Documentos de Académico
Documentos de Profesional
Documentos de Cultura
_____________________________________________
Date__3/30/2016
TABLE OF CONTENTS
Page
Table of Contents.
TABLE OF CITATION...
Certificate of Interested People
Corporate Disclosure Statement...
Certificate of Service...
Certificate of Compliance
I.
The Commissioner of Internal Revenue Actions (CIR)
II.
The CIR has not disputed the key allegations raised in the
Appeal..
III.
IV.
V.
VI.
VII.
VIII.
Mandamus..
IX. Congress never removed the authority of the Federal District
No.
i
iv
v
vi
vii
viii
2
4
6
8
10
11
15
19
24
X.
Legal Standing
25
28
stringent standards...
XIII. The Appellant's filings are not barred by res judicata
XIV. Proper Service of Summons denied by Fort Myers Court
29
Procedures..
XV. The Appellant has met all requirements for the relief
30
requested.
APPENDIX "A"..
31
30
32
TABLE OF CITATION
Page No.
Ad Hoc Shrimp Trade Action Comm. v. United States, 515 F.3d 1372,
1379-80 (Fed. Cir. 2008)...
Associated General Contractors of California v. Coalition for Economic
24
27
23
2000)..
Ex parte Levitt, 302 U.S. 633, 634 (1937)
Forman v. Davis, 371 U.S. 178, 181 (1962).
Haines v. Kerner, 404 U.S. 520 (1971).
7
27
29
29
10
29
1980)..
Lexmark Int'l, Inc. v. Static Control Components, Inc., supra, 134 S.Ct.
29
at 1389...
Lujan v. Defenders of Wildlife, 112 S. Ct. 2130, 2136 (1992).
Match-E-Be-Nash-She-Wish Band of Pottawatomi Indians v. Patchak,
23
26
27
Tel. Co., 464 U.S. 30, 36, 104 S.Ct. 304, 307, 78 L.Ed.2d 29 (1083)..
Short v. Murphy; Roots v. Callahan, 475 F.2d 751 (5th Cir.1973)...
United Public Workers , 330 U.S. at 89, cert. denied, 112, Ct. 1670
10
24
(1992)
United States v. Gonzalez, 671 F2.d 441, 443 (11th Cir. 1982)
United States v. Smith, 493 F.2d 906, 907 (5th Cir. 1974)
27
10
7
iii
UNITED STATES OF AMERICA, Plaintiff-Appellee v.
RICKY NELSON DAWSON, Defendant- ppellant.No.1311198, UNITED STATES COURT OF APPEALS FOR
26
iv
vi
Certificate of Service
A copy of Appellant's Reply Brief has been priority mailed on 3/30/2016, to:
Department of Justice
Tax Division
Attorney Sherra Wong
Post Office Box 502
Washington, D.C. 20044
vii
Certificate of Compliance
The Reply Brief is written in 14 pt., in Times New Roman. The Brief is
6,843 words long.
The Appellee's Reply Brief was served, by first Class mail on 3/25/2016.
This reply brief is filed in a timely manner.
viii
15-15465-DD, 1610071-EE
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
ROY J. MEIDINGER,
Plaintiff-Appellant
v.
COMMISSIONER OF INTERNAL REVENUE,
Defendant-Appellee
ON APPEAL FROM THE ORDERS OF THE
UNITED STATES DISTRICT COURT FOR THE
MIDDLE DISTRICT OF FLORIDA
REPLY BRIEF FOR THE APPELLANT
Roy J. Meidinger, Pro Se
14893 American Eagle Ct.
Fort Myers, Fl. 33912
Tel # 239-694-5597
Cell # 954-790-9407
Email-RoyJMeidinger@comcast.net
APPELLANT, ROY M. MEIDINGER, litigant pro se, respectfully files this reply
brief in response to the Respondent-Appellees Appeal Brief, and states as follows:
VII. The Commissioner of Internal Revenue Actions (CIR)
In all pleadings filed by the Appellee in the District Court and in the
Appellate Court, The Commissioner of Internal Revenue admitted that he did not
and will not investigate and collect taxes from the taxpayers identified in the
healthcare industry. The CIR admits he deliberately and knowingly blocked any
investigations of the thousands of identified taxpayers violating the tax code per
information relayed to the office by the Appellant in the Form 211 submitted to the
IRS and duly received by said office. He alleged that he has the discretionary
authority not to conduct any investigation and not to collect any taxes due. He
provided no statute giving him this authority. In all denials, the CIR never gave a
reason why he used his discretionary authority. The Tax code says just the
opposite, he is authorized and required to make the inquires, determinations,
assessments and collect all taxes under title 26 U.S. Code.
