Said Joe Biden, at his rally in Flint, Michigan yesterday. Transcript.
What exactly was Trump's claim and is there any basis for it? Here's FactCheck.org (with a long quote from Trump):
The supposed “incentive” referenced by Trump is likely a reference to the financial assistance for hospitals treating COVID-19 patients that was created by bipartisan legislation — and that Trump himself signed into law in March. As we’ve explained, the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, created a 20% add-on to be paid to hospitals treating Medicare patients with COVID-19; Medicare is the federal health insurance program for those 65 years and older....
We asked the Centers for Medicare & Medicaid Services whether it could point to any specific cases of fraudulent reporting or billing for COVID-19 cases and it didn’t answer our question. Instead, the agency noted the requirement of a positive COVID-19 test for the enhanced Medicare reimbursement — a requirement implemented in September — and said that if, upon review, the medical record lacks a positive test, that increased payment will be considered an overpayment and recouped by CMS....
Medicare payments are based on the diagnosis and diagnosis-related groups — not on outcomes or a death certificate. That said, it’s worth understanding how COVID-19 deaths are classified. Death certificates, as we’ve written, can list multiple causes or conditions that contributed to a person’s death. So the disease often shows up alongside other comorbidities.
Those ailments could be caused by COVID-19, such as acute respiratory distress syndrome, or they can be long-term conditions, such as diabetes. It is well-known that seniors and people with underlying medical conditions are at increased risk of severe illness from COVID-19.
But in 92% of death certificates in the U.S. citing COVID-19, the disease is listed as the underlying cause of death — meaning the condition that started the chain of events that led to a person’s death — according to the CDC. The CDC says that its “mortality statistics are compiled in accordance with World Health Organization (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD).
ICD provides the basic guidance used in virtually all countries to code and classify causes of death” — including “the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate.”
Bob Anderson, chief of mortality statistics at the CDC’s National Center for Health Statistics, told our colleagues at PolitiFact: “If a terminal patient still had, say 6 months to live, but was infected by the virus and died, the certifier might determine that COVID-19 was the underlying cause of death because of the timing. In the same way, if that same terminal cancer patient was in a car accident and died from that trauma, the car accident would be the underlying cause.... If, on the other hand, death from terminal cancer was imminent or COVID-19 symptoms were mild, COVID-19 might be viewed only as a contributing factor — not the underlying cause — or, if the patient was asymptomatic, it might not be viewed as a factor at all — and therefore, not reported on the death certificate.”
ADDED: The best defense of Trump here is that he wasn't accusing the medical personnel of fraud. He was trying to explain why the death statistics for the United States look bad in comparison to other countries. The key question is whether other countries are counting COVID deaths different from us.
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119 comments:
"the certifier might determine"
Lotsa mights there.
Anyway, Trump is right about the incentive. Biden is wrong about Trump doing things "for money."
Better keep your eye on fatality rates and excess mortality, slightly less subject to gaming the stats.
A Minnesota legislator, who is also a physician, showed a letter from the state health department saying that if the deceased could reasonably be presumed to have been in contact with an infected person, C19 should be the cause, even in the absence of a positive test. I believe Dr. Birx said that died WITH should be coded as died OF, back at the beginning.
Since there is, indeed, a financial incentive, are we required to believe nobody, nobody nohow, is going to try to take advantage of it?
Money's one thing. Public perception of lethality is another, and more important. One way or another.
If Joe Biden is too stupid to understand the system of counting inflates the death rate because of comorbidities, because of policies stupid politicians enacted that incentivize counting deaths as covid deaths...then he's too stupid to be President
the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, created a 20% add-on to be paid to hospitals treating Medicare patients with COVID-19
It's impossible for that to have no affect peoples' judgement, if only subconsciously.
"If a Medical Examiner, in their best medical opinion, suspects COVID-19 is the cause of death, should COVID-19 be listed as the cause of death without laboratory test confirmation?"
Yes, a Medical Examiner may conclude the cause of death is COVID-19 and list it in Part I of the death certificate.
"If a Coroner suspects COVID-19 is the cause of death, should COVID-19 be listed as the cause of death without laboratory test confirmation?"
Yes, if COVID-19 is probable or suspected, list “Probable COVID-19” or “Suspected COVID-19” in Part I.
Just google and read some of the death certificates- the numbers are inflated to some extent. States do try to fix this in some cases- you will see in pretty much all the states some deaths being subtracted each day from the past while others are added. Excess deaths are definitely running higher than normal by around 200K-250K, so COVID is killing people who would have otherwise not have died in the last 8 months. My main point has always been that most of those 200K would have died in the next 18 months anyway. The very fact that such a large fraction of the dead were nursing home residents is the basic proof of this- such residents largely die within two years of entering a nursing home. Many of the rest of the dead were nursing home residents in all but fact- very elderly people being cared for by family.
There was this from the Politifact essay:
"It is well-known that seniors and people with underlying medical conditions are at increased risk of severe illness from COVID-19."
This is probably true, but here is the thing- such people are at higher risk of dying from any respiratory illness, including common colds.
There have been 9.5 million positive COVID cases. If they were randomly distributed within the US population, 80,000 of them would have died of something else this year even without COVID's existence: [9,000,000/330,000,000] x 3,000,000 if you want to see the math. We know, however, that the positives are not randomly distributed- the elderly and the infirm are over-represented in the 9.5 million positives because every nursing home resident has been tested by this point as has just about every hospital patient, plus the people who work with such testees. I would guesstimate the median age of a positive test is 50 years old or higher- that number is falling as we test college students and primary school students, but the numbers still favor the elderly.
Well no one has died of old age since March. So there is that.
During this pandemic, I've been in to see both my GP and a specialist with whom I've had a continuing relationship. I've also been in and out of the hospital several times. None of the many medical personnel I've encountered have been reticent about this, and all believe that the numbers are inflated to help the hospitals financially.
