Your Doctor Needs Insurance because you might sue him for malpractice, the state he's in requires it, or both, Raising the cost of healthcare.
3) The pharmaceuticals your Doctor prescribes you needs Insurance because you might sue them for complications. Raising the cost of healthcare.
4) Your Hospital needs insurance because you might sue them for hiring the doctor that you sued for malpractice, or because he prescribed you something that didn't work, or the state they are located in requires it or a combination of all of the above. raising the cost of healthcare.
5) The ambulance chasing lawyer on TV needs more money to buy TV commercials to help you, so he sues the insurance companies of your doctor, the pharmaceutical company, and your hospital for malpractice, so you get the 5-25% of the total compensation that you deserve and he pockets the 75%-95% to pay for his paper costs and time, which of course, Raises the cost of Insurance, which in turn raises the cost of healthcare.
1) Repeat step 1

Until we get a president and congress that will pass healthcare reform that will truly end this cycle for good, expect your health costs to skyrocket.

Re:The real fraud... (0)

Anonymous Coward | about 2 years ago | (#41423603)

Malpractice reform will lead to mabye 3% reduction in costs. But somehow you think it's the main driver of costs. Republicans like to bang the malpractice is causing all the problems drum but they are at least honest it's a minor addition of costs.

Besides, the litigation explosion and huge increase in jury awards was more than 20 years ago. During Reagan's time. Lawsuits and awards have steadily declined sine the 80s. So why hasn't health care cost fallen since you think it's increasing costs exponentially?

Re:The real fraud... (3, Informative)

ScentCone (795499) | about 2 years ago | (#41423659)

Republicans like to bang the malpractice is causing all the problems drum but they are at least honest it's a minor addition of costs.

You are (deliberately, it seems) missing the big picture. It isn't malpractice, per se. It's the enormous use of people, supplies, fantasitcally expensive equipment, time, space, and a mile-long wake of paperwork that comes from practicing over-the-top procedures, tests, and drug use designed to fend off spurious malpractice suits. So something like a $10 urine dip-stick test that could be done a couple of times over a couple of 5-minute office visits becomes a $2500 speciality lab visit to the hospital so that the doctor's favorite specialist can do a bladder exam ... so that one in a hundred thousand people who might have more than a the normal drop of blood in their urine and also happen to have something else you might catch through the multi-thousand-dollar exame might be caught sooner, though not likely.

Multiply that scenario by thousands of other conditions and tests, mostly involving entire teams of people operating hideously expensive radiological devices or blood sniffing devices, and all of the record keeping, etc., and you've got your ridiculous costs. And it's all done to avoid making malpractice insurance premiums go even higher, because of slimes like John Edwards who get rich over nonsense suits. The suits are down because spending to head them off has gone through the roof, by untold billions of dollars.

Re:The real fraud... (1, Insightful)

ColdWetDog (752185) | about 2 years ago | (#41423863)

Even if you factor all of that in, it probably represents something like 20-30% of the 'extra' costs in US medicine. It's a significant and important aspect of the problem, but it's not the sole nor major driver.

Briefly you have:

- The issue of 'defensive medicine' as you point out.
- The issue that much of US medicine is set up as a for profit entity with expectations of increasing growth and profits. Many of the big players are heavily leveraged.
- The multiple sacred cows - physicians, insurers, hospitals and, not least, patient expectations (I want that MRI and I want it NOW).
- And the fact that it's a highly complex, labor intensive field.

Hard to fix something that crazy.

Re:The real fraud... (3, Interesting)

Beryllium Sphere(tm) (193358) | about 2 years ago | (#41423749)

Not what my doctor says, though it is a plausible contributor to one of the problems he identifies. He's been paying malpractice insurance premiums for forty years and has been an expert witness in malpractice cases, so he knows what he's talking about.

He sees the problem as fueled by unnecessary procedures and caramelization (wow, that's a great autocorrect failure. I wrote cartel-ization). Unnecessary procedures might be caused by fear of litigation(*), or by a desire to milk the system.

Drug companies like to say that their prices are necessary to recoup research costs, but that doesn't explain doubling the price of a drug after it's already on the market. He's seen that happen.

Health insurance companies have lavish offices in expensive parts of downtown. They didn't get that money by being lean, scrappy competitors.

What he wants to see happen is single payer! That doesn't have to mean government, by the way. A nonprofit mutual insurance company is an option.

(*) If skipping a test might lead to a lawsuit, then skipping the test might lead to a patient getting hurt, in which case it's a necessary test.

Easily Predicted... (1)

Anonymous Coward | about 2 years ago | (#41423111)

In a fee for service environment:

improved efficiency = increased throughput = higher cost

savings only come about when you increase throughput on a flat wage, which lowers your per unit cost.

