Cutting Waste and Keeping Faith
Authors: M. Gregg Bloche
Journal: Annals of Internal Medicine (1998)

Editorials15 April 1998Cutting Waste and Keeping FaithM. Gregg Bloche, MD, JDM. Gregg Bloche, MD, JDGeorgetown University Law Center; Johns Hopkins University School of Public Health; Washington, DC 20001Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-8-199804150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail On the surface, the logic of the federal campaign against health care fraud and abuse is compelling. In 1996, the U.S. government spent $279 billion on Medicare and Medicaid [1]. The patients who benefit from these programs have neither the clinical know-how nor the personalized financial incentive to effectively monitor providers' use of federal dollars. This combination of consumer acquiescence and huge sums of money invites abuse. The 1997 finding by the U.S. Department of Health and Human Services that Medicare overpaid providers by more than $23 billion in 1996 suggests that more than a few persons are eager to ...References1. United States. Health Care Financing Administration, Office of Strategic Planning. 1997 HCFA Statistics. Washington, DC: HCFA Press Office; 1997. HCFA publication no. 03403. Google Scholar2. Aaron HJ. Serious and Unstable Condition: Financing America's Health Care. Washington, DC: Brookings Inst; 1991. Google Scholar3. Starr P. The Social Transformation of American Medicine. New York: Basic Books; 1982. Google Scholar4. Arrow K. Uncertainty and the welfare economics of medical care. American Economic Review. 1963; 53:941-73. Google Scholar5. Relman AS. Dealing with conflicts of interest [Editorial]. N Engl J Med. 1985; 313:749-51. Google Scholar6. American College of Physicians. Understanding the fraud and abuse laws: guidance for internists. Ann Intern Med. 1998; 128:678-84. Google Scholar7. Thompson DF. Understanding financial conflicts of interest. N Engl J Med. 1993; 329:573-6. Google Scholar8. Vladeck BC, Brown JG. Letter to the American Hospital Association and 11 other health care organizations. Health Law Reporter. 1995; 4:d43. Google Scholar9. Mechanic D. The functions and limitations of trust in the provision of medical care. J Health Polit Policy Law. [In press]. Google Scholar10. Breyer S. Regulation and Its Reform. Cambridge, MA: Harvard Univ Pr; 1980. Google Scholar11. Medicare and Medicaid Programs; Physicians' Referrals to Health Care Entities with Which They Have Financial Relationships. 63 Fed Reg 1659-1728 (1998) (to be codified at 42 C.F.R. pts. 411, 424, 435, 455) (proposed 9 January 1998). Google Scholar Author, Article, and Disclosure InformationAffiliations: Georgetown University Law Center; Johns Hopkins University School of Public Health; Washington, DC 20001Acknowledgments: The author thanks Judy Feder for comments and suggestions and Erin Rosenberg and Vo-Ellyn Sakowitz-Klein for research assistance.Grant Support: In part by an Investigator Award in Health Policy Research from the Robert Wood Johnson Foundation.Corresponding Author: M. Gregg Bloche, MD, JD, Georgetown University Law Center, 600 New Jersey Avenue, NW, Washington, DC 20001. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 April 1998Volume 128, Issue 8Page: 688-689KeywordsHealth careHealth care facilitiesHealth promotionMedical servicesMedicareMotivationPatient advocacyPerceptionRunningTaxes Issue Published: 15 April 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...