tag:blogger.com,1999:blog-51540187587994511162024-03-18T23:07:08.074-04:00Solo Docs, So LongOnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.comBlogger449125tag:blogger.com,1999:blog-5154018758799451116.post-45785779517416102092020-09-04T12:34:00.006-04:002020-09-04T12:34:51.223-04:00Plea Deals: The Duplicitousness of the Government<p> I was offered a plea deal by the prosecutor. </p><p> The plea deal involved paying the government a large sum of money in exchange for no prison time. Plea deals are possible up until the moment the jury delivers a verdict, but the plea deal I was offered was made early in the game, around the time of my indictment. </p><p> If I pleaded guilty to the 210 charges in the indictment and agreed to not go to trial or otherwise take the government to task for wrecking my reputation and my life, and if I paid the government a lot of money (negotiable, perhaps), I could get on with my life. </p><p> Clearly, the prosecutor didn't regard me as a risk to society, someone who needed to be isolated from the world so that I couldn't "commit more crimes." You wouldn't offer a plea deal to a serial murderer.</p><p> But it's a crime to lie to an officer of the court. Punishments for lying to FBI agents, the police, a prosecutor--any official in the CRIMINAL SYSTEM (people have stopped calling it the "criminal justice system," funny thing) are extreme. Lying is termed an "obstruction of justice."</p><p> The penalty for obstruction of justice in the federal system is 5 to 10 years in prison, plus a fine. </p><p> For interfering with a witness or tampering with evidence (18 U.S.C. § 1512)--5 years. For obstructing proceedings before Congress or government agencies (18 U.S. C. § 1505)--5 years. For influencing a juror or an officer of the court (18 U.S. C. § 1503)--10 years. </p><p> If I pleaded guilty, I would be lying to ("influencing") an officer of the court, because I <i>wasn't</i> guilty. The punishment for this is 10 years in prison plus a fine. "It's part of the game," people told me. "Take a plea deal." </p><p> I cannot accept this. People should not have to say they're guilty when they're not. Legislators made a law that punishes lying. Prosecutors force innocent people to lie to avoid the charade of a trial and almost certain prison time. Innocent people who believe in the uprightness of the justice system and go to trial are punished more heavily when a jury convicts them--punished for not lying.</p><p> I was not guilty of a crime or any wrongdoing. I refused to say I was guilty to avoid prison. I went to trial. I got a prison sentence and a fine </p><p> I don't recommend this path, and I don't discourage it. </p><p> But today, I can live with myself.</p>OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com6tag:blogger.com,1999:blog-5154018758799451116.post-70466302996177614782020-09-01T18:10:00.001-04:002020-09-01T18:10:28.431-04:00Is Federal Prison Camp "Club Fed"?<p> No.</p><p> If there is a "Club Fed" out there, it wasn't where I went. It wasn't where Martha Stewart went, either. (She went to Alderson Federal Prison, in West Virginia. I was at Coleman, near Leesburg, Florida.)</p><p> The term, "Club Fed," may have been coined to foment anger in the public against prisoners who "deserve" to be punished and are, instead, the story goes, being treated to the high life.</p><p> Prison is a ruthlessly punishing experience--even prison camp, the "best" of the prisons. It's not "camp" at all. It is an experience of constant surveillance, curtailment of most freedoms (except the freedom to think, as long as you keep your thoughts to yourself), temptation to rat on others if you think it might cut your time, and constant fear that you'll be caught in a fight or someone will do something that implicates you in a scheme (to get cell phones, perfume, drugs, cigarettes? I don't know--) and gets you sent to "County," i.e., the county jail, where conditions are worse and you may be in solitary confinement, a.k.a. "the Shoe." Prison is nothing but mind-numbing sameness. The world closes in on you in prison. Unbeknownst to you, your brain shuts down, a little bit more each day. The walls within which you live are like a vise: they narrow your sensorium to such an extent that you forget most of the outside world. Survival matters. You are reduced to survivalism. </p><p> When I was released home after prison, I couldn't remember the names of my cats or dogs, I "forgot" how to turn on the oven, and I didn't recognize the contacts in my cellphone. My sons thought I had developed dementia.</p><p> It's true that in prison you get enough calories to sustain yourself. There is air and water, and you have prison friends. You can stay alive, strictly speaking. (The water, however, at Coleman, was contaminated by Legionella last winter, and many women became direly sick.) I could walk outside on the track, get access to a piano most days for 30 minutes, and have books sent to me by my family. If that was "Club Fed," then I suppose I was in Club Fed.</p>OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com0tag:blogger.com,1999:blog-5154018758799451116.post-42124027813413685812020-08-31T12:27:00.001-04:002020-08-31T12:27:16.367-04:00Prison Was the Best Year of My Life: Part 2<p> I had a routine. Every morning I woke at 5:30 AM. Because inmates have so few belongings in prison, morning ablutions take very little time. Most of the hundred inmates in my unit were sleeping, so I might have the entire row of sinks and showers and toilets to myself. The bathroom smelled bad and the fixtures in the barracks-style bathroom were all malfunctioning: clogged toilets, dripping faucets, cold showers, no showers. Black mold everywhere, except when an outside inspection was due. Then, inmates were recruited to paint over the mold. After the inspection, the mold returned quickly. It was not a wholesome place to breathe.</p><p> I went to breakfast at "Main Line," a giant warehouse-type building on the grounds, open at 6 AM for an hour. I brought teabags purchased through the commissary. Breakfast was the only meal where milk was available--nonfat, almost transparent, in baggies, two per inmate. No scissors permitted--you opened them with your teeth. I drank tea with skim milk, went to my job (it was a work camp), then began my 10-miles-a-day walking routine. Three times around the track was a mile. I brought a book and studied Spanish while walking. I made a "hat" out of a baseball cap and pieces of cardboard retrieved from the trash, covered with reflective candy wrappers, to protect against the blistering sun. I wore heavy green men's pants and a long-sleeved button-down men's shirt--prison-issued garb. It might be 100 degrees out, but I kept to the routine. It kept me sane and I was grateful to be in a prison where we were allowed outside for limited periods each day. Since COVID, inmates are not permitted outside. This must be causing a great deal of additional suffering.</p><p> Inmates often joined me for a few laps, sometimes to be friendly, sometimes to ask questions about their health or their legal problems, and sometimes to trade Spanish-practice for English-practice. A third of the inmates were native Spanish speakers, luckily for me.</p><p> If any aspect of my routine was broken, lots of inmates came looking for me. "Are you all right? I didn't see you on the track!" "Where were you at breakfast?" "Is something wrong?" Inmates care about one another. There is solidarity of a sort I had never known before. It made me feel loved and cared for. We were equals, we had to look out for each other, and we did. Of course, there were risks and hostility and people you might not trust--but not many. I steered clear of them, as best I could. </p><p> When had so many people ever seen me, <i>as me,</i> rather than as a commodity or a person playing a fixed role? When had so many people cared about me? When had I ever had so many friends?</p><p> How could this <i>not </i>have been the best year of my life? </p>OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com1tag:blogger.com,1999:blog-5154018758799451116.post-34183389909448753612020-08-30T10:47:00.003-04:002020-08-30T10:47:49.548-04:00Prison Was the Best Year of My Life: Part 1 This is not a general rule nor should it be taken to mean prison is good or fun or cushy. It is not. It is an awful experience and one I would not choose to repeat. Not one of the 400-plus women where I was housed would have chimed in that their time in prison, too, was the best of their lives.<div><br /><div> But for me, prison afforded a chance to focus on myself for a change. </div><div><br /></div><div> I didn't have full-time responsibility of my 30-year-old son with autism, a person who needs 24-hour care (his brother took over that year, with help from paid, trained caregivers). </div><div><br /></div><div> I didn't have thousands of patients whose needs always came first because they were so pressing and that was my commitment. I didn't have an office staff to take responsibility for. Or stacks of paperwork to do past midnight. </div><div><br /></div><div> I didn't have to deal with farm chores, downed tree limbs, broken irrigation pipes, the neighbor's wayward cows, rotted fence posts, alligators in the pond, sick chickens, ants in the bees' sugar, the bush hog needing welding, the mower's belt breaking, a wobbling ceiling fan, mice in the barn, leaves in the gutters, wax myrtle taking over the pasture, crows stealing pears, whiteflies and sooty mold on the citrus. There were no texts, emails, phone calls, tax returns, or bills to pay. </div><div><br /></div><div> I was liberated from all the things that make life life, the interesting, the annoying, the splendid, the awful, the unforeseen. I was on an adventure. It appealed to the part of me that had been an anthropologist before I took up medicine. How could I know anything about this other culture--now a huge aspect of American life--if I weren't part of it? Now, I was part of it.