Unfortunately, healthcare IT (a field in which I work) is one in which the benefits are not immediately realized by the ones who bear the costs. In fact, one could argue that even the benefits (in terms of short term patient harm reduction via medication errors, etc) will really only increase longer term costs when patients live longer and as a result require more care.

There are fundamental, paradigmatic, changes that need to happen in the healthcare system if it is to survive.

PS: I'm Canadian, so that is the context of my comment.

Just socialise the damn thing already (3, Insightful)

ryzvonusef (1151717) | about 2 years ago | (#41423115)

You know, I was reading an article where it stated that socialised medicine would cost *less* than what what it costs to run Medicaid and Medicare (on a per person basis)

You Yanks fear the word "socialist" so much you spend far more to get rid of it!

i apologize world, it is embarassing (3, Insightful)

circletimessquare (444983) | about 2 years ago | (#41423149)

universal healthcare will result in longer lives and less healthcare spending in the usa. just like every other goddamn country with it

but, much like gun control, there is a certain feverish moron in my country that will never listen to reason on the subject, and he enabled by special interest groups in washington: the NRA and the healthcare insurers

maybe the feverish morons will shoot themselves and die waiting in the emergency room

Re:i apologize world, it is embarassing (2, Insightful)

Anonymous Coward | about 2 years ago | (#41423235)

Wow, way to bring gun control into this.

Re:i apologize world, it is embarassing (1, Troll)

circletimessquare (444983) | about 2 years ago | (#41423293)

but it's exactly the same issue: all sense and reason, and the track record of all other western industrialized nations, show you want:

1. universal healthcare to live longer and spend less
2. tighter controls on guns for far lower senseless death rates

so why not in the usa? because of a qausireligious group of faith-based feverish morons who believe certain ignorant things, and their minds will never see the light of day on the obvious

Re:i apologize world, it is embarassing (1)

sumdumass (711423) | about 2 years ago | (#41423417)

Dude, seriously, if you want Gun control then change the fucking constitution. Until then, stop saying I do not have a right that is imbedded in the constitution simply because you don't like it and want to read into it things that never existed. If you are allowed to succeed, then your right to free speech, your right to be secure in your papers, person, and effect from unwarranted searches, your right to a fair trial without unusual and or cruel punishment, your right to retain the rights other citizens hold, and all that are meaningless drivel waiting on the next guy to force alternative meanings into it by cracked out readings or outright disregarding the intent as well as obvious language of the Constitution.

If that makes me a qausireligious group of faith-based feverish morons who believe certain ignorant things, then come pry my bible from my cold dead hands- if you can. Otherwise fuck off and do it right else risk screwing everything else up. Your sense of righteousness has no fucking legal standing in the US so just because you think a certain way does not mean other rights will not be taken from you because you agree with the right. The US constitution is what bars the government from doing things, not your imaginary moral guard.

Re:i apologize world, it is embarassing (2, Informative)

circletimessquare (444983) | about 2 years ago | (#41423437)

i don't have to change the constitution. what the constitution says about gun ownership has nothing to with what certain morons believe it justifies

Re:i apologize world, it is embarassing (0)

Anonymous Coward | about 2 years ago | (#41423463)

I think the Supreme Court's interpretation of the Second Amendment was quite clear. If that offends you or the people you're labeling as morons, I can't say I particularly care.

Re:i apologize world, it is embarassing (0, Offtopic)

circletimessquare (444983) | about 2 years ago | (#41423495)

good, then you won't mind when a new supreme court has a new interpretation

Re:i apologize world, it is embarassing (1)

amiga3D (567632) | about 2 years ago | (#41423951)

This is what I love about self appointed intellectuals who think they have all the answers and know what's good for all us poor unwashed masses out here. The way they can take a simple sentence written in plain English and reinterpret it to mean whatever they feel it should have said to start with. Returning to the topic, I agree the current system is so totally screwed that even something as fucked as socialized medicine would be better than the cluster fuck we currently enjoy. I think the entire idea behind Obamacare was to so fubar the entire American Healthcare Sytem that the slate would have to be wiped clean and started over from scratch. A brilliant and effective idea I have to admit. Something drastic will have to be done and I'm sure it'll be socialized medicine. Welcome to Europe where things are so wonderful (at least you seem to think so).

Re:i apologize world, it is embarassing (2)

sjames (1099) | about 2 years ago | (#41423623)

Actually, it's an entirely different thing. The gun market is operating well and shows inflation comparable to the total inflation rate. Few people actually NEED a gun, but those who do (and most who just want one) can afford it.

In contrast, everybody needs healthcare from time to time but many can't afford it at all and the rest are forced to spend an increasing percentage of their total income on it. Healthcare costs have inflated at several times the rate of general inflation for decades now.

