Prescription for Profit how Doctors Defraud Medicaid or The Real Environmental Crisis

Prescription for Profit - How Doctors Defraud Medicaid

Author: Paul Jesilow

In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing.
How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment.
The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity.
Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.

Publishers Weekly

In this timely expose of ``tension between . . . medicine as a profession and as a business,'' professors Jesilow, Pontell, and Geis (the latter emeritus) of the University of California's School of Social Ecology contend that since the 1965 establishment of a reimbursement of Medicaid fee-for-service policy, a ``marginal'' group of physicians, in addition to fee-splitting, has been multiplying superfluous visits, needless tests and procedures, and more. (Annual cost of unnecessary surgery in the U.S. is estimated here at $3.92 billion.) Citing case files and extensive interviews with both private medical personnel and government officials involved in enforcing Medicaid and Medicare fees, the authors discuss AMA attitudes, insurance, fraud detection, penalties (suspension, fines) and how guilty doctors tend to rationalize their misconduct. And, anticipating a U.S. national health serivce, the authors appraise those of other countries. (July)

Library Journal

Since the federal government began determining fees and regulating treatments through Medicaid in the mid-Sixties, some healthcare providers have blatantly taken advantage of the system and fleeced the American public. Jesilow and other colleagues in the School of Social Ecology at the University of California, Irvine, report on doctors, pharmacists, and insurance companies who have been convicted or who have confessed to Medicare crimes. The authors expose the greedy and self-serving behavior of these outlaws, estimated to cost between 10 and 25 percent of the total program cost for state and federal governments. The authors conclude that changes can come about only through a basic overhaul in the medical care delivery system--an issue that is on the front page of newspapers daily. Timely, well written, and carefully documented, this book is sure to keep the reader's interest.-- Patty Miller, New Hampshire Technical Coll. Lib., Laconia

See also: Sins of the Father or America Alone

The Real Environmental Crisis: Why Poverty, Not Affluence, is the Environment's Number One Enemy

Author: Jack M Hollander

Drawing a completely new road map toward a sustainable future, Jack M. Hollander contends that our most critical environmental problem is global poverty. His balanced, authoritative, and lucid book challenges widely held beliefs that economic development and affluence pose a major threat to the world's environment and resources. Pointing to the great strides that have been made toward improving and protecting the environment in the affluent democracies, Hollander makes the case that the essential prerequisite for sustainability is a global transition from poverty to affluence, coupled with a transition to freedom and democracy.
The Real Environmental Crisis takes a close look at the major environment and resource issues--population growth; climate change; agriculture and food supply; our fisheries, forests, and fossil fuels; water and air quality; and solar and nuclear power. In each case, Hollander finds compelling evidence that economic development and technological advances can relieve such problems as food shortages, deforestation, air pollution, and land degradation, and provide clean water, adequate energy supplies, and improved public health. The book also tackles issues such as global warming, genetically modified foods, automobile and transportation technologies, and the highly significant Endangered Species Act, which Hollander asserts never would have been legislated in a poor country whose citizens struggle just to survive.
Hollander asks us to look beyond the media's doomsday rhetoric about the state of the environment, for much of it is simply not true, and to commit much more of our resources where they will do the most good--to lifting the world's population outof poverty.

Table of Contents:

	List of Illustrations
	Preface
	Introduction: A Crisis of Pessimism	1
1	A World Apart	19
2	Six Billion and Counting	28
3	Can the Earth Feed Everyone?	38
4	Fish Tales	55
5	Is the Earth Warming?	66
6	Water, Water Everywhere	90
7	The Air We Breathe	106
8	Fossil Fuels - Culprit or Genie?	124
9	Solar Power to the People?	142
10	Nukes to the Rescue?	156
11	Wheels	165
12	Don't Harm the Patient	179
13	Choices	192
	Notes	203
	Index	229
	About the Author	237