</div><div> </div></div>OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com2tag:blogger.com,1999:blog-5154018758799451116.post-29027060670059388522020-08-29T09:13:00.002-04:002020-08-29T09:13:25.436-04:00Dr. C.: Still Here<p> It has been eight years since my clinic, Colasante Clinic, PA, was raided, five since the feds indicted me, four since my trial and sentencing, three since I went to prison, and two since I was released from prison.</p><p> If such a thing should happen to you, I'm here to say: You can survive it. </p><p> I've had a lot of time to reflect on what happened to me. Either I have a serious character disorder, or something went terribly wrong in our justice system, because I am still unable to "accept responsibility" or "feel remorse" for the events that transpired in my life and my family's lives, and which affected my patients' ability to rely on me and the survival of my clinic. </p><p> Instead, I have been moved to try to understand how the criminal system in this country operates and how it could go so wrong, so often, and in so many people's lives. </p><p> To that end, I am now in my second year of law school at Stetson College of Law. </p><p> One of the courses I'm taking this semester is "Criminal Law." It's no more than a dip-of-the-toe in a river of lawmaking, and it's filled with stories of hardship and sordidness at the human level, and characterized by the valiant attempt by a governing body to uphold and revise methods for controlling a population's passions. "The Law" is really scads of statutes and regulations--more than any group of people ever needs--and hundreds of years' worth of common-law decisions by courts here and in England. It's fascinating material, but at this point in my training, it's like scrounging around under ten-foot weeds in my overgrown garden in a rainstorm and coming across a snail or two. What happened to me in this country, and why? I did not break the law, but a jury was made to think I did. My friends in prison may have broken laws, but questions remain in their cases, too: Should the laws they broke have been enacted in the first place? Was their punishment in proportion to the harm--if any--they might have done? What are we doing with so many Americans in prison, anyway?</p><p> I have heard many stories, mainly from people in prison but also from those whose lives have forever been changed by a run-in with the law and a prison sentence--people who come forward with their stories when they know another person has been through a parallel ordeal. I will tell you about some of them, if they give me permission.</p><p> I'm going to relate, on this blog, what I experienced during my trial, at sentencing, while awaiting imprisonment, in prison, and since prison, as well as some of what I understand from law school. I still garden, cook, study medicine, listen to politics, read books, raise bees, keep chickens, hang out with friends, and forage for wild food. </p><p> I hope what I relate might be helpful, or of interest, to someone, somewhere. </p><p><br /></p>OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com1tag:blogger.com,1999:blog-5154018758799451116.post-3064892478957182772017-08-30T10:37:00.002-04:002017-08-30T10:37:36.919-04:00A Certain Cachet<div dir="ltr" style="text-align: left;" trbidi="on">
I am not ashamed of my 162 felony convictions--because they are bogus.<br />
I am going to start wearing a button on my blouse that says, "I have 162 felony convictions--and I'm innocent. Something is wrong with our justice system!"<br />
No one would go out of his way to choose this status, but I've detected a certain cachet to the label, "felon." Believe it or not, there are some exceptional people in this group and we bond as easily as the members of other grief support groups.<br />
I have new friends: fellow felons and felon-sympathizers. When I say, I'm a felon! they emerge from their fringe positions in our hierarchy and introduce themselves. We sit and chat--there's an immediate rapport. I have always enjoyed the company of a wide range of people.<br />
Our justice system has a vested interest in enlarging this coterie of felons by enforcing mandatory minimum sentences (12 years for carrying marijuana across state lines, for instance) and by "catching" people like me.<br />
I went to a smoke shop on University Avenue right after my sentencing, bought a pack of cigarettes. (I wish I could smoke them all--I need an escape! Alas, you can't escape your fate.)<br />
The very friendly guy behind the counter had a shaved head, metal earring, muscle tee. <br />
"Have you ever been to jail--or prison?" I asked. (Lots of people say yes.)<br />
"Why do you ask?" he answered.<br />
"I'm going to prison!" I told him. <br />
"Wow, really?" he raised his eyebrows and looked me up and down. "You don't look like the type." I detected something like respect in his tone of voice.<br />
"The type is expanding," I said. "You have to start thinking of people like me as criminals."<br />
"That's for sure. What'd you do?" he asked. "Drunk driving?"<br />
"No. I did my job. Nothing wrong. It's a white-collar thing."<br />
"Wow, cool," he said. "The country's crazy." <br />
"Yeah."<br />
"I'm sorry," he said, speaking as one who knows. "You're going to be in good company, anyway."<br />
"We'll see." <br />
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OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com7tag:blogger.com,1999:blog-5154018758799451116.post-16654681864462353892017-08-24T17:51:00.000-04:002017-08-24T17:51:03.599-04:00Tallow Plums<div dir="ltr" style="text-align: left;" trbidi="on">
Look what I found along the edge of the woods! Lots of soft plum-like fruits dangling from low bushes and strewn over the grass--tallow plums (Ximenia americana). They have big seeds, and slightly astringent flesh, and are also known as hog plums or yellow plums. <br />
I had to consult my field guides to identify them. <br />
See the very best wild foods guru Green Deane's site "Eat the Weeds" and look up<a href="http://www.eattheweeds.com/tallowplums"> tallow plums</a>.<br />
I cooked them in water, strained them through a sieve, and added honey from my beehives. Makes a delicious juice. High in the nutritive fatty acids: linoleic, linolenic and arachidonic.<br />
There is so much wild food in Florida we could live, if we had to, without Publix.<br />
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OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com1tag:blogger.com,1999:blog-5154018758799451116.post-31903868701390004942017-08-24T17:22:00.002-04:002017-08-24T17:56:04.403-04:00Chanterelles<div dir="ltr" style="text-align: left;" trbidi="on">
This is the season to search for chanterelles.<br />
They're little orange mushrooms poking out from under the leaves and basket grass under under big trees.<br />
It's pretty hard to mix them up with anything poisonous, but you should ask someone who knows about mushrooms to go into the field with you to identify them, just in case.<br />
See: <a href="http://www.thesurvivalgardener.com/identify-chanterelle-mushrooms/">http://www.thesurvivalgardener.com/identify-chanterelle-mushrooms/</a> <br />
False chanterelles taste bitter, whereas the real thing is delicately sweet. High in protein, low in fat, high in fiber, with lots of trace minerals. Fresh, free, forageable.<br />
I was picking up some new egg cartons from the barn when I spotted them under a Live Oak.<br />
Toss them over medium heat in a spot of butter and eat plain, on toast, or with eggs.<br />
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OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com0tag:blogger.com,1999:blog-5154018758799451116.post-34687719942024445652017-08-24T17:06:00.000-04:002017-08-24T17:06:31.234-04:00Math Problem<div dir="ltr" style="text-align: left;" trbidi="on">
Here's what the government's prosecutor claimed at my sentencing: that I had been "overpaid" by Medicare a sum that was greater than the total amount I had ever been paid in the first place, from 2004 to when I closed my clinic in 2013. <br />
And that now I should be required to repay this "overpayment" in full--and then some.<br />
All the figures were up on the overhead projector screen. It just didn't add up. <br />
Who did the math?<br />
Was anyone wincing?<br />
Every person there had a higher degree.<br />
Six weeks in the courtroom. <br />
You know, we all just wanted to go get some lunch. <br />
And I suppose the calculator in the courthouse went berserk. Thick walls.<br />
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OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com1tag:blogger.com,1999:blog-5154018758799451116.post-26463764910294059372017-08-24T16:58:00.001-04:002017-08-24T16:58:21.734-04:00Sledgehammer<div dir="ltr" style="text-align: left;" trbidi="on">
Who has 162 felony convictions? Anyone?<br />
Come on. When you hear that, you've got to be thinking: something's wrong. <br />
(Somebody wanted to kill a cricket with 162 slugs of a sledgehammer.)<br />
(Actually, it was 210 slugs, but some of them missed the mark.)<br />
I love this country, but we get a lot wrong, we sure do.<br />
I can't explain it, but I feel lighter. <br />
Must be my cricket-slugged-spirit heading into outer space.<br />
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OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com5tag:blogger.com,1999:blog-5154018758799451116.post-19053875962705632242017-08-22T11:10:00.006-04:002017-08-24T16:21:46.968-04:00There Is Fiction in the Space Between<div dir="ltr" style="text-align: left;" trbidi="on">
We're always dichotomizing the world: good guys, bad guys. <br />
At a time when everyone was eulogizing Nelson Mandela, someone on the other side of the aisle reported that he'd been a monster: he had innocent people murdered, he ordered gasoline-filled tires to be put around their necks before setting them on fire.<br />
Everyone you know belongs to one of your myths, the ones you mostly keep to yourself, the ones in which you're a hero. <br />
<br />
