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re: “Las Vegas” NP Fraudulently Bills Medicare for ~$900M. Gets $300M

Posted on 6/30/26 at 6:53 am to
Posted by Bard
Definitely NOT an admin
Member since Oct 2008
59757 posts
Posted on 6/30/26 at 6:53 am to
quote:

But it’s not “socialized medicine” even in the slightest.


It absolutely is. It's government forcing people to pay into a program to pay for not only their own healthcare (whether they need it or not) but to also pay for the healthcare for others.

As such, it actually helps drive the costs of healthcare up because it funds demand instead of supply. Want to fix medical costs? Fund SUPPLY.

There are approximately 23k medical school seats yet there are ~53k applicants each year. Offer medical schools some sort of package to increase their seats to meet at least half of that marginal demand and costs will eventually start coming down once the extra graduates hit the job market.
Posted by Tarps99
Lafourche Parish
Member since Apr 2017
13031 posts
Posted on 6/30/26 at 6:53 am to
quote:

This is mostly correct. Although their reimbursements are worse, they are by far the most reliable and prompt payer. They will always pay, whatever you charge, within ~14 days.


That is the reason why medical providers bill for thousands in the hopes of collecting a few hundred dollars. Same with regular insurance.
Posted by RFK
Mar-a-Lago
Member since May 2012
3292 posts
Posted on 6/30/26 at 6:56 am to
quote:

The issue isn't really what a doctor charges, it is that insurance is involved in all aspects of medical care with no billing transparency.
Well once we die, we literally won’t be able to care about that (or anything).

There is a bigger picture here. The role of healthcare in a society. Our system shouldn’t limit access to care to make an elite few rich. Doctors should go to medical school because they have a passion for it IMO.
Posted by stout
Porte du Lafitte
Member since Sep 2006
183558 posts
Posted on 6/30/26 at 7:02 am to
quote:

Incredible work. Thanks for the analysis.



Posted by the808bass
The Lou
Member since Oct 2012
129151 posts
Posted on 6/30/26 at 7:53 am to
quote:

Want to fix medical costs? Fund SUPPLY.


Ding ding ding.

This isn’t the only solution, but it certainly would help.

Also, we should make account on the front end when we’re accepting women into medical schools. We know that X% of them won’t be practicing full-time within a few years of beginning practice. Account for that when you decide the number of seats you’re going to fill.

Lots of stuff we can do on the side that isn’t “throw more money at it.”

Enable independent outpatient surgery centers.

Allow people to purchase catastrophic insurance policies.
Posted by the808bass
The Lou
Member since Oct 2012
129151 posts
Posted on 6/30/26 at 7:54 am to
quote:

Our system shouldn’t limit access to care to make an elite few rich. Doctors should go to medical school because they have a passion for it IMO.


Get the frick out.

How much money do you donate to charity every year?
Posted by Bjorn Cyborg
Member since Sep 2016
36090 posts
Posted on 6/30/26 at 8:00 am to
quote:

but IMO any profit above 10-15% is too much. That’s what a restaurant (hopefully) makes off the meal you buy. Medicine offers just a different service. Not sure why the margins should be higher.


What a fricking retarded comparison.

The barriers to entry and liability are infinitely greater than a restaurant.
Posted by dgnx6
Member since Feb 2006
90478 posts
Posted on 6/30/26 at 8:03 am to
Where is the nothing will happen crowd?


Posted by dgnx6
Member since Feb 2006
90478 posts
Posted on 6/30/26 at 8:06 am to
quote:

My brother has a small clinic in rural Mississippi that accepts Medicare. I’m surprised at this story - the government paperwork requirements are so onerous that he has to pay a separate full-time clerk and another account manager just to manage Medicare.




Good on him. Most doctors now just work for large hospital chains because of shite like this.


Posted by onmymedicalgrind
Nunya
Member since Dec 2012
12226 posts
Posted on 6/30/26 at 8:17 am to
quote:

Also, we should make account on the front end when we’re accepting women into medical schools. We know that X% of them won’t be practicing full-time within a few years of beginning practice. Account for that when you decide the number of seats you’re going to fill.

You know this will never happen.

quote:

Enable independent outpatient surgery centers.

Hospitals were doing everything in their power to squash this….they have failed. So now they are trying to a big slice of this pie while limiting physician ownership. They will fail at this too.
Posted by YipSkiddlyDooo
Member since Apr 2013
3816 posts
Posted on 6/30/26 at 8:19 am to
quote:

My brother has a small clinic in rural Mississippi that accepts Medicare. I’m surprised at this story - the government paperwork requirements are so onerous that he has to pay a separate full-time clerk and another account manager just to manage Medicare.


Filing a part B claim is as simple as generating the 1500 form and submitting it. As long as it’s a valid e/m or CPT code, Medicare pays without question or delay. You’re just making shite up now.
Posted by Strannix
C.S.A.
Member since Dec 2012
53939 posts
Posted on 6/30/26 at 8:21 am to
quote:

He may disagree, but IMO any profit above 10-15% is too much. That’s what a restaurant (hopefully) makes off the meal you buy. Medicine offers just a different service. Not sure why the margins should be higher.


I'm talking about the endless horde of foreign invaders you dolt.
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
12226 posts
Posted on 6/30/26 at 8:23 am to
quote:

That is the reason why medical providers bill for thousands in the hopes of collecting a few hundred dollars. Same with regular insurance.

You don't bill medicare or private insurance a dollar amount. You bill for your services. What you get is what you get.
Posted by the808bass
The Lou
Member since Oct 2012
129151 posts
Posted on 6/30/26 at 8:23 am to
quote:

You know this will never happen.


Probably not until after the civil war.
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
12226 posts
Posted on 6/30/26 at 8:27 am to
*whispers* my wife has been in practice less than 10 years and is already part time *whispers*
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