Wednesday, June 29, 2011

Obama Plan To Spy On Doctors Cancelled. . . For Now

Sometimes, legitimate ideas die as a result of guilt by association. For example, you can bet that Pop Tarts would not be as popular today if Ted Bundy or Hitler gave them a rousing endorsement. And sometimes, good ideas get twisted by bad people. That’s the case with Obama’s latest attack on doctors, it was good idea perverted. Fortunately, they are abandoning it. . . for now.

The idea in question stems from the problem that more and more doctors are refusing to take Medicare/Medicaid patients. This has become such a problem that there is an acute doctor shortage developing for these patients. I’ve discussed the main reason for this before (LINK): doctors lose money on Medicare patients because the government doesn’t fully reimburse them.

In any event, whether the reason is simple economics or the crushing imposition of paperwork and other requirements/limitations imposed when doctors accept Medicare/Medicaid patients, fear of being ensnared in a Medicare/ Medicaid fraud through some paper work error, or just prejudice, it is a solid and good idea to determine the reason doctors won’t see these patients. Why? Because the government has promised to provide Medicare/Medicaid patients with medical care and it can’t do that if doctors won’t see them. Therefore, the government must get to the root of the problem and fix it. Thus, investigating this is a good idea.

Also, the mere fact that such an investigation is done secretly does not make it evil. Sometimes these things are best conducted secretly. Perhaps the only way to get at the truth is to conduct a secret investigation. Maybe doctors will be more honest in “blind” interviews than they would be on surveys. It’s the same thing with secret shoppers, where the only way to truly judge service is to keep the store from knowing which customers are rating them.

So far, so good. But here’s the catch. . . trust.

If Obama had been a trustworthy fellow, then I might say that conservatives are making too big of a deal about his plan to secretly call 4,185 doctors’ offices in nine states. But Obama is not a trustworthy fellow, and I doubt very much this study was planned to actually investigate the problem. Instead, I think it was intended to generate data for another ObamaCare anti-doctor campaign, e.g. “look how bad these evil doctors are, one even called Medicaid patients ‘filthy.’”

And let me give you the main reason for my suspicion other than Obama’s history and the fact that generating such data would be in his political interests: I can see no value in the type of information this study would be likely to collect. Indeed, the only way this study method works is if doctors are some form of James Bond villain, who would lie on official surveys but couldn't stop themselves from blurting out the truth to random people on the phone: “well, I would never say this on a survey, but you seem trustworthy Mr. John Smith, so let me tell you what’s really going on before I turn you away mwhooo ha ha!!” This is why the whole premise of this study is laughable -- unless you realize its real goal is to goad doctors' receptionists into make unflattering comments about Medicare/Medicaid.

And thus, a good idea is perverted.

Fortunately, HHS has canceled the program after doctors complained. But if history is any judge, they will try again. In the meantime, we should remain vigilant for more attempts by Team Obama to generate politically helpful data. In fact, coming on the heels of the “gun walking” scandal, this is starting to look like a trend.

34 comments:

Tennessee Jed said...

I suppose research and data are always helpful in valdiating root causes of what is an observable problem. The issue, to me, is how to make a survey, as free from bias as possible as well as non-intimidating. In other words, I see the same problems at work in this case as I do with polls.

You have an observable problem, e.g. there are not enough doctors to go around for patients on medicare. We can surmise that some of the shortage is due to doctors who are refusing those patients. We can further intuit that a probable cause is that medicare will pay less than a private individual or or insurance carrier.

So the survey would have to be constructed very carefully, and it may even be for reasons beyond our rational fear that Obama (or any other administration) would twist the findings to support their agenda. If we look at other surveys with far less on the line, we see evidence of people n ot answering truthfully. A great example would be what we often refer to at this site as our "guilty pleasure" viewing. People may lie about what they watch because they want to appear more "high brow."

So I don't pretend it is an easy solution, but agree with the notion obtaining good objective data is important to make intelligent decisions, whether in business or government.

T-Rav said...

Andrew, sounds like this might have been a good idea originally; my optometrist is retiring due in part to the costs of treating Medicare patients, and I know of several other doctors in the area who are doing the same or simply refusing to treat the patients. So I agree this move could have been for good; naturally, though, Obama lost no time in screwing it all up.

Also, regarding the gunwalker scandal, the ATF chief is going to be testifying before Congress after all. I wonder what he'll have to say about his superiors...

LawHawkRFD said...

Andrew: I wouldn't trust the Obama administration to investigate whether the sun came up this morning. Even a good idea goes bad when in the wrong hands. After all, this administration investigated Black Panther voter intimidation, and couldn't find any. If they can't find something that is clearly there, how can we trust them to fairly investigate something that may or may not be there?

Writer X said...

Contrast this with the time that Obama invited all the glassy-eyed doctors to the White House and used them as props. I wonder, are they still his biggest fans now?