Tracy Chapman's song, "Telling Stories" conveys a pitiful truth, that we hardly ever connect with one another, and that all our statements are fictions of one sort or another, not certainties. There is a theory in psychology that all our thoughts arise spontaneously from the unconscious, and our egos decide whether or not to own them. Our egos are so egoistic that they assimilate these thoughts and defend them as if they were created by them, not dredged from the vast underground river dubbed by Carl Jung as the collective unconscious. I<br />
The stories we tell come from that murky, watery place too. We tell them as though they're based in the material world, but our minds have been usurped by other forces <br />
"There is fiction in the space between you and me," I say to the prosecutors, the whistleblower, the jury, the judge. <br />
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<a href="http://www.youtube.com/watch?v=0vHsPaUP4MM">http://www.youtube.com/watch?v=0vHsPaUP4MM</a></div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com1tag:blogger.com,1999:blog-5154018758799451116.post-80784833708479857202017-08-22T11:07:00.001-04:002017-08-22T11:07:30.706-04:00At Last. Convicted and Sentenced: a Post-Mortem<div dir="ltr" style="text-align: left;" trbidi="on">
Where to begin?<br />
Finally, I have permission from my lawyers to write in my blog again. Here's my question.<br />
What do you do when:<br />
a) You're falsely accused by a whistleblower, who is followed like dogs in heat by the government's agents;<br />
b) You're misrepresented in court by that same government, whose powers and finances are huge;<br />
c) You're convicted by a jury of your "peers," but the convictions and exonerations of 210 charges are not internally consistent, revealing general confusion about the case itself;<br />
d) The judge, who is very smart and likable and has done his best to sort out the information he's dispensed (hundreds of bankers' boxes of data; zip drives of more data, too much to assimilate) also gets it wrong;<br />
e) People who know nothing about you or the case, and have never even met you, make the decision that you're guilty and treat you on social media and anywhere else they find an audience like roadkill?<br />
What do I do?<br />
I file appeals of the verdict and the sentences. More paperwork.<br />
And I take the long view. Every day the sun comes up. When it's wet the milkweed, sunflowers, citrus trees and pagoda plants are content, so I am, too.<br />
The unassailable fact of death for every one of us at the end of the line makes this path of mine nothing but a path. I accept this path. I even look forward to the next bend in the road. <br />
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OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com2tag:blogger.com,1999:blog-5154018758799451116.post-56196116993103736412017-08-22T09:35:00.001-04:002017-08-22T09:35:34.488-04:00Convicted<div dir="ltr" style="text-align: left;" trbidi="on">
I was convicted of 162 charges, acquitted of 35, on Monday, May 2, 2016 at 4:30 pm.<br />
The trial lasted 5 weeks.<br />
The jury of 16, gleaned from 200-plus contestants, was pared down to 12 for the decision.<br />
One juror posted snoring icons on her Facebook page during the trial, demonstrating her (and the others'?) level of interest. <br />
I admit, it was not "interesting."<br />
Some jurors closed their eyes and appeared to doze off for short stretches, which I'm told is common during long, complicated trials like mine. <br />
I wrote lots of post-it notes to my two lawyers (one on each side, like on TV) day after day, witness after witness, hoping it would assist them. I don't think it did. <br />
There are lots of factors that go into a verdict, factors that have more to do with the jurors living inside the webworks of their own personal histories, splaying the thousand crisscrossed strands of past injustices at the hands of people who look and act like me, than the particulars of my case.<br />
"It's not about truth and justice," a prominent lawyer told me. "This isn't Perry Mason."<br />
I haven't read the newspaper report, but if you want to, here is the link.<br />
<a href="http://www.gainesville.com/article/20160503/ARTICLES/160509923"> http://www.gainesville.com/article/20160503/ARTICLES/160509923</a></div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com2tag:blogger.com,1999:blog-5154018758799451116.post-66920997311590749082017-08-22T09:35:00.000-04:002017-08-22T09:35:00.797-04:0012 (Angry?) Men (and Women)<div dir="ltr" style="text-align: left;" trbidi="on">
<i>12 Angry Men</i> is one of the best films of the 20th century.<br />
Every one of the actors went on to achieve stardom fame.<br />
What makes the film superb is its replication of the average American jury, character by character, based on personality types. <br />
I had the rare opportunity to catalogue, mostly by guessing, the personality types of a typical jury, because I watched my own jury over a five-week trial which ended on Monday May 2, 2016.<br />
Five weeks is a long time to study the faces of one's jurors, to hope they call upon their better selves, to hear their laughter, to see them grimace and twitch before re-fabricating their poker faces, and to watch them move in and out of consciousness, sometimes dozing under the blue-hued fluorescent lights of our stark, retro-Gainesville icebox of a federal courthouse. <br />
What matters most to people, the film emphasizes, is their <i>own</i> lives, what <i>they</i> do for work or fun. Persuading them to abandon their personal passions long enough to come to a thoughtful verdict is a mighty task.<br />
It takes a Henry Fonda to make us <i>think</i> beyond the pablum we assimilate day after day via media hype, inherited opinions, and free-floating prejudices. <br />
Henry Fonda was Juror #8, a thoughtful architect who wasn't sure if the defendant was guilty or not, but simply wanted to talk about it. His fellow jurors, if they were thinking about it at all, wanted to convict the "killer" (they were <i>sure</i> he was guilty) and get the heck out of there.<br />
Most juries don't have a Henry Fonda in their group. It takes a ton of courage to stand up to eleven other people. It takes guts to dig in one's heels, to force people around you to <i>contemplate a thing</i>, and to hang onto dignity and aplomb in the process. <br />
I think my jury was absent a Henry Fonda: his character type is too rare.<br />
But what I found fascinating was how otherwise my own jurors correlated to the ones in this film version of Reginald Rose's television play. Down to the last juror, I matched their countenances to the characters in <i>12 Angry Men</i>. Sidney Lumet's casting choices were right on. Here were my jurors, one through twelve, right off the screen.<br />
#1 was the German watchmaker, played by George Voskovic, an immigrant who might have pushed for what's great about America's courts, that we're (supposedly) innocent until proven guilty, but went with the flow: easier.<br />
#2 was the high school football coach, John Fiedler. The moral compass, honest and credible, he fell prey to the jury's affection and coddled it, instead of serving, Aeneas-like, as the guide.<br />
#3 An an elderly man named McCardle, played by Joseph Sweeney. He was open to persuasion, which is good when the persuasion has its basis in rectitude.<br />
#4 A garage owner, Ed Begley, who might as well have slept through the proceedings.<br />
#5 A businessman and the twisted father of an estranged son, played by Lee Cobb. A force to contend with, he would have sent a kid (his son's age) to the electric chair to keep from feeling the pain of his own son's rejection.<br />
#6 A smiley, indifferent salesman, Jack Warden, with fewer regrets than a pickpocket.<br />
#7 The meek, balding, unpretentious bank clerk, John Fiedler, wide-eyed, sincere, but stomped on so many times in his adolescence he habitually traded his conciliation for a spot of kindness.<br />
#8 The stockbroker, E.G. Marshall, whose business acumen might have pointed out the special interests at work below the surface, and saved the kid. Again, no fight in him, at least not for the other guy.<br />
#9 An advertising executive, indecisive, played by Robert Webber; the imitation of authority, without the oomph.<br />
#10 A house painter, who might have taken the lead because he was tough, but didn't because he was tired, Edward Binns.<br />
#11 A man who rose up from the slums and called people out on their baser instincts, early to join the rebel (Fonda) team, but not the first. Fighting Stockholm Syndrome ("I will not believe my oppressors!") is hard inner work. Played by Jack Klugman.<br />
#12 This should have been Henry Fonda, right? It should have been the self-employed guy who stood up to the soup-pot of humanity, stirring up suspicions, bringing to the surface those tiny wedges of onion and cayenne that are the other jurors' submerged intellects. It's the person who could have reminded them of the most important instruction the judge gives: to look for reasonable doubt.<br />
No such luck in my case. I love this country anyway, because it keeps the <i>idea</i> of a perfect world alive, but the perfect juror comes out of Hollywood. Thanks anyway, Henry, for telling us how it should have gone.</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com1tag:blogger.com,1999:blog-5154018758799451116.post-74855534865347690132015-11-08T12:46:00.000-05:002015-11-08T12:46:16.756-05:00A Decent Society<div dir="ltr" style="text-align: left;" trbidi="on">
"What is a decent society? A decent society is one whose institutions do not humiliate people. A civilized society is one whose members do not humiliate one another."<br />
Avishai Margalit, <i>A Decent Society</i><br />
<i><br /></i>
<i> </i>As self-appointed exemplars of civilization at its best, we in the United States, though there are many nations worse than ours, have a long way to go before we can declare with honest self-awareness that we are a decent and civilized people. <br />
