Back when I worked as a political advisor and campaign communications guy, we had the general purpose term to explain how to pay for anything, without raising taxes: "We have to start by rooting out the waste, fraud, and abuse."
There was no shortage of these in government programs then--nor now, for that matter. But it was a simplistic party line, positioning any opponent who tried to argue its naivete to be hit back with, "You don't think there's waste, fraud, and abuse in (program name here)? Well, I'm not content to see tax dollars thrown away. I want (program) to work for (our children/our seniors/our whatever) and I don't think that's naive at all!"
I suppose I never looked ahead and imagined my present life with the folks, where any debate with a care provider might progress to them playing the "fraud card."
Two months ago, Dad had been released from the hospital after a battle with an out-of-control systemic infection and a secondary staph. His legs and feet were a total mess, swollen and splitting and slick with weeping fluid. The orders had gone in for home care to be in 3 times a week to monitor wound healing and change the dressings.
The home care service screwed up the orders and stopped sending anyone after the first week. I got the nurse supervisor on the phone, who worked herself up to: "He needs unskilled service and that's not covered. If I send someone that's fraud. You want me to commit Medicare fraud. I'm not going to be a party to you defrauding Medicare."
I got off the phone and called in more artillery. After another nurse and two of his physicians got involved, and I demanded a copy of the orders, he got his thrice-weekly visits. Somehow I never got an apology for being called a fraudster.
Then there was last week, when the dermatologist continued the process of tapering down his dosage of Prednisone. He'd gone from 60mg to 20, and now we were down to lower increments. Week 1 would be 17.5, then to 15, and so on. She wrote prescriptions for sixty 5 mg and sixty 2.5 mg pills. Great. Until I went to CVS to pick them up and the pharmacist said, "We gave you thirty pills each, because that's a month's supply."
"Um, no," I said. "I have a schedule and the first week, he'll consume..." I did the math in my head. "...21 of the fives and 7 of the two point fives."
She glared at me. "Both prescriptions say take one every morning. I can call the doctor, but you'll have to wait. I can't just dispense based on your say-so. That would be fraud."
I took a deep breath and did not flinch. "I am not suggesting that you commit fraud and you know that perfectly well." A couple of other customers had appeared at the counter and the pharmacist looked a little queasy at the direction in which she had taken the exchange. "Why don't you just call the doctor. I'll be here."
About thirty seconds later, I was paged back to the counter. The pharmacist called across, but pointedly did not make eye contact. "We're getting the additional pills and they'll be ready in about 2 minutes."
I couldn't resist. "What was the problem?" The nearest technician looked up. "Oh, the prescription said 'Take every morning as instructed' and we misread it as 'Take one every morning as instructed.'"
I caught the pharmacist glaring daggers at the technician. I smiled sweetly and said, "See? No fraud. Just a little...misreading. It could happen to anybody."
Seriously, folks. Before you suggest I'm a scam artist and invoke that particular f-word, make sure it's not your screw-up.


Salon.com
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