If Trump needs a defence, then so do they.
Ivor Cummin's new video, posted yesterday
The COVID-19 epidemic ended in May.
Mandatory mask-wearing regulations were imposed in June.
Since then, we have been in a COVID-19 casedemic. This means that growing numbers of people are testing positive for COVID-19. However, very few people are dying -- or even becoming very sick.
You would have to be pretty naive to think that hospitals, who’s income has been greatly effect by government restrictions on care, as well as the avoidance of care by people too scared, wouldn’t code hospitalizations and death certificates in a way to try to recoup some money, especially when the guidance they receive from the CDC tells them to code everyone who dies with PCR positive test, no maximum CT value limit as at least a contributing factor.
You can bet if hospitals are paid more for COVID patients they're going to have more COVID patients than if they weren't. They have already admitted that people who 'show symptoms' of COVID, even though untested, COVID is a presumed diagnosis. If anyone is under the illusion that hospitals today aren't about making money, take a look at their CEO's salaries.
Well... Yes, they are.
Based on CDC, based on WHO etc. It would be remiss to note that the CDC and the WHO as well as other allegedly expert organizations are at least somewhat suspect in their predictions and assertions throughout the covid episode. Not the least of which is the refusal to note that the origin of the chinese lung rot is in fact China. One can suspect anything these organizations purport or report when they haven't the honesty or integrity to name the source of and the behaviors of the source of the outbreak.
The biological reasons why COVID epidemics are seasonal
COVID-19 is not an exception. It too is a seasonal epidemic, and therefore it ended in May.
https://www.usatoday.com/story/news/factcheck/2020/04/24/fact-check-medicare-hospitals-paid-more-covid-19-patients-coronavirus/3000638001/
If any group of people is placed beyond questioning, then every fraud will immediately move toward that group and try to blend in.
So why do the hospitals make more???
Point the first: the cdc definition of a kung flu "case" is the presence of a positive test result. No symptoms or anything else are required.
This seriously over states the number of cases since the test produces many false positives. The lowest report I've seen is 30% but I've also seen 70%.
It does not detect the virus directly.
The test sensitivity depends on how many cycles it is run. Run enough cycles and you can find a positive result in a banana. The recommended number of cycles was raised in July. This results in more "cases"
94% of all deaths have had multiple othe co-morbidities.
Most kung flu deaths are with the virus (or at least a positive test report) very few are from the virus.
Money is a big part of it. An extra 20% if a death can be classified as Kung flu? And there are some people who don't think this influences reporting? Not necessarily "fraud" in a legal or moral sense. But certainly influence.
And a lot of people are making a lot of money on testing.
Even more money being made on the vaccine.
John Henry
In short, we are being
What the heck is wrong with Biden? He's perverted! (Grope and sniff). Make up "facts" and let anything come out of his cranky old mouth in an incoherent rant.
Time to pull out Shakespeare and say that Joe's campaign speeches are all too often a tale full of sound and fury, told by an idiot, and signifying nothing. POrobably misqouted the Bard there, but as Joe might say, close enough.
Biden lied. Of course he did. But in a predictable politics as usual sort of way. If there is a financial incentive to inflate the death count, then the death count is inflated. But that’s probably true throughout the industrialized world, so it’s unlikely to be a major factor in our relative death rate.
Anecdote is not data, but I know two people who have died recently with covid listed as a proximate cause of death. One had a terminal brain tumor, and the other had a stroke. Absent a positive test for covid, they would both still be dead. I also have neighbor who did not keep an appointment for a covid test, but got sent a letter saying she had tested positive. I have no idea if there is fraud involved or just incompetence.
There are 2 economic forces at work, and economic forces definitely affect human behavior, even "professionals". To argue otherwise is foolish.
1. Hospitals get a premium for Covid19 patients leading to increased hospitalization rates.
2. Intubation was overused leading to the death of many patients and intubation carries a hefty dollar charge.
You get what you pay for. And no he isn't saying anything about the doctors and nurses. The billing folks however will do their job and generate revenue.
Hospitals and the people that work at hospitals have a large financial incentive to falsely attribute deaths to Covid-19. To suggest that this does not occur is to deny human nature.
Of course part of the problem is objectively deciding whether or not Covid-19 is the cause of a death. This is not easy, particularly since in the vast majority of deaths involving Covid-19, or 93% of the deaths blamed on Covid-19 according to the CDC, there is at least one other factors contributing to the death. The fact is that the great majority of the people allegedly dying from Covid-19 are seriously ill for other reasons. That doesn't mean they are or were just weeks away from death but the majority of them would have, statistically speaking, died within a year anyway.
So the reality is that there is significant subjectivity in the attribution of the cause of deaths involving Covid-19.
Despite that subjectivity -- the entirely legitimate doubt -- it has become standard practice to attribute any death involving Covid-19 to Covid-19. It's absurd to believe this has nothing to do with large financial incentive that hospitals have to blame this on Covid-19.
Not accusing the doctors and nurses, accusing the hospital administration. Based on the medical personnel I've known, they would also believe their administrators are up to shenanigans but they're just happy the money is being squeezed out of someone else this time.
That is exactly what is happening. Trump is not wrong. I read a blog every morning called
Powerline, and if you open it now, and scroll down you can see Scott Johnson's recent reporting on this issue --
LINK TEXT
Check out the ratio of people dying while in a long term care facility and those that aren't. Scott has been doing this reporting since the start of the Chinese Communist Lung Flu disease.
Remember when Obama accused doctors of stealing kids' tonsils to make a little extra money?
https://www.realclearpolitics.com/video/2009/07/22/obama_doctors_taking_tonsils_out_for_money_instead_of_diagnosing_it_as_allergies.html
Not doctors, but hospitals. You would think Joe Biden would no perversion when he see it. But in this case, no.