Re:i apologize world, it is embarassing (1)

amiga3D (567632) | about 2 years ago | (#41423969)

Soon the bureaucrats will be in total control then things will get better. The same people that run the post office are on the way to help.

Re:i apologize world, it is embarassing (1)

Anonymous Coward | about 2 years ago | (#41423821)

Funny, what I had heard was that gun control caused a lower rate of murders using guns, however, the rise in murders using knives rose to the point of basically making it a wash.

Re:i apologize world, it is embarassing (1)

circletimessquare (444983) | about 2 years ago | (#41423881)

You heard wrong, propagandized moron

Re:i apologize world, it is embarassing (0)

Anonymous Coward | about 2 years ago | (#41423387)

The issue of gun control is different: the divide in opinion in America (or rest of world) is dominated by the difference in urban and rural life, c.q. population density. There is simply no one "reasonable" standpoint on this issue.

The healthcare issue is totally political on the other hand. And if Americans opt for some kind of healthcare provided by the government, which both parties do (but not all Americans), then indeed only universal coverage can be qualified as "reasonable".

But you can apologize for the level of your public debates/propaganda wars in America, those are quite emberrassing

Re:i apologize world, it is embarassing (1)

circletimessquare (444983) | about 2 years ago | (#41423465)

i agree

a rural dweller should have a shotgun for security

if only there were some way to change gun laws based on population density

Re:i apologize world, it is embarassing (0)

Anonymous Coward | about 2 years ago | (#41423839)

By not trying to impose it centrally, but leave it up to the states or more local government? Like what's happening defacto. Reality exerts itself, issue resolved, details left.

Re:i apologize world, it is embarassing (1)

Q-Hack! (37846) | about 2 years ago | (#41423429)

universal healthcare will result in longer lives and less healthcare spending in the usa. just like every other goddamn country with it

but, much like gun control, there is a certain feverish moron in my country that will never listen to reason on the subject, and he enabled by special interest groups in washington: the NRA and the healthcare insurers

maybe the feverish morons will shoot themselves and die waiting in the emergency room

Actually wether or not we have universal healthcare or free market health care really doesn't change life expectancy. On the other hand, how much junk food a country eats, does. Our problem is that we have neither universal healthcare or the free market. Instead we have some bastardization of the two. Personally I think we need to bring back a pure free market. The only regulation from the government needs to be that the doctor has a medical license from an accredited school. After that, let the insurance companies and doctors do what they do and it will become cheaper for all.

you're ignorant beyond belief (5, Insightful)

circletimessquare (444983) | about 2 years ago | (#41423457)

a free market in real life translates to "give as many expensive tests as we can get away with"

healthcare isn't a MARKETPLACE. it is not driven by best price, because the buyer has no control to seek the cheapest service. no knowledge of medicine. no time when he is having a heart attack to shop around

face reality: there are some issues in life, where, believe it or fucking not, market forces do not help, and make things worse

i say this as a committed capitalist. capitalism works. but i'm not a looney tune frothing at the mouth ignorant free market fundamentalist who believes the magic unicorn and rainbows marketplace is a magic elixir that solves all problems. it doesn't

Re:you're ignorant beyond belief (-1, Troll)

udachny (2454394) | about 2 years ago | (#41423621)

i say this as a committed capitalist

- that's how we know that your comment is a troll. You are one of the Marxists populating the world, which simply means you are one of the thieves populating the world.

Maybe you should leave the people alone, and that will be enough for them to have their free market. And you can have your 'socialized' health care in that free market if there are enough people that believe in your idea and together, voluntarily, you will establish your 'socialized medicare system'.

No, what you actually want to do is to force everybody into a government system, which has nothing to do with free markets, capitalism, and it certainly takes away individual freedoms from people. But you like that idea, you want to take away individual freedoms.

Medicare in USA is bankrupt, same with Social Security. Those are welfare programs, they have no assets behind them, USA T bills and bonds are NOT assets.

First the taxes were collected under the guise of 'SS' or 'Medicare' fund, that money was spent as all general income taxes are spent on whatever the politicians want to spend it on.

The money was replaced with IOUs, and those are bonds (or bills), they have to be sold in the market to raise money to pay benefits. This means that eventually that debt has to be bought back by USA and this means the taxes have to be raised SECOND TIME to pay for the same 'benefit'. This means that SS and Medicare benefits are not paid by specific SS and Medicare taxes, they are paid by general taxes and redistributed like all welfare.

--

SS and Medicare (and basically USD and bond) are the biggest ponzi scams in the world today and American people are forced to participate in them. People can opt out of private ponzi scams, but they can't opt out of gov't ran ponzi scams, they are forced into them. You want more people to be forced into another, bigger ponzi scam, that's all there is to it. You are a thief, not a capitalist, not a free market anything, you are simply a thief, like all pro-government types.

