As new Federal indictments generated by ongoing investigations into Medicare fraud target more South Florida health care agencies, it is valuable to consider the health care business paradigms that fuel this type of corrupt activity. Why do people who enter a profession to help care for those suffering and in need end up exploiting others and using fraud to obtain public funds?
In any business, if your business is to be stable or to grow you must draw repeat customers or new clientele. We rarely, if ever, hear about businesses feeling proud that they have shrunk and dissolved because they successfully filled a societal need and now that the need is satisfied and no longer present the business is no longer needed and its operators can now pursue other endeavors. In many industries products are built to break down or become obsolete so that consumers will need to buy new products or pay for repairs, which sustains a variety of businesses. Building things to last is typically not economically desirable in our society and planned obsolescence is a key practice in many industries. How many of us use a car, TV, phone, or computer that we used 10 years ago?
In the context of healthcare, if healthcare were effective then people would become healthy and there would be less, not more need for services and products in the health care field. For a long time, health care has been an expanding segment of the national economy, with corporations essentially profiting from the public being increasingly unhealthy. In some cases, where there is a lack of patients needing services, health care providers will find ways to artificially, i.e., fraudulently, create business to sustain or expand their operations. Other ways of keeping the patients coming and profits flowing include the expanding medicalization of ordinary physical and mental distress. New medical disorders are defined and given codes so that insurance companies can pay physicians to treat those symptoms. Medical treatments themselves produce many adverse effects that lead people to seek additional medical care. The cost of health care is the top reason for individuals in the USA seeking bankruptcy protection in the courts. People's health and savings are being drained by a system that seeks to perpetuate and expand profit. Many people are dependent or invested in that system, including physicians, health care business executives, politicians, pharmaceutical corporations, insurance companies, and more. Thus, there has been no sincere concerted effort to reform the healthcare system to consistently promote health and reduce costs.
Unless a fundamentally different economic model is applied to our society this pattern will not change. If people are economically pressured to sustain a livelihood by committing fraud or mistreating others, we can't expect to repair this solely by prosecuting a portion of the offenders who happen to get caught brazenly engaging in corruption and racketeering. A deep examination of how we address health and support societal wealth is called for if we wish to minimize crime and build a healthy society.