Hospital groups are pushing back against President Trump's claims this week that doctors are overreporting COVID-19 deaths for financial gain. Trump made the comments at a Wisconsin rally on Saturday.
"You know some countries they report differently," Trump is quoted as saying in Newsweek. "If somebody's sick with a heart problem, and they die of COVID, they say they die of a heart problem. If somebody's terminally ill with cancer, and they have COVID, we report them. And you know doctors get more money, and hospitals get more money. Think of this incentive. … We're going to start looking at things."
WHAT'S THE IMPACT?
Hospitals and health systems are eligible to receive higher payments for complex coronavirus-related treatment under the Coronavirus Aid, Relief and Economic Security Act, under which they receive a Medicare add-on payment of 20%. However, American Hospital Association president and CEO Rick Pollack refuted Trump's claims.
Asked to respond, the AHA referred to a viewpoint article written by Pollack in September, in which he sought to dispel what he called certain "myths."
"Hospitals do not receive extra funds when patients die from COVID-19," Pollack said. "They are not overreporting COVID-19 cases. And they are not making money on treating COVID-19.
"The truth is, hospitals and health systems are in their worst financial shape in decades due to the coronavirus. In some cases, the situation is truly dire. An AHA report estimates total losses for our nation's hospitals and health systems of least $323 billion in 2020. There is no windfall here."
Pollack also noted that healthcare organizations adhere to strict coding guidelines and use the COVID-19 code for Medicare claims only for confirmed cases. Inappropriate coding can result in criminal penalties and exclusion from the Medicare program altogether.
In a more recent and direct response to the president's latest comments, American Medical Association president Dr. Susan Bailey bemoaned that physicians are being pulled into a public battle over the legitimacy and motivation behind their work.
"The assault on public health and the undermining of efforts to defeat COVID-19 began with unfounded suspicions about the science and evidence of this novel coronavirus and how it spreads," Bailey said on Tuesday. "It grew with speculation about harmful and unproven treatments for COVID-19, false claims that masks were a source of infections, and by misleading suggestions that increased testing alone explains why case counts are surging.
"It expanded again with inaccurate, dangerous statements about children being 'almost immune' from the most serious effects of COVID-19, a reckless plan of 'focused protection' and naturally acquired 'herd immunity' as a pathway out of this pandemic, and most recently with wild and highly offensive claims that physicians are inflating the number of COVID-19 cases and deaths to increase our incomes."
Bailey said that many public health officials have been threatened and intimidated, prompting some to quit or retire, and decried the "campaign of misinformation" as a betrayal of public trust that threatens the work being done to treat and contain the virus.
"Our AMA will always stand on the side of patients and physicians, of science and evidence, and of free and honest conversations that build the trust that is so crucial to our work," she said. "We will not hesitate to call out political intimidation and fear-driven rhetoric that undermines this trust or that interferes with our ability to deliver the very best care to patients."
The American College of Emergency Physicians also issued a statement, calling Trump's assertions "reckless" and "false."
"To imply that emergency physicians would inflate the number of deaths from this pandemic to gain financially is offensive, especially as many are actually under unprecedented financial strain as they continue to bear the brunt of COVID-19," ACEP wrote. "These baseless claims not only do a disservice to our health care heroes but promulgate the dangerous wave of misinformation which continues to hinder our nation's efforts to get the pandemic under control and allow our nation to return to normalcy."
THE LARGER TREND
The numbers of COVID-19 cases continue to bring grim news, especially in the U.S., which struggled early in the pandemic to secure testing capacity and necessary personal protective equipment for frontline healthcare workers.
As of Wednesday morning, the Johns Hopkins University coronavirus tracker showed more than 8.7 million confirmed cases of the virus in the U.S., with the death toll climbing to over 226,000. Both lead the world. Second on the list is India (with 7,990,322 cases, 120,010 deaths), while Brazil comes in third (with 5,439,641 cases, 157,946 deaths).