By Dylan Selbst – Class of 2023
As medical students, we have extensive experience in assessing the legitimacy of our information sources. We spend the better part of our adult lives engaging with the scientific method through countless hours of research and prerequisite courses. Nevertheless, navigating the onslaught of novel research and health policy changes related to the COVID-19 pandemic remains daunting and cumbersome.
Our understanding of the current pandemic is rapidly evolving on a microbiological, epidemiological, and political scale. Now, more than ever, it is crucial to be able to separate the facts from the falsehoods. The distortion of information by online media compounds this complicated situation. Unlike traditional forms of journalism, in online media, the burden of proof is no longer bestowed upon the claimant; with virtually infinite ways to consume information, it has become the consumer’s duty to determine what bits of information are reliable.
This struggle to determine the reliability of information has spawned an increased awareness and debate about “fake” news. Despite all the media attention that it gets, real “fake” news is often reasonably easy to spot. For example, when reading a proclamation from a “friend” on Facebook that “Bill Gates released the coronavirus and wants to inject us all with microchipped vaccines,” I felt it was an absurd conspiracy theory and wrote it off as fake news. However, when I encountered a somewhat plausible yet politically fueled claim referring to the intricacies of Medicare reimbursements for patients with COVID-19, the onus was then on me to assess its validity.
The claim was in the form of a Facebook post from a website with a seemingly politically biased URL linked at the bottom. The post and attached headline said something along the lines of “The government is paying doctors to say their patients have COVID-19”. To me, this was an inflammatory headline designed to sow distrust in the healthcare system and downplay the health effects of the current pandemic. However, I couldn’t help but try to understand if this claim had any legitimacy.
After all, claims like these may erode public trust in healthcare and the authority of organizations designed to protect our national public health interests. Trust between patients and the healthcare system is integral to building a positive patient-physician relationship. The potential loss or damage to this relationship can lead to nonadherence, decreased tendency to seek out care, and adverse outcomes (Ozawa & Sripad, 2013).
Intrigued by the backstory behind this claim, and admittedly naive to the intricacies of reimbursement for patients with COVID-19, I decided to pursue more background research on its source and legitimacy.
The true story behind the post begins with the signing of the Coronavirus Aid, Relief, and Economic Security (CARES) Act on March 27th, 2020. One of many provisions included in this bill granted the Centers for Medicare and Medicaid Services a 20% increased compensation for patients with Medicare diagnosed with COVID-19 to deal with complications associated with treating and managing their condition (Centers for Medicare & Medicaid Services, 2020).
Two weeks after the act’s signing, on April 9th, 2020, Republican Senator (and physician) from Minnesota Dr. Scott Jensen claimed, “Right now Medicare has determined that if you have a COVID-19 admission to the hospital, you’ll get paid $13,000. If that COVID-19 patient goes on a ventilator, you get $39,000, three times as much” (Palma, 2020).
These statements were not outright lies; in fact, they are reasonably close to the truth; the Kaiser Family Foundation estimated the average Medicare reimbursement for non-COVID-19 patients with respiratory infections with comorbidities and complications to be $13,297 and the reimbursement for 96+ hour ventilation support for that patient to be $40,218 (Levitt, Schwartz, & Lopez, 2020). With no knowledge of the situation, Senator Jensen’s claims seem to indicate corruption and conspiracy within our government and healthcare system. However, with relevant context, the reimbursement for COVID patients seems to fall right in line with expected values, even before the 20% increase from the CARES act.
Despite the very relevant context behind what Dr. Jensen said, his statement gained tremendous attention, especially on social media. Over the following weeks, memes, posts, and even conspiracy theory videos claiming “the government is paying doctors to say their patients have COVID” pervaded the internet.
The root cause of this issue lies in the sad reality that a headline claiming “The government is paying doctors to say their patients have COVID-19” captivates considerably more attention than one that says “There is a 20 percent increased weighting factor of the assigned Diagnosis-Related Group for patients diagnosed with COVID-19”. Unfortunately, factual, non-inflammatory headlines seldom get the social media traction they desperately deserve.
This example is but one of many displays of plausible news that I have encountered recently. The uncertain nature of a global pandemic combined with the power of social media and a thirst for conspiracy sparked the spread of many conspiracy theories, not only limited to health policy.
The world of journalism is not as dichotomous as reputable stories and abhorrent fake news. In between these two extremes lies a pervasive and murky middle ground of misleading and sensationalized journalism. This misleading of the uninformed public is eroding the healthcare system and has the potential to affect us as future physicians and our future patients.
This is not a call to political action, but rather a plea for awareness. Misleading headlines are pervasive throughout journalism today, but they can be especially detrimental when they work to undermine public trust in our healthcare system. As medical students, we should feel free to open a dialogue with others about healthcare issues and always be sure to come to any argument armed with reputable sources. Shortly, we will be physicians ‒ leaders in the hospital and within our communities ‒ and we will be trusted to be pillars of truth and honesty in a sea of misinformation.
References
Ozawa, S., & Sripad, P. (2013). How do you measure trust in the health system? A systematic review of the literature. Social Science & Medicine, 91, 10–14. doi: 10.1016/j.socscimed.2013.05.005
Centers for Medicare & Medicaid Services. (2020, April 27). New Waivers for Inpatient Prospective Payment System (IPPS) Hospitals, Long-Term Care Hospitals (LTCHs), and Inpatient Rehabilitation Facilities (IRFs) due to Provisions of the CARES Act. Retrieved May 21, 2020, from https://www.cms.gov/files/document/se20015.pdf
Palma, B. (2020, April 17). Is Medicare Paying Hospitals $13K for Patients Diagnosed with COVID-19, $39K for Those on Ventilators? Retrieved from https://www.snopes.com/fact-check/medicare-hospitals-covid-patients/
Levitt, L., Schwartz, K., & Lopez, E. (2020, April 7). Estimated Cost of Treating the Uninsured Hospitalized with COVID-19. Retrieved from https://www.kff.org/uninsured/issue-brief/estimated-cost-of-treating-the-uninsured-hospitalized-with-covid-19/