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The Great American Healthcare Billing Scam
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Download or read book The Price We Pay written by Marty Makary and published by Bloomsbury Publishing USA. This book was released on 2019-09-10 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Book Synopsis Never Pay the First Bill by : Marshall Allen
Download or read book Never Pay the First Bill written by Marshall Allen and published by Penguin. This book was released on 2021-06-22 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: From award-winning ProPublica reporter Marshall Allen, a primer for anyone who wants to fight the predatory health care system--and win. Every year, millions of Americans are overcharged and underserved while the health care industry makes record profits. We know something is wrong, but the layers of bureaucracy designed to discourage complaints make pushing back seem impossible. At least, this is what the health care power players want you to think. Never Pay the First Bill is the guerilla guide to health care the American people and employers need. Drawing on 15 years of investigating the health care industry, reporter Marshall Allen shows how companies and individuals have managed to force medical providers to play fair, and shows how you can, too. He reveals the industry's pressure points and how companies and individuals have fought overbilling, price gouging, insurance denials, and more to get the care they deserve. Laying out a practical plan for protecting yourself against the system's predatory practices, Allen offers the inspiration you need and tried-and-true strategies such as: Analyze and contest your medical bills, so you don't pay more than you should Obtain the billing codes for a procedure in advance Write in an appropriate treatment clause before signing financial documents Get your way by suing in small claims court Few politicians and CEOs have been willing to stand up to the medical industry. It is up to the American people to equip ourselves to fight back for the sake of our families--and everyone else.
Book Synopsis Phantom Billing, Fake Prescriptions, and the High Cost of Medicine by : Terry L. Leap
Download or read book Phantom Billing, Fake Prescriptions, and the High Cost of Medicine written by Terry L. Leap and published by Ilr Press. This book was released on 2011 with total page 237 pages. Available in PDF, EPUB and Kindle. Book excerpt: Confronting medical fraud and its economic, psychological, and social costs.
Book Synopsis The Social Transformation of American Medicine by : Paul Starr
Download or read book The Social Transformation of American Medicine written by Paul Starr and published by . This book was released on 1982 with total page 532 pages. Available in PDF, EPUB and Kindle. Book excerpt: Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
Book Synopsis The Great American Health Hoax by : Raymond Francis
Download or read book The Great American Health Hoax written by Raymond Francis and published by Simon and Schuster. This book was released on 2015-02-03 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: Described as "one of the few scientists who has achieved a breakthrough understanding of health and disease," Raymond Francis draws deeply from his years of personal experience and professional training. A chemist and a graduate of MIT, Raymond exposes the truth about why the conventional approaches to health and disease aren't working. In The Health Hoax, Francis blends wisdom from his previous books with new information and research, then he pulls out all the stops and creates a simple roadmap to health so that you can get well, stay well and never be sick again. Francis believes that, through education, we can put an end to the epidemic of chronic disease while providing a solution to the biggest social and economic problem of this century—the costs of global aging. In The Health Hoax, Francis exposes the truth about how to stay healthy and introduces us to a way of life that can become a "highway to health", while he quite effectively demonstrates that we really don't have to be sick. Then, he reminds us that not only is there absolutely no fun in being sick, but we are going broke trying to pay the cost. Francis realizes that the only solution for individuals and society as a whole is to maintain health. But health is a solution that we must choose, and once we make that choice, we must learn how to achieve it. Fortunately, learning how to be healthy has never been easier—The Health Hoax makes it simple. Because the human organism is a magnificent self-regulating, self-repairing system, it is capable of being completely functional and in excellent health for well over 100 years of vital, productive life. We are the sum of everything that goes into our system – it is our job to support it. When we make the choice to properly care for ourselves, our bodies will reward us with the gift of good health and long life. All we need is a tool to help us master the elements of health that are the most important. This book is that tool. It will empower you to choose health and never be sick again!