26 U.S.C. 6201 provides that:
"6201.
Assessment authority
(a) Authority of Secretary. The Secretary is authorized and
required to make the inquiries, determinations, and assessments
of all taxes (including interest, additional amounts, additions to
the tax, and assessable penalties) imposed by this title, or
accruing under any former internal revenue law, which have not
been duly paid by stamp at the time and in the manner provided
by law. Such authority shall extend to and include the following:
(1) Taxes shown on return
The Secretary shall assess all taxes determined by the taxpayer
or by the Secretary as to which returns or lists are made under
this title." (Underscored for emphasis.)
The CIR actions are a direct violation of the above-quoted law. The
Commissioner is aiding and abetting the healthcare industry in their kickback
scheme, accounting fraud, tax evasion scheme and restraint of trade scheme. The
Department of Justice should be prosecuting him instead of defending his actions
as principal and/or as accessory after the fact as provided under 18 U.S. Code 2
and 18 U.S. Code 31.
1 18 U.S. Code 2 - Principals"Principals
VIII. The CIR has not disputed the key allegations raised in the Appeal
The Commissioner of Internal Revenue has not disputed the following:
a. The Appellant did identify specific taxpayers and specific tax evasion
practices;
b. The Patients' contracts with the provider supersedes the contract between the
provider and the Insurance Companies;
c. The Patient's bill is the recognized income revenue for tax purposes;
d. The healthcare providers give no discounts to anyone, patient or insurance
company;
e. The accrual-basis of accounting is the required methodology in the
healthcare industry for determining the realized income for tax purposes;
f. The partial cancellation of debt given to the insurance company is a
kickback or a payment, to the insurance company for steering or referring
insured members to the provider; This may also be called as Referral fee;
(a)
Whoever commits an offense against the United States or aids, abets, counsels, commands, induces or procures its
commission, is punishable as a principal.
(b)
Whoever willfully causes an act to be done which if directly performed by him or another would be an offense against
the United States, is punishable as a principal."
The entire Appellee's Reply Brief is null and void, and should be stricken from the
record. The Appellee did not make any reply to the Appellant's Briefs and motions
in either case. The Appellee abandoned all rights, therefore only the pleadings filed
by the Appellant can stand. This court already decided this issue in UNITED
STATES OF AMERICA, Plaintiff-Appellee v. RICKY NELSON DAWSON,
Defendant-Appellant. No. 13-11198, UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT. October 8, 2014, where the Court stated:
"We also deny Dawson's related motion to modify the record on
appeal. Federal Rule of Appellate Procedure 10(e)(2) provides
that "[i]f anything material to either party is omitted from or
misstated in the record by error or accident, the omission or
misstatement may be corrected and a supplemental record may
be certified" by the parties' stipulation, the district court, or this
Court. The Rule "does not empower a district court to modify
parties' stipulations or make new findings of fact after docketing
of the appeal in the court of appeals." United States v. Smith, 493
F.2d 906, 907 (5th Cir. 1974) (per curiam) Here, because evidence
of another reimbursed victim was never introduced before the
district court, Dawson may not now supplement our record with
this new evidence. We also decline to use our inherent power to
supplement the record "in the interests of justice." CSX Transp.,
Inc. v. City of Garden City, 235 F.3d 1325, 1330 (11th Cir.
2000)."
