Part of the problem is that each fusion puts more strain on the spine above and below it. Around 30 years ago I took care of patients that a pair of local orthos that did the same thing. These were state industrial dollars. Most ended up very addicted to pain meds and had repeated surgery's - a major funding source for the hospital. Unfortunately the Back Pain syndrome has a lot of problems with no easy answers. A lot of progress has been made in the last 30 years but we have far to go. If its bone an ortho may be an answer, but disks and nerves? Id look for a Neurosurgeon.

There's a reason Medicare's "administration" costs are so low: nobody is doing any administering. If so, somebody should have noticed that this doctor was doing an unusually high # of surgeries and looked into it.

How many more so called doctors are out there doing the surgery for the Medicare $$$?
I have a friend whose 90 year old mother had a hip replacement in February with disasterous results. This poor old woman, who previously was semi mobile and living in her house is now in a full scale nursing home confined to a hospital bed, in diapers, with all the other ailments that go along with that confinement.
And of course Medicare is paying for all of that care.

If they can program a system to flag possible threats to national security, why can't they write a program for this to flag suspicious practices.

All I have to say about this one is don't believe something just because it's printed in the Wall Street Journal. Dr. Makker's only mistake was talking to the WSJ reporter because if he hadn't done that, they wouldn't have been able to use his name in their article. It never pays to talk to a reporter who's out to get you.

...why can't they write a program for this to flag suspicious practices[?]

"They" *have* written such a program - problem is, "they" is the WSJ, not Medicare.

Makker made more mistakes than just talking to a reporter who was out to make a point. Every unneccessary surgery he did was a much bigger mistake. The guy is a frickin' sociopath and should not be allowed to practice medicine. He should really be behind bars.

This is not new, from birth to death there are a lot of unnecessary procedures going on. This guy is just the tip of the iceberg.

"Gaming" Medicare for reimbursements?

If this is happening with Medicare, don't you think that it is happening with any insurance scheme?

Haven't you noticed that the physician/surgeon collects their insurance reimbursement whether the results are what they promised, or not?

There is a very deep vein of unethical behavior which goes on amongst medical practitioners of all types. Just remember Jayant Patel, a plastic surgeon who killed patients on at least two continents. The AMA is constitutionally incapable of policing their own members, and instead usually act to close ranks and protect the miscreants within their own ranks.

And...just take a tram up to OHSU, where not too long back, the feds slapped down the hospital and the practitioner group for consistantly defrauding Medicare for procedures done whilst the physician of record was on the golf-course, out-of-the-country, or otherwise absent from the operating theater entirely. They stifled that fairly well.

And, finally, as always, what protections do the patients of these a**holes have? Well, they could get some legal representation, but that costs more than the initial medical procedures in many cases. Justice is only for the rich.

I don't think Medicare pays for full-scale nursing homes except for very short periods. Basically, one's own assets must pay for long-term care until one is a total pauper; only then does one qualify for Medicaid which pays for nursing homes for the indigent only.