<i><br /></i></div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com5tag:blogger.com,1999:blog-5154018758799451116.post-38844553700954187202015-10-30T15:20:00.000-04:002015-10-30T15:22:16.121-04:00Another Witness for the Feds: Ms. Barker<div dir="ltr" style="text-align: left;" trbidi="on">
I saw a retail place for rent in Hawthorne, next to the post office. <br />
<div>
Four or five hundred square feet: big enough for medical consultations, an EKG machine, minor surgery equipment, the usual apparatus for small-time doctoring.<br />
<div>
Maybe I ought to hang out a shingle again, I thought. <br />
<div>
There are no days when I'm not practicing medicine, off-label, so to speak. Wherever I go. someone catches me by the sleeve and asks for advice, or a prescription. People call me at home for "second opinions." </div>
<div>
You don't stop being a doctor just because the feds indict you, it seems. My license is intact, though this probably irks the bejeezus out of the prosecutor. </div>
<div>
And the indictment is a joke, whatever happens, whatever story the prosecutor tells at my trial, fanning a spark she caught from the FBI agent's flint into a blaze. The indictment simply has no basis in fact. And if facts can be twisted like fencing wire to rein in a different story, a story completely opposite to the truth, a story that sends me to jail, then we don't live in a country of educated, honorable, truth-seeking, self-questioning people.<br />
<div>
<div>
"Do you think I ought to go back into medical practice?" I asked my sister, a nurse, who lives in my home state of Pennsylvania. She's someone who relies on intuition and spiritual guidance to make decisions, and these count for as much as anything, in my book. </div>
</div>
<div>
"You need a diversion from the mess they've put you in," she said. "And you're so good at medicine. You should be helping people."</div>
</div>
</div>
<div>
I miss patients and medicine, the magnificence of the human body healing itself, the riddle of symptoms, figuring out how they add up to diagnoses, turning those diagnoses into cure, kneading the cures into a prolongation of life.</div>
<div>
"Why don't you look for a space to set up practice?" my sister suggested. "And pay attention to signs along the way, from the universe." </div>
<div>
This is pretty much what I expected her to say. (We ask people for the advice we want to get. We prompt them to offer exactly that.)</div>
<div>
I called the phone number on the sign for the space next to the post office. Myra Jill Barker (352) 481-2376. There it is, in case the prosecutor wants it.</div>
<div>
"Ms. Barker, hello."</div>
<div>
"Who's this?"</div>
<div>
"I'm calling about the property owned by Mr. Lewis, next to the Hawthorne Post Office."</div>
<div>
"What do you want?" she demanded.</div>
<div>
"Are you a realtor? Or are you selling that property privately?"</div>
<div>
"I'm a realtor," she said, and there was pride in her tone.</div>
<div>
"Is Mr. Lewis willing to rent the space?"</div>
<div>
"Yes, he is."</div>
<div>
"Can I look at it?"</div>
<div>
"I just showed it this morning to someone who wants to rent it."</div>
<div>
"All right, then. Perhaps I could call you back in a week, in case that person doesn't go forward with the rental."</div>
<div>
"No," Ms. Barker said firmly. "That's not going to happen."</div>
<div>
"What do you mean?" I asked.</div>
<div>
"Because that person is not someone I want to rent it to."</div>
<div>
"Okay," I said, mystified. "Do you want to show it to me?"</div>
<div>
"I would, but first tell me what you plan to do with it."</div>
<div>
"I'm Dr. Colasante, and I'm thinking about opening a small office there. A consulting clinic."</div>
<div>
Then the phone connection was lost. Click-click, dial tone.</div>
<div>
Probably my AT&T connection, which drops calls every day.</div>
<div>
I called back. </div>
<div>
"I'm sorry for the dropped call," I said. "I wanted to--"</div>
<div>
Ms. Barker burst into my sentence. "I've cleaned up all your dead bodies!"</div>
<div>
"What?"</div>
<div>
"I've cleaned up all your dead bodies, and I'm sick of it!"</div>
<div>
(Was she delusional? I couldn't tell, not over the phone.)</div>
<div>
"I don't understand, Ms. Barker. What do you mean?"</div>
<div>
"I used to work for the fire department. I hauled away all your dead bodies!"</div>
<div>
"Would you like to talk about this?" I asked. "I'm confused by what you're saying." Was she calling me a murderer? </div>
<div>
"No I would not like to talk. And I will not rent to you."</div>
<div>
"You're saying you won't rent to me?"</div>
<div>
"That's right, I won't."</div>
<div>
"But isn't your client, Mr. Lewis, the one who would make that decision, rather than you, the realtor?"</div>
<div>
"Good-bye!"</div>
<div>
With that, she hung up. Which made me think the call hadn't been dropped a few minutes ago. She'd hung up on me then, too, but answered my call-back to drive in a sword. </div>
<div>
Experiences like this send a jolt through my nervous system. What's going on? </div>
<div>
Apparently there are people who think I am scum of the earth, and Ms. Barker is one of them. How many more are there? Dozens? Hundreds? If I open a clinic, will people throw rocks through the windows? Will they trail me with Tazers or, worse, shotguns? </div>
<div>
I know there isn't cause for this, so they must be piggybacking on the government's attack, a government that is piggybacking on Pat McCullough's lawyer's--Mr. Cohen's--attack, a lawyer who hopes to profit big-time from a whistleblower commission (he's already borrowed against multiple future expected whistleblower payoffs, to the tune of $30 million)--money that would go to Pat, whose attack served her purposes, and hers alone, at great cost to everyone, taxpayers included, except her.</div>
<div>
When someone powerful like the government makes an accusation, does everyone else follow suit, like the Pied Piper's retinue, blowing horns, shouting curses, waving swords, adding their own anger to the mess of inchoate anger rising up out of their unsatisfying lives, sullying the small possibility of any truth coming out? </div>
<div>
What if the truth is complicated and time-consuming to unravel? It's much easier to jump to firm, pat conclusions. "She's a liar, she's a thief, she's a fraud!" Those are simple, satisfying things to say about me, to take in and vomit out like a good, fat, five-course meal. They take a load of guilt off the accusers, who feel pure and clean in their hearts, afterward.</div>
<div>
"Was Ms. Barker's refusal to talk to me a sign?" I asked my sister.</div>
<div>
"I don't know," she said. "But it gives you another taste of what it's like to live in that part of Florida."</div>
<div>
"What do you mean?"</div>
<div>
"It's different down there. People are different."</div>
<div>
"Right," I said. But really, I was thinking about Mr. Ivey, from yesterday, and all the patients here in Florida whom, different or not, I had come to love. People I wanted to help live a long time, because they had big hearts, and things to teach me.</div>
<div>
"Maybe you should come home," my sister said. "People need you here, too. Come back up north. You're a bird who's lost your migratory path. Maybe Florida isn't the place for you."</div>
<div>
</div>
<div>
<br /></div>
<div>
</div>
</div>
</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com6tag:blogger.com,1999:blog-5154018758799451116.post-12671132346925522152015-10-30T13:52:00.003-04:002015-10-30T13:52:42.322-04:00Ace Hardware, 10/28/15<div dir="ltr" style="text-align: left;" trbidi="on">
I was at Ace Hardware buying a few ounces of seeds for fall collards and mustard greens when the man behind me tapped my shoulder. "You'ze Dr. Colasante?"<br />
"Yes."<br />
"You'ze the doctor who used to see people down there yonder?" He pointed in the direction of Hawthorne Medical Center, now weed-strangled, vermin-infested, defunct. <br />
I noticed his custodian's button-down shirt with the name embroidered over his breast pocket: "IVEY."<br />
"Yes, I'm Dr. C.," I answered. <br />
"I know you!" he smiled broadly. <br />
"Really?" I asked. "But I don't recognize you, Mr. Ivey. I'm sorry."<br />
I was trying to place him, but we'd had eight thousand patients back then, a lot.<br />
"I <i>did</i> take care of some Iveys," I recalled, ticking off a few of names for him.<br />
"I wasn't never one of your patients," he explained, "but a lotta my kinfolk was."<br />
In truth, I'd seen enough Iveys, and Williamses, and Manns, and Rutledges, and Gordons to fill a telephone book. <br />
Each family practically had its own shelf of medical charts. They were good, cheerful, hard-working, belly-laughing, church-going, soulful, thoroughly respectable people, who made my job a lot of fun. I did what I could to get them well and keep them going, but clinic visits with them were never <i>only</i> about health. <br />
We talked about politics, family gatherings, kids, school, the upcoming church picnic, fishing, shrimping, God's will, the weather at the lake, and how to cook collards. We talked about justice and injustice, race, prejudice, hate, love, the Bible, and forgiveness. <br />
I was an extension of the community--honored to be so!--and office visits were one more way of "communing." <br />
"So that's why you don't look familiar," I said, relieved. "I'm sure I would have remembered you." <br />
We paid for our purchases and went out to the street together. I covered my brow with my seed bags to cut out the glare of the morning sun ricocheting off the hood of my Prius. <br />
"You was a good doctor!" he exclaimed. "Everybody says so."<br />
"Maybe I ought to go back into practice," I mused. "I've been thinking about it."<br />
"You ought to!" he practically shouted.<br />
"Who's <i>your</i> doctor?" I wanted to know.<br />
"Tell you the truth," he said, shaking his head, "I don't got no doctor."<br />
"Don't you have insurance?"<br />
"I have insurance, but no doctor. Don't know where to go. There <i>is</i> no place."<br />