The Appellee also failed to timely answer any brief in either case making all
assertions made by them against the Appellant futile. FRCP 12(a) (3)(B) provides:
"An officer or employee of the United States sued in an
individual capacity for acts or omissions occurring in connection
with the performance of duties on behalf of the United States
shall serve an answer to the complaint or cross-claim - or a reply
were conducted, prior to any denial of the 211 claim. The discussions, which did
take place with the IRS Attorney, verified the tax issues, that resulted in the
Whistleblower evaluation done by the Ogden UT. team, recommending to proceed
forward. The Washington Whistleblower Office and the CIR deferred any
investigations. These are the individuals,that the Appellant in his writ of
mandamus, are requesting to do their duty under the law.
On pg. 4 of the brief, the Appellee notes that Judge Chappell instructed the
Appellant to petition the tax court for review of the IRS's rejection of the second
and third claims, citing the Tax Court's jurisdiction under 26 U.S.C. 7623(b)(4) to
review the IRS's final determination of form 211 claims. On pg. 63 of the brief, the
appellee disagrees with the judge, and states as follows:
"But in Cooper II, .The Tax Court recognized that Congress
did not authorize the Court (TAX Court) to direct the Secretary
to proceed with an administrative or judicial action.
Please note in the Tax Court case No. 16513-12W, the initial brief did
request an award, but this was done prior to discovery. After receiving new
evidence, through discovery, showing no investigation was done by the defendant,
a motion was made to change initial brief and change the relief sought. At this time
the Tax Court learned it did not have the authority to grant the relief sought or the
authority to correct violations of the Administrative Procedures Act and dismissed
the case. The D.C Circuit Appeals Court stated the Tax Court did not have
authority to remedy violations of the APA. After fully understanding adjudication
process of trying to correct a violation of the APA, the Appellant moved to the
Federal District Court. I thank the DC Circuit Appeals court of identifying the
issue involved and stating it was not a Tax Court issue.
XI.
26 USC 7623, the intent of Congress was to seek the aid of individuals to
identify tax evasion schemes and illegal practices. By bringing these taxpayers to
the attention of the IRS, the IRS would investigate, calculate the taxes and
penalties due and collect these amounts. In Harold Bruce LONDON, Christine
Saunders London, Plaintiffs-Appellants,v.FIELDALE FARMS CORPORATION,
Defendants-Appellees, No. 04-10040, United States Court of Appeals, Eleventh
Circuit, June 1, 2005 this court stated:
"As in all cases of statutory construction, our task is to interpret the words of the[]
statute[] in light of the purposes Congress sought to serve."Norfolk Redevelopment
& Housing Auth. v. Chesapeake & Potomac Tel. Co., 464 U.S. 30, 36, 104 S.Ct. 304,
307, 78 L.Ed.2d 29 (1983) (quotation and citation omitted); see also United States v.
Gonzalez, 671 F.2d 441, 443 (11th Cir.1982). (Emphasis ours.)
The Appellant has performed his mandate under the foregoing provision in
going against the erring taxpayers which have committed a rampant and palpable
violation of the IRS Code thereby causing billions of damages to the State and to
the public. However, despite the efforts exerted by the Appellant and the expenses
he incurred in voluntarily commencing investigations against the erring taxpayers,
the Internal Revenue Commissioner failed and refused to perform his duty as
mandated by the IRC.
XII. Duty owed to Plaintiff
Appellant disputes pg. iv, of the Brief, which states that "the Commissioner
owes no duty to Meidinger to investigate" but on page 28 of the same Brief, the
Appellee states:
"see also Your Home Visiting Nurse Servs., Inc. v.Shalala, 525
U.S. 449 (1999) (petitioner not entitled to mandamus under 28
U.S.C. 1361 when the government manual at issue suggests
permissive, rather than mandatory, action)."
The Internal Revenue Manual clearly states it is mandatory for
the IRS to do investigations. Specifically, IRM 25.2.2.7 (06-18-2010),
Processing of the Form 211 7623(b) Claim for Award, states as follows:
"10. The law requires the Whistleblower Office to analyze
7623(b) claims, and authorizes the Whistleblower Office to
request assistance from the whistleblower or their counsel. In
most cases, the IRS should be able to receive information from a
whistleblower, conduct a debriefing to ensure the information
provided is fully understood and that the IRS has all relevant
information the whistleblower can offer, and then proceed with
an investigation or examination without further assistance from
the whistleblower."
