No CrossRef data available.
Article contents
Reviews in Medical Ethics: Medicare: Where is the Common Sense? A Review of by David A. Hyman
Published online by Cambridge University Press: 01 January 2021
Extract
In his deliciously funny book, Medicare Meets Mephistopheles, Professor David Hyman argues that Medicare corrupts our most base impulses. It urges us, for example, to grab for more than our fair share of benefits while offering providers “the prospect of staggering amounts of money – even as…actuaries were promising Congress that the Medicare program would be easily affordable.” Modeled on C.S. Lewis’ The Screwtape Letters, Professor Hyman's satirical examination of Medicare takes the form of a memo to Satan from an underling demon in the Department of Illness and Satanic Services (DISS), reporting on the success of Satan's diabolical plot to corrupt humanity. Sprinkled with political cartoons, absurd (but true) stories of Medicare's over-the-top fraud enforcement efforts, and a historical account of Medicare's genesis (replete with Congressmen and strippers), Medicare Meets Mephistopheles gives us a well-researched and easy-to-read primer on the biggest pot of gold in medicine.
- Type
- JLME Column
- Information
- Copyright
- Copyright © American Society of Law, Medicine and Ethics 2006
References
Hyman, D., Medicare Meets Mephistopheles (Washington, DC: The Cato Institute, 2006): at 27.Google Scholar
Id., at 31.Google Scholar
Id., at 41.Google Scholar
Id., at 45.Google Scholar
Id., at 50.Google Scholar
Id., at 53.Google Scholar
Id., at 57Google Scholar
Id., at 63.Google Scholar
Id., at 59.Google Scholar
Id., at 67.Google Scholar
Id., at 41.Google Scholar
The Medicare Prescription Drug Benefit and Modernization Act uses a means test for premiums under Part B, which pays for physician services. Medicare Prescription Drug Benefit and Modernization Act, Pub. L. 108–173 (2003). See also Hyman, supra note 1, at 17.Google Scholar
Mashaw, J. and Marmor, T., “Understanding Social Insurance: Fairness, Afford-ability, And the ‘Modernization’ Of Social Security and Medicare” Health Affairs 25 (2006): W114–134 at w131.Google Scholar
Hyman, supra note 1, at 41.Google Scholar
Supra note 13.Google Scholar
Hyman, supra note 1, at 41. “This one-way ratchet has operated in all aspects of the Medicare program. As a group, the elderly received far more from the public trough than they ever paid in (and more than is economically sustainable) even before the MMA, which made things substantially worse for younger taxpayers.”Google Scholar
Hyman, supra note 1, cartoon at 58.Google Scholar
Hyman, supra note 1, at 16.Google Scholar
A monthly income of $712 is the cutoff for most states. Help Paying for Medicare, at <http://www.medicarerights.org/main-contentmedicarecosts.html> (last visited October 10, 2006).+(last+visited+October+10,+2006).>Google Scholar
In 1988, the Medicare Catastrophic Coverage Act was enacted, which created the Qualified Medicare Beneficiary (QMB) program. In 1990, the Specified Low-Income Medicare Beneficiary (SLMB) eligibility group was established. Key Milestones in CMS Programs, available at <http://www.cms.hhs.gov/History/Downloads/CMSProgramKeyMile-stones.pdf> (last visited October 10, 2006).+(last+visited+October+10,+2006).>Google Scholar
Supra note 23.Google Scholar
Barents Group LLC, A Profile of QMB-Eligible and SLMB-Eligible Medicare Beneficiaries, HCFA Report (prepared for the Health Care Financing Administration) (1999): at xiii.Google Scholar
Supra note 13.Google Scholar
Lamphere, J. and Rosenbach, M., AARP Report, Bridging the Gaps Between Medicare and Medicaid: The Case of QMBs and SLMBs [Report prepared for the AARP's Research Group, Public Policy Institute] (Commerce Clearing House, Inc., 2006).Google Scholar
Wilson, R. F., Students Assisting Seniors' Year End Report, November 15, 2004 (reporting on the yearly progress of a program established at the University of South Carolina to assist low-income senior citizens to enroll in the QMB and SLMB programs).Google Scholar
Supra note 26, at xii.Google Scholar
Supra note 29.Google Scholar
Medicare and Medicaid Guide (Commerce Clearing House, Inc., 2006).Google Scholar
Medicare and Medicaid Guide 1 (Commerce Clearing House, Inc., 2006): at 6.Google Scholar
