HOAXES, SCAMS, AND YOUR MEDICAL CARE.

• Position: MEDICINE & HEALTH

Hoaxes and scams have been dominating the news lately. We have a marginally known actor faking a hate crime supposedly to raise his Hollywood profile. His attempt to claw his way up the ladder could have resulted in race riots, injury, and death. His punishment?--all charges dropped.

The scandal concerning Hollywood and other elites buying their children's way into top-rated universities really hit home. I remember when I had tutored some recent Vietnamese immigrants for a debate contest to win a scholarship for college. I could only hope that their hard work was rewarded and not wiped away by special favors bestowed on the "haves."

There also are a slew of health-care hoaxes, as corporate stakeholders, legislators, and government agencies promise everything and have no accountability for their failure to keep their promises.

Take the large health systems' claim that hospital consolidation and buying up physician practices would benefit consumers with cheaper prices from coordinated services and other unspecified savings. A major study of California hospital mergers found just the opposite. The analysis showed that the price of an average hospital admission went up as much as 54%. When the large hospital systems bought doctors' groups, the prices rose even more. There was as much as a 70% increase in prices of medical services in geographic areas with minimal competition. This finding seems obvious to any of us who has the choice of shopping at Walmart, Target, or Costco.

Logic aside, some legislators believe that having the government take over medical care would solve our access and cost problems. Single payer means no competition whatsoever. The single-payer plans that abolish private insurance leave patients with an empty choice. Patients can contract with a physician to pay cash for government medical services covered by the government but, if the physician contracts for such services, he cannot be part of the government program for any patient for two years. Realistically, these single-payer bills make it financially unfeasible for physicians to contract with patients privately. Thus, only well-heeled patients, along with independently wealthy doctors, can buy their way out of the system.

There are variations on the theme of government involvement that allow buy-ins to Medicare, Medicaid, or iterations of the Patient Protection...