There is no standard for reporting statistics. Literacy levels, infant mortality, and cause of death are reported differently everywhere.
They couldn't just say, "Trump is correct."
"The best defense of Trump here is that he wasn't accusing the medical personnel of fraud." It's not a "defense", it's the clear meaning of his words. He made a measured and completely correct statement about economics and incentives. Joe Biden, as usual, just lied about it.
Well, I haven't factchecked.orged it, but I have been reading that regular flu cases have dropped to near zero. If true, I wonder why?
Joe makes money the old-fashioned way, he launders it via his son from China and Ukraine.
And fact check dot org? Really? Might as well ask Soros or Obama for their opinion.
I work at one of the biggest hospitals in the US, and we know all about incentives. Federal government offers us money to do something, off we go to get the money, whether or not it makes sense for our business. I remember a decade ago when part of the First Stimulus Bill was a lot of money for hospitals that change over to Electronic Data Records. Well, we have been changing over - since the '70s. It turns out to be a big job, and believe it or not we're going as fast as we can. But to get all that federal money, suddenly there were these benchmarks that had to be met, benchmarks that had absolutely nothing to do with what made sense for us to do next.
My very liberal boss in IT commented: The inmates are running the asylum.
I worked for a large hospital system for 14 years through the the roll-out of Obamacare until 2018. I can damn well tell you, Medicare payments are crucial to the financial health of a hospital you and you better believe that a hospital will implement policies that maximize those payments.
There is a tremendous amount of wiggle-room and judgement calls to be had at the level of diagnosis and treatment, and financial matters absolutely play a role in the procedures that are put in place.
Physicians who work for hospitals must follow the policies and procedures and best practices as dictated by the hospital administration, and these exist as a result of a political process internal to the hospital that must balance patient health and economic considerations and many times the personalities of the individuals involved in the decision making.
To believe that these sort of incentives and disincentives somehow don't matter and don't happen is to be a fool; it may be unintended, but it's still going to take place.
They dismiss his claim out of hand. But does it have any truth behind it? People- all people- are motivated by incentives. Hospital administrators are notorious for manipulating data to achieve bonus territory stats. This has been a practice long before the Wuhan virus hit. (or Covid if you prefer to not remember where it came from).
It has been shown beyond doubt, that in the US, stats for Wuhan deaths include anyone who died with the Wuhan virus, not just people who died of the Wuhan virus. That's a reality and we still don't have a clear standard for counting these deaths.
There are many types of incentive. The press has an incentive to show higher totals of Wuhan virus deaths because they can make that reflect badly on Pres. Trump. Of course, that would only work if they had members of the scientific bureaucracy working that same line because they (a) hate Trump on the whole, and (b) want as much funding as they can get. They are incentivized to show higher totals- all of them.
So is Trump's comment out of line? Well- it sounds harsh and probably could have been worded better, or not mentioned at all. But that's Trump. The thing is this: he gets knocked for saying things that no one else would think to utter. But many, many people think it. It is definitely not out of the realm of humans who we know can be incentivized to act a certain way, or say certain things. Or, in some cases, deny the truth even when it's sitting on your head.
!. I have a friend who is a Medical Doctor who told me hospitals do receive more for treating Covid patients.
2. Why isn't anyone bringing up Obama's comments while arguing for passage of Obamacare against the Medical profession accusing them of amputating legs or removing tonsils because they wanted to make more money. The American College of Surgeons issued a statement at that time to "have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care".
3. It would be great if Biden ever took questions or sat down for interviews with credible journalists to probe him about his claim and also how Obama sold Obamacare, in part, by trashing the medical profession.
The "true" death count from the 'rona is between the excess death number (with deaths FROM the lockdown, i.e. suicides, delayed cancer diagnoses etc subtracted), and the number of reported 'rona deaths. Period.
It's not, and won't be an exact number, but that's the range and it is what it is, incentives aside.
The IFR continues to show it's a flu-monia. Basically the mortality profile of pneumonia (only old people die, and a few unhealthy young people), but with the infectivity of a moderate (not even bad, i.e. not the swine flu contagious capability) flu.
Period.
Get your skulls around those facts.
This stuff really irritates me.
My Mom died in 2011. Below is what is listed as cause of death on her death certificate.
A. Acute cardio respiratory failure
B. Acute renal failure
C. Pneumonia
So what killed Mom? We were never told she had Pneumonia, the doc said her kidneys were shutting down and that she needed to start and stay on dialysis for the rest of her life. Mom said, "No, I'm not going to start dialysis, I'm 87 years old, I've had a good life." We put her in hospice and she lived for two more weeks, I was there when she stopped breathing. So what killed Mom? In my mind it was her decision to not start dialysis. I often wonder if in some data bank her primary cause of death is listed as Pneumonia.
Also, the entirely inconsistent thing about this is of course, Biden is from the party that says things like (Obama): Doctors will do unnecessary operations just to make more money. They'll prescribe expensive branded drugs just to get a free pen from a drug rep.
But you think they won't misclassify a death in a person who was going to die anyway as a 'Rona death to get a 20% markup?
The CDC has already published a report that includes a statement that only 6% of the reported deaths due to Covid are “Covid only” deaths. (I’m not going to look this up again, but unless it has been scrubbed it doesn’t take long.) Hospitals are receiving funds based on Covid deaths. It is unlikely that those deaths are ultimately “reported” by Doctors and other frontline workers. It does seem likely that Biden is too stupid to know that or too corrupt to acknowledge it.
Trump is making distinctions that need to be made between “death by Covid” and “death with Covid.” Biden is making political hay.
As for what is going on now: https://issuesinsights.com/2020/10/29/5-more-covid-charts-democrats-and-the-press-dont-want-you-to-see/
I do not believe that our "death rate" is higher than almost all the European countries.