Id., at 3001.Google Scholar
Medicare and Medicaid Guide 6 (Commerce Clearing House, Inc., 2006): at 30, 527.Google Scholar
31 U.S.C.A. §3729(a) (2006).Google Scholar
Krizek, supra note 40, at 936.Google Scholar
Florida Attorney General's Office, “Message from Attorney General Charlie Crist,” at <http://myfloridalegal.com/NewsBrie.nsf/OnlineBriefs/7FC487B351EC11BF8525718F004A77B4> (last visited October 10, 2006). (last visited October 10, 2006).' href=https://scholar.google.com/scholar?q=Florida+Attorney+General's+Office,+“Message+from+Attorney+General+Charlie+Crist,”+at++(last+visited+October+10,+2006).>Google Scholar
Supra note 43.Google Scholar
Supra note 43.Google Scholar
Supra note 43.Google Scholar
“The Loneliest Losers,” Sports Illustrated, November 18, 2002.Google Scholar
SMU Football webpage, at <http://smu-mustangs.cstv.com/sports/m-footbl/smu-m-footbl-main.html> (last visited October 10, 2006).+(last+visited+October+10,+2006).>Google Scholar
Supra note 48.Google Scholar
“McLeod Regional Medical Center to Pay US Over $15 Million to Resolve False Claims Act Allegations,” November 1, 2002, Department of Justice website, available at <http://www.usdoj.gov/opa/pr/2002/November/02_civ_634.htm> (last visited October 10, 2006).+(last+visited+October+10,+2006).>Google Scholar
Hobbs, J. M., “So Much To Lose: Minor Problems Can Lead to Major Losses for any Health Care Professional,” The Legal Intelligencer, July 10, 2006.Google Scholar
Burnham, S., “Let's Repeal the Field Code!” Montana Law Review 67 (2006). “The English codifier Jeremy Bentham referred to the common law as ‘dog law,’ for a person trains a dog by punishing it for not following a rule, and thus teaches it what the rule is after the fact.”Google Scholar
LSU Law Center's Medical and Public Health Law Site, at <http://biotech.law.lsu.edu/cases/adlaw/AAMC_v_US_review.htm> (last visited October 10, 2006). (last visited October 10, 2006).' href=https://scholar.google.com/scholar?q=LSU+Law+Center's+Medical+and+Public+Health+Law+Site,+at++(last+visited+October+10,+2006).>Google Scholar
After the University of Pennsylvania settled, the American Association of Medical Colleges filed suit for declaratory and injunctive relief, based on the government's alleged retroactive application in the PATH investigations of a 1995 clarification to the law. The United States Court of Appeals for the Ninth Circuit noted that the government admitted the highly confusing nature of the regulation and that carriers had been providing guidance that was often erroneous to providers. Am. Ass'n. Of Med. Coll. v. U.S., 217 F.3d. 770 (9th. Cir. 2000) aff'd in part. Ultimately, the Ninth Circuit affirmed the lower court's dismissal for want of jurisdiction, but reversed the dismissal with prejudice, leaving the AAMC free to bring suit again later.Google Scholar
Chielli, J., “Teaching Hospital Audits Hit Region,” Physician's News Digest, May 1998, available at <http://www.physiciansnews.com/cover/598wp.html> (last visited October 10, 2006). (last visited October 10, 2006).' href=https://scholar.google.com/scholar?q=Chielli,+J.,+“Teaching+Hospital+Audits+Hit+Region,”+Physician's+News+Digest,+May+1998,+available+at++(last+visited+October+10,+2006).>Google Scholar
Id. Although the PATH audits finally concluded in 2005 with settlements in excess of $130 million, hospitals believe they are still vulnerable to similar audits given all the ambiguity of Medicare's rules and the economic penalties they may face if they do not settle. Health Sciences Compliance Newsletter, Spring 2005, USC Office of Compliance, available at <http://www.usc.edu/admin/compliance/pdfs/Health%20Sciences%20Compliance%20NewsletterSpring%202005.pdf#search=%22university%20of%20pittsburgh%20path%20settlements%22> (last visited October 10, 2006). (last visited October 10, 2006).' href=https://scholar.google.com/scholar?q=Id.+Although+the+PATH+audits+finally+concluded+in+2005+with+settlements+in+excess+of+$130+million,+hospitals+believe+they+are+still+vulnerable+to+similar+audits+given+all+the+ambiguity+of+Medicare's+rules+and+the+economic+penalties+they+may+face+if+they+do+not+settle.+Health+Sciences+Compliance+Newsletter,+Spring+2005,+USC+Office+of+Compliance,+available+at++(last+visited+October+10,+2006).>Google Scholar