Re:you're ignorant beyond belief (0, Flamebait)

circletimessquare (444983) | about 2 years ago | (#41423877)

Please read the above, world. I have to share a country with blathering morons like this. Again, it is embarrassing, I apologize.

Re:you're ignorant beyond belief (0)

Anonymous Coward | about 2 years ago | (#41423899)

You can quit any time you want, you still have the right to buy a gun in the good old US of A, do everybody a favor, blow your goddamn brains out.

Re:Just socialise the damn thing already (0)

Anonymous Coward | about 2 years ago | (#41423157)

YOU LIE!!!!1

Re:Just socialise the damn thing already (-1)

Anonymous Coward | about 2 years ago | (#41423177)

Wrong.

Take the Canadian health care system. It's crap, and I speak from personal experience. There are people who are literally dying waiting to be seen, and a much larger crowd literally getting crippled because they wait too long to be operated on.

No one has figured out how to deliver a good medical system on the cheap. No one.

Re:Just socialise the damn thing already (0)

Anonymous Coward | about 2 years ago | (#41423243)

[citation needed]

Re:Just socialise the damn thing already (0)

Anonymous Coward | about 2 years ago | (#41423611)

You forgot to sign your post:

Sincerely, Tea Partier who actually has never been anywhere near Canada and learned everything he "knows" from Rush Limbaugh and Glenn Beck

Re:Just socialise the damn thing already (-1)

Anonymous Coward | about 2 years ago | (#41423231)

I know you are lying because I have friends in Canada and the U.K.. They envy the short wait times I experience and the great care I get. An MRI the same day the doctor orders it? Not in Canada. A joint replacement for a 70 year old in Britain? Not likely. And I don't want to wait 3 months or 6 months just to see a doctor. Keep your socialized medicine. We don't want it.

Re:Just socialise the damn thing already (1)

Anonymous Coward | about 2 years ago | (#41423295)

I'm from the US, and I'd love great care. Having to wait a bit if better than not getting it at all!

But hey, I can't compete with your generalizations and anecdotal evidence. You have yours, so who gives a fuck, right?

Re:Just socialise the damn thing already (0)

Anonymous Coward | about 2 years ago | (#41423339)

UK here. I have never had to wait for a critical problem. The longest I have had to wait for a non critical problem was about four months which is a perfectly acceptable wait considering that it was non critical visit to a specialist (not a general doctor, you can see them next day at the latest) and regarding your joint replacement comment, my dad is 68 and only had to wait a month for his knee replacement. If you feel like smothering yourself in debt just so you don't have to wait for non critical operations then go ahead, just because you have socialised medicine doesnt mean you cant have private medicine as well..

Re:Just socialise the damn thing already (1)

Chris Mattern (191822) | about 2 years ago | (#41423239)

You know, I was reading an article where it stated that socialised medicine would cost *less* than what what it costs to run Medicaid and Medicare (on a per person basis)

You mean, like all the articles that said it would cost less to switch to electronic records?

Re:Just socialise the damn thing already (0)

Anonymous Coward | about 2 years ago | (#41423285)

The Germans love to provide services via insurance. A huge amount of the social framework is held together by insurance, and it was an easy decision for them to go with the model of healthcare in which you have private hospitals and heavily regulated health insurance providers.

They had exactly the problem described in the summary: http://en.wikipedia.org/wiki/Overutilization

The only solution anybody could come up with, short of redesigning the entire system, was to force the end user to pay for a certain percentage of the care they recieved out of their own pocket (with a few exceptions in the case of those who really can't pay). It wasn't a great compromise, but it did work.

You cannot partially socialise health care and expect it to work perfectly. If you want socialised health care, the hospitals have to be integrated into the system or you have to make ugly hacks and compromises to combat overutilisation. Of course, trying to nationalise hospitals in the US would be so ludicrous an idea that it wouldn't even be career suicide to propose it - everybody would just assume it was a bad joke.

Re:Just socialise the damn thing already (3, Insightful)

xs650 (741277) | about 2 years ago | (#41423287)

>

You Yanks fear the word "socialist" so much you spend far more to get rid of it!

You Wanks assume Yanks are all the same. That is not a valid assumption.

The majority is the same (1)

bussdriver (620565) | about 2 years ago | (#41423499)

The majority of voting yanks are wankers. Those who do not vote do not matter.
The half that vote has severely limited choices and are misinformed most are probably wankers.
I'm a yank but I'm in the minority; the voting informed who are not wankers.
http://www.youtube.com/watch?v=B5OWRRJh-PI [youtube.com]

Re:Just socialise the damn thing already (2)

MacGyver2210 (1053110) | about 2 years ago | (#41423289)

I'm just thinking of all the social benefits of this.

Less employes, more automation, and somehow it costs MORE with LESS effort on their part.