I do not believe that our "death rate" is higher than almost all the European countries.
Pretty much everything they accuse Trump of is made up, taken out of context, misquoting, or taking statements that he has made ambiguously and acting like that's his official policy.
4 years of relentless negative media smears might be paying off for Biden.
If you're inside the system, you know what the incentives are and you follow them. It goes without saying. The system is designed that way. Because everyone is following the incentives without questioning them, any criticism is automatically rejected with much umbrage, resentment and righteous anger.
This is what Trump was talking about.
The left turn every opportunity into a purpose for personal grift.
Northwestern trustee, former Obama-Biden admin official behind Chicago's $66M COVID hospital that treated just 38 people
I thought “everybody” was familiar with the numerous reports that Covid death rates are inflated. Evidently that doesn’t include Biden, the morons who support him and the fact checkers and mediaswine who cover for him.
And to back my previous comment, just came across this article: Hospital takes in millions to treat 38 people
I have some friends from childhood who live in the western Suburbs of Denver. (Lakewood/ Wheat ridge) One, who works in the restaurant business, said he suffered from a cold a few weeks ago. I think it was probably covid. He was never tested. (thankfully he knew enough to quarantine for 2 weeks just in case)
Anther friend WAS tested for covid, and it came back positive. She said her symptoms are mild and similar to a head cold.
Buck Sexton played clips of the parade of "experts" who came out early in the pandemic
(including Faucci) who proclaimed in various ways - that wearing a mask was not suggested or recommended. or even effective!
Who is more likely to die from the job? Cops or Corona doctors? Lefties do not seem to think cops are risking much.
There are much worse diseases these health care workers can contract. These doctors and nurses who are whining about working with an occasional Covid patient should go to third world countries and actually see people dying of horrible diseases. There might not be a doctor for one hundred miles and the clinics have to bring in water from a well and not have enough medication to treat the sick people. Yeah, go ahead and whine about fake covid.
All the stats are nearly worthless if you compare them to what real science uses. The tests are not all that accurate, they are only administered to a non-representative subset of the population, testing regimens have changed over time so time-series analysis is often inappropriate, there are levels of administrative rules and then human judgment that can and do affect the way things are recorded.
It is a mess and will be foe quite some time.
Trump too often shoots from the lip with half-formed ideas he heard somewhere, and not precisely expressed, leaving him open to charges of lying. I think it is usually more-or-less good faith, but he does exaggerate as do many salesmen, which is really what he is--a salesman.
It would help if people, esp the media, would just calm down and treat these kinds of things as if he is a realtor trying to sell you a condo. Treat him skeptically and call out where his overstatements cross the line, but he is NOT Hitler.
"...It’s perverted. He may believe it because he doesn’t do anything other than for money..."
When I read these lines I had to laugh - first thing came to mind was "Joe Biden". Is Biden describing himself? So, so funny!
Well, we know where some of that money went.
The city of Chicago spent $66 million turning McCormick Place — the largest convention center in North America — into a coronavirus hospital.
Although the facility treated a mere 38 patients during its month of operation, Chicago’s deputy mayor for economic development and Northwestern University trustee and former Obama administration official Samir Mayekar doubled down on his support of the hospital.
"Hindsight is 20/20. I get that. But for Samir Mayekar to say after the fact he is not even a little bit embarrassed by this debacle — but to double down and say he is ‘proud’ of it, and then add that taxpayer money was 'not spent in vain' — is a joke and an insult."
According to the Chicago Sun-Times, Mayekar said he is “incredibly proud of” the facility, adding that the expenditure — which amounted to $1.7 million taxpayer dollars per patient — was “not spent in vain.”
Chicago hired a highly politically connected company called Walsh Construction to complete the project, passing over two other companies that offered more attractive proposals. McPier, the governmental body that runs McCormick Place, passed on proposals from Pepper Construction and Power Construction Company, which reportedly offered to either forgo fees or donate payment to pandemic relief to avoid profiting from a humanitarian disaster.
What about the YouTube video of two front-line doctors from LA who said hospital administrators were pressuring doctors to add Covid to the diagnosis in order to increase reimbursement from Medicare? That video, featured on, among other programs, Tucker Carlson (Fox), was censured and deleted by YouTube, but those of us who saw it, and especially those of us who have worked in hospital administrations, understood that this was probably a pervasive problem that exaggerated the number of deaths "caused" by Covid in order to help these hospitals' bottom line.
THis is just another Lie by Biden or a smear. Notice he says the word SUGGEST. Trump did not SAY IT. He "Suggested"it. Which is what Biden wants him to SUGGEST. This is just old media game of taking an ambiguous Trump quote and then saying he IMPLIED or SUGGESTED something, and then acting like HE SAID IT EXPLICITLY.
Which is a LIE.
Here's what i think Trump SUGGESTED, based on the transcript. He suggested that the current system of reporting gives an incentive for people to over-report and that our numbers would be lower and more accurate if it didn't. That's common sense.
Notice that good ol'Joe. Good ol' friendly uncle Joe is accusing Trump calling Nurses and Doctors FRAUDS out for $$, which is a complete LIE.
People with a financial incentive to lie, will lie. Joe Biden is the embodiment of this.
I do recall reading an article about a mother who said that if her son died of coronavirus, it’s because coronavirus uses guns and bullets to kill its victims. Wish I could find it. I’ll keep looking.
"Fact" checkers... WHY am I so suspicious of them???? Hmmmmmmmmmmmmmmmm...
Good Ol' Joe isn't a meanie like Trump. He's full of decency - unlike Trump. Yeah, right.
Biden has called Trump: A fool, a liar, a racist, a friend of nazis, a clown, a fraud, a murderer, an incompetent, unpatriotic, a creep who thinks solderer are Losers, and a crook. Now he's saying Trump is responsible for 150,000 Americans dying of CV-19 AND that the Doctors and nurses are frauds and grifters.