Book Synopsis Catastrophic Care by : David Goldhill
Download or read book Catastrophic Care written by David Goldhill and published by Vintage. This book was released on 2013-01-08 with total page 386 pages. Available in PDF, EPUB and Kindle. Book excerpt: A visionary investigation that will change the way we think about health care: how and why it is failing, why expanding coverage will actually make things worse, and how our health care can be transformed into a transparent, affordable, successful system. In 2007, David Goldhill’s father died from infections acquired in a hospital, one of more than two hundred thousand avoidable deaths per year caused by medical error. The bill was enormous—and Medicare paid it. These circumstances left Goldhill angry and determined to understand how world-class technology and personnel could coexist with such carelessness—and how a business that failed so miserably could be paid in full. Catastrophic Care is the eye-opening result. Blending personal anecdotes and extensive research, Goldhill presents us with cogent, biting analysis that challenges the basic preconceptions that have shaped our thinking for decades. Contrasting the Island of health care with the Mainland of our economy, he demonstrates that high costs, excess medicine, terrible service, and medical error are the inevitable consequences of our insurance-based system. He explains why policy efforts to fix these problems have invariably produced perverse results, and how the new Affordable Care Act is more likely to deepen than to solve these issues. Goldhill steps outside the incremental and wonkish debates to question the conventional wisdom blinding us to more fundamental issues. He proposes a comprehensive new way, where the customer (the patient) is first—a system focused on health and maintaining it, a system strong and vibrant enough for our future. If you think health care is interesting only to institutes and politicians, think again: Catastrophic Care is surprising, engaging, and brimming with insights born of questions nobody has thought to ask. Above all it is a book of new ideas that can transform the way we understand a subject we often take for granted.
Book Synopsis License To Steal by : Malcolm K Sparrow
Download or read book License To Steal written by Malcolm K Sparrow and published by Basic Books. This book was released on 2007-12-14 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: Who steals? An extraordinary range of folk -- from low-life hoods who sign on as Medicare or Medicaid providers equipped with nothing more than beepers and mailboxes, to drug trafficking organizations, organized crime syndicates, and even major hospital chains. In License to Steal, Malcolm K. Sparrow shows how the industry's defenses, which focus mostly on finding and correcting billing errors, are no match for such well orchestrated attacks. The maxim for thieves simply becomes "bill your lies correctly." Provided they do that, fraud perpetrators with any degree of sophistication can steal millions of dollars with impunity, testing payment systems carefully, and then spreading fraudulent billings widely enough across patient and provider accounts to escape detection. The kinds of highly automated, quality controlled claims processing systems that pervade the industry present fraud perpetrators with their favorite kind of target: rich, fast paying, transparent, utterly predictable check printing systems, with little threat of human intervention, and with the U.S. Treasury on the end of the electronic line. Sparrow picks apart the industry's response to the government's efforts to control this problem. The provider associations (well heeled and politically influential) have vociferously opposed almost every recent enforcement initiative, creating the unfortunate public impression that the entire health care industry is against effective fraud control. A significant segment of the industry, it seems, regards fraud and abuse not as a problem, but as a lucrative enterprise worth defending. Meanwhile, it remains a perfectly commonplace experience for patients or their relatives to examine a medical bill and discover that half of it never happened, or that; likewise, if patients then complain, they discover that no one seems to care, or that no one has the resources to do anything about it. Sparrow's research suggests that the growth of capitated managed care systems does not solve the problem, as many in the industry had assumed, but merely changes its form. The managed care environment produces scams involving underutilization, and the withholding of medical care schemes that are harder to uncover and investigate, and much more dangerous to human health. Having worked extensively with federal and state officials since the appearance of his first book on this subject, Sparrow is in a unique position to evaluate recent law enforcement initiatives. He admits the "war on fraud" is at least now engaged, but it is far from won.
Download or read book A Second Opinion written by Arnold Relman and published by PublicAffairs. This book was released on 2007-08-05 with total page 244 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dr. Arnold Relman, Professor Emeritus at Harvard Medical School and former editor-in-chief of The New England Journal of Medicine brings together sixty years of experience in medicine in a book that holds the keys to a new structure for healthcare based on voluntary private contracts between individuals and not-for-profit, multi-specialty groups of physicians. Timely, provocative, and newly updated, A Second Opinion is a clarion call to action. If we heed Dr. Relman's plan, Americans could at last achieve a lasting, sensible solution to national healthcare.
Book Synopsis Mismanaged Money in American Healthcare by : Lisa Famiglietti
Download or read book Mismanaged Money in American Healthcare written by Lisa Famiglietti and published by McFarland. This book was released on 2023-09-01 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: Warren Buffett famously invoked the metaphor of a tapeworm when describing what healthcare is to the American economy. The United States spends approximately 20% of its gross national product on healthcare, but it is unclear where the money goes or who is minding the store. This healthcare crisis is mostly about money--not lack of money, but rather misspending of money. From the perspective of a healthcare auditor and provider, this work describes the problems of American healthcare finance and proposes solutions. Extensive charts and graphs are used to trace where money goes in the American healthcare system, while other topics such as ethics in healthcare billing, un-auditable hospital costs and scams are discussed. There is evidence that clearly identifies where the money goes, and its destination may surprise the reader.