Seems legit. Score another one for Medi*** reform. Wake me up when they actually do something about campaign financing.

Re:Just socialise the damn thing already (5, Insightful)

girlintraining (1395911) | about 2 years ago | (#41423357)

You Yanks fear the word "socialist" so much you spend far more to get rid of it!

You're parroting a commonly held misconception about how politics in the United States works. Firstly, your elected representatives come from more than two parties; Your voters have a wider diversity of candidates to choose from, and are less apt to vote along party lines. This also spreads out the concentration of money paid to your elected representatives by private interests. Put more simply, it's harder to buy legislation in your country. As well, the disparity between the rich and poor is far less pronounced. This results in your legislators being more likely to represent the actual will of the people, rather than the apparent or manufacturered will.

It's also no small matter that the UK has the BBC. It's more important than you guys give it credit for: The licensing fees you pay are amply repaid not just in terms of quality programming, but also unbiased programming. The BBC can't be co-opted with a corporate buyout. In our country, the media is largely controlled by a few dozen men like Murdock. An informed voter is a voter that can't easily be duped; And the BBC provides a mechanism to prevent your media from becoming too biased towards any one political view. Compare the US section of the BBC with any major news network here -- stories that make front page there, or are internationally relevant, simply don't make it. They aren't reported. It's not just that there's bias in what is reported, there's also things that the public simply isn't told about. You can probably deduce what this means for the political landscape.

Lastly, the UK was bombed into near-nothingness. The US never has been. The closest we've come to having to reassess economically was the Great Depression. Because we never had to rebuild from scratch, we never learned the social lessons that an experience like that offers -- specifically, we never really developed a cultural center of "We're all in this together". American culture has long been based on individualism -- which during times of material prosperity is great, but during economic trouble, it creates a "blame the victim" mentality. You are poor because you want to be poor, not because some bad shit just happened to drop on your head. The American Dream has become a political crucible -- maintaining our collective ego has forced us into social policies that are ultimately harmful and destructive to our way of life. It's a societal-scale version of the Just World phenomenon.

It's not socialism per-se that we're afraid of -- it's the idea that we aren't in control of our own fate. That we aren't individuals, but actually part of something more than ourselves, and that our success is determined only in part on our own choices, rather than entirely by it. It's ego protection, individually and collectively. And when you read anti-socialist opinions in our media, they may use the same words you know and understand, but they don't mean the same things. It all goes back to the cold war, the super power stuff, and that collective ego I mentioned earlier.

For us, socialism is a sign of weakness; It's a sign that we've become like the russians, the iranians, and all the other boogie men we've bomed the hell out of. So even when it would be good and proper for us to adopt socialist social policies, we don't... we'd rather go on maintaining the notion that We're Number One. America is on a path of self-destruction because it simply can't acknowledge, individually or collectively, that we need help and we need to work together. Our problems are world problems too -- but until that fact ingrains itself into our culture, it's pointless to expect change. America, as an idea and as a culture, would rather die than admit defeat.

Just like the British did at the height of their empire. It's a phase we'll outgrow eventually, just like you guys did. But it won't happen quickly, or easily, or gracefully.

Re:Just socialise the damn thing already (0, Flamebait)

Anonymous Coward | about 2 years ago | (#41423775)

What is such insightful and well reasoned opinion doing in slashdot? You ma'am must be new here.

Why not both? (0)

Anonymous Coward | about 2 years ago | (#41423419)

Why does it have to be either/or? I don't mind having taxes support those who can't afford to pay. In fact, we're already doing that. Just expand Medicaid. Problem solved. The social safety net is there to solve problems that private industry won't solve. It may not be the best way to solve those problems, but it's the only way we've got.

On the private side, what's lacking is real health insurance. I can purchase a $500k CSL auto policy for $1200/yr with $3k deductible for collision. Car insurance doesn't care who fixes your car. There are no "networks" or "copays for oil changes". We take better care of our cars than our people and....

Fuck it. What you said. Just socialize it already. Hire some Swedes as consultants, give 'em free reign for a few years, and be done with it.

World Bank data (2010) (3, Informative)

Anonymous Coward | about 2 years ago | (#41423449)

Sticking to wealthy countries (source [worldbank.org] ):

Country | % Health spending/GDP | % Public health spending/Total health spending
USA 17.9 53.1
Netherlands 11.9 79.2
France 11.9 77.8
Germany 11.6 77.1
Switzerland 11.5 59.0
Denmark 11.4 85.1
Canada 11.4 70.5
UK 9.6 83.9
Sweden 9.6 81.1
Japan 9.5 82.5
Norway 9.5 83.9
Finland 9.0 75.1

I'm fairly certain that the total U.S. government spending per capita on health care is more than the UK spends per capita for its universal system.