Form 11369 is mandatory; to be filled in by the Whistleblower Office for all
211(b) claims and the information on it can only be obtained through an
investigation.
Further, 26 CFR 301.76234, (2) Administrative claim file, states that:
"(iii) Form(s) 11369, Confidential Evaluation Report on Claim
for Award, including narratives prepared by the relevant IRS
office(s), explaining the whistleblowers contributions to the
actions and documenting the actions taken by the IRS in the
case(s). The Form 11369 will refer to and incorporate additional
documents relating to the issues raised by the claim, as
"In Cooper II, the Tax Court observed that the Secretary has
the responsibility of seeking tax revenue in every possible
situation. 136 T.C. at 601 (citing 26 U.S.C. 7601 and 7602)."
The statute making it mandatory for the Commissioner to do his job is found
on 26 U.S. Code 6201 - Assessment authority, which states that:
"Assessment authority
(a) Authority of Secretary, The Secretary is authorized and
required to make the inquiries, determinations, and assessments
of all taxes . imposed by this title,."
"(1) Taxes shown on return
The Secretary shall assess all taxes determined by the taxpayer
or by the Secretary as to which returns or lists are made under
this title."
Assuming for the sake of argument that the Congress wanted the
Commissioner of Internal Revenue to have discretionary authority not to
investigate 7623(b) 211 claims which identified taxpayers who violated the tax
code, the Congress would have clearly stated it.
Both Congress and States have passed anti-kickback laws for the Healthcare
Industry to stop paying for referrals of patients. Congress specifically wanted the
CIR to collect taxes on kickbacks paid by healthcare providers to anyone for
referring patients. The CIR has no discretionary authority to overrule the intent of
these laws.
Under 26 U.S. Code 162 - Trade or business expenses, it is clear that:
"(c)ILLEGAL BRIBES, KICKBACKS, AND OTHER PAYMENTS
(2)OTHER ILLEGAL PAYMENTS
No deduction shall be allowed under subsection (a) for any
payment (other than a payment described in paragraph (1))
made, directly or indirectly, to any person, if the payment
constitutes an illegal bribe, illegal kickback, or other illegal
payment under any law of the United States, or under any law of
a State (but only if such State law is generally enforced), which
subjects the payor to a criminal penalty or the loss of license or
privilege to engage in a trade or business. For purposes of this
MEDICAID
taxpayers name on a form 11369 and give the reason why the claim is being
denied. The CIR is required to make a determination on a case by case basis. The
CIR gave and is giving, full immunity to the entire healthcare industry of the tax
code in connection with its kickback scheme! This is beyond his authority.
XIV. Federal District Courts Have Authority To Issue Writs Of
Mandamus
The federal District Court gets its authority to issue writs of mandamus from
statutes 28 USC 1331 and 28 USC 1361. The cause of the action is 5 USC 701706, the Administrative Procedures Act. The Administrative Procedure Act (APA),
Pub.L. 79404, 60 Stat. 237, enacted June 11, 1946, is the United States federal
statute that governs the way in which administrative agencies of the federal
government of the United States may propose and establish regulations. The APA
also sets up a process for the United States federal courts to directly review
agency decisions. It is one of the most important pieces of United States
administrative law. The Act became law in 1946.
To set aside formal rulemaking or formal adjudication whose procedures are
trial-like, a different standard of review allows courts to question agency actions
more strongly. For these more formal actions, agency decisions must be supported
by "substantial evidence" after the court reads the "whole record", which can be
thousands of pages long.
Unlike arbitrary and capricious review, substantial evidence review gives the
courts leeway to consider whether an agency's factual and policy determinations
were warranted in light of all the information before the agency at the time of
decision. Accordingly, arbitrary and capricious review is understood to be more
deferential to agencies than substantial evidence review. Arbitrary and capricious
review allows agency decisions to stand as long as an agency can give a reasonable
explanation for its decision based on the information it had at the time. In contrast,
the courts tend to look much harder at decisions resulting from trial-like
procedures because those agency procedures resemble actual trial-court
procedures, but Article III of the Constitution reserves the judicial powers for
actual courts. Accordingly, courts are strict under the substantial evidence standard
when agencies acts like courts because being strict gives courts final say,
preventing agencies from using too much judicial power in violation of separation
of powers.