So, that's good ol' decent honest Joe Biden. Where are all the never-trumpers and sainted moderates who get the vapors over Trump's "Mean Tweets"? Where is Mitt Romney and Flake? Nowhere. Only Trump's insults upset them. The D's can insult and lie and be mean and its A-OK.
"Lotsa mights there."
The defense offered is typical. Designed to provide an alternative that is plausible, even if it's unlikely. It's called "plausible deniability" not "likely deniability". It's offered every time the Left gets caught. Like defense lawyers, they immediately start thinking up ways that their client might be innocent, even if they know it's a long shot. They just need to offer up some doubt, because if you give some people that, they do the rest on their own.
Reminds me of when Obama said doctors pull people tonsils out and cut off limbs to make money.
Meanwhile over at Inty: " Northwestern trustee, former Obama-Biden admin official behind Chicago’s $66M COVID hospital that treated just 38 people.
https://campusreform.org/?ID=15674
Every person I know whose been tested said early false positives, like all tests now using PCR, were rampant. And each person reported that the REQUIRED re-tests were counted as SEPARATE “positive cases” and one friend (a psychologist) was told by the local hospital that was how they were told to report. Over reporting. And there are zero recorded “flu deaths” this year. Why? What happened? Was every at risk person who died from seasonal flu (50-80,000?) counted as a COVID death this year? Does a 20% kicker explain it? Would jump through a hoop for a 20% revenue bump in your business or salary? Cmon man. Think like a real person not a political analyst.
Want to know about Milwaukee County's "Covid" deaths?
Go to this link: https://county.milwaukee.gov/EN/Medical-Examiner/Public-Data
The right-hand column has arrows by which you can navigate through reported deaths. Make your own judgment about the "cause of death."
Trump MAY have been wrong about "doctors" profiting from listing c.o.d. as "covid" but he wasn't wrong about HOSPITALS earning extra bucks for that diagnosis.
Are these the same medical professionals who wrote doctors excuse notes to healthy teachers protesting Gov. walker?
Are these the same medical professionals Obama said routinely ignore foot infections because the medical professionals made more money waiting and cutting off the leg?
Anyone willing to look at the can find esteemed medical academics making Trump's case. It's not hard to find the mortality charts that make the case.
Then there are the deaths in motorcycle wrecks listed as Covid or people in Hospice care in there last days dying of cancer listed.
Hospitals have an abundance of integrity, just like universities.
And then there's this...
https://fee.org/articles/physicians-say-hospitals-are-pressuring-er-docs-to-list-covid-19-on-death-certificates-here-s-why/
Joe has the "gall" to run for president. Actual normal people who know real information (i.e. not Joe Biden) know what this is. $$$$$$ If I peddled influence as well as Biden, I wouldn't have any idea how these things worked, or need to.
Tag: Fake Outrage
ADDED: The best defense of Trump here is that <-- as usual, he was right.
The key question is whether other countries are counting COVID deaths different from us. <--differently.
Anyone who is being honest knows that there is a thumb on the scale here. The fact that we seem to NOT even have a flu season supports it.
Joe Biden is a liar, a coward, a hair sniffing serial groper and a terrible father, who's pimped out his drug-addled son as his bagman for millions of international dollars.
There is no best defense for this creep and that is why so many medical professionals have pushed back on his inflammatory claims and will now vote for Biden.
The doctors may not be reacting to the financial incentives, but the billing departments almost certainly are. How could they not?
Yesterday I ranked European countries' death rates with the US States to see if there was any info to be gleaned.
I took fourteen Western European countries plus Canada and put them into the 50 states plus DC table. I sorted by deaths per million. (Sixty six entries total)
The worst ten are: NJ, NY, MA, CT, LA, RI, MS, Belgium, DC, AZ.
NJ, NY, MA, CT, RI, DC, & Belgium all have similar curves: a large spike in the spring. Belgium and many of these states are showing a second wave half the size of the first and not peaking yet.
Here is an explanation from NPR in April as to why Belgium had the highest death rate in Europe:
"Why Belgium's Death Rate Is So High: It Counts Lots Of Suspected COVID-19 Cases"
Belgium's counting methods may have been right or wrong, but you can certainly argue that the methods were similar in the (primarily northeastern) states where Covid hit first.
OTOH, there is not doubt that excess deaths in the US roughly match the number of Covid deaths.
Other items of interest to me:
The UK comes out at # 22, right at the bottom third.
Sweden (the poster child for how to do everything wrong) is #28, between Alabama and Nevada and slightly better than France. Sweden is not yet suffering a second wave of deaths.
WI was 47th, in the bottom third.
Norway was last (best) but I left Finland off because it wouldn't be fair to include them.
An Yancey said, excess deaths roughly match Covid deaths, so there is no doubt Covid is killing people, directly and indirectly.
It is a scandal that we did not have Joe Biden as President. No one would have died of Covid.
Neither the Trump Campaign, nor any Trump “surrogate” or other spokesperson, has answered for Trump’s trash talk on this subject.
The more anyone digs into this topic, the worse that Trump’s quote looks. As always, if there actually had been something that was intelligent and contrarian to be said about how medical reimbursement schemes might impact COVID epidemic numbers, Trump didn’t say it.
Time and time again, the Trumpists tie themselves in knots, trying to come up with a plausible explanation that could make Trump something other than an insulting liar. This story amounts to one of their toughest challenges. Even Althouse is having trouble finding any easy way to explain away this one.
This the story of the Trump presidency, in one blog post. That even where Trump has a clear field and might be able to articulate an arguably conservative position, Trump takes the dumb and simplistic approach.
Charlottesville.
Shit hole countries.
Muslim bans.
Enough.
Everybody knows, what you pay for, you get more of.
