Page 20 - DMN3Q21

A recent issue of Healthcare Michigan carried a shocking article - “COVID Testing Has Become a financial Windfall,” written by Jay Hancock and Hannah Norman. In it we read an unconscionable tale of price gouging for COVID tests, with some charging over $1000 for a test that others administer for $20 - $30. And, according to the article, the government mandates that insurers pay the full price.
The next day, I received the following warning in an MSMS newsletter: “a phishing attempt [that] may affect you. The phishing email will inform you about funds owed, or funds due as result of the advance/accelerated COVID payments. Please be diligent and carefully review all emails that include secure information. Check the email address.”
Do these two items have anything in common? I would say yes. Smaller often is better. Private practice is more personal than public institutions, and more personal than large corporate enterprises.
In the first paragraph we have an example of large hospital systems abusively charging patients who do not care because large insurance companies pay the bills. The second typifies the type of abuse that occurs when a big payer like the government dispenses large sums of money without caring whether those who receive this windfall needed that much, or whether they needed anything at all. On top of that, it should not be surprising if some sharpster eventually figures out
a way to take some of this easy money. Neither example has the kind of controls that small local
businesses would institute to control their daily expenses. Experience has shown that Medicaid and Medicare have suffered massive frauds, and huge consolidated hospital systems have perpetrated fraud by inflating the price
of even a simple service, bloating it with allocations
for the ER, laboratory, x-ray, cafeteria, sundry clinics, maintenance, the parking structure, the pharmacy, maybe the gift shop, and any other services they can manage to apportion among all the patients who come to the hospital, even those who have come in for a simple shot.
This is not to say that we should not have Medicare, Medicaid, or any big hospitals. They all serve important purposes, but it is an illustration of why we should not
By: Susan Adelman, MD
20 Detroit Medical News Third Quarter 2021
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