PRESCRIPTION FOR PROFIT

HOW DOCTORS DEFRAUD MEDICAID

A hard-hitting, well-documented exposÇ of how physicians milk the Medicaid system. The cost of Medicaid fraud is unknown, but every year about two hundred physicians are suspended from the program because of fraudulent or abusive practices. The authors (all professors at the School of Social Ecology at the University of California, Irvine) look at these violations and examine the system that has provided the opportunity for them as well as the backgrounds of doctors who commit them. (Some of the violations are outrageous: bills for therapy while the therapist, a psychiatrist, was having sex with a patient; bills for abortions on nonpregnant women.) Medicaid's fee-for-service system makes fraud easy: By simply checking a box on a form, a doctor (or a billing clerk) can charge for services not performed. Meanwhile, ripping off the government apparently doesn't create guilt feelings: Interviews with 42 physicians reveal that these M.D.s see themselves as the innocent victims of bad laws and bureaucratic interference. And the medical fraternity has taken a relatively benign attitude toward Medicaid fraud, with state regulatory boards rarely revoking licenses of apprehended physicians. The authors offer no quick solution to the problem, noting that tension between government regulation and professional norms of behavior is growing. Finally, they look at the health-care systems of Great Britain, Canada, and Australia, to consider how they cope with fraud, concluding that the problem can be solved only through structural changes in the delivery of health-care services. Exactly what changes are necessary remains unclear. More fuel for the debate on health-care reform, filled with horror stories that can't help but add to the public's growing disillusionment with doctors.

Pub Date: July 1, 1993

ISBN: 0-520-07614-1

Page Count: 270

Publisher: Univ. of California

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: May 1, 1993

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IN MY PLACE

From the national correspondent for PBS's MacNeil-Lehrer Newshour: a moving memoir of her youth in the Deep South and her role in desegregating the Univ. of Georgia. The eldest daughter of an army chaplain, Hunter-Gault was born in what she calls the ``first of many places that I would call `my place' ''—the small village of Due West, tucked away in a remote little corner of South Carolina. While her father served in Korea, Hunter-Gault and her mother moved first to Covington, Georgia, and then to Atlanta. In ``L.A.'' (lovely Atlanta), surrounded by her loving family and a close-knit black community, the author enjoyed a happy childhood participating in activities at church and at school, where her intellectual and leadership abilities soon were noticed by both faculty and peers. In high school, Hunter-Gault found herself studying the ``comic-strip character Brenda Starr as I might have studied a journalism textbook, had there been one.'' Determined to be a journalist, she applied to several colleges—all outside of Georgia, for ``to discourage the possibility that a black student would even think of applying to one of those white schools, the state provided money for black students'' to study out of state. Accepted at Michigan's Wayne State, the author was encouraged by local civil-rights leaders to apply, along with another classmate, to the Univ. of Georgia as well. Her application became a test of changing racial attitudes, as well as of the growing strength of the civil-rights movement in the South, and Gault became a national figure as she braved an onslaught of hostilities and harassment to become the first black woman to attend the university. A remarkably generous, fair-minded account of overcoming some of the biggest, and most intractable, obstacles ever deployed by southern racists. (Photographs—not seen.)

Pub Date: Nov. 1, 1992

ISBN: 0-374-17563-2

Page Count: 192

Publisher: Farrar, Straus and Giroux

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: Sept. 1, 1992

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DEAR MR. HENSHAW

Possibly inspired by the letters Cleary has received as a children's author, this begins with second-grader Leigh Botts' misspelled fan letter to Mr. Henshaw, whose fictitious book itself derives from the old take-off title Forty Ways W. Amuse a Dog. Soon Leigh is in sixth grade and bombarding his still-favorite author with a list of questions to be answered and returned by "next Friday," the day his author report is due. Leigh is disgruntled when Mr. Henshaw's answer comes late, and accompanied by a set of questions for Leigh to answer. He threatens not to, but as "Mom keeps nagging me about your dumb old questions" he finally gets the job done—and through his answers Mr. Henshaw and readers learn that Leigh considers himself "the mediumest boy in school," that his parents have split up, and that he dreams of his truck-driver dad driving him to school "hauling a forty-foot reefer, which would make his outfit add up to eighteen wheels altogether. . . . I guess I wouldn't seem so medium then." Soon Mr. Henshaw recommends keeping a diary (at least partly to get Leigh off his own back) and so the real letters to Mr. Henshaw taper off, with "pretend," unmailed letters (the diary) taking over. . . until Leigh can write "I don't have to pretend to write to Mr. Henshaw anymore. I have learned to say what I think on a piece of paper." Meanwhile Mr. Henshaw offers writing tips, and Leigh, struggling with a story for a school contest, concludes "I think you're right. Maybe I am not ready to write a story." Instead he writes a "true story" about a truck haul with his father in Leigh's real past, and this wins praise from "a real live author" Leigh meets through the school program. Mr. Henshaw has also advised that "a character in a story should solve a problem or change in some way," a standard juvenile-fiction dictum which Cleary herself applies modestly by having Leigh solve his disappearing lunch problem with a burglar-alarmed lunch box—and, more seriously, come to recognize and accept that his father can't be counted on. All of this, in Leigh's simple words, is capably and unobtrusively structured as well as valid and realistic. From the writing tips to the divorced-kid blues, however, it tends to substitute prevailing wisdom for the little jolts of recognition that made the Ramona books so rewarding.

Pub Date: Aug. 22, 1983

ISBN: 143511096X

Page Count: 133

Publisher: Morrow/HarperCollins

Review Posted Online: Oct. 16, 2011

Kirkus Reviews Issue: Aug. 1, 1983

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