To be clear hospitals are paid by Medicare by the principle diagnosis via the system of Diagnosis Related Groups (DRG). Most DRG’s come in triplets with the base reimbursement being the base diagnosis (i.e. “Simple Pneumonia) without comorbidities or complications (CC’s) or major comorbidities or complications (MCC’s). You get an increment in your DRG payment is you have a CC and you get an even higher increment in payment if you have an MCC. With that as a back drop here is the way hospitals are paid more for a COVID dx:
“More recently, the CDC implemented a new ICD-10-CM diagnosis code, U07.1, COVID-19, which is effective as of April 1, 2020. The new code also is considered a major complication or comorbidity (MCC).”
Furthermore, unlike any other diagnosis code, U07.1 does not require a physicians declaration that it was a clinical problem addressed during the hospital stay. If the test is ordered in the hospital and is positive, coders can code U07.1 without a physician notation confirming a COVID-19 diagnosis.
So in this sense hospitals do get paid more for a COVID diagnosis. Physicians are not paid extra as they are not paid by the diagnosis but by the level of service provided in the encounter.
Finally it should be noted that given the added costs of managing COVID 19 positive patients (the costs of droplet precautions with PPE, special rooms etc) and the often prolonged stays in the hospital due to illness burden and limited options for post acute care, the extra payments for COVID care have not covered the costs. By and large hospitals have lost millions to billions of dollars during the pandemic.
It is entirely true Joe. I have to do tons of business with hospitals and they have the most corrupt doctors (sorry redundant) on the planet. Anyone who has had any cowork with the UW Madison hospital knows they are in it for the dark money. It is a training ground for overpriced, unethical incompetents.
snopes fact checks
Our ruling: True
We rate the claim that hospitals get paid more if patients are listed as COVID-19 and on ventilators as TRUE.
Hospitals and doctors do get paid more for Medicare patients diagnosed with COVID-19 or if it's considered presumed they have COVID-19 absent a laboratory-confirmed test, and three times more if the patients are placed on a ventilator to cover the cost of care and loss of business resulting from a shift in focus to treat COVID-19 cases.
Here's the thing. Anyone who has worked in a doctor's office knows how to "Juice" Medicare, Medicaid claims because they just don't pay enough (often with with private insurance, also). Hospital billing workers wouldn't hesitate to over count, and justify fudging COVID19 deaths. It's what they get paid to do. How many people here have had a claim not covered because of a coding "error", then they re-code and it goes through? It's normal.
Fernandinande said...
"the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, created a 20% add-on to be paid to hospitals treating Medicare patients with COVID-19
"It's impossible for that to have no affect peoples' judgement, if only subconsciously."
Yes, it's obvious and the effect is probably far from insignificant. BUT, could your argument fit on a bumper sticker? If not, it's null in the world of politics.
Dems criticize healthcare providers for being mercenary all the time. Today they pose as outraged that someone else made a similar criticism.
D.D. Driver said...
Remember when Obama accused doctors of stealing kids' tonsils to make a little extra money?
https://www.realclearpolitics.com/video/2009/07/22/obama_doctors_taking_tonsils_out_for_money_instead_of_diagnosing_it_as_allergies.html
How soon they forget...if they even heard about it at all....
This stuff really irritates me.
My Mom died in 2011. Below is what is listed as cause of death on her death certificate.
A. Acute cardio respiratory failure
B. Acute renal failure
C. Pneumonia
So what killed Mom? We were never told she had Pneumonia, the doc said her kidneys were shutting down and that she needed to start and stay on dialysis for the rest of her life. Mom said, "No, I'm not going to start dialysis, I'm 87 years old, I've had a good life." We put her in hospice and she lived for two more weeks, I was there when she stopped breathing. So what killed Mom? In my mind it was her decision to not start dialysis. I often wonder if in some data bank her primary cause of death is listed as Pneumonia.
Blogger Kathy from Boston said...
!. I have a friend who is a Medical Doctor who told me hospitals do receive more for treating Covid patients.
I am a medical doctor (retired) and I was in Tucson Medical Center in July having a lobe of my lung out. Chatting with the nurses, I mentioned that I had heard the hospital got $19,000 more per case with WuFlu. They told me I was wrong. It was $40,000.
Back when I was still in practice, I was very aware of the medical records' role in revenue enhancement. People would ask me to code a diagnosis differently as it would increase revenue. This was after DRGs came along.
Perhaps Trump was talking about this:
Northwestern trustee, former Obama-Biden admin official behind Chicago's $66M COVID hospital that treated just 38 people
Some people are really invested in making this crisis as bad as possible, and they absolutely refuse to accept any good news about it. Now why would someone do that? The incentives are financial for some, but others have their own incentives.
Curious George said...
Not doctors, but hospitals. You would think Joe Biden would no perversion when he see it. But in this case, no.
-------------=============
you guys are doing all this backwards
Joe Biden is interested in concealing own perversion and "perverse incentives" >>> he has been acting on those all his life >>> which is also the essence and core of deep state being discussed in other posts.
to show an understanding of this state of affairs is to be accused of taking advantage of it >>> Biden sees no difference in his way of making money (trading favors in politics) vs making money exchanging values in a market as producers
ref : passage from ATLAS SHRUGGED - Francisco and James
“When I die, I hope to go to heaven -whatever the hell that is – and I want to be able to afford the price of admission.”
“Virtue is the price of admission,” Jim said haughtily.
“That’s what I mean, James. So I want to be prepared to claim the greatest virtue of all – that I was a man who made money"
"Any grafter can make money"
"James, you ought to discover some day that words have an exact meaning "
Our ruling: True
We rate the claim that hospitals get paid more if patients are listed as COVID-19 and on ventilators as TRUE.