In fact, there are two separate medical facilities in Hawthorne, each no more than a few blocks from where we were standing. I said so, tipping my head in both directions. <br />
"Naw," he said without elaborating. "No place to go, not really." <br />
So we had an office visit right there in the street. I parried him with questions, made some guesses based on his physical appearance, found out what his blood pressure was, and wrote him a slip for lab work. He seemed grateful.<br />
"Hey, 'fore you go," he whispered hoarsely, pulling my shirtsleeve.<br />
I leaned in to hear, feeling conspiratorial.<br />
"How you gonna cook them mustards?" <br />
And before I could answer he was telling me to put a little sugar in the greens after draining the pot liquor, along with salt and onions, and maybe some pork, if I liked it. "Sugar's the secret to taking out some of that bitter."<br />
"Thanks for the tip!" I said.<br />
"Sure thing."<br />
I was getting in the car, starting up the engine.<br />
"We can meet, or talk on the phone, once your test results are in," I suggested. I'd taken down his phone number. "But really, Mr. Ivey, you need a doctor."<br />
"Yeah, I know, Doc! " he called out jocularly, walking away. "And you know what?" he looked back. " I'm waitin' for you!"<br />
<br />
<br />
</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com0tag:blogger.com,1999:blog-5154018758799451116.post-44939434344914572702015-10-27T13:22:00.000-04:002015-10-27T13:23:28.092-04:00Rudeness Is Not a Felony<div dir="ltr" style="text-align: left;" trbidi="on">
Some of my detractors have posted blog comments that amount to hip-hip-hoorays for convicting me.<br />
Naturally I wondered what that was about. <br />
If these blog readers--prior patients--claim I should be apprehended, pay a fine, go to jail, then what for?<br />
I analyzed the impugning comments and tabulated the following accusations.<br />
<br />
1. Dr. Colasante made us wait in the waiting room for an hour and a half before being seen.<br />
2. Dr. Colasante's staff didn't give us our test results over the phone when we called.<br />
3. Dr. Colasante did tests that we didn't think were necessary, and the proof is that the results turned out to be normal.<br />
4. Dr. Colasante's staff was rude.<br />
5. The reports we got from our insurance companies didn't make sense to us, therefore Dr. Colasante must have billed for services we didn't get.<br />
<br />
Do these complainants know the difference between being unhappy with an experience, and being the victim of a bona fide crime?<br />
If you're unhappy with how you've been treated at a place of business, it's for one of two reasons. Either the business has a problem providing satisfactory service, or you have expectations that exceed the stated objectives of the business, or are impossible to meet.<br />
We all know people who are chronically unhappy with whatever comes their way. I happen to like most of these crotchety types and enjoy trying to please them, though I usually fail. They have a world view that places them at the bottom, empty-handed, disappointed by the universe, never valued enough. Following a predictable formula they turn their unhappiness into blame. But crime? <br />
Making a patient wait his or her turn in the waiting room while other same-day patients are being seen in order, is not a crime.<br />
Not giving patients results of sensitive, HIPAA-regulated tests over the phone is not a crime.<br />
Rudeness is not nice, but it's not a crime.<br />
Not understanding an insurance claim submitted by a doctor doesn't mean the doctor committed a crime.<br />
Not a crime, and certainly not a felony, and not two hundred ten felonies, each of which carries a maximum of ten years in jail. <br />
</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com5tag:blogger.com,1999:blog-5154018758799451116.post-66716925896948847762015-10-26T10:02:00.001-04:002015-10-26T10:54:49.569-04:00Haply, I Think on Thee, Ultimate Justice<div dir="ltr" style="text-align: left;" trbidi="on">
<h3 style="font-family: Arial, Verdana, Tahoma;">
SONNET 29</h3>
<span style="font-family: Arial, Verdana, Tahoma;">When, in disgrace with fortune and men's eyes,</span><br />
<span style="font-family: Arial, Verdana, Tahoma;">I all alone beweep my outcast state, </span><br />
<span style="font-family: Arial, Verdana, Tahoma;">And trouble deaf heaven with my bootless cries,</span><br />
<span style="font-family: Arial, Verdana, Tahoma;">And look upon myself, and curse my fate, </span><br />
<span style="font-family: Arial, Verdana, Tahoma;">Wishing me like to one more rich in hope, </span><br />
<span style="font-family: Arial, Verdana, Tahoma;">Featur'd like him, like him with friends possess'd,</span><br />
<span style="font-family: Arial, Verdana, Tahoma;">Desiring this man's art and that man's scope, </span><br />
<span style="font-family: Arial, Verdana, Tahoma;">With what I most enjoy contented least; </span><br />
<span style="font-family: Arial, Verdana, Tahoma;">Yet in these thoughts myself almost despising,</span><br />
<span style="font-family: Arial, Verdana, Tahoma;">Haply I think on thee, and then my state, </span><br />
<span style="font-family: Arial, Verdana, Tahoma;">Like to the lark at break of day arising </span><br />
<span style="font-family: Arial, Verdana, Tahoma;">From sullen earth, sings hymns at heaven's gate;</span><br />
<span style="font-family: Arial, Verdana, Tahoma;">For thy sweet love remember'd such wealth brings</span><br />
<span style="font-family: Arial, Verdana, Tahoma;">That then I scorn to change my state with kings. </span><br />
<span style="font-family: Arial, Verdana, Tahoma;"><br /></span>
<span style="font-family: Arial, Verdana, Tahoma;"> Shakespeare</span></div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com0tag:blogger.com,1999:blog-5154018758799451116.post-91558631145564141012015-10-24T09:51:00.001-04:002015-10-24T09:51:16.033-04:00Facts about Whistleblowing<div dir="ltr" style="text-align: left;" trbidi="on">
Most whistleblower cases take advantage of the False Claims Act, a piece of legislation that is used to accuse and indict doctors who accept Medicare and Medicaid patients. Any business that bills the government for services is vulnerable to charges under the False Claims Act. A "false claim" is when an individual knowingly bills the government for services that weren't provided. In the medical field, the government expands this definition to included services that "weren't necessary," thereby allowing FBI agents and federal prosecutors to step into the physician's role, deciding <i>sans patient, sans symptoms</i>, whether a medical test or treatment was necessary or not. <br />
In my case, most of the 210 charges in the original indictment are based on the contention that I provided services (hearing tests, counseling about diet, weight loss, addiction) that "weren't necessary." In some cases, the government claims there isn't enough documentation in the chart to support a claim that services were provided, especially counseling services. <br />
Eighty percent of whistleblowers end up with nothing: their accusations are baseless, the cases have no merit. Of the whistleblowers who collect a reward for reporting physicians and other government service providers, the average payment is $150,000. Attorneys take forty percent of whistleblower payments, and taxes take thirty percent or more (see: <a href="http://www.huffingtonpost.com/2012/06/04/whistleblower-law-false-claims-act-awards-james-holzrichter_n_1563783.html)">Whistleblower Awards</a>).<br />
If there is justice in our legal system, there will be no whistleblower payment related to my indictment and there will be no case won by the government, because there isn't a legitimate case against me.</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com1tag:blogger.com,1999:blog-5154018758799451116.post-79042236590622265132015-10-23T22:45:00.004-04:002015-10-23T22:45:27.102-04:00My Trial Date<div dir="ltr" style="text-align: left;" trbidi="on">
The trial date in my case was originally set for September 7, 2015. Now it's January 4, 2016, at 9 AM. The trial will take place in the federal courthouse in Gainesville, Florida. Trials are open to the public. The first day is likely to be taken up with jury selection. The first month of my trial, I'm told, is likely to be used by the government: it's typical for a federal prosecutor to take weeks and weeks articulating its accusations, trying to get them to stick like poison darts in the jurors' heads. Until the prosecutor is finished doing this, the defense is not allowed to talk back.<br />
The government's investigation of my family practice clinic started mid-year in 2009--that means it will have taken nearly seven years to bring this case to trial. In that time, no prosecutor or government agent has ever asked me anything about what they presumed was fraud, or about billing and coding in a medical clinic, how my medical practice functioned, why it was different from the average family practice clinic, or who I was. It was different--and that was enough, apparently, to presume guilt conduct an expensive investigation, raid my new medical clinic two years into the investigation, and indict me five years after the investigation started.<br />
Pat McCullough, who purchased the clinic after eighteen months of due diligence, called federal authorities in April or May 2009, announced that she had purchased a fraudulent medical clinic and wanted to report the doctor who sold it to her. In this way she was able to slither out of paying the purchase price (which I financed) while collecting the outstanding receivables and selling everything of value. She kept running the clinic at half-mast for the remainder of the year, failed to pay many employees, declined to pay monthly bills, was reported to the Labor Board, lost most of the regular patients, closed the doors for good in 2010, and declared bankruptcy later that year. <br />
