The recently revisited healthcare fraud in Florida has been gracing headlines and turning heads, but those of us who shop Health Care System related books know better. I'm Andy Lazris, and since I've spent over two decades in the medical industry as a primary geriatric care physician, my take is slightly different. Shocked? Offended? Indignant?
I'm all of the above, but that can hardly be pinned on Mr. Esformes, who was unfortunate enough to be a part of the tiny percentage of healthcare frauds in the USA that is actually prosecuted. Philip Esformes was paying cash bribes so that doctors would send their patients to his nursing homes so that he could then bounce them around the system, paying little mind to their real medical needs.
You see, when Crown Prince Mohammed bin Salman had Jamal Khashoggi slaughtered, his only real reaction was to ask about the international affront. Why? For this royal, murder and censorship was part of a system he knew better than the rest of us. The only difference between Khashoggi and undoubtedly countless others was the level of publicity. That's was a scam looks like to medical personnel.
The medical industry is just as fueled by capitalist endeavors and personal gain as every other industry, if not more. It's easy to turn a profit when you're selling for years.
Sure, I agree he should be punished, but perhaps before he's sentenced, the courts should thank him as they collect his fine. He's proven in black and white just how pointless our medical legislature and regulation are. As if they didn't already know.
His scam did run from 1998 to 2016, after all, and in all that time, our blessed system couldn't do anything for the people caught in his cycle of homes. He's reported to have ordered several unnecessary but pricey treatments for patients, keeping the profits near and dear. His partners in crime were Medicaid and Medicare. A true crime against humanity, but it also sounds a little familiar.
Doctors On The Dime
Pharmaceutical companies have been doing the same, except their bribes are called disclosed payments, and they're accessible online. Payments, or rather grants, gifts, and more are presented to doctors so long as they're kind enough to prescribe their benefactor's products.
So the next time you get a prescription pad, check to see who the highest bidder was for your life because your doctor might have put you up for rent.
There are still doctors in the system who'd never stoop to that level, but given some of them have the decency to take bribes out of the public eye, there's no way of knowing the ratio. Along with that, how long could morality even survive in such destitution? In 2018 alone, Dr. Kevin Foley made $29 million in appreciative payments.
Then take a look at Rituxan, a cancer medication. Six companies paid $53.6 million to 3,202 doctors and 24 teaching hospitals, including Massachusetts General, Yale-New Haven, and Tufts. If you think that's bad, then stay tuned because it gets worse, as it often does in the world of healthcare fraud. Fortunately, this tune is graced by a whistleblower. Here's a summary of the wrongdoings
This drug reactivated Hepatitis B
This drug was approved for off-market use
It was used to train employees to sell drugs without the FDA finding out
It leads to fatal brain infections
Given that it's been in circulation since 1997, it's at least on par with Esformes, except where he's faced with $44 million in penalties, these mammoth companies only paid $20 million to make their lawsuits go away. Also, since it was done by respectable companies, it wasn't referred to as fraud, even though Esformes is painted as the looming villain in a medical fiction book.
It's Snot Nonsense
COVID-19 was the biggest marketing campaign for healthcare, and just as well, because they were running out of ways to make the other big C billable. In 2022 it was determined that COVID-19 became the vehicle of $149 million worth of fraud.
Of course, the scammers' partners in crime were the ever-helpful Medicaid and Medicare. Since their inception, these have been the unimaginative way to defraud taxpayers for financial gain, and it seems to have become something of a tradition. Don't tell that to the hyped-up masses so excited to declare that the pandemic has finally exposed all the aberrations in medicine. It's a trick as old as time.
Doctors have been documented and occasionally caught visiting comatose patients, greeting their families, and nonchalantly billing Medicare for a consult. The evils in our industry prey on palliative care. That's why I wrote The Geriatrics Vengeance Club, showing how our "lifesaving" neglects the most vulnerable in our society.
Naturally, during the pandemic, when many were stranded overseas, unable to visit loved ones, or struggling to get medical attention, a plan was hatched. It's as if someone said everyone thinks they're going to die, so let's charge them for reassurance. Then came the shiny new vaccine, so revolutionary it passed tests and trials without even having to take them.
The novel virus also became a great way to tell patients that they needed expensive tests, to exploit policy, and to set up fake telehealth services. When this was publicized, the media made a point of righteously highlighting that these scammers had brought healthcare's integrity into question. A better description would be that they brought its existence into question.
What's the point of a healthcare system that's a platform for theft, abuse, and everything bad?
It's Science! It's Medicine! No, It's Bogus!
If you're ever told by a physician that your BMI (body mass index) isn't right, then that's your sign to pull out your apple and keep them away. Over or under, the system that's ruled our doctors like a maniacal tyrant seems legitimate enough, a doctor, but like the latter, the former isn't as inclusive as it's meant to be.
If you purchase non-fiction book, you'll see that people of each race and background have different body types, and that's not accounted for in the studies that gave us these scales and measures.
In the two hundred years since it was invented, nobody updated the system! Since this largely affects people of color, it's just another racist element of the healthcare system. It might not seem like such a big deal. All a patient has to do is ignore weight-related comments. People with higher BMIs pay more for insurance and have trouble getting diagnosed with eating disorders because, apparently, a small and outdated system takes precedence over what science has been saying for decades.
We each have different body chemistries, and at an unhealthy weight, we genuinely need consideration from our physicians as they prescribe medication and diagnose. Sadly innovation is only present in online fiction book shop.
People of color shouldn't have to lose out, and when they have to go the extra mile and dollar to be taken seriously, one can't say it's not healthcare fraud.
Don't Hate The Player, Hate The Game
I rest my case. What's worse? Being a liar in a world of liars or actively working to institutionalize and legalize lies? I'd say they're both quite bad, but certainly, the latter is worse. If you have a look at Curing Medicare, I explain how Medicare is, without question, a huge problem with its own kaleidoscope of crimes going on inside.
We all know that humans aren't t be trusted with the opportunity to take advantage, so why do we continue to act shocked that anyone would seek to profit off of the elderly or the abused when lies are in the bones of our system? Perhaps it's because of big pharma's significant contribution to our GDP or because of their contribution to the political pockets.
What's important is that wherever possible, people focus on changing rules and policies, not punishing those who are manifestations of man's evil creation. The business of saving lives is too important to be left to interpretation or goodwill. Malevolence has to be stamped out wherever it appears, or it's highly unlikely there'll ever be a change.
In my fiction book, January 6th And The Millenial Horde, I create an alternative history where the nation's reaction to the Capitol attacks was vastly different. Check out my online bookstore to see why reviewers loved this awards-nominated novel that shows us exactly what we're headed toward.
To see how quickly things can go south when a bad system is left unchecked, read my Civil War book online, Three Brothers From Virginia. Click here to check out the nonfiction books that include COVID-19 books!