Political hit job on doctors to damage Medicare

Nick Coatsworth’s latest misreading of reality¹ was enabled through a joint investigation by the ABC, The Sydney Morning Herald and the Age, who reported they had, “…uncovered flaws in Medicare’s systems that make it easy (for doctors) to rort and almost impossible to detect fraud, incorrect payments and errors. The leakage is estimated to represent nearly 30 per cent of Medicare’s annual budget, or about $8 billion ($8,000,000,000) a year.”

This would have been heady stuff to Nick, who had already referred to the Australian Medical Association (AMA) as the “peanut gallery” and suggested pharmacists could replace doctors as diagnosticians.

Our Nick jumped onto the “thieving doctors” bandwagon immediately, assisted by the Nine Entertainment-owned SMH and Age. (The Australian Financial Review is also part of that stable.) These papers have eagerly pushed the “thieving doctors” line, as well as publishing pieces defending their fop figurehead.²

The ABC (state media) were a little more circumspect in their doctor denunciations, merely attaining shabbily unprofessional status. In case anyone has forgotten, it was these doctors that worked through a pandemic risking a possibly fatal infection to save lives before a vaccine arrived.

“A joint investigation by the ABC and Nine newspapers has found doctors are abusing the $28 billion system, at times putting patients at risk and even billing dead Australians to boost profits.

Medicare expert Margaret Faux has estimated the leakage has cost about $8 billion a year, or nearly 30 per cent of Medicare’s annual budget.”

Maggie and the Malignant Medico Mafia

Medicare expert Margaret Faux’s bravery in exposing the Australian medical profession as a band of self-serving thieving swine has not come without personal cost. This poor woman is now afraid to leave home.

“I never imagined I’d be called “Mediscare Faux” and be scared to leave my house.” (she exclaimed fearfully)

One can picture this frightened individual peering timidly from behind a curtain as angry doctors roar past her home in their ill-gotten Porsches and Lamborghinis, shouting threats at this dedicated whistleblower.

Why she hasn’t been afforded round-the-clock police protection says much about the power of the AMA.

Maggie pulled no punches in her article which also mentioned the “vitriol” she witnessed coming “…from people who call themselves health professionals.”

“We often hear it said that “most doctors do the right thing” but we actually do not know that. We want to believe it, but there is no empirical evidence to support this claim.”

Exactly.

Sure, they might spend time comforting people (and their families) who are found to have a serious condition. Or risk infectious diseases from a scalpel nick when up to their elbows in blood and guts at an operating table. And maybe they do cure illnesses and save the lives of the sick and injured on a daily basis. But as Maggie points out, is any of this empirical evidence of good intent?

Maggie Making Moolah Maligning Medicos?

Critics might say that a person with a business centred on profiting from initiating medical billing schemes is irreparably biased. Well let me quickly disavow you of such cynicism.

In Maggie’s own words: “For almost four decades I have witnessed Medicare being abused and it is crushing me. I have worked hard to build a business designed to do everything possible to help doctors understand Medicare and bill correctly, but I am fighting a losing battle.”

It is clear the woman is a saint who only wants to help doctors. Not some ambitious empire-building type, thriving on national publicity at the expense of pandemic-weary doctors.

Maybe bringing doctors into disrepute through the use of state media and the largest private media group in Australia was a little unfortunate – but best to think of it as part of the process. Eggs, omelettes.

“Much has been said of my conservative estimate of 30 per cent leakage from Medicare. Some have demanded an algorithm while others have suggested that such high figures have never been seen before. They are wrong.”

That settles that, and as she modestly explains, “…my thesis presents the best available evidence”.

Is Maggie daunted by the doctor’s terror campaign? Judge for yourself.

“Having dedicated my life’s work to Medicare, and the principles of universal health coverage, there is no turning back. I will continue my research and do whatever I can to resuscitate the notion that health is a right not a privilege. That will include exposing unpalatable truths.”

There you have it. Not only prepared to point out problems with Medicare billing but willing to offer solutions too. Truly we are blessed by the serendipity which sees Margaret Faux as the Founder and CEO of a company that specialises in medical billing.

Synapse is proud to be the first Australian provider of medical billing, coding, transcription and administrative services to achieve certification to ISO 9001 for our quality management system and ISO 27001 for our information security.

A healthcare service & MedTech company that is disrupting medical billing, clinical coding and healthcare education in worldwide locations.

Well, Synapse has certainly “disrupted” medical billing in Australia.

One General Practitioner was quick to thank Maggie for her efforts.

@TcameronTodd Apr 3rd, I’d like to thank @MargaretFaux for her contribution to #GPs moving to private billing in greater numbers than ever before. Her false claims at the end of the early phase of the pandemic drove anger and frustration, pushing GPs to abandon MBS direct billing. (Bulk billing)

Enough fun – let’s get to the punchline

“The findings of this (University of Sydney) study do not support the media claims of widespread fraud by GPs”

Independent report finds Medicare is ‘complex and ambiguous’ as GPs welcome dismissal of rorts

By Natasha Robinson April 3, 2023

EXTRACTS (Full article)

The nation’s “complex and ambiguous” Medicare funding system has resulted in confusion and inadvertent incorrect billing, as new evidence suggests GPs routinely underbill and claims of widespread rorting are dismissed.

The allegation of $8bn in rorting sourced to a single expert, compliance consultant and lawyer Dr Margaret Faux would amount to a significant slice of all Medicare benefits. The Pradeep review was triggered by reports published in Nine Newspapers and broadcast on the ABC’s 7:30 program.

