Doctors committing medical fraud appears to be a growing issue in America. Just today, the U.S. Justice Department announced that it is “charging 412 in health fraud schemes worth $1.3 billion.” The FBI has a division dedicated to pursuing medical fraud cases, the cost of healthcare is skyrocketing in the nation, and Congress is pushing hard to find a viable alternative to ObamaCare (AHCA) making conditions ripe for such announcements. But ARE physicians REALLY committing healthcare fraud in growing rates? If so, why is this trend taking place?
Opinion by C J Oakes
Doctors are Paid Very Well, Right?
According to the U.S. Bureau of Labor Statistics, physicians and surgeons make on average about $208,000 per year. So, they get paid well. Paid well means that there should be no need to engage in healthcare fraud, right?
The simple fact is that people from all walks of life, every socio-economic situation commit crimes of graft. The key difference between the crimes committed by people who have less is that they are often prosecuted harder and pursued with greater intensity than so-called white collar criminals. For instance, one study found that although fraud, embezzlement, and tax evasion costs the nation more than burglary, robbery, and larceny, those who commit the latter are more likely to be caught and penalized.
In other words, wages matter little when it comes to committing crime. Doctors can be just as guilty as anyone else of greed. When someone devises a scheme they believe will evade authorities and are later caught, the reaction is the same whether rich or poor: Surprise.
What Else Could be Driving Physicians to Commit Medical Fraud?
Anytime it becomes easy to commit a crime, people become more tempted. If they dwell on the temptation or are faced with external forces, doing the crime becomes easier.
For instance, doctors are faced daily with the frustration of wading through a myriad of law related to what they can and cannot do. Most have spent between eight and 12 years at university and have entered their practice with massive student debt. In the early years of a practice, it can be very tough juggling the law, the business, and the patients. Physicians are just as prone to suffer cash flow problems as any other business, but unlike the entrepreneur, a doctor cannot simply bankrupt the practice and try a different business model. A doctor is a doctor.
A doctor also has a lot of power.
A doctor also often lives among other business owners who often do not face the same legal limits yet make even higher incomes.
A doctor also has a reputation to uphold.
And doctors are just as desirous as anyone else to “get ahead” in life.
And doctors have been engaging in fraud schemes for decades.
The only difference today is that with the government and nation facing a healthcare crisis and skyrocketing threaten to shut down certain programs such as Medicare and Medicaid, law enforcement is being told to eliminate fraud and waste where possible.
The only difference between today and 1984 for instance, is that in the 80s, crack dealers had the target on their backs. Today, it is on doctors.