Fraud
John R. McLean, 59, a cardiologist in Salisbury, Maryland, a hundred miles from Baltimore, has been convicted of six counts of health-care fraud and faces a stiff sentence in Federal prison. According to the FBI, between 2003 and 2007 Dr. McLean implanted more than 100 unnecessary cardiac stents in his patients and collected more than $711,000 from the government in fees for these procedures and related evaluations. Peninsula Regional Medical Center, where Dr. McLean performed his cardiac catheterizations, agreed to pay $2.8 million, admitting no liability, to settle associated claims with the Federal Government. Medical malpractice lawsuits from Dr. McLean’s aggrieved patients are sure to follow against him and Peninsula.
I haven’t the slightest idea what would make an apparently stolid, older member of the medical profession go bad (it surely would have been better to go bankrupt in the first place, which he will undoubtedly be doing now anyway) but I do know how corrupt and fraud prone our medical care system is. Anyone who passed Economics 101 should realize the problem.
Throw money at something and that something will soon become expensive; keep throwing money and soon nobody can afford it. Every ersatz and fraud imaginable will arise to sop up the money flow. Look what happened in the housing boom. Is anyone really surprised that similar things happen in health care?
Every American over the age of 65 with a beating heart and Medicare is potentially eligible for a coronary stent. Who’s to stop it? Not the patient; he doesn’t pay for the procedure and it might help him—the doctor even told him it would help him. The doctor has a financial incentive to put the stent in. The hospital has a financial incentive to let the doctor put the stent in. Clarence Darrow wrote a book about the corruptness of the criminal justice system in 1903, and the system has not fundamentally changed since. (Download “Resist Not Evil” as a PDF or .epub for free. It’s a great read.) The only finger left in the dyke is the common decency of most physicians, not always so decent it turns out.
I’m happy to sue a doctor who commits Medicare fraud. I only wish the conditions that create these frauds didn’t exist.