By accusing me of being a fraudulent doctor she succeeded in tapping in to Obama's stepped-up plan to "crack down on healthcare fraud" by getting hyped-up FBI agents and federal prosecutors to believe they had an easy win in front of them, "low-hanging fruit" as one defense lawyer said, while not having to pay for the prosecution. Even better, Ms. McCullough--freed from all debt when her bankruptcy request was granted in 2011--is sitting in the catbird seat, waiting for what she hopes will be the government-sanctioned reward for whistleblowers who catch doctors committing fraud: around 20% of whatever the government "takes back" from payments made to me (for legitimate services) over as many years as they can convince a jury I was stealing payments, not working for them.<br />
If I really were a scheming, fraudulent professional, an uncouthAmerican citizen, if I were so clever as to know how to set up a systematic way of tricking the government into paying me what I hadn't earned and didn't deserve, and if that is what I really had in mind to do--wouldn't I have made it easy on myself, and done what Pat did? Why bother with medical school? Why train to be a doctor for thirteen years, many sleep-deprived, and study medical journals every evening after office hours for the rest of my life, and lie awake at night wondering if I misdiagnosed someone, or prescribed one medicine when another might have been better, or could have made a patient feel better sooner, or suffer less, or kept him, finally, from dying?<br />
Whistleblowing is definitely the way to go, not medical school. There are no penalties for making a mistake--a false accusation--and the rewards are…well, ask Pat.<br />
<br />
</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com4tag:blogger.com,1999:blog-5154018758799451116.post-78970017409447775032015-10-22T09:10:00.001-04:002015-10-22T09:10:13.688-04:00Resurrection: Why Stop Blogging?<div dir="ltr" style="text-align: left;" trbidi="on">
When I was indicted in June 2014 my new lawyers told me to stop blogging. <br />
"The government will take everything you write and twist it to make it work for them, to make you seem guilty." <br />
My lawyers know I haven't committed a crime, not in any sense of the word--they have said as much. Yet prosecutors are adept at making innocent behavior (e.g., a doctor taking care of patient after patient, day after day, hundreds per week, and submitting proper claims for payment to insurance carriers) the appearance of high crime, ever aware that a naive jury--a jury prejudiced in the ways everyone everywhere carries cultural bias--can be swayed along the curves of that naiveté and bias to convict a defendant, regardless of the facts. <br />
The facts, it turns out, are malleable. <br />
Wait: facts aren't malleable, but people see them through the wavy lenses of their prejudice, and that prejudice can be fanned and set to flame, so that in the end the facts seem to support one's prejudices, not stand on their own.<br />
(Isn't this why so many African-Americans and poor people end up in jail? Prejudice wins.)<br />
I'm not African-American, and I haven't been poor since my college and medical school days, but there is enough cultural bias against doctors in America for a skillful prosecutor to have an advantage. <br />
According to this bias, we doctors are rich, jaded, uncaring, too busy, without ethics--and we take advantage of people at their nadir to make a few bucks. A jury of people who can be fanned into fury by a prosecutor who accuses me of being rich, uncaring and without ethics, is a jury that will ignore the facts underlying my innocence and goodwill--people who will ignore their own personal experience of their own (I hope) caring doctors--to satisfy a deep-seated prejudicial wish to put rich, unethical people in jail.<br />
I see no reason to stop blogging. True, the prosecutor has introduced my entire blog into evidence for the upcoming trial, and plans to use it, I presume, as kindling for the jury's prejudice. If the prosecutor wants to "win" so much that she has to cut and paste blog posts, and twist what I have repeatedly said (i.e., I'm innocent, I'm innocent, I'm innocent) into a crazy, backward "admission" of guilt, she's the one who should be incarcerated for her sleight-of-hand failure of ethics: for ignoring truth and facts in the interests of "winning." <br />
Who wins, when an innocent person is convicted of a crime and sent to jail? </div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com2tag:blogger.com,1999:blog-5154018758799451116.post-83051090916344031252014-05-18T09:13:00.002-04:002014-05-18T17:51:24.241-04:00210 Charges against Me? Come on, Get Real<div dir="ltr" style="text-align: left;" trbidi="on">
When Henry Milken was indicted in 1989, it was on 98 charges of racketeering and securities fraud. Milken was an extraordinarily successful entrepreneur who pretty much invented junk bonds. He developed a novel formula for looking at new, small, cash-poor companies and figuring out which ones were likely to make it big, then he invested in them. Roberts and Stratton (authors of <i>The Tyranny of Good Intentions </i>--<i>How Prosecutors and Law Enforcement are Trampling on the Constitution in the Name of Justice"</i>) report that in 1986 Milken had made his employer, Drexel Burnham Lambert, the most profitable firm on Wall Street, "with revenues in excess of $4 billion and earnings of $545.5 million."<br />
By contrast, my solo rural clinic billed $45,000 to Medicare in 2012. In prior years, during the heyday of Hawthorne Medical Center, when the clinic was open three times as many hours as the typical family practice office and offered a multitude of procedures that no other family doctors or urgent care centers offered, the clinic may have earned as much as $1 million from Medicare. In those busy days, personnel expenses--including payroll, health insurance coverage, two retirement plans for employees and paid sick and vacation time--cost the clinic around $1 million per year.<br />
Nevertheless, the government decided to stack a whopping 210 charges against me.<br />
I understand that the number of charges doesn't necessarily correlate with the terribleness of the crimes--at least, that's what a lawyer told me. But, what does it correlate with? The uncertainty of government agents, who must substitute <i>quantity </i>for <i>quality</i>?<br />
<i> </i>Or is the number of charges supposed to instill in me 210 times as much fear as only one federal criminal charge? <br />
It makes no sense to have done listed so many "counts," at least not from the standpoint of getting the court to mete out a maximum sentence, since each charge carries a possible 10-year sentence. At this rate, the prosecutor seems to want to put me in jail (should the government's <i>might</i> override my <i>right</i>) for 2,110 years. Is this ridiculous, or not?<br />
For that matter, the government's agents could have indicted me on 2,000 charges, or 20,000, given how they chose to interpret office notes and define charges. I imagine that they went through patient charts (or had "experts" do this), tallying up office notes that looked like good examples of "billing for procedures that weren't necessary," or "billing for services that weren't provided," until they got to 200, and then they got tired.<br />
"Let's do a few more," a few stalwart investigators said. "We're on a roll here."<br />
"Ah, man, I'm whooped," the others countered. "We've got enough to put that witch in jail for ten lifetimes."<br />
"Yeah, but we could get so many more charges on her--the sky's the limit!"<br />
"Think of the press coverage!"<br />
"He's right," said another. "Practically every office note could be seen as criminal, when you look at it our way. None of these services was really <i>necessary."</i><br />
"Family doctors aren't <i>necessary</i>," one quipped.<br />
"Not from the standpoint of the fraud laws, they aren't."<br />
"Doctors aren't <i>necessary, </i>are they? Let's get rid of them all!"<br />
"And go back to shamans, and faith healers, and leeches, and boomba-bamboozle-the-masses medicine," they laughed.<br />
"The masses are so <i>easily</i> bamboozled, too."<br />
"The idiots," someone shouted. <br />
It was getting raucous in the cooped-up quarters of the FBI office, the agents hemmed in by patient records--12,000 medical charts--in stacks and messy piles everywhere they turned.<br />
"Damn, this is a drag."<br />
"Hey, everyone, I'm <i>starving," </i>announced lead agent Robert Murphy--who had put on some weight in the four years since the paper-laden Colasante investigation had started.<i> "</i>This desk work is a bummer."<br />
"Sitting around all day sucks! When are we ever gonna use these <i>guns</i><i>?"</i><br />
<i> "</i>What's the point in having guns, if you can't <i>use</i> them?" <i> </i><br />
"Call it quits, everyone," ordered Murphy. "Let's go out for pizza."<br />
"Pizza! Yes!"<br />
"Love that pizza!"</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com6tag:blogger.com,1999:blog-5154018758799451116.post-34501465862919414222014-05-16T17:20:00.000-04:002014-05-16T17:20:21.917-04:00Washington Post Article: George Will Regrets Gov't Power to Seize Assets<div dir="ltr" style="text-align: left;" trbidi="on">
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<span class="entry-title">The heavy hand of the IRS seizes innocent Americans’ assets</span><a class="more-button" href="http://www.washingtonpost.com/opinions/george-f-will-the-heavy-hand-of-the-irs/2014/04/30/7a56ca9e-cfc5-11e3-a6b1-45c4dffb85a6_story.html#"><span class="more-arrow"></span></a></h1>
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By <span class="author"> <a href="http://www.washingtonpost.com/george-f-will/2011/02/24/ABVZKXN_page.html" rel="author">George F. Will</a></span>,
<span class="timestamp updated processed">Published: April 30</span>
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<span class="dateline"></span> Flint, Mich.<br />
Earnest moralists lament Americans’ distrust of government.