Book Synopsis An American Sickness by : Elisabeth Rosenthal
Download or read book An American Sickness written by Elisabeth Rosenthal and published by Penguin. This book was released on 2017-04-11 with total page 434 pages. Available in PDF, EPUB and Kindle. Book excerpt: A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Book Synopsis The Great American Jobs Scam by : Greg LeRoy
Download or read book The Great American Jobs Scam written by Greg LeRoy and published by Berrett-Koehler Publishers. This book was released on 2005-07-21 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: What do Wal-Mart, Dell, Fidelity Investments, Boeing, and Cabela's have in common? They're all part of a $50 billion a year scam in which—in the name of "job creation"—corporations play states and cities against each other to win hefty taxpayer subsidies that routinely exceed $100,000 per job. But do they provide more jobs, higher wages, or improved living standards in exchange? Greg LeRoy exposes these deals for what they are—no-strings-attached free rides for corporations that rarely create any new jobs. In fact, after securing these packages, many companies lay people off, pay poverty wages, or even relocate to other states. This is the Great American Jobs Scam: a costly bait-and-switch that swindles communities in more ways than one. They lose jobs—or gain jobs so low-paying they do nothing to help the community—and they lose revenue through massive corporate tax breaks. That means fewer resources for maintaining schools, public services, and infrastructure. LeRoy exposes corporations' careful orchestration of this scam, dissects government and corporate mumbo-jumbo with plain talk, and offers commonsense reforms that will give taxpayers powerful new tools to protect our communities.
Download or read book Deadly Spin written by Wendell Potter and published by Bloomsbury Publishing USA. This book was released on 2010-11-09 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: That's how Wendell Potter introduced himself to a Senate committee in June 2009. He proceed to explain how insurance companies make promises they have no intention of keeping, how they flout regulations designed to protect consumers, and how they make it nearly impossible to understand information that the public needs. Potter quit his high-paid job as head of public relations at a major insurance corporation because he could no longer abide the routine practices of the insurance industry, policies that amounted to a death sentence for thousands of Americans every year. In Deadly Spin, Potter takes readers behind the scenes of the insurance industry to show how a huge chunk of our absurd healthcare expenditures actually bankrolls a propaganda campaign and lobbying effort focused on protecting one thing: profits. With the unique vantage of both a whistleblower and a high-powered former insider, Potter moves beyond the healthcare crisis to show how public relations works, and how it has come to play a massive, often insidious role in our political process-and our lives. This important and timely book tells Potter's remarkable personal story, but its larger goal is to explain how people like Potter, before his change of heart, can get the public to think and act in ways that benefit big corporations-and the Wall Street money managers who own them.
Book Synopsis Deadly Medicines and Organised Crime by : Peter Gotzsche
Download or read book Deadly Medicines and Organised Crime written by Peter Gotzsche and published by CRC Press. This book was released on 2019-08-21 with total page 251 pages. Available in PDF, EPUB and Kindle. Book excerpt: PRESCRIPTION DRUGS ARE THE THIRD LEADING CAUSE OF DEATH AFTER HEART DISEASE AND CANCER. In his latest ground-breaking book, Peter C Gotzsche exposes the pharmaceutical industries and their charade of fraudulent behaviour, both in research and marketing where the morally repugnant disregard for human lives is the norm. He convincingly draws close co
Book Synopsis The Battle Over Health Care by : Rosemary Gibson
Download or read book The Battle Over Health Care written by Rosemary Gibson and published by Rowman & Littlefield Publishers. This book was released on 2012-04-08 with total page 233 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the most substantial health care reform in almost half a century, President Obama's health care overhaul was as historic as it was divisive. In its aftermath, the debate continues. Drawing on decades of experience in health care policy, health care delivery reform, and economics, Rosemary Gibson and Janardan Prasad Singh provide a non-partisan analysis of the reform and what it means for America and its future. The authors shine a light on truths that have been hidden behind a raucous debate marred by political correctness on both sides of the aisle. They show how health care reform was enacted only with the consent of health insurance companies, drug firms, device manufacturers, hospitals, and other special interests that comprise the medical-industrial complex, which gained millions of new customers with the stroke of a pen. Health care businesses in a market-oriented system are designed to generate revenue, which runs counter to affordable health care. Gibson and Singh take a broader perspective on health care reform not as a single issue but as part of the economic life of the nation. The national debate unfolded while the banking and financial system teetered on the brink of collapse. The authors trace uncanny similarities between the health care industry and the unfettered banking and financial sector. They argue that a fast-changing global economy will have profound implications for the country's economic security and the jobs and health care benefits that come with it, and they predict that global competition will shape the future of employer-provided insurance more than the health care reform law.
