The Health Care Compliance Professional'S Manual: Fill & Download for Free

Except for the truly destitute, health care will never be free. In some countries, such as the USA, you will pay for it in insurance premiums, and in other countries, where health care is considered a government obligation, you will pay for it in taxes. That is what we call socialized medicine, but then again almost all countries provide "socialized" military, police and fire protection as well as primary and secondary education. The loaded question then is, "Are you willing to swap your insurance premiums for higher taxes?"The better question to ask is, "How does the american health care system rate compared to the rest of the world?"Well... We Americans may say we have the best medical care in the world, but the World Health Organization (WHO) statistics beg to differ. Year after year, we rate around number 40 among nations for life expectancy and even worse for infant mortality. Health care costs gobble up 16% of our GDP, while countries in the top-ten of longevity, such as France, Germany and Canada spend roughly half that percentage. What they all have in common is tax-funded medicine.It seems counterintuitive; doesn't it?First of all, the health care industries in these countries do not have to deal with billing issues. With the exception of a small copayment to discourage overuse, every visit to the doctor is paid for. So every hospital no longer needs a billing department to process myriad numbers of paperwork and haggle with the insurers. Scratch 10% off the bill.Hospitals and doctors do not advertise their services. This is a zero sum game. If hospital A advertises and takes 20% of the patients from hospital B, pretty soon hospital B will do its own advertising to get back that 20% of market share. So if you cut the advertising budget, you can shave another 5% off the bill.If all the patients' bills are covered, the hospitals don't have to deal with cost shifting. This is the expense your insurance company shells out to pay for the truly destitute patients, who as previously mentioned, can't pay their medical bills. Medicaid may pay a pittance of the bill to the hospital, but if the hospital wishes to remain economically viable, it will shift the remaining cost to the paying customers. Sometimes the hospital gets "lucky," and the poor patient owns a home in the most rundown part of town. Sooner or later, the collection service for the hospital will own that house. Be that as it may, unless the hospital resides smack square in the middle of a gold coast location, cost shifting will add another 20% to the patient's bill.Then there are the smaller percentages that all add up. American hospitals have administrative costs unheard of in other countries. You have the risk management departments that scold the medical staff for not doing enough for the patient and the corporate compliance departments that tell them they did too much. The drug costs are way out of whack with what the rest of the world pays, and then there are the end of life patients, who can run up $20K to $50K in expenses for their final two weeks of getting jammed with tubes and catheters. In the European countries, these patients are sent home or to the hospice, and they receive a steady dose of Brompton's cocktails (a mixture of heroin and cocaine) until they pass into eternity.The health care budgets of Japan, South Korea and the European countries are formulated by professional epidemiologists, who fine tune their line items by the incidence and prevalence of the various diseases and injuries. In contrast, the prime mover for the health care budget in the USA is Medicare, which the Congress votes on. After that, the private insurers follow suit by basing their reimbursements on a percentage of what Medicare pays. Reimbursements and not epidemiological need are the lifeblood of american medical economics. Unfortunately, Medicare reimbursements are greatly influenced by which lobbying groups hold the greatest sway over Congress, and so cardiologists installing pacemakers and other high end devices can thank the manufacturers of these instruments for setting a high reimbursement rate for these procedures. (Note: I don't mean to single out cardiologists; other specialties implant their own value-added prostheses. It's just that generous economics favors overuse of unnecessary procedures.)So there are some of the problems. Let's talk one solution such as tax-funded (socialized) medicine. What model works?The cleanest way to this path is with a value added tax (VAT). Think of it as a national sales tax. In Germany, the VAT is 19.5%. Gasp! Are they crazy?Actually, they may be crazy like foxes. First of all, that VAT does a whole lot more than subsidize the health care industry. After health care takes its 50% cut of this money, companies such as Mercedes and BMW no longer have to pay health care costs for their workers. Now the list price of their cars is 10% cheaper. The remaining VAT revenues then offset the corporate tax rate. Companies may use tax loopholes to cook the books, but nobody cheats the cash register. The VAT there comes off the top of the price and not some accountant's net-zero bottom line. Plus, the lower corporate tax rate discourages corporate relocations to foreign locales or what is better know as "inversions." Neither can a company sell intellectual content from a server located in a tax haven and then pocket the money with absolutely no tax obligation.On the plus side, the VAT revenues partially subsidize child daycare, maternal leave, subsidized lunches and mass transit commuting to work. Finally, the VAT helps protect all the domestic industries. If an american car enters Germany, the customer will have to pay—in addition to the import duty—the full 19.5% VAT, but with the exception of the german employees working for the german distributors and dealers, none of that money will benefit the american workers and by extension the american companies building that car.Can tax-funded health care ever come to the United States? I don't think so. The health insurers, the big pharmaceutical houses and the device makers are all too entrenched with Congress. If you really want tax-funded medicine, move to Australia. I've never been there, but I hear that it's nice.

Certifications in Compliance depend on your industry and area of specialty.Certified Regulatory Compliance Manager is good for bank compliance roles.Certified Fraud Examiner can help in banking compliance, particularly in the anti-money laundering space.IT and health care have compliance certifications that are good for compliance professionals as well.

Medical data is protected by Health Insurance Portability and Accountability Act (HIPAA ) laws, which is for the protection of medical data from cyberattacks. The main aim of HIPAA laws is to ensure the security of patient’s medical information to render high quality health care. Due to HIPAA , you have faced difficuilty in accessing healthcare data.To know more about HIPAA and cyber security in health care ,this community will help you Society of Cyber Risk Management & Compliance Professionals | Opsfolio