Re:Just socialise the damn thing already (0)

Anonymous Coward | about 2 years ago | (#41423563)

and so how about people who do not want their government to handle their medical care, fuck their rights, yes?

Re:Just socialise the damn thing already (0)

Anonymous Coward | about 2 years ago | (#41423601)

EMTALA, Medicare, Medicaid and Monopoly Protections for Providers ensure Doctors treat everyone irregardless of ability to pay, and cost-shift to the people most capable of paying it. Cost shifting is, by definition, Socialism.

The result of that is a 7-9% increase in cost, year over year, and has been so since the 80's.

Please note; A Percentage Year over Year is an exponential function; this pattern will, with absolute certainty, bankrupt the Federal Government and destroy the country.

That is the reason everyone is terrified of the word "Socialism". We know it doesn't work, and we have the math to prove it. Obama Care with it's $2,000 per year "Behavior Tax" for those lacking insurance is an invitation to a Tax Rebellion and it's requirements insurers take everyone irregardless of their current medical condition and charge them a reasonable price is a 100% certain preamble to to collapse the medical systems payment structure; everyone will buy insurance the moment they get sick.

If we ended EMTALA, Ended Medicare and Medicaid, and Ended the monopoly protections, after a few years costs would return from the stratosphere to affordable. Gangsters could sell their rims to pay for their Wive's (Joined via a Shotgun Marriage) Child Birth. The cost of surgery would go down substantially; think $10k for a heart stint instead of 100.

Of course, if you are stupid and didn't save money, buy inexpensive insurance, etc, then well. You sir deserve what's coming.

That's Capitalism, though, and that, too, is a dirty, scary word invoking visions of robber-barons smoking humans like cigars, alive.

Re:Just socialise the damn thing already (1)

KalvinB (205500) | about 2 years ago | (#41423647)

Socialized Medicine: Because if someone can't afford excellent care, everyone should have mediocre care.

There's a reason people come to the US for medical treatments.

Re:Just socialise the damn thing already (1)

dunkelfalke (91624) | about 2 years ago | (#41423943)

People come to lots of different countries for medical treatments. Don't delude yourself that USA is somehow special in this particular case.

Re:Just socialise the damn thing already (1)

clarkkent09 (1104833) | about 2 years ago | (#41423757)

I guess we don't want the disaster like the British NHS inflicted on us by "well meaning" but clueless idiots.

'Tis a shame... (1)

QuietLagoon (813062) | about 2 years ago | (#41423131)

... that there are always some who will push the legal and ethical envelope in order to make a larger profit. Such is the way of Capitalism, it appears.

Re:'Tis a shame... (1)

fustakrakich (1673220) | about 2 years ago | (#41423341)

Why capitalism? Every human system ever devised is rife with corruption.

Re:'Tis a shame... (1)

frosty_tsm (933163) | about 2 years ago | (#41423703)

Why capitalism? Every human system ever devised is rife with corruption.

Exactly, look at how corrupt communism was.

Re:'Tis a shame... (1)

TheSync (5291) | about 2 years ago | (#41423595)

there are always some who will push the legal and ethical envelope in order to make a larger profit. Such is the way of Capitalism, it appears

Isn't is more the way of Socialism, as these doctors are billing the government?

If they were actually billing the patients, the patients would probably say "screw you, why am I paying you twice for the same procedure? See you in court!"

Be fair (4, Insightful)

Anonymous Coward | about 2 years ago | (#41423167)

Forgive my AC status, but for obvious reasons I can't divulge too many details. I was a contractor for a state government to facilitate writing an EHR system to integrate various state repositories for the purposes of the grants relevant to this story.

Of course this is going to cost more up front. We had to bring online hundreds of medical facilities who were operating with paper only with processes who's roots go back to the 1950s. The purpose of the grants was to MITIGATE the costs, not cover them completely.

The fact is that in the long run this will save money and is well worth the increase now. That increase would have been larger for every year longer we waited to bring some of these places into the modern era.

Not necessarily fraud (5, Informative)

Cipster (623378) | about 2 years ago | (#41423173)

Physician here. Medicare/Medicaid is tied to really arcane and often inane rules. You must document X of this and Y of that and word it in a specific way to get paid. What you actually do for the patient does not always matter but the way you document it makes a big difference. EMR has made it easier to conform to the rules and makes sure you write notes that can be easily billed for. It has simplified documenting for things that are tedious to do on paper (like review of systems, and counseling).

Re:Not necessarily fraud (0)

Anonymous Coward | about 2 years ago | (#41423871)

They are not archaic or inane rules. They are intentionally vague to allow enough room to argue when needed, just like the tax system, and just like the legal system. EMR s do not make it easier to follow the rules, it just changes them, like spreadsheets and turbo tax did for taxes. Still enough room to claim fraud and abuse if they are paying out too much. After all, you can't control people if our make the rules too clear.

