I am often asked what ethical questions are posed by healthcare reform. Like healthcare reform itself, this is an very complex issue about which confusion abounds. For example, healthcare reform extends healthcare coverage to more individuals. But it does so in part by cutting Medicare. Is this right? Are we financing our social goals on the backs of seniors? Healthcare reform also tries to push the costs of Medicare down through a program called the Medicare Shared Savings Program. I can’t explain the whole thing here but the basic idea is that Medicare rewards you if you drive down the costs for a given patient population while maintaining or improving quality. This sounds like a wonderfully noble idea except that it creates a huge incentive to fudge your self-reported results on quality. If there is one things we have learned throughout the history of Medicare, it is that incentives to fudge the numbers lead to a whole lot of number fudging. So the ethical questions abound while gathering little attention. The whole topic of healthcare reform is so hot politically that no one wants to touch the ethics questions. I also address some of these questions on my blog for ethics and compliance professionals which is ethicswhisperer.com. Recent posts can also be seen on the right side of this page,
ethicswhisperer.com- 4 Myths about Compliance Program Assessment February 16, 2015The first myth about compliance program assessment is that it is an optional part of an effective compliance program. The same sentence in the Sentencing Guidelines that mandates a hotline also mandates compliance program assessment. And, even if program assessment were not mandatory, it is would be incumbent on your organization to undertake assessment. Org […]Mark Pastin
- Compliance Headhunters September 21, 2014We are contacted by headhunters because we know a lot of compliance officers and we know whether they are available. However, it is extremely difficult to help these folks as they often have no idea what a compliance officer does. They are generally working from a job description written by someone in HR who also has little idea what a compliance officer doe […]Mark Pastin
- Keeping up September 8, 2014While there will continue to be new posts on longer topics on ethicswhisperer.com, I also encourage you to follow markpastin.com, which is updated more frequently and focuses on issues of the day. Of course, your comments are always welcome on any of our sites.Mark Pastin
- The Next Hot Word in Compliance July 13, 2014Hear yea! Hear yea! Hear yea! The next hot word in compliance will be UPQUALING. This, of course, is on the model of UPCODING. Healthcare reform is a gamble on the idea that incentives can be given to lower the cost of care while maintaining or improving its quality. This has been tried before with limited success under the rubrics "managed care," […]Mark Pastin
- A Big Compliance Mistake February 9, 2014Secretary of the US Department of Health and Human Services Kathleen Sibelius recently announced that health plans offered through exchanges will not be considered Federal health plans – and many breathed a huge sigh of relief. Not so easy.What the Secretary's announcement means is that plans purchased through exchanges will not be administratively unde […]Mark Pastin
- 4 Myths about Compliance Program Assessment February 16, 2015
Mark Pastin 