Give this administration's track record with transparency, I'm not sure I even trust that the HHS cancelled its spying program.

AndrewPrice said...

Jed, I think that's right. Like most issues where you are trying to figure out a root cause of some public policy issue, you need to design your study very carefully to get at the answers. You can't lead people to give the answer you want, you can't narrow the choices to what you expect and thereby miss the real answer, and you can't presuppose anything.

This "study" did none of that. This study would have been a group of people calling doctor's offices and fishing around for information. You are not likely to get any useful information in that way. Thus, I think this was designed entirely to get a few "bad" quotes from upset receptionists which Obama could then use to show that doctors are greedy and evil.

AndrewPrice said...

T_Rav, I know a lot of doctors who simply will not take Medicare patients because (1) they lose money and (2) the paperwork requirements are too onerous.

On the gun walking, I see that he's going to testify and Obama still won't talk about his future. I think that's to hold his job over his head -- say the right thing and I'll back you, say the wrong thing and you're gone. But we'll see. Most bureaucrats do not want to take the fall for anyone else, and this guy is a bureaucrat.

rlaWTX said...

I had generally the same reaction when I read about this - first was "not that big of a deal", then as it soaked in "Obama will use this to screw someone".

one of the requirements for legit survey research is informed consent. Which means that at one end or the other the surveyee gets told what happened. another requirement is anonymity. But if the surveyees id themselves every time you call... AND there has to be trust in the surveyers to abide by anonymity... any trust here???

AndrewPrice said...

Lawhawk, Obama is not someone we should trust.

rlaWTX said...

and I used to billing for a radiology group and this included Medicare appeals... I went to a seminar (mostly just a "buy our product" pitch) and learned that the govt could come after the biller for 10 years after the mistake was made - scared me half to death... my time was up in April!!!

AndrewPrice said...

Writer X, That's a good point too. There is nothing you can trust about these people. Remember the "fishy e-mails", where they wanted us to turn each other in for thought crimes?

And the claim that's he's the most transparent administration in history is just laughable. This administration is Nixonian in its penchant for secret plots and enemies lists. In fact, I keep meaning to write an article pointing out the parallels between Obama and Nixon, I just never get around to it.

AndrewPrice said...

rlaWTX, All true. And that's the first big tip off something is wrong here. This is all being done in secret when there's no reason to do it in secret AND when they could just as easily have asked these questions in a blind survey and gotten honest and much more complete answers from doctors (rather than receptionists). The only reason I can see for doing it this way is they are hoping to engage in a verbal game of goading people to make bad statements by leading them on the phone.

That makes this a public relations game, not a genuine attempt to gather information.

AndrewPrice said...

rlaWTX, People should not underestimate the fear of dealing with the government. If you make any mistake on a form for payment, you have technically violated the False Statement Act (which does not require a showing of intent). That means they can prosecute you, fine you, and send you to jail if they want to. If you then add the numbers up wrong, you've made a false claim. That's even worse.

And the problem is that the government does not accept the "innocent" mistake claim when it decides to target you. So if they decide "we're going to make an example of those doctors in West Texas because there's been a lot of fraud," you may one day have the FBI show up at your house because you made a handful of typos or because a patient lied to you.

That's a huge risk that many doctors just don't want to take -- especially since they are losing money on Medicare patients in the first place.

Plus, you can trip yourself up with things like offering a discount to someone because you feel bad for them. Medicare requires your lowest rate. If you give out a discount to someone, then you've violated the law if you continue to charge Medicare anything more than the discounted rate.

Why put yourself at risk with these kinds of issues?

BevfromNYC said...

Writer X: the "glassy eyed" doctors Obama invited to the WH were young docs who are paid employees of hospitals, so they have no idea how much it takes to keep a private practice up and running. Doctors in private practice have an entirely different take on the entire issue.

BevfromNYC said...

I have sent this on to the private practice docs in my family. I can't wait to here what they have to say on the topic!

AndrewPrice said...

Bev, I figured his gathering of doctors were somehow unusual because I didn't hear a lot of doctors I know who were big supporters of his plans.

Let us know what you doctor-relative says, I would be interested to hear their take. Like I say in the article, it makes sense to investigate the problem, but this is not investigating the problem -- this is spying on doctors for political reasons.

Apparently, it was angry doctors who got this plan stopped. Good for them. Of course, now they need to watch to make sure it isn't done in some other way or done by stealth.

Tennessee Jed said...

absolutly Andrew. Nor was I in the least surprised it was not since Barrack is truly the prince of agenda. Great topic, by the way

AndrewPrice said...

Thanks Jed! I think this is an interesting topic and I wanted to point out that collecting information on the topic itself was not wrong, it was Barrack's attempts that were wrong.... as usual.

And you're right, everything he does it part of an agenda and we need to be cognizant of that.