What really is regrettable is that government does much to earn
distrust, as Terry Dehko, 70, and his daughter Sandy Thomas, 41,
understand. </article>
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Terry, who came to Michigan from Iraq in 1970, soon did what
immigrants often do: He went into business, buying Schott’s Supermarket
in Fraser, Mich., where he still works six days a week. The Internal
Revenue Service, a tentacle of <a data-xslt="_http" href="http://www.heritage.org/research/reports/2013/08/federal-spending-by-the-numbers-2013">a government that spent $3.5 trillion in 2013</a>, tried to steal more than $35,000 from <a data-xslt="_http" href="http://www.ij.org/michigan-civil-forfeiture-background">Terry and Sandy that year</a>.</div>
Sandy,
a mother of four, has a master’s degree in urban planning but has
worked in the store off and on since she was 12. She remembers, “They
just walked into the store” and announced that they had emptied the
store’s bank account. The IRS agents believed, or pretended to believe,
that Terry and Sandy were or conceivably could be — which is sufficient
for the IRS — conducting a criminal enterprise when not selling
groceries. <br />
What pattern of behavior supposedly aroused the
suspicions of a federal government that is ignorant of how small
businesses function? Terry and Sandy regularly make deposits of less
than $10,000 in the bank across the street. Federal law, aimed primarily
at money laundering by drug dealers, requires banks to report cash
deposits of more than $10,000. It also makes it illegal to “structure”
deposits to evade such reporting. <br />
Because 35 percent of Schott’s
Supermarket’s receipts are in cash, Terry and Sandy make frequent trips
to the bank to avoid tempting actual criminals by having large sums at
the store. Besides, their insurance policy covers no cash loss in excess
of $10,000. <br />
In 2010 and 2012, IRS agents visited the store and
examined Terry’s and Sandy’s conduct. In 2012, the IRS notified them
that it identified “no violations” of banking laws. But on Jan. 22,
2013, Terry and Sandy discovered that the IRS had obtained a secret
warrant and emptied the store’s bank account. Sandy says that if the IRS
had acted “the day before, there would have been only about $2,000 in
the account.” Should we trust that today’s IRS was just lucky in its
timing? <br />
The IRS used “civil forfeiture,” the power to seize property
<em>suspected</em>
of being produced by, or involved with, crime. The IRS could have
dispelled its suspicions of Terry and Sandy, if it actually had any, by
simply asking them about the reasons — prudence, and the insurance limit
— for their banking practices. It had, however, a reason not to ask
obvious questions before proceeding. <br />
The <a data-xslt="_http" href="http://www.newyorker.com/reporting/2013/08/12/130812fa_fact_stillman?currentPage=all">civil forfeiture law</a>
— if something so devoid of due process can be dignified as law — is an
incentive for perverse behavior: Predatory government agencies get to
pocket the proceeds from property they seize from Americans without even
charging them with, let alone convicting them of, crimes. Criminals are
treated better than this because they lose the fruits of their
criminality only after being convicted.<br />
Sandy remembers her father
exclaiming, “Aren’t we in the United States? We did nothing wrong.”
They did something right in discovering the <a data-xslt="_http" href="http://www.ij.org/">Institute for Justice’s activities against civil forfeiture abuse</a>.
IJ, a libertarian defender of property rights and other American
premises, says that what was done to Terry is done routinely across the
nation — indeed, it was done almost simultaneously to the owner of a gas
station near Schott’s Supermarket who deposited his cash receipts
whenever he could get to the bank, typically every few days. <br />
Civil
forfeiture proceeds on the guilty-until-proven-innocent principle,
forcing property owners of limited means to hire lawyers and engage in
protracted proceedings against a government with limitless resources
just to prove their innocence. Says IJ:<br />
“To make matters worse,
forfeiture law treats property owners like random bystanders and
requires them to intervene in the lawsuit filed by the government
against their property just to get it back. That is why civil forfeiture
cases have such unusual names, such as <a data-xslt="_http" href="http://www.ij.org/michigan-civil-forfeiture-background">United States v. $35,651.11 in U.S. Currency</a> — the case involving Terry and Sandy.”
<br />
In what it probably considered an act of unmerited mercy, the IRS
offered to return 20 percent of Terry’s money. Such extortion —
pocketing others people’s money — often succeeds when the IRS bullies
bewildered people not represented by IJ, which forced the government to
return all of Terry’s and the gas station owner’s money. <br />
IJ’s
countersuit seeks an injunction to prevent such IRS thefts and
extortions. Meanwhile, earnest moralists might consider the possibility
that Americans’ distrust of government is insufficient.</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com0tag:blogger.com,1999:blog-5154018758799451116.post-36469783345244143402014-05-15T16:25:00.000-04:002014-05-15T16:25:07.434-04:00New York Times Article: Doctors Are Leaving Private Practice<div dir="ltr" style="text-align: left;" trbidi="on">
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Apprehensive, Many Doctors Shift to Jobs With Salaries</h1>
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<span class="byline" itemid="http://topics.nytimes.com/top/reference/timestopics/people/r/elisabeth_rosenthal/index.html" itemprop="author creator" itemscope="" itemtype="http://schema.org/Person">By <a href="http://topics.nytimes.com/top/reference/timestopics/people/r/elisabeth_rosenthal/index.html" rel="author" title="More Articles by ELISABETH ROSENTHAL"><span class="byline-author" data-byline-name="ELISABETH ROSENTHAL" data-twitter-handle="nytrosenthal" itemprop="name">ELISABETH ROSENTHAL</span></a></span><time class="dateline" datetime="2014-02-13">FEB. 13, 2014</time>
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<img alt="" class="media-viewer-candidate" data-mediaviewer-caption="Dr. Suzanne Salamon, with a patient at Beth Israel Deaconess Medical Center in Boston, said she has had trouble filling a prestigious fellowship because of relatively low salaries." data-mediaviewer-credit="Katherine Taylor for The New York Times" data-mediaviewer-src="http://static01.nyt.com/images/2014/02/14/us/SALARY/SALARY-superJumbo.jpg" itemid="http://static01.nyt.com/images/2014/02/14/us/SALARY/SALARY-master675.jpg" itemprop="url" src="http://static01.nyt.com/images/2014/02/14/us/SALARY/SALARY-master675.jpg" /><div class="media-action-overlay">
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<span class="caption-text">Dr. Suzanne Salamon, with a
patient at Beth Israel Deaconess Medical Center in Boston, said she has
had trouble filling a prestigious fellowship because of relatively low
salaries.</span>
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Katherine Taylor for The New York Times </span>
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<br /><div class="story-body-text story-content" data-para-count="227" data-total-count="227" id="story-continues-1" itemprop="articleBody">
American
physicians, worried about changes in the health care market, are
streaming into salaried jobs with hospitals. Though the shift from
private practice has been most pronounced in primary care, <a href="http://www.nytimes.com/2014/01/19/health/patients-costs-skyrocket-specialists-incomes-soar.html?_r=0" title="Related Times article">specialists</a> are following.</div>
<div class="story-body-text story-content" data-para-count="259" data-total-count="486" itemprop="articleBody">
Last
year, 64 percent of job offers filled through Merritt Hawkins, one of
the nation’s leading physician placement firms, involved hospital
employment, compared with only 11 percent in 2004. The firm anticipates a
rise to 75 percent in the next two years.</div>
<div class="story-body-text story-content" data-para-count="367" data-total-count="853" itemprop="articleBody">
Today,
about 60 percent of family doctors and pediatricians, 50 percent of
surgeons and 25 percent of surgical subspecialists — such as
ophthalmologists and ear, nose and throat surgeons — are employees
rather than independent, according to the American Medical Association.