Hospitals and doctors do get paid more for Medicare patients diagnosed with COVID-19 or if it's considered presumed they have COVID-19 absent a laboratory-confirmed test, and three times more if the patients are placed on a ventilator to cover the cost of care and loss of business resulting from a shift in focus to treat COVID-19 cases.
https://www.usatoday.com/story/news/factcheck/2020/04/24/fact-check-medicare-hospitals-paid-more-covid-19-patients-coronavirus/3000638001/
Can Joe Biden say Coronavirus came from China?
If not, why are we believing anything else he says on the matter?
Phil 314 said...
... here is the way hospitals are paid more for a COVID dx:
“More recently, the CDC implemented a new ICD-10-CM diagnosis code, U07.1, COVID-19, which is effective as of April 1, 2020. The new code also is considered a major complication or comorbidity (MCC).”
Furthermore, unlike any other diagnosis code, U07.1 does not require a physicians declaration that it was a clinical problem addressed during the hospital stay. If the test is ordered in the hospital and is positive, coders can code U07.1 without a physician notation confirming a COVID-19 diagnosis.
So in this sense hospitals do get paid more for a COVID diagnosis. Physicians are not paid extra as they are not paid by the diagnosis but by the level of service provided in the encounter.
...
By and large hospitals have lost millions to billions of dollars during the pandemic.
----------=============
so this coding advantage effect is still positive marginal but real as far as tax-payer-funded payments go.
There is no 220,000 deaths from COVID number.
There are 220,000 deaths from influenza, pneumonia, or COVID.
The NIH/CDC do not have a column for COVID alone. There is no such thing as a COVID death. Only deaths of people who had COVID.
Every part of the reporting on this disease has been a lie.
Fun with numbers.
Pneumonia kills a lot of children every year.
The numbers are purposely conflated. If we didn't have Cuomo in New York killing off people in Nursing homes and New Jersey jumping in on the fun the numbers of deaths from COVID are completely different.
Even with the numbers we have now there is no justification for the police state bullshit.
"The key question is whether other countries are counting COVID deaths different from us."
Shouldn't it be "differently" because it modifies the verb "are counting"? And I believe it's "differently than we do."
That long winded explanation by politifact was true up until May — so one could say “died OF”. The our betters turned around and changed it to “died WITH” With only about 10% of infections being tabulated and about 8000 people dying every “normal” day because of causes, we have a built in 800 or so of deaths “WITH’ to keep the fear monger in going.
DavidUW wrote:
"The "true" death count from the 'rona is between the excess death number (with deaths FROM the lockdown, i.e. suicides, delayed cancer diagnoses etc subtracted), and the number of reported 'rona deaths. Period.
It's not, and won't be an exact number, but that's the range and it is what it is, incentives aside."
I couldn't have written it better myself. Add in that, statistically, all else being equal, the 9.5 million Americans with positive results would have included 70,000-100,000 people who would have died this year even if COVID didn't exist- about 1 in 110 people die every year in America from all causes- that is 3,000,000/year.
Not doctors, but hospitals. You would think Joe Biden would no perversion when he see it. But in this case, no.
They made the same mistake when they misdiagnosed health care affordability and availability, conflating insurance and health care, mistaking progressive costs for progressive prices, and other market distortions.
In this thread, OMG, Maine needs to panic! Another Maine citizen has died of covid! Everyone must mask! A lady in her nineties died of covid! A lady in her NINETIES! I seem to recall that in my lifetime not too long ago if someone in their 90s died, the reason was old age, regardless of what else they might have had- unless it was obvious homicide of some kind.
And if you look at this official CDC graph, it's pretty obvious what the dreaded covid is doing is simply hatening deaths of people who are going to die soon anyway. Maybe not for that <2% 0f deaths under 40. But if you take a closer look at those deaths, well more than 50% of them had medical problems that required constant medical care to keep alive. IOW- the dreaded covid is killing off the weak and the elderly. Margaret Sanger would be proud of it's accomplishments.
Trump is 100% correct. When the hospitals were shut down for everything but Covid and they were bleeding money in massive quantities, the only thing keeping them afloat was the extra cash they got for coding deaths as Covid.
There have been dozens of stories on this. Are people that locked into the liberal bubble that they never get any accurate information?
Back when I was still in practice, I was very aware of the medical records' role in revenue enhancement. People would ask me to code a diagnosis differently as it would increase revenue.
I worked at a hospital based Psychology practice for 10 years and spent a lot of time working with the billing people to get proper coding. It was a particular challenge because I developed a diagnostic assessment practice that they were unfamiliar with. My income was totally dependent on coders and the bureaucrats who gave the orders.
Most people do not understand how these things work. The bureaucrats (usually with degrees in Hospital Administration) run the show and mostly listen to government and insurance bureaucrats. Practitioners do not have much input into the system. If the system says to code COVID as a contributing factor, it is done regardless of the practitioners expert opinion.
Factcheck.org is the scathingly partisan and dishonest project of the Annenberg Foundation's Annenberg Public Policy Foundation. This is the same foundation that funded Obama and Bill Ayers for years, setting up the former for the national stage and running cover for Ayers and several other terrorist murderers. Annenberg's Factcheck.org has repeatedly refused to retract demonstrably false claims they made during the 2008 election, intentional lies that I detail in my report: Michelle and Barack and Bernadine and Bill: The Real Story of the Obamas and the Terrorist Couple.
Factcheck.org is the scathingly partisan and dishonest project of the Annenberg Foundation's Annenberg Public Policy Foundation. This is the same foundation that funded Obama and Bill Ayers for years, setting up the former for the national stage and running cover for Ayers and other terrorist murderers. Annenberg's factcheck.org has repeatedly refused to retract demonstrably false claims they made during the 2008 election, intentional lies that I detail in my report: Michelle and Barack and Bernadine and Bill: The Real Story of the Obamas and the Terrorist Couple. They are a pure propaganda unit.