Fraud. (4, Insightful)

Bysshe (1330263) | about 2 years ago | (#41423195)

Doesn't sound like electronic records is the problem. Fraud seems to be the problem.

So the fraud is now exposed... (4, Interesting)

Slyswede (945801) | about 2 years ago | (#41423205)

My impression is that the US health care system has been doing this for as long as it has existed. Having digital records should be a great help to the insurance companies to make it easier to track down fraudulent health care providers.

Since I live in Sweden I don't usually have a problem with health care bills, but once during a vacation to the US I had to visit a hospital due to severe stomach pain. Four hours and a trip through the CT machine later I was released with a prescription for some pills. Six months later (back home in Sweden) a bill for $14000 arrives...

When I brought this to my insurance company and explained that the examination I went through couldn't possibly have cost that much they just shrugged and said "yeah, they always try this when dealing with foreign insurance companies". A few weeks later they had everything settled at just under $3000.

So what's the point of this story? If a system is open to exploitation you need someone to monitor it. Monitoring is easier with good records of what's been going on.

Re:So the fraud is now exposed... (1)

TemperedAlchemist (2045966) | about 2 years ago | (#41423399)

B-but what about all the job creators! :(

Re:So the fraud is now exposed... (1)

Beryllium Sphere(tm) (193358) | about 2 years ago | (#41423671)

An electronic record system would have allowed automatic sanity checks that would have prevented an incident I know about.

The patient's daughter was a nurse, and reviewed an itemized bill. The daughter challenged one of the items. The billing department patronizingly reassured her that it was correct. The item was a prostate exam for her mother.

Greed (0)

Anonymous Coward | about 2 years ago | (#41423241)

So hospitals got greedy and it's somehow Obama's fault uh...

Re:Greed (1)

Virtucon (127420) | about 2 years ago | (#41423797)

It's Obama's fault for oversimplification of the problem and with his Democratic cohorts, Pelosi, Reid et al. for doing a lot of backroom deals [washingtontimes.com] to push bad legislation through. Do we all want affordable health care? Yes! Do we want to be able to make sure that we can get care for pre-existing conditions? Yes! Do we want 16000 new IRS agents enforcing the insurance mandate? No.

Ask yourself why an industry like the health care industry has seen increases in costs much faster than inflation? Sure, the number of uninsured has risen but also some of these deals that were made allow the drug companies and others to not be challenged in terms of their costs. They will continue to rake in record profits and are allowed monopolies in this country that they shouldn't have. You think software patents are bad? How about the prohibition of importing drugs from say India? You have a licensed monopoly and they will rape you for every dollar.

Electronic Record keeping isn't bad, it's bad when you have fraud already and you don't work on closing that out before you give crooks another way to steal from us all.

Also, despite the "grand legislation" there are more uninsured as of 2011 then there were back in 2008 when they started tracking it. [gallup.com]

Almost 18% of GDP is spent on healthcare in this country now and in comparison to other developed nations [guardian.co.uk] we spend more than our peers. Germany spends 10% of their GDP on Healthcare with 22% coming from private spending, meaning insurers and the government pay out 78%. In the US, 17.9% of GDP is spent on healthcare with 47% coming from private spending. It's an industry out of control and the whole Obamacare legislation won't fix it.

So, I don't just blame Obama, I blame the Democrats and the Republicans, in fact all of these idiots in DC and the statehouses who have allowed this to happen to us. I'll be retiring in 20 years, probably into a cardboard box. Why? Because I'll get free health care and I won't have to pay any taxes.

Health technology entrepreneur here (0)

Anonymous Coward | about 2 years ago | (#41423299)

We started making health care BI apps two years ago, just when they instituted meaningful use and were starting the incentive program. Up until a few months ago, there was stellar interest from hospitals to purchase our technologies - but the MU incentive changed things dramatically.

We were shoved under the rug and hospitals started adopting 1970s technology. (We are cutting edge on HTML5, MongoDB, iOS.) They are now adopting old brand names at a dramatic rate.

The regulations agency, ONC, is also operating like a gang. They push quite meaningless regulations that are designed to be difficult to understand by everyone except those that are in bed with them (vendors such as Cerner, McKesson, Epic). Yet, they claim that they are "fueling innovation".

This is nothing short of a multi-billion dollar government IT racket. Superior quality technology is not getting a chance because of it. Bad for the users, bad for the patients, bad for the doctors, and not fair to the tax payer.

Re:Health technology entrepreneur here (0)

Anonymous Coward | about 2 years ago | (#41423841)

(We are cutting edge on HTML5, MongoDB, iOS.)

