How to Stop Medicare Fraud

It is sad that once a doctor who bills for unnecessary or more likely unperformed services is finally under suspicion THEN the authorities contact the patients and find out GOLLY GEE that no they did not have two surgeries a day for a week with the suspect doctor. Suppose in order to get paid, the doctor had to submit with his claim an simple written in high school English statement signed by the patient that “yes” these services were performed.  I know.  I know.  More paperwork!  But we are dealing with millions upon millions of dollars leaving the system for false claims.

Right now the patient gets on EOB (explanation of benefits).  Even if you actually read the darn thing it is often impossible to “translate” what the abbreviations and medical jargon.  If the patient on the way out of the office had to sign a simple statement attesting to the services he or she received a lot of this billing fraud would not occur.

Just a thought. 

What Elected Officials Do

Politics is a messy business.  On the one hand sometimes the process involves identifying a problem and then using reason and logic to find an affordable and workable solution.  On the other hand, there is the “hidden agenda” of politics.  This is the process of advocating a “solution” under the guise of solving a problem but in reality hoping merely to benefit one group, individual or “special interest.”  Often the two become blurred and even interchangeable.

Consider World War II.  At the time hostilities had broken out in Europe and Asia, the overwhelming sentiment in America was to stay out of the war.  With 20/20 hindsight most Americans would say that it was “right” for America to enter the war primarily because (a) we won and (b) Hitler and the Japanese were evil.  However, none of that was clear in 1940.  Largely “hidden agenda” politics was used by our elected officials to advance resistance to the Axis powers with less than logical solution identification politics.  Finally, the bombing of Pearl Harbor tipped the balance into war.   

This is why it is so important to elect persons of integrity and intelligence to office.  When the “rubber meets the road” the personality of the elected official is the measure of the scales in which the decision will be made. 

Movie Review: “Social Network”

I would give this flick four out of five stars.  It is very interesting and well done.  The twin brothers who claim MZ stole Facebook from them are a little cartoonish but the flick is fascinating.  Particularly interesting is the role Sean Parker of Napster “fame” played in Facebook.  Also intriguing is that Larry Summers is the president of Harvard, and he, of course, went on to be Obama‘s economic advisor.  I still can’t for the life of me figure out how Facebook which is a free service with no advertising is worth so darn much money.  The movie doesn’t even attempt to explain that.  Lastly, I found it humorous that the film hints that all of these great innovations (Napster and Facebook) are really about smart guys trying to impress a lady.  Well, Hollywood had to put its signature approach in there somewhere. 

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Handicapping the Governor’s Race

On the Republican side, Betty Ireland is likely to win that primary.  On the Democratic side, Thompson, Purdue, Tomblin and Tennant will pretty much evenly divide up the vote.  Right now the edge in that primary goes to whichever candidate can win the media battle. 

The key right now on the Democratic side is to figure out what issue will surface as the “driver” for the May vote.  If the “driver” is the economy then the scales tip towards Tomblin because of his knowledge of the budget and his status as acting Governor.  Labor has a tough row to the hoe in this primary since Purdue, Tennant and Thompson are all worthy of allegiance from the unions.  For this reason a large turnout by Democrats probably favors Purdue.


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Who To Vote For?

The governor’s race is now officially underway.  When I decide for whom to vote for a position such as that, I ask myself one question:  Who is likely to inspire those around him or her to look for solutions to problems?  For my money one of the best at doing that was former Governor Gaston Caperton.  He had zero political experience when elected but served two successful terms.  I attribute his success to his ability to inspire and motivate those around him to perform at a high level.  That is basically how he built a successful insurance business when he was in the private sector.

Too many politicians approach governing as a zero sum game meaning if I win, you lose so everything is a trade off.  A good executive asks the question how do we get this done and listens to anyone and everyone.  The other “trick” is do remember that “building a consensus” or “hammering out a compromise with all the stakeholders” DOES NOT mean that the right solution has been found.  Government by consensus merely means nothing of importance will be done.


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