Ask medical professionals to choose a statement from the list above
regarding federal efforts to root out health care fraud and abuse, and it
is more likely that they will select responses from the end of the list than
from the beginning. The article by Kalb1 in
this issue of THE JOURNAL reveals the scope of the government's antifraud
enterprise, but the question remains: what exactly is
The story of fraud and abuse law is a tale of path dependence. The enactment
of Medicare and Medicaid legislation 35 years ago was hailed as a step toward
completing the New Deal and creating the Great Society. Indeed, these programs
have proved a tremendous boon to the nation's elderly and indigent; to health
facilities, suppliers, and professionals; and to innovation in medical science.
Yet any sizable government program inevitably creates incentives for overspending.
In 1964, however, achieving political consensus required replicating within
Medicare the unthreatening, familiar landscape of private indemnity insurance:
separate hospital and professional components; private contractors as fiscal
intermediaries and carriers; payment based on usual and customary fees; and
a pledge of noninterference with physician decision making. These constituted
the medical profession's price, which President Lyndon Johnson was happy to
pay. "Five hundred million [dollars]," he reportedly exclaimed when told the
supposed cost of these concessions, "Is that all? Do it. Move that damn bill
out now before we lose it."2 Absent, unfortunately,
was the private marketplace's sensitivity to premium increases.
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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and
Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early
dhildhood mortality and growth failure data and their association with maternal
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