“We’re seeing it changing fast,” said Mark E. Smith, president of
Merritt Hawkins.</div>
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Health
economists are nearly unanimous that the United States should move away
from fee-for-service payments to doctors, the traditional system where
private physicians are paid for each procedure and test, because it
drives up the nation’s $2.7 trillion health care bill by rewarding
overuse. But experts caution that the change from private practice to
salaried jobs may not yield better or cheaper care for patients.</div>
<div class="story-body-text story-content" data-para-count="233" data-total-count="1508" itemprop="articleBody">
“In many places, the trend will almost certainly lead to more expensive care in the short run,” said <a href="http://healthforum.brandeis.edu/publications/articles-papers.html" title="Papers by Robert Mechanic">Robert Mechanic</a>, an economist who studies health care at Brandeis University’s Heller School for Social Policy and Management.</div>
<div class="story-body-text story-content" data-para-count="270" data-total-count="1778" itemprop="articleBody">
When
hospitals gather the right mix of salaried front-line doctors and
specialists under one roof, it can yield cost-efficient and coordinated
patient care. The Kaiser system in California and Intermountain
Healthcare in Utah are considered models for how this can work.</div>
<div class="story-body-text story-content" data-para-count="502" data-total-count="2280" id="story-continues-2" itemprop="articleBody">
But
many of the new salaried arrangements have evolved from hospitals
looking for new revenues, and could have the opposite effect. For
example, when doctors’ practices are bought by a hospital, a colonoscopy
or stress test performed in the office can suddenly cost far more
because a hospital “facility fee” is tacked on. Likewise, Mr. Smith
said, many doctors on salary are offered bonuses tied to how much
billing they generate, which could encourage physicians to order more
X-rays and tests.</div>
<div class="story-body-text story-content" data-para-count="265" data-total-count="2545" itemprop="articleBody">
Mr.
Mechanic studied 21 health systems considered good models of care —
including the Mayo Clinic and the Palo Alto Medical Foundation — and
discovered that many still effectively rewarded doctors for each
procedure. “It doesn’t make any sense,” he said.</div>
<div class="story-body-text story-content" data-para-count="330" data-total-count="2875" itemprop="articleBody">
Hospitals
have been offering physicians attractive employment deals, with incomes
often greater than in private practice, since they need to form
networks to take advantage of incentives under the new Affordable Care
Act. Hospitals also know that doctors they employ can better direct
patients to hospital-owned labs and services.</div>
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“From
the hospital end there’s a big feeding frenzy, a lot of bidding going
on to bring in doctors,” Mr. Mechanic said. “And physicians are going in
so they don’t have to worry — there’s a lot of uncertainty about how
health reform is going to play out.”</div>
<div class="story-body-text story-content" data-para-count="361" data-total-count="3507" itemprop="articleBody">
In addition, <a class="meta-classifier" href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier" title="Recent and archival health news about Medicare.">Medicare</a>
had reduced its set doctors’ fees over the last decade, while insurers
have become more aggressive in demanding lower rates from individual
practices that have little clout to resist. Dr. Robert Morrow, a family
doctor in the Bronx, said he now received $82 from Medicare for an
office visit but only about $45 from commercial insurers.</div>
<div class="story-body-text story-content" data-para-count="344" data-total-count="3851" id="story-continues-3" itemprop="articleBody">
Dr.
Cathleen London practiced family medicine for 13 years outside Boston,
but recently took a salaried job at a Manhattan hospital. She said she
accepted a pay cut because she could see that she was losing ground in
her practice. “I think the days of what I did in 1999 are over,” she
said. “I don’t think that’s possible anymore.”</div>
<div class="story-body-text story-content" data-para-count="274" data-total-count="4125" itemprop="articleBody">
The
base salaries of physicians who become employees are still related to
the income they can generate, ranging from under $200,000 for primary
care doctors to $575,000 in cardiology to $663,000 in neurosurgery, <a href="http://www.beckershospitalreview.com/compensation-issues/7-trends-in-hospital-employed-physician-compensation.html">according to Becker’s Hospital Review,</a> a trade publication.</div>
<div class="story-body-text story-content" data-para-count="200" data-total-count="4325" itemprop="articleBody">
Because
of the relatively low salaries for primary care doctors, Dr. Suzanne
Salamon said that for the last two years she has had trouble filling a
prestigious Harvard geriatrics fellowship she runs.</div>
<div class="story-body-text story-content" data-para-count="320" data-total-count="4645" id="story-continues-7" itemprop="articleBody">
Dr.
Howard B. Beckman, a geriatrician at the University of Rochester, who
studies physician payment incentives, said reimbursements for primary
care doctors must be improved to attract more people into the field. “To
get the kinds of doctors we want, the system for determining salaries
has to flip faster,” he said. </div>
<aside class="marginalia comments-marginalia selected-comment-marginalia" data-marginalia-type="sprinkled" data-skip-to-para-id="story-continues-4" style="display: block;"><div class="comments-view">
Doctors
can become employees by practicing in a hospital building, or by
selling their multispecialty practice to a hospital, so their office
becomes part of a network. That has attracted specialists, including
many cardiologists who took up such offers several years ago after
Medicare reduced physician payments for cardiac procedures like the
placement of <a class="meta-classifier" href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/stents/index.html?inline=nyt-classifier" title="Recent and archival health news about stents.">stents</a>
to hold open clogged arteries. The fraction of cardiologists employed
by hospitals rose to 35 percent in 2012, up from 11 percent just five
years earlier, according to the American College of Cardiology.</div>
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Dr.
Joel Jacowitz, a cardiologist in New Jersey, and his 20 or so partners
decided to sell their private practice to a hospital. In addition to
receiving salaries, that meant they no longer had to worry about paying
malpractice premiums themselves or finding health insurance for their
staff members.</div>
<div class="story-body-text story-content" data-para-count="419" data-total-count="5935" itemprop="articleBody">
Dr.
Jacowitz said that the economics drove the choice and that the only
other option would have been to bring in more revenue by practicing bad
medicine — ordering more heart tests on patients who did not need them
or charging exorbitant rates to people with private insurance. He said
he knew of one cardiologist in private practice who charges more than
$100,000 for a procedure for which Medicare pays about $750.</div>
<div class="story-body-text story-content" data-para-count="223" data-total-count="6158" itemprop="articleBody">
“Some
people are operators and give the rest of us a bad name,” he said,
adding that he had changed his opinion about America’s fee-for-service
health care system. “I’m fed up — I want a single-payer system.”</div>
<div class="story-body-text story-content" data-para-count="368" data-total-count="6526" itemprop="articleBody">
Dr.
Kirk Moon, a radiologist in private practice in San Francisco, also
sees advantages for the nation when doctors become employees. “I think
it’s pretty clear that sooner or later we’re all going to be on salary,”
he said. “I think there’ll be a radical decrease in imaging, but that’s
O.K. because there’s incredible waste in the current system.”</div>
<div class="story-body-text story-content" data-para-count="368" data-total-count="6894" id="story-continues-8" itemprop="articleBody">
Various
efforts to change incentives for doctors and hospitals are being
tested. An increasing number of employers or insurers, for example, pay
health systems a yearly all-inclusive payment for each patient,
regardless of their medical needs or how many tests are dispensed. If
doctors order unnecessary tests, it costs the hospital money, rather
than bringing it in.</div>
<div class="story-body-text story-content" data-para-count="487" data-total-count="7381" itemprop="articleBody">
And
instead of offering bonuses for productivity — doctors cite pressures
from hospital employers to order physical therapy for every discharged
patient or follow-up M.R.I. scans on every patient who got an X-ray —
some hospital systems are beginning to change their criteria. They are
providing bonuses that reward doctors for delivering high quality and
cost effective care, such as high marks from patients or low numbers of
patients with asthma who are admitted to the hospital.</div>
<div class="story-body-text story-content" data-para-count="287" data-total-count="7668" itemprop="articleBody">
“The
question now is how to shift the compensation from a focus on volume to
a focus on quality,” said Mr. Smith of Merritt Hawkins. He said that 35
percent of the jobs he recruits for currently have such incentives,
“but it’s pennies, not enough to really influence behavior.”</div>
</div>
OnaColasantehttp://www.blogger.com/profile/12516818299832410490noreply@blogger.com0