Under 5 U.S. Code 706 - Scope of review, it is stated that:
Scope of review
"To the extent necessary to decision and when presented, the
reviewing court shall decide all relevant questions of law,
interpret constitutional and statutory provisions, and determine
the meaning or applicability of the terms of an agency action.
The reviewing court shall
(1)
compel agency action unlawfully withheld or unreasonably
delayed; and
(2) hold unlawful and set aside agency action, findings, and
conclusions found to be
(A)
arbitrary, capricious, an abuse of discretion, or otherwise not in
accordance with law;
(B)
contrary to constitutional right, power, privilege, or immunity;
(C)
in excess of statutory jurisdiction, authority, or limitations, or
short of statutory right;
(D)
without observance of procedure required by law;
(E)
Pottawatomi Indians v. Patchak, 132 S.Ct. 2199, 2210 (2012) (zone of interests test
in APA contexts is not especially demanding).
The Federal District Court has not shown any case law saying it does not
have the authority to grant the relief requested. See Ad Hoc Shrimp Trade Action
Comm. v. United States, 515 F.3d 1372, 1379-80 (Fed. Cir. 2008). (Our case law
is arguably inconsistent about whether a finding that a court does not have
authority to grant the relief requested should be considered jurisdictional.).
"Since a writ of mandamus cannot compel a discretionary action, taxpayers'
contention that the Federal Mandamus Act, 28 U.S.C. 1361, conveys jurisdiction
is without merit (Short v. Murphy; Roots v. Callahan, 475 F.2d 751 (5th Cir.1973).
Additionally, 28 U.S.C. 1361 says "[t]he district courts shall have original
jurisdiction of any action in the nature of mandamus to compel an officer or
employee of the United States or any agency thereof to perform a duty owed to the
plaintiff."
XV. Congress never removed the authority of the Federal District Court
to write writs of mandamus or gave this authority to the Tax Court
When Congress changed the IRS Whistleblower program in 2006, it did not
change 28 USC 1331 or 28 USC 1361 or 5 USC 701-706. These statutes
give the Federal District Courts the authority and jurisdiction over the subject
matter of this case. The Tax Court and the Washington DC appeals court have said
the Tax Court does not have any authority or jurisdiction of the subject matter of
these statutes. 26 USC 7623(b1), (b2), & (b3) gives limited authority to the tax
court for the determination of the amount of the reward.
The Appeals Court does have the authority to issue a writ of mandamus.
Under the standard of review, de novo, the Appeals Court is reviewing the entire
record, it has the authority to issue a writ of mandamus. This standard of review
puts the this court in the shoes of the Federal District Courts. In the briefs filed in
the district court cases the Appellants request for relief did not exceed the
authority of the federal district court. The relief requested never asked the court to
issue a reward, or make a determination as to how much taxes the identified
taxpayers owed. The Appellant only asked the court to ensure that the IRS
performs a mandatory administrative duty. The relief asked for was to correct a
wrongfully denied investigation of the taxpayers which the Appellant identified.
The commissioner is wrong when he says he has discretionary authority not
to do an investigation because of 26 USC b1. This provision deals with the
question of the amount of the reward, not with the discretionary authority of the
CIR. (See IRM 25.2.29.2(4) & (10)(b))
XVI. Legal Standing
The legal right to initiate a lawsuit. To do so, a person must be sufficiently
affected by the matter at hand, and there must be a case or controversy that can be
resolved by legal action. There are three requirements for Article III standing: (1)
injury in fact, which means an invasion of a legally protected interest that is (a)
concrete and particularized, and (b) actual or imminent, not conjectural or
hypothetical; (2) a causal relationship between the injury and the challenged
conduct, which means that the injury fairly can be traced to the challenged action
of the defendant, and has not resulted from the independent action of some third
party not before the court; and (3) a likelihood that the injury will be redressed by a
favorable decision, which means that the prospect of obtaining relief from the
injury as a result of a favorable ruling is not too speculative. Lujan v. Defenders of
Wildlife, 112 S. Ct. 2130, 2136 (1992) (Lujan). The party invoking federal
jurisdiction bears the burden of establishing each of these elements. Id.
