Reply #30: I worked in the medical industry for years, some of the most corrupt people I ever met

[dugaresa]

I work in an entirely different field now, but the years I worked in the medical industry were quite eye opening.

I am sure it is the same now, but its all about the money and contrary to the complaining a lot of people have gotten very rich.

The people I worked with provided medical services, they were arrogant, rude, and they were corrupt. The game was to try and figure out how to extract as much money out of what ever insurance carrier they could. Medicare, Medicaid, Blue Cross, etc.

Regulations put in place to try and control how items/services were billed were constantly fought.

They would visit congressmen to try and get these items repealed or get loop holes.

Technically every patient has a collection of diagnosis codes associated with their care, these diagnosis codes have a matrix of acceptable healthcare procedure codes. The problem is that some patients only need one procedure or one service, but what stops a company from taking every other patient and applying all the codes to them as long as you get a physician to write a script saying those services are necessary? When you have the same doctor as a co-owner in such a business, the floodgates are open.

15+ years ago I remember a service provider joking how the state of California (where he was located and where I was doing some consulting) would be bankrupted by the medicaid system because of the services they were paying for on behalf of undocumented workers. Now I am not against providing healthcare but I had a funny feeling that he knew that they were providing services for "imaginary" undocumented workers.

I also want to add that these very people who got rich bilking the government and insurance carriers out of money, the very actions that help cause our rates to go up and our taxes to be illegal taken are typically republicans who "hate big govt".