CrispyRice said...

"NO Mr. Smith! I expect you to DIE!!"

Mwahahahahaaaaaa!

Sorry, got carried away there.

I hadn't heard that this plan had been cancelled. I'm glad to hear it. It struck like the whole Gunwalker thing - we've got an idea in our head, now let's go create data to support it.

>>eyeroll<<

AndrewPrice said...

Crispy, I had the same Goldfinger thought! LOL!

Yeah, I think this is all about obtaining data to prove a political point they want to make -- it has nothing to do with diagnosing the real issue.

CrispyRice said...

Because diagnosing the real issue would clearly indicate that the gov't best solution is to hand it over to a private organization and let them handle it. SHHHHhhhhhhh...

AndrewPrice said...

Crispy, That is the ultimate problem, isn't it? A fair look at this would reveal that the problem is.... government.

And that's the last thing Team Obama wants people to find out. Plus, a legitimate study like this would show that everything he just passed in ObamaCare was exactly the wrong thing and will only make this problem much worse.

Ed said...

It just never stops with this guy! I can't see any legitimate reason either for doing a "study" this way. They could have done it all with a survey without the need to spy on anyone. So I agree the purpose of this has to be political. Typical.

AndrewPrice said...

Ed, I agree. That's why this is so troubling, because it was never about diagnosing the problem and solving it, it was about generating politically charged data.

Think "gun walking" and "fishy snitch" e-mails.

Ed said...

Andrew, It's all part of the Obama pattern. Everything he's done has been about gaining political advantage, right down to his spending the stimulus money on his friends. He's a Chicago politician in the truest sense.

AndrewPrice said...

Ed, That he is -- gansta through and through. He's rewarded his friends, punished his enemies in petty ways (see e.g. space shuttles), he's spied on people, and he's using the job for political gain. He's our first Robber in Chief since the Gilded Age.

AndrewPrice said...

FYI.....

The Sixth Circuit just held that ObamaCare can legally force you to buy insurance. This wasn't that big of a surprise frankly, as they sit over Michigan.

In the end, this one will go to the Supreme Court.

Koshcat said...

I am a practicing physician and this "survey" was completely unnecessary. Why are physicians increasingly not taking Medicare/Medicaid? Poor reimbursement, too many regulations, too much paperwork. There is no secret. After this ass goes around bad mouthing physicians about doing unnecessary procedures for money, he wonders why none of us trust him. The intent issue worsened with the HCA bill. Previously to be charged with the crime of fraud the government had to prove intent. Not anymore. So you can be doing something that may have previously been considered legal but now is not but you were unaware of the change. Doesn't matter. The way the laws are written, every single physician could be found out of compliance. So very fascist.

AndrewPrice said...

Koshcat, Having dealt with this from the legal end, I agree that your fears are entirely justified. The law is set up in such a way that the government can basically get any doctor it wants because its rules and regulations are so thick and incomprehensible that you will do something wrong no matter how careful you are. And even if you don't, all it takes is a single typo on a form.... there is no intent requirement.

That means that any prosecutor who decides to make an example of you can. Who wants to participate in that kind of system?

(Not to mention the other problems you mention -- too much paper work, too much hassle, not enough reimbursement.)

This stuff is no secret and I think Obama's clumsy attempt to send in secret agents to "figure it out" only shows us what his real mindset is -- get more "evidence" that he can use to slander doctors, a group that completely opposes him. I can see no other legitimate reason for doing this the way he was trying to do it.

patti said...

great, the next time i call a doc and have questions, i will be the one falling under suspicion. and that's what this administration is doing: undermining regular joes. that and improving race relations so that roving mobs threatening to kill all the white folks/ripping off businesses in broad daylight are things of conspirators.

oh wait...

AndrewPrice said...

Patti, You should only trust in government.

I haven't heard about the riots thing... did I miss something?

DUQ said...

I think Patti means the flash mobs.

That is depressing on the ObamaCare thing though. Does this hurt our cause?

AndrewPrice said...

DUQ, That could be. I've stayed out of the flash mob scene -- too Democratic for me. ;-)

Actually, I don't think the Sixth Circuit's ruling is relevant at all. The Supremes are going to be more interested in the Florida action because that has all the state attorneys general in it. And this is one of those cases they're going to start from scratch on in any event.

So I think the Sixth Circuit stuff is just "for show," so to speak.

StanH said...

Big Brother is indeed watching…wow!

As others have said up-thread, just because they say it’s cancelled doesn’t mean a thing, one of the czars will take care of it.

Maybe the doctors should change their country of origin to Mexico, and hire illegal aliens to process their Medicare& Medicaid billing, and if something goes wrong they’ll get a Mexican mulligan?
You can't beat'em join'em!

AndrewPrice said...

Stan, Good point -- start using liberalism against them! LOL!

I like that term... "a Mexican Mulligan."

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