By contrast, a 2020 Australian National Audit Office report estimated the value of Medicare noncompliance at between $366m and $2.2bn a year.

But neither this report nor the Pradeep report considered the issue of incorrect billing from the perspective of how much public money is saved each year by doctors who routinely underbill.

Now a University of Sydney report has quantified this saving of taxpayer money at $350m a year, arising through mass underbilling by GPs who are scared of triggering an audit if they bill too many long consultations.

The study underscores the failure of Medicare and its associated bureaucracy – there are 5800 different MBS [Ed: Medicare Benefits Schedule] items – to meet the challenges of modern health care.

Royal Australian College of GPs president Nicole Higgins said the evidence was unsurprising to the profession. In February, “nudge” letters were sent to 600 GPs who had been charging a large number of long consultations when treating patients with complex and chronic disease. Many of the GPs targeted in such audits are women, who are more likely to spend a longer period of time with patients.

“This report provides evidence that GPs have been subsidising the healthcare system for a long time,” Dr Higgins said. “GPs can no longer afford to continue subsidising Medicare and this is now resulting in the closure of practices. The Pradeep report into Medicare compliance also supports that the system is complex and ambiguous and this has resulted in fear and underbilling.” – Independent report finds Medicare is ‘complex and ambiguous’ as GPs welcome dismissal of rorts – (behind a paywall so hosted by Dingo News) – Natasha Robinson – The Australian

Kudos to The Australian for breaking this story (and their rival’s back) with this exculpatory evidence vindicating doctors.

Nine Entertainment media need to STFU!

In this video, Nick is sticking with the discredited $8,000,000,000 figure. Explaining it’s “…not just about rorts and fraud, it’s also about waste and over-servicing, that is, doctors ordering things for patients that they don’t need.” Then he states it’s more in the order of $2.2,000,000,000. Confused? This sums up the “doubling down while backpedalling” stance Nick and his backers at the Nine Entertainment network have adopted.

Nick continues to shove doctors under the (now non-existent) bus and attack the AMA’s President Steve Robson, who apparently “has gotten it completely wrong” in calling this concerted political attack on his members a “slur”. Professor Robson made this call months ago (Oct 17, 2022) and like his members, it’s been vindicated.

The SMH decided on a “defensive attack” when confronted with the latest report that exonerates doctors.

“(Dr Pradeep Philip’s) report was triggered by a series of reports by The Sydney Morning Herald, The Age and the ABC’s 7.30 which uncovered flaws in Medicare’s systems that make it easy to rort and almost impossible to detect fraud, overservicing and errors.

The inappropriate billing occurs in all areas of the health sector including GPs, surgeons, pathologists, anaesthetists and radiologists.

The reports upset lobby groups including the Royal Australian College of General Practitioners and the AMA, which came out with brickbats in an attempt to deflect attention from the substance of the articles and denounce estimates that up to 30 per cent – or $8 billion – could be lost a year in leakage.”

Even the SMH’s own article contradicts their claims and justification for this long-running campaign to harm the medical profession. Their interpretive bias negated by unassailable facts.

“(Dr Pradeep Philip) tried to put a dollar figure on non-compliance, estimating it at between $1.5 billion and $3 billion a year, but acknowledged that a lack of available data, limited desktop analysis, short time frame and “conservative” definitions of non-compliance and fraud meant a definitive analysis was impossible.” – Medicare review blows apart the AMA’s ‘nothing to see here’ argument – Adele Ferguson – SMH

They even linked to an article by Natassia Chrysanthos who contradicts their grossly exaggerated $8,000,000,000 figure and points out that the problems are systemic rather than the result of dishonest doctors.

“Medicare is haemorrhaging up to $3 billion a year in waste, according to a government-commissioned review of the health system’s integrity, which warns it risks losing billions more to rorts in an overly complex and opaque bureaucracy that needs urgent reform.”

“(Dr Pradeep Philip) said most Medicare wastage stemmed from non-compliance errors rather than premeditated fraud and acknowledged that doctors had been offended by the allegations of intentional rorting.”

After 30 stories erroneously vilifying doctors where’s that apology?

30 stories is just the SMH’s effort. Then there’s the videos and stories on Channel 9 and the ABC. Also the articles from other news groups that picked up on this manufactured controversy.

The ABC has made some moves to address their mistake in joining with the sensationalist, politically biased and insulting campaign triggered by Ms Faux and propagated by Dr Nick and other hostile talking heads.

AMA Vice President, Dr Danielle McMullen: “The unfounded claims of $8 billion of fraud gave the medical profession a huge blow. They felt like they’d been hit by a bus. But this report vindicates their hard work and shows that the overwhelming majority of doctors are doing the right thing and that our Medicare system is held together by the altruism and goodwill of the medical professionals working in it.” – AMA Transcript – AMA Vice President on ABC 7.30 Report

After their last futile attempts at face-saving, the Nine entertainment network seems to have gone quiet on “doctor fraud” (07/04/2023). Perhaps they’re organising their apology?

On Monday, Nicole Higgins from the RACGP issued a press release, based on early briefings of the review, saying doctors had been “slandered by baseless claims of ‘rorting’ for no good reason”.

“We have been vindicated and we await an apology,” she said.

– Fini –

Notes

¹ If anyone has ever wondered why Dr Nick is a preferred target of Dingo News – it’s because of who and what he represents – choices he made when he became a dangerous COVID-minimising figurehead for vested interests.

² Comments such as “the handsome doctor” (AFR) and “a sunny disposition and a healthy dose of good looks” (SMH) permit a personal appraisal. (OK, insult.)