Hew Is Bullying Physicians

Daily Observer

November 17, 1975

The New York Times and other papers around the country printed articles exposing the profit of doctors treating Medicaid patients. The Department of Health, Education and Welfare reported that 207 physicians earned a total of $29 million dollars from Medicaid. This represents .2 per cent of all the physicians in the United States, who averaged somewhat over $100,000 in Medicaid billings.

HEW then went on to publish the names of some of the physicians who earned the largest amounts.

The implication of this exposure is that there had been fraud or some other sort of malfeasance.

If HEW has proof of corruption it should bring the physicians to court.

Medicaid is an arbitrary contract that the state establishes with the doctors, to pay a fee which is about 50 per cent of the normal fee, for those patients on welfare.

By and large, doctors do not accept Medicaid patients in order to fleece the government, but to render medical care to a disadvantaged minority of the country, disadvantaged not by the medical profession, but by the poverty that results from the administrative mismanagement of our rulers.

Prior to Medicaid, physicians attended to this segment of the population for no fee whatsoever, in their offices, in clinics, and in hospital wards. There were no headlines then of the expenditure of time and monies that doctors offered. There were no headlines stating that such and such a physician was donating 50 or 100 thousand dollars a year as public service.

Furthermore, the naming of names of physicians who have billed Medicaid of $100,000 a year or more makes no mention of the services rendered, or of the overhead incurred in order to see these patients and render proper care.

The average physician spends 50 to 60 per cent of annual earnings on overhead, and the sum can run much higher if the income is the result of the half- rations that Medicaid pays.

The Medicaid contract is quite unilateral, and the state reserves the right to reduce the fees by fiat and without consultation with the doctors.

On the one hand the government decries the fact that not enough doctors accept Medicaid patients, and on the other, insinuates some criminal behavior on the part of those that do. If a doctor sets up an x-ray department, a laboratory, hires paramedical personnel, nurse practitioners and the like in order to serve a large Medicaid constituency, his Medicaid billing may well be several hundred thousand dollars yearly.

John A. Svahn, administrator of HEW’s Social and Rehabilitation Service said that single physicians may have submitted Medicaid claims on behalf of a group who treat poverty patients. He added that the American Medical Association had been advised in advance of the decision to release the names and raised no objections. Curiously, the doctors named, were not given the chance to object.

Perhaps by the same token, the HEW and the AMA should release the names of their highest paid administrators, and include their entertainment allowances, and what was accomplished during their five-day, forty-hour week.

Then these figures could be compared with the services rendered by the Medicaid physicians, and calculated on an hourly basis. With overhead deducted, it just might turn out that the doctors were receiving a lower rate of pay than those who shamelessly insinuate some sort of wrong doing.

Doctors who take Medicaid patients are not employees of either the state or the federal government. They are in private practice. Their earnings are not a matter of public record.

If the HEW or IRS has some doubts, the doubts should be properly investigated and indictments sought. Otherwise, the doctors should enjoy the right of privacy.

The country has lost its sense of decency and priority. We saw that with Watergate, and we see it now with the bullying, threatening, blackmailing underworld tactics of HEW.

I am not interested in physicians who might defraud the government; they can be brought to trial.

But I am most interested in government that by innuendo sullies the names of physicians who render service to the people. And I am most concerned with the American Medical Association, one of whose most august leaders recently completed a jail term for fraud, that allows its membership to be cannibalized by HEW.

The article appeared in the Oct. 31 issue of the New York Times, Halloween, the night with kids dressed as clowns, write dirty words on houses, and deface the paint on automobiles; the night when government clowns scratch obscenities into the emblem of the medical profession. Shame.