quickly change once the public
understands that the greed of the few has placed lives at risk.
The financial fraud and patient-care abuses that are rampant in healthcare require a system of regulation analogous to the manner in which the Federal Aviation Administration oversees the airline industry. Each state has a degree of medical regulation carried out by their medical boards; but the system varies in its effectiveness and is subject to local political pressures. The state medical boards are incapable of fighting the vast amount of abuse exposed in this document.
The push on the part of Federal prosecutors to go after fraud and corruption
is, in its own way, actually a step towards imposing national regulation on
the healthcare industry. Regulation is what the healthcare industry
fears most. The multitude of Qui Tam suits, just a few of which
we report above, suggests that the government is aware that something must
be done. Unfortunately, this “regulatory” approach hinges on the willingness
of a whistleblower to come forward. Much crime is still well hidden
because no one is willing to blow the whistle.
Only a fraction of
healthcare fraud is ever discovered.
Since its inception in 1965, the Medicare program has had an initiative
devoted to the “quality problem."
There are now 51 taxpayer-funded contractors, called Quality Improvement
Organizations (QIO’s), in 50 states that are
supposed to assist healthcare providers in improving the care to Medicare
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