Please, for the safety of millions of patients everywhere, never use these on ANYTHING related to healthcare. You have no clue what you are talking about and the fact that you would want to base your healthcare systems on "cutting edge" (bleeding edge) technologies furthers that point.

You are being shoved under the rug because hospitals want established companies with a track record of success and reliability. They don't want the "hot new thing" from some garage startup. They want a system built on PROVEN reliable technologies with a wide support base. Healthcare is no place for your little fad technology.

Re:Health technology entrepreneur here (0)

Anonymous Coward | about 2 years ago | (#41423907)

HTML5, MongoDB, iOS.

Superior quality technology

Wow. Please stay away from anything mission-critical. Maybe you could find a nice niche writing fart apps for Android?

sfp Nigga (-1)

Anonymous Coward | about 2 years ago | (#41423333)

Not everyone thinks EMRs are a good idea, (1)

Adult film producer (866485) | about 2 years ago | (#41423351)

Imagine that you are a cardiologist. You work at a large hospital in Oklahoma City. You are about to perform a heart catheterization on a patient. The âoesystem goes down.â What ? You mean that a computer system might fail? You have no medical records because they are digitalized on âoethe system.â You have no idea what this patientâ(TM)s history is or what it is they need or what you had planned to do for them. You ask the patient,â..do you mind telling me what it is that I see you for?â

http://032a410.netsolhost.com/WordPress/?cat=6 [netsolhost.com]

Re:Not everyone thinks EMRs are a good idea, (0)

Anonymous Coward | about 2 years ago | (#41423605)

This can happen...I was actually witness to a four day downtime of the primary ADT system at a major facility..the health records manager at the time joked, "paper doesn't go down."

But, this comes back to a question of proper engineering (which I admit, I rarely see)...for the most part, it is possible to create local caches of relevant records, and critical equipment are powered through specially designated outlets that are supplied with backup power...an additional UPS can provide an extra buffer...not to mention that downtime procedures should be in place.

But...this all assumes that the system has been properly engineered...to be clear, when I say that I mean the product (I have seen some scary vendor behaviour), and the initial configuration as established on deployment (I have seen some ridiculously bad choices made here)...unfortunately, there are a great number of people (who's opinions are valued) who think that running an emergency department is no different from running a mcdonalds...and, for the most part, they aren't around to deal with the repercussions of their work.

Re:Not everyone thinks EMRs are a good idea, (1)

Revotron (1115029) | about a year ago | (#41423999)

All hospitals have downtime procedures if the electronic system were to fail. This includes everything from chart printouts to comprehensive failover systems. No amount of engineering and technology can prevent you from losing paper charts, yet you're still stuck in a very similar conundrum. Most system failures are a result of human error.

Clearly the benefits of electronic systems outweigh the risk, just like owning a car. Sometimes your car might not start when you need it to if you fail to properly maintain it, and you'll have to walk to wherever you need to go, but does that mean you shouldn't own a car at all, and that you should ALWAYS walk?

Not restricted to Medicare (4, Informative)

pesho (843750) | about 2 years ago | (#41423477)

The type of fraud described in the article is not restricted by medicare but is pretty much standard practice in most medical offices that use electronic billing.It is a simple play on the "power of the default" that makes it difficult for doctors to behave honestly even if they don't intend to carry out fraud. The way it works is that when a doctor or a nurse pulls a page for a particular task, all possible tests and procedures are checked by default. In many cases there are a dozen or so check boxes that the doctor will have to actively uncheck if he/she needs to just take the pulse of the patient. Naturally, doctors don't have neither the time nor the patience to click around the screen. They also don't have the incentive to reduce their income while wasting their time. An obvious and simple solution would be to set the default to all procedures unchecked and require manual input for to check the boxes. If I remember correctly this is how electronic records are handled in the Keiser hospitals. Another thing that should be required is to retain and provide unique tracking information for every sample and test being done. This is also not difficult because the sample tracking is already part of the software. Finally it should be legislated that the medical records belong to the patient, not the medical office. I don't see why I have to repeat the same panel of tests and fill same questionnaires every time I choose to ask for a second opinion or if due to various reasons I seek help from a different practitioner.

My 0.02 (0)

Anonymous Coward | about 2 years ago | (#41423779)

My guess is providers are charging more money and seeing higher profits as a result of the reduced overhead costs associated with the electronic medical records push. Perhaps providers have found a way to manipulate the electronic system in their favor as well.

Paper gets lost, forgotten, destroyed (0)

Anonymous Coward | about 2 years ago | (#41423851)

I am not surprise in the least. As an employee of a group benefits provider (ie: private healthcare insurance), we were often told that the reason our own benefits plan (ie: the one that us employees paid into and used) did NOT have an electronic drug card was because it cost too much. They explicitly said that payouts to customers on the paper system was lower because receipts were lost, forms improperly filled out, etc.

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