Download or read book Overcharged written by Charles Silver and published by Cato Institute. This book was released on 2018-07-03 with total page 587 pages. Available in PDF, EPUB and Kindle. Book excerpt: Why is America's health care system so expensive? Why do hospitalized patients receive bills laden with inflated charges that com out of the blue from out-of-network providers or demands for services that weren't delivered? Why do we pay $600 for EpiPens that contain a dollar's worth of medicine? Why is more than $1 trillion - one out of every three dollars that passes through the system - lost to fraud, wasted on services that don't help patients, or otherwise misspent? Overcharged answers these questions. It shows that America's health care system, which replaces consumer choice with government control and third-party payment, is effectively designed to make health care as expensive as possible. Prices will fall, quality will improve, and medicine will become more patient-friendly only when consumers take charge and exert pressure from below. For this to happen, consumers must control the money. As Overcharged explains, when health care providers are subjected to the same competitive forces that shape other industries, they will either deliver better services more cheaply or risk being replaced by someone who will.
Book Synopsis Who Killed HealthCare?: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure by : Regina Herzlinger
Download or read book Who Killed HealthCare?: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure written by Regina Herzlinger and published by McGraw Hill Professional. This book was released on 2007-04-17 with total page 314 pages. Available in PDF, EPUB and Kindle. Book excerpt: A renowned authority from Harvard Business School confronts America's health care crisis-and how consumer control can fix it PRAISE FOR WHO KILLED HEALTHCARE? “A brilliant analysis... A must-read.” – Bill George, Professor, Harvard Business School and Former CEO of Medtronic “As it becomes more and more obvious to everyone that our current health care system is unsustainable, this is the book that had to be written.” – Daniel H. Johnson, Jr. MD, former president of the American Medical Association “Regina Herzlinger’s ideas to tackle the crisis of the U.S. health care system are based on keen knowledge of the system’s existing difficulties along with insights that introduce the reader to new streamlined choices that have the potential of getting both quantity and cost under control.” – Joseph Kennedy, founder, chairman, and president, Citizens Energy Corporation, CEO, Citizens Health Care, former representative (D-Mass) “Regina Herzlinger... offers a vision of the way things can be, should be, and will be sooner or later. The only question is: how long do we have to wait?” – Greg Scandlen, founder, Consumers for Health Choices“Regi Herzlinger has brilliantly articulated a better way – embracing the principles of competition and innovation that cause every other sector of our economy to thrive. Discharging American health care from the ICU can only happen by putting individual Americans – not politicians and bureaucrats – back in charge of their health care decisioins.” – U.S. Senator Tom Coburn (R-Okla), M.D. “Following on the heels of her landmark Market-Driven Health Care, Herzlinger lays it on the line with her expose of what many who work in the health care industry have felt in their gut. Now it is articulated in an entertaining and must-read portrayal, with you and me as the only way out.” – Dennis White, executive vice president for strategic development, National Business Coalition on Health“A wonderful Orwellian romp through issues which carry a deadly irony. The killers of health care are, of course, the third parties, each of which has an itchy palm and a commitment to profit or power which exceeds the commitment to service, with each engaging the others within a politically shaped box. Rarely has the case for the public been made with so much force, foresight, and wit, and a better way forward shown so clearly.” – James F. Fries, MD, Professor of Medicine, Stanford University School of Medicine “You can practically hear the war chants as Professor Herzlinger sets out her view of what’s wrong with the health care system and how to fix it. You’d best read it so you can decide which side you will be on when the battle is joined.” – Paul Levy, CEO, Beth Israel Hospital, Boston, MA “Regina Herzlinger, the nation’s leading expert on consumer-driven health care, has given us a brilliant analysis of the flaws in our health care system and what it will take to get it back on track. Her latest book is a must-read.” – Bill George, Professor of Management Practice, Harvard Business School, Former CEO, Medtronic, and author of Authentic Leadership“You don’t have to agree with her diagnosis and prescription for the U.S. health care system, but you do have to read her book. Once again, Professor Herzlinger has put together a well researched, well written, and very provocative blueprint for the future of health care.” Peter L. Slavin, MD, President, Massachusetts General Hospital
Book Synopsis Healthcare Fraud by : Rebecca S. Busch
Download or read book Healthcare Fraud written by Rebecca S. Busch and published by John Wiley & Sons. This book was released on 2012-05-01 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.