In deciding whether a party has standing, a court must consider the
allegations of fact contained in the party's declaration and other affidavits in
support of his assertion of standing. See Warth v. Seldin, 422 U.S. 490, 501 (1974)
(Warth). see also Warth, 422 U.S. at 501 (when addressing motion to dismiss for
lack of standing, both district court and court of appeals must accept as true all
material allegations of the complaint and must construe the complaint in favor of
the party claiming standing).
This nation will never be able to compete in the international industrial arena
because the IRS will continue to cover up its error. (See Attached
Addendum)
The harm sustained by the Appellant and the nation, will continue forever if
this Appeal is denied.
XVII. Both cases have to be reviewed in their entirety
The CIR has emphatically stated the final orders of each court are correctly
and timely appealed. These final orders were made in response to all the
Appellants motions for reconsideration. These motions incorporate the entire case
filed with the Court, which included dismissal orders 1& 2 of each case. Case 2
was dismissed prior to case 1 being dismissed. Judge John Steele cited case 1 as
his authority, not the conclusions listed by Judge Sherri Chappell.
In note 4, on page 19, the Appellee stated that "But see Foman v. Davis, 371
U.S. 178, 181 (1962) (courts of appeal should not dismiss notices of appeal on
grounds amounting to "mere technicalities"); Kicklighter v. Nails by Jannee, Inc.,
616 F.2d 734, 738 n. 1(5th Cir. 1980) (appeals of orders not specifically designated
in the notice of appeal are allowed where it is clear that the overriding intent was to
give effectively to appeal).
Reconsideration: As normally used in context of administrative adjudication
"reconsideration" implies reexamination, and possibly a different decision by the
entitywhich initially decided it. Kerr-McGee Nuclear Corp v. New Mexico
Environmental Imp. Bd., App., 97 N.M. 88, 637 P.2d 38, 42.
XVIII.
The Appellants filings are made Pro Se and must be held to less
stringent standards
The Appellant in this case has commenced the filing of the cases subject
of this appeal as Litigant Pro Se. The Constitution provides that all people shall
have access to the District Courts, no matter if they are represented by counsel or
not. In actions filed by litigants Pro Se, the Court ruled that their pleadings shall be
held to less stringent standards (Haines v. Kerner, 404 U.S. 520 (1971)) as
compared to those represented by attorneys.
Appellant urges this Court to rule on the merits of the case and not on
mere technicalities which he may not be knowledgeable of. Nonetheless, the
Appellant is confident that the ommissions committed by the IRS in not
conducting an investigation of the 211 forms which he filed is worthy to be
reviewed in order to shed light into like circumstances which may arise in the
future.
XIX. The Appellant's filings are not barred by res judicata
The second and third 7623(b) filings were for different time periods and
incorporated new taxpayers. The old taxpayers were also re-incorporated into the
new filings, but were for different time periods, therefore, for different tax evasion
violations.
The second case filed in district court was changed and contained additional
information. It must be noted, the subject matter or violation of the Administrative
Procedures Act was never adjudicated in either the Tax Court or the Federal
District Court. Said violation is the subject of this instant appeal.
XX. Proper Service of Summons denied by Fort Myers Court Procedures
Lastly, on the question of the summons, the rules provide that the Clerk of
the Court must sign the summons, according to Rule 4(a)(1)(F). Without the clerks
signature there is no summons. The clerk of the court for Fort Myers Division does
not sign the summons for a miscellaneous case it is there local procedure. The
Defense lawyer, who appeared for the CIR verified this procedure and information,
after the Appellant spoke to her and when the reply was filed in response to
defendant's motion to dismiss.
