Dr. Travis is a dentist in Austin. He is also an extremely good guy, who at least was (have not had contact with him in years) extremely active in "Doctors Withoug Borders" (sorry if I got this name wrong--you should know the group). I mention Dr. Travis because he called in to Bill Bennett's morning talk show this morning--always assuming my memory is correct as to the name of the dentist I knew, and that it was the same lperson calling in).
Dr. Travis called in about MEDICAID, and the terrible way in which Medicaid is distorting the way health care professionals lpractice. His point was that health care "reform" on a Federal level willl be a disaster, and that Medicaid is an example of a Federal program that is NOT working well.
How did I get to know Dr. Travis? Well, it was totally in a professional capacity, before I retired from practice as a lawyer. I represented a woman and her two children (yes, in my my former life I was a PERSONAL INJURY lawyer, and did do medical malpractice). This family was covered by Medicaid. The mother took her children to a dentist, under Medicaid. That dentist proceeded to put a filling in almost every sURFACE (yes, more than one filling per tooth) of every tooth that the children had (slight exaggeration, but only slight). He did this without consulting the parents, and in fact refused to allow parents in the room. This same dentist was accused, by other parents who I did not represnt, of physically ABUSING their children (violently, rather than sexually). Dr. Travis was my expert withess that the fillings the dentist put in were completely unnecessary (another kind of abuse of children--two little girls). My main factual witness to the unethical practices of this dentist was his former dental assistant (another very nice person--as only a non-nice person like myself can adequately recognize). The case was settled, and did not go to trial.
Dr. Travis' pont to Bill Bennett was exactly the same point he made to me in connection with the actioins of the dentist in my case (about a decade ago). Since Medicaid cuts the amount it will pay dentists (and doctors) to the bone, and beyond, in a failed attempt to control costs, SOME dentists (and doctors) give in to the temptation to PAD THEIR BILL. Some, of course, simply bill for services they did not perform. The more devious ones, like the dentist in my case, simply perform services that are UNNECSSARY in order to make their treatment of Medicaid patients economically beneficial, when such treatment would otherwise be economically detrimental to the dentist or doctor. For example, it did not take this dentist that much additional time to fill MULTIPE teeth, and teeth surfaces, than if he had only put in a few fillings (or none at all, if he had merely cleaned the teeth). Thus, the Medicaid bill came to several THOUSAND dollars, which would enable the dentist to come out ahead even after Medicaid cut the payment (as it DID).
Dr. Travis told Bill Bennett that he had seen this happen (oviosly meanig more than just my case of a decade or more ago, although that was cetainly one instance where Dr. Travis saw it happen), although Dr. Travis was careful to say that most dentists did not give in to this temptation. The more pressure the government puts on, of course, the more likely that this will become more and more common. People WILL figure out a way to make money--no matter what unreasonable regulationis the government imposes. After all, it is really pretty hard to say--after the fact--whether fillings were "necessary", even as people like these two little girls walk around with a mouth full of fillings they did not need.
What is the MAIN source of "reliable" (for now) money in the country today? Right. It is the Federal Government. The Federal Government is the main new employer. It is the source of "bailouts" for the favored. It is the source of grants for "glboal warming" scientists--or those who can fit themselves somehown in the "green" umbrealla). Who does gool ol'boy T. Boone Pickens look toward to provide fianancing for his "wind farms" and natural gas vehicles? Right. It is the Federal Government. Almost everyone has an incentive to figure out a way to feed at the Federal trough. Even oil companies figure out how to twist the payments for "green" fuel to benefit them. . How many "green" companies exist only because of Federal moeny--even to the point of being sometimes fraudulent? I would suggest that almost ALL of them exist because of Federal money, since we are told they HAVE to have Federal subsidies to "compete" in the "free" market.
Joe Biden was right. Waste, fraud and abuse is INEVITABLE, and moreover human ingenuity makes it impossible to stop. It is the MASSIVE funds being distributed by the Federal Government--mainly for the purpose of advancing Federal POWER over the lives of all of us--that creates the problem. There is just too much money being spent, and the Federal Government is too big to adequately monitor how that money is spent. This is apart from the THEORETICAL (as well as practical) point that central planning cannot run most of an economy. The "waster" does not even have to be deliberate. It is inherent in the amount of money involved, and the fallibility of human beings making decisions about this much money--and power.
