GLITCH IN THE MACHINE
I applaud the story written by Joe Eaton as he tries to understand the issues related to Medicare fraud, but take exception to the excuse that anyone would think that Medicare might have a reluctance to anger "real" doctors who file inaccurate claims.
I am a pulmonary/critical care physician who has been in the same community for 30 years, seeing the same types of patients and using the same codes. Two years ago, I started receiving very nasty notes from Medicare demanding a return of dollars. Some were direct requests for payment stating that if I did not immediately send a check they would take legal action, but most were [payments] withheld, essentially keeping dollars from monies due. My practice is about 70 percent elderly patients with breathing problems, so this had an immediate impact on my income and ability to support my staff and landlord. Years later, the denial was reversed and I eventually got credit toward future payments. During the process, the government sends me hundreds of checks for 78 cents, to cover an interest charge they incurred during the months of delay. So who is really benefitting here? It is not me, and I wonder if the taxpayer is. The real irony of this is that when I got my 1099 from Medicare, it shows my income almost double the amount of dollars that I actually received. Am I supposed to pay tax on that money as well?
I think what needs to be investigated are the investigators. How does the government reimburse "private contractors"? From my experience and that of many others, it seems as though the system may be emphasizing, algorizing, rewarding, and incentivizing the wrong elements. If Visa did things this way, they would have been out of business a long time ago.
—Michael Gurevitch, MD, Pasadena, California
Why was Florida Governor Rick Scott not mentioned in the article? As I recall, back in the day, he and others paid the largest Medicare fraud settlement on record so that no criminal charges would be filed. ... Thanks for a good article that supports stopping "fee-for-service" payments and heading for another system.
—Charles Garascia, Pueblo, Colorado
HOW CAN WE TREAT THE SERIOUSLY MENTALLY ILL BEFORE TRAGEDY OCCURS, INSTEAD OF AFTER?
What impressed me most about Nevada County's implementation of Laura's Law was the care and compassion shown by Judge Anderson and others involved with the program. A better solution would seem to lie in finding ways to make those qualities more readily available to those who need help.
—Nick McNaughton, Los Angeles, California
Jeneen Interlandi’s feature story also generated a lot of discussion on Twitter.
This piece is so, so good: important, well-written, relevant, etc. File under "wish I'd written, glad you did."
—Melissa B. Warnke, @thewarnke
Sam Bagenstos, a professor at the University of Michigan law school, had some criticisms:
This @PacificStand piece conflates 2 distinct things: Assertive Community Treatment & Assisted Outpatient Treatment.
There's good evidence that ACT works, but the evidence on AOT is not positive.
—Sam Bagenstos, @sbagen
THE RADIOACTIVE REMEDY
This @PacificStand piece on radiation exposure at health mines is fascinating.
—Becca Worby, @bworbs
Fascinating article from @MadeleineTwnsnd on patients trying radon therapy.
—Lenny Teytelman, @lteytelman
Amazing story in Pacific Standard on people seeking (unproven) pain cures in a former uranium mine.
—Kara Platoni, @KaraPlatoni
Don't be the only person on the Internet today who hasn't read Madeleine Thomas' story on radioactive "health" mines.
—Kate Wheeling, @KateWheeling
Pacific Standard has many fascinating and forward-thinking articles, but its pieces on trigger warnings are wrongheaded and damaging. They fundamentally misunderstand trigger warnings, which have existed for ages under different names. A syllabus that mentions disturbing content counts as a trigger warning. Warnings do not prevent students from learning, they enable students with post-traumatic stress disorder and other sensitivities to learn more effectively because they don’t have traumatic flashbacks or overly fixate on the particular trigger during class. We are not talking about students who "want to see only that which supports their own point of view," as Craig Klugman writes in "Trigger Warnings on College Campuses Are Nothing but Censorship," and to assert that is downright offensive. Those who don't want to hear debates because of their political views are not talking about trigger warnings. They are misinterpreting the definition of trigger warnings, or their professors are.
People who advocate for minimum wage laws fail to grasp that they are advocating for something done by force that no one truly understands. "But compared to past experiments on the federal level, 2016's grand experiment of state-level wage tinkering could help us better understand the macroeconomic impact of a higher minimum wage—and, as its advocates hope, pull hundreds of thousands of Americans out of poverty and destitution," Jared Keller writes in "America’s Grand Wage Experiment." But government mandates do not "pull" people out of poverty; that ignores how wealth grows. And it fails to address where money originates.
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