In addition, the Appellee has filed an answer to the Allegations made by the
Appellant in his appeal and Appeal Brief, which connotes that the Appellee is now
estopped to raise the issue on valid service of summons considering that they have
been informed and received a copy of the Appellants Notice of Appeal and Appeal
Brief.
XXI. The Appellant has met all requirements for the relief requested
Based on all the filings in Federal District Court This Court must issue the
writ of mandamus.
If this Court decides not to issue the writ the damages identified in Appendix
A will continue. These damages can be stopped by simply telling the CIR to do
his job, as the IRC statutes dictate.
Signed_________________________________________ Date_______________
The economic catalyst that formed the mutual billing practices is traced to the change of
Medicare compensation.
In 1982, Medicare went from paying an allocation of all medical costs, based on all patient bills,
to a fixed amount for different diagnosis.
The original payments were determined through cost analysis for various medical diagnostics.
But, each year afterward, reimbursement rates were increased based on private-pay patients
increased billed amount.
The Social Security law states, healthcare providers were to list the actual amounts collected
from the private-pay patients on the Medicare beneficiaries' bills. Most of the providers in the
healthcare industry put the same prices on all Medicare beneficiaries' invoices, but not the actual
amount they collect from the private-pay patients.
The largest group, of private-pay patients, are the privately insured patients, which make up 70
percent of the patients. The providers list the same prices on all insured private-pay patients'
bills, but forgive a large portion of the patients debt owed, so the actual amount collected is much
lower, in some states almost 90 percent lower.
This forgiveness of debt is paid to the insurance companies for steering their insured members to
the healthcare providers.
The financial auditor of the healthcare industry is not the Centers for Medicare/Medicaid
Services, but the Internal Revenue Service.
The IRS made a huge error, it treated both the public and private business the same. On the
Medicare or public side of the providers business it is okay to write off the difference between
the amount billed and the amount collected, as a contract adjustment. This is fraud or tax evasion
when it is done on the private side. This is a direct violation of the anti-kickback statutes.
In 1982, the cancelled debt for hospitals was about 1%. Each year, the hospitals used supra
billing tactics to increase the amounts billed and today they are cancelling more than 85%. The
cancelled debt, which is given to the third party payers, who steer their insured members to the
healthcare provider. For the past thirty years the hospitals increased prices by 1354%, increased
cancelled debt by 982%, increased hospital revenue by 372%, while the Consumer Price Index
increased by 95%
If the providers wanted more customers they should, lower their prices; compete on prices and
quality of service.
The damages done to our nation during the past 30 years are staggering:
The industry, utilizing its billing practices and kickbacks, have stolen $22 trillion through
over-charges.
75,000 manufacturing companies have been lost, including 7 million jobs lost.
The graph below shows the United States was adding new manufacturing companies at a rate of
2500 a year, but after 1982 the United States was losing 2500 manufacturing companies a year.
For the Past 30 years the United States has stopped manufacturing growth, lost 75,000
manufacturing companies and 7 million manufacturing jobs.
Hillary Clinton wants to expand the Affordable Care Act. This would increase the nation's
healthcare bill. The ACA calls for the purchase of a commodity, insurance. The motivation to
compete, lower costs and improve quality is lost when the customers must purchase the
commodity.
Bernie Sanders wants a single payment system. This would lower the nation's healthcare
expenditure to 1/3 to 1/2 of what they are today. The lower and middle classes would not have to
pay co-payments and deductibles. The premiums allocated by businesses for each employee
would be paid to the employee, which would be an annual increase of $12,000 a year; this
money would now be taxed, increasing tax revenue, without increasing tax rates.
To pay for the single payment system:
Lower corporate tax rate to 10 percent and eliminate the deduction on stock dividend
income.
Lower employee benefit cost allows manufacturing companies to compete with other
nations.
As the United States medical costs for employee benefits began to increase in early 1980s, we
could not compete with industrial countries, we began to have a trade deficit. We are now
running a trade deficit of 50 billion dollars a month.
The bad side of a single payer system? 250,000 insurance company sales jobs are eliminated.
Please share this information with your family, friends and neighbors.
Roy J. Meidinger lives in south Fort Myers