Are Doctors Profiting by Reporting That ‘Everybody Dies of COVID’?

Hospitals do get a premium for treating COVID patients but there is no evidence deaths are being inflated.

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At a campaign rally in Waterford Township, Michigan, on October 30, Trump claimed that doctors were profiting from COVID-19 deaths, saying the following:

Our doctors get more money if somebody dies from COVID. You know that, right? I mean, our doctors, they’re very smart people. So what they do is they say, I’m sorry, but everybody dies of COVID.”

It’s hard to know the source for the president’s claim. There is no evidence that “doctors get more money if somebody dies from COVID” or that doctors are saying “everybody dies of COVID.” Through the CARES Act, which passed with bipartisan support in late March and was signed by President Trump, hospitals get a 20 percent premium or add-on to treat Medicare patients admitted with COVID-19. However, there has been no evidence to suggest that this has caused fraudulent COVID-19 death reports. 

Former FDA Commissioner Scott Gottlieb discussed Trump’s allegation in an interview Sunday on Face the Nation. Gottlieb explained that the CARES Act provides 20 percent more money to hospitals treating coronavirus patients because it’s expensive to treat these patients. He also explained the circumstances under which hospitals could claim that extra money.

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  1. Avatar photo
    The Stray Goose

    Something weird is going on. I don't trust Trump but I don't trust those numbers either.

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  2. Avatar photo
    Jess

    Some clarifying points:
    1. The money is only for hospitalized Medicare patients (their treatment).
    2. As of September 1st, a positive Covid test is required for the hospital to get the money.
    3. The money goes to the hospital where the patient was admitted, not a doctor.
    4. The costs of treating a Medicare patient with Covid often exceed the payment. There are many expenses beyond those with regular pneumonia, such as private rooms, negative air flow, sterilization, and PPE. Plus, the hospital stay for nursing home patients can be extended as they must test negative for the virus twice before returning to the nursing home. Elderly, frail patients with severe Covid can take a month to test negative.

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  3. Joe1776

    Are you sure the extra money is only for pneumonia cases? I don't think that is correct. I think hospitals get extra money for covid cases beyond just pneumonia cases.

    https://www.aha.org/advisory/2020-04-16-coronavirus-update-cms-releases-guidance-implementing-cares-act-provisions

    The point is not that Doctors are lying. The rules in many states say they should list a death as a covid death if the person died with covid unless it is obvious the person did not die because of covid.

    It is often the case that we are not sure of the cause of death. Consider a person who smoked, had a bad diet, didn't exercise, was overweight, bad genes for heart attack and has a heart attack. Did the smoking cause his heart attack? Well it is not obvious that it didn't.

    So if you are paid extra for every "tobacco death" and you can indicate it is a "tobacco death" as long as it is not obvious smoking didn't contribute to the death you will see every heart attack death from a smoker listed as a "tobacco death."

    The red herring of the media is that Trump (or others) are necessarily implying doctors are being dishonest. But that is not the issue. The doctors are marking the death certificates as they are instructed by the department of health in their states. And those departments of health are saying to mark all of these deaths as covid. For example here is the instruction given to Illinois Doctors:

    "So, everyone who's listed as a COVID death doesn't mean that that was the cause of the death, but they had COVID at the time of the death." Dr. Ezike outlined.

    https://week.com/2020/04/20/idph-director-explains-how-covid-deaths-are-classified/


    There is uncertainty when we talk about this sort of causation question. The instructions and the payments all make it clear that any uncertainty is resolved in favor of counting it as a covid death. This will mean the actual number of deaths caused by covid will be less than the "covid death" count. No one is claiming anyone is committing fraud or "lying", and therefore arguing there is no evidence of fraud is a strawman.

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  4. Avatar photo
    Shawn Gallagher

    If there is a government incentive, someone is abusing it. Maybe not enough to skew numbers but someone is abusing it.

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  5. Avatar photo
    CynthiaW

    " hospitals get a 20 percent premium or add-on to treat Medicare patients admitted with COVID-19."

    There is a lot of space between this fact and the concept that "doctors get more."

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    1. Raincheck

      Or that people have to DIE of Covid.

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      1. Avatar photo
        CynthiaW

        Yes, good point.

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  6. Avatar photo
    Tom B.

    Surely President Trump would never lie about something as serious as the COVID pandemic just to bolster his re-election chances.

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