Blogger roesch/voltaire said...
There is no best defense for this creep and that is why so many medical professionals have pushed back on his inflammatory claims and will now vote for Biden.
More ignorance from R/V.
Obamacare destroyed the healthcare system we had an which satisfied 85% of the population. Hospitals saw this as an opportunity to control doctors and bought up most small medical groups. This allowed them to establish incentive systems. Most GPs I knew were paid a certain amount and there was an annual bonus which was half their annual income. Internists were similarly incentivized.
A friend of mine that I have known 30 years is a pulmonary doc. He is not allowed to admit patients to the hospital where he worked for all those years. He has to send a sick patient to the ER so they wait until a salaried ER doc approves admission. What do you think their bonus is based on ?
Doctors, especially young ones, are now employees on salary and vote like employees. The days of doctors as small business people are gone except for some older ones who have gone to cash only to avoid Obamacare. Actually, there are some younger ones going the same way these days.
This is not the article I was recollecting upthread, but it does document the state of Washington claiming gunshot victims as being deaths from COVID-19.
Biden/Harris have a few techniques to deal with facts they dislike:
-Ignore
-Yell about something else (Joe)
-Hand-wave it away as debunked or old news
-Lie about it
-Laugh about it (Harris)
I just saw Amy Klubuchar on Chris Wallace's show this morning. When confronted with unpleasant facts about things Biden said on the record, she did what a person with some human decency does: she got uncomfortable, she quickly acknowledged reality (Wallace had video cued up), and then quickly tried to change the subject. She may eat with a comb and otherwise have unpleasant habits, voting or otherwise, but she's preserved some of her humanity. She's gone as far as such a person can go in politics.
Trump is simply pointing out what most people already knew. Or suspected.
If medical facilities are going to receive more money based upon checking a certain box, they're going to check that box. As they always have long before Covid.
Unless you actually believe that ace bandage on your bill really cost 45 bucks.
the dreaded covid is killing off the weak and the elderly. Margaret Sanger would be proud of it's accomplishments.
Envious. Everyone knows the implications of social progress, the direct and collateral damage of the wicked solution. Ms. Sanger, tear down the walls!
Abortion deaths are only counted as an abortion death if the person filling out the death certificate writes "abortion" as the cause of death. That's exceedingly unlikely to happen, unless the person filling out the death certificate is pro-life, or the abortion fatality is criminal. That's why women who die in an abortion are routinely not counted as abortion deaths. Simultaneously, abortion deaths are always counted as pregnancy deaths. Thus we are told that abortion is safer than pregnancy.
It's very politicized, in other words. Statistics about who died and what caused the death are very misleading. If there is a financial or political incentive for the statistic, then the statistics become absolutely ridiculous. See, for instance, 1 out of 4 women will be sexually assaulted at college. Literally nobody believes this, which is why women keep going to college.
Yet people repeat the statistics!
People- all people- are motivated by incentives.
Also, you can't make people understand something if their compensation depends on them NOT understanding it.
Gall, is that anything like nerve?
Biden is a liar and a dimwit, nothing he says should be taken seriously. Meanwhile, it seems to me Trump's "incendiary claims" are true. The incentives produce what they do, even though the actions and results are not what was intended.
When did WHO gain the power to make binding regulations on the CDC or any other US government body?
I strongly suspect they have not in fact gained any such power.
I'm not the first to say it but incentives exist whether or not anyone desires to act in accordance with them and on any other topic about the US health system, progressives would agree. This is why they want to nationalize health care, because they believe medical professionals and insurance companies can't be objective about care when they profit from it.
Gabriel @ 3:58: Are you suggesting that government agencies do not use incentives to feather their own nests? The most self-serving entities in this country in regard to medical care are Medicare & Medicaid. And they are by far the most wasteful as there is NO incentive to cut costs or oversee claims.
Good friend of mine (a reliable conservative) was president of the American College of Surgeons when Obamacare was being considered. Hence the College’s pushback at the time. Since then most professional medical associations have fallen to the SJW and are now repeating DNC talking points on this recent issue. See, American College of Physicians. They’re all grifters.
Hospital administrators are notorious for padding bills. The Lahey Clinic system around Boston assesses a "hospital usage fee" if you have routine procedures done at their main facilities in Burlington and Peabody, MA.
Thus I was charged an ADDITIONAL $500 when I got a routine cortisone shot in my knee at the Peabody hospital.
I raised bloody hell, and got most of that taken off. But I learned my lesson: I now request any such simple procedure be done in Arlington or Lexington, where that fee is not tacked on.
Why do they do this? Because every illegal Yard Aztec who limps into the ER with a Weedwhacker injury and gets "free" treatment is paid for by patients with insurance.
That's why.
Bastards!
It is fact that hospitals treating COVID GET PAID MORE. Coding patients in hospital has become a science using crafted software to maximize profit. It is driven by the government coding. If they have empty beds, they encorage the primary care doctors to admit patients if there is any possible justification. Been in the hospital software business and healthcare for decades and you have to be naive or blind to not see strong manipulation of coding to maximize profits in this pandemic. Trump once again is correct.
It is fact that hospitals treating COVID GET PAID MORE. Coding patients in hospital has become a science using crafted software to maximize profit. It is driven by the government coding. If they have empty beds, they encorage the primary care doctors to admit patients if there is any possible justification. Been in the hospital software business and healthcare for decades and you have to be naive or blind to not see strong manipulation of coding to maximize profits in this pandemic. Trump once again is correct.
@mockturtle:Are you suggesting that government agencies do not use incentives to feather their own nests?
No. You may have confused me with another commenter. I'm relaying to you what progressives say when it's not an election year and the topic is not COVID.
I'm well aware, in my offline life, how poorly state and Federal government manage Medicaid and Medicare costs...
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