Yes, Dr. Travis made other ponts about the road down which we are heading. Since Medicaid (and Medicare) try to impose sometimes ridiculous--and erratic, in terms of what is "favored" and "disfavored" by the central planners--restrictions on reimbursement for medical services, what else happens? Well, medical care providers see more patients than they can handle. They RUSH. Waiting rooms pile up. Care is shewed toward the few procedures that ARE "favored".
For example, I observed--in my legal practice--hospital bills cut from $22,000.00 or more to $8,000.00 or less (by either Medicare or Blue Cross). That is insane. It means that either the hospitals are PADDING the bills, or they are cutting CARE to the bone to cut as many expenses as possible. I saw specific examples of anesthesiologists paid only $100.00 out of a $400.00 to $600.00 bill by Medicare, for MAJOR surgery. Anesthesia is a MAJOR problem in opeations--perhaps the most immediately life threatening area of most operations. I do not WANT my anesthesia monitored by a doctor who KNOWS he or she is ging to be paid $100.00. This is the kind of thing you get when government central planning DISTORTS the decisions people make. Of course, you also get outrageous charges to the patients who PAY THE FULL PRICE (or somewhere close to it).
The result (of government domination) is a system where ONLY the "rich" can get adequate medical care, and everyone else is reduced to substandard carre. Oh, it may be more EQUAL substandard care, but it is substandard care--much WORSE than we have today (although we are already getting there with Medicare, Medicaid and the rest).
You think government can "control" the dentists, doctors, etc.? Think again. Take that case of mine. There WAS an investigation (from the state, if I remember right, since the states actually run Medicaid under Federal supervision). As far as I know, nothing was done. They LIED to me about how I would be informed of the results of the investigation (par for the course for government), but this dentist was allowed to keep practicing despite the really disturbing evidence against him.
P.S. I FAVOR "tort reform" on a STATE level. The idea, however, that government "oversight", or "panels" of experts, can adequately hold medical care professionals to account is a conservative DELUSION. The tort systme is actually a DECENTRALIZED method of holding medical care professionals to account, and if you believe in the concept of federalism a FEDERAL "tort reform" should horrify you. As I have said, however, I am probably the only person in America who truly believes in federlism anymre. The TEST of whether you believe in federalism is whether you want the Federal Government to impose a policy YOU LIKE on the whole country. I don't think Rush Limbaugh meets this test. I think I do. For example, I did NOT believe the Supreme Court should declare a fetus a human being, just as I did not beleve the Supreme Court should impose legalized abortion on every state. Ideally, it should have been a state by state decision, subject to the democratic process. I support a Constitutional Amendment NOW, or any Federal pro-life legistalion, simply because the Supreme Court, and the left, have MADE this Federal by the power grab imposing their views by judicial (Federal) fiat on the entire country. Texas, for example, has pretty much limited personal injury recoveries by legislationi and decisions of the "conservative" (business oreiented) Texas Supreme Court. That MAY eventually cause a shirt back the other way, as the pendulum swings. When I started as a lawyer, in about 1974, the Texas Supreme Court tilted FAR toward the "left", and toward very liberal personal injury policies. That is the ordinary give and take in a democratic, DECENTRALIZED system. It is how it SHOULD work. Cntral planning, of all kinds, distorts these ordinary adjustments, catastrophically. Even if central planners are correct in most of their decisions, and we have no reason to think they will be or that they even have access to all of the information necessary to make decisions in the first place, the inevitable WRONG decisions--even if a minority of the total decisions--will be FATAL.
P.S. 2: You should not assume that poor Dr. Travis, or AnY Dr. Travis, is the dentist I used as an expert those many years ago. I would not want to "stigmatize" someone that way with extravagant praise. The FACTS above are correct. The NAME may be wrong. Oh, the name of the dentist who called Bill Bennett is correct, but my long ago expert may ot be the same man.
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