Over the final weeks of his campaign, as the United States suffers a third major wave of coronavirus cases, President Donald Trump has begun casually accusing doctors and hospitals caring for COVID-19 patients of deliberately inflating the death toll to make more money. His baseless conspiracy theory appears to originate with one of his favorite Fox News shows.
Trump complained at an October 24 Wisconsin rally that the COVID-19 death count was being padded so that “doctors get more money and hospitals get more money.” He repeated the accusation during a Michigan rally on Friday, suggesting that doctors are deliberately misclassifying deceased patients as dying of the virus because “our doctors get more money if someone dies from COVID.” Later that day, American Medical Association President Dr. Susan R. Bailey condemned the president’s comments, calling it a “malicious, outrageous and completely misguided charge.”
Over 230,000 coronavirus deaths had been reported in the United States as of Saturday afternoon, according to the New York Times. As a result of limited test capacity, such official tolls are a significant undercount of the actual number of deaths, as estimated from the number of excess deaths during the pandemic compared to a typical year.
But since the early days of the pandemic, Trumpist media figures, including those on Fox, have tried to minimize the impact of the virus and the scale of the president’s failure by arguing the recorded death count is actually overstated. They claim that the number of deaths has been significantly inflated due to the inclusion of people who died after testing positive for the disease but also had underlying conditions.
Trump has seized on a particularly sinister variant of that conspiracy theory -- that doctors and hospitals are deliberately fudging the numbers in order to make more money off the dead. The fever-swamp talking point appears to have originated on Fox.
In April, fact-checkers at USA Today, Factcheck.org, and PolitiFact all traced viral misinformation about hospital payments and the COVID-19 death count back to an April 8 appearance on Fox News’ The Ingraham Angle by Dr. Scott Jensen, a Republican state senator from Minnesota and family physician. Jensen offered the standard right-wing narrative that federal guidance for counting COVID deaths is too broad, resulting in inflated figures. But he then invoked the hospitals’ financial incentives, saying:
I would remind him that anytime health care intersects with dollars, it gets awkward. Right now, Medicare has determined that if you have a COVID-19 admission to the hospital, you’ll get paid $13,000. If that COVID-19 patient goes on a ventilator, you’ll get $39,000, three times as much. Nobody can tell me after 35 years in the world of medicine that sometimes those kinds of things impact on what we do.
According to the fact-checkers, no evidence has emerged suggesting that medical personnel are fabricating COVID-19 cases.
FactCheck.org reported that in an interview, “Jensen said he did not think that hospitals were intentionally misclassifying cases for financial reasons.” But USA Today’s report a few days later in April points out that Jensen had written on Facebook that “increasing the number of COVID-19 deaths may create an avenue for states to receive a larger portion of federal dollars” due to higher Medicare reimbursement rates for COVID-19 patients. And on a return visit to Ingraham’s program on April 13, he argued that “the counting of the cases will be critical” and that if New York Gov. Andrew Cuomo or New York City Mayor Bill de Blasio “can increase those numbers, and they both talked about doing that, then they're going to be able to get more of the dollars.”
“So last week I think we were criticized for talking about money, but the fact of the matter is, this is about money,” Jensen concluded.
As Factcheck.org noted, Jensen’s interview “generated a frenzy of headlines on social media suggesting that hospitals may have a financial motivation when it comes to classifying cases or deaths as related to COVID-19.” The talking point also spread to other pro-Trump fever-swamp outlets like One America News and the Gateway Pundit blog and made an appearance in the coronavirus conspiracy video Plandemic.
The bogus narrative returned to Ingraham’s program over the summer. Dr. Ramin Oskoui, one of Ingraham’s regular “Medicine Cabinet” coronavirus guests, argued on her July 17 broadcast that the Department of Health and Human Services should “audit every COVID death and every COVID diagnosis of every hospital.”
“Remember, we're paying bonus money to patients who are intubated for COVID and who are diagnosed as having COVID in the hospital,” Oskoui said. “That's coming to hundreds of millions of dollars. I think so the American people don't get cheated, these hospitals need to be audited, every single one of them, every single case.”
Ingraham hosts one of Trump’s favorite programs. He tweeted in response to her show at least 51 times over a two-year span, the fifth-highest total of any program. And her misinformation-filled show has particularly influenced his response to the coronavirus, specifically his obsession with the antimalarial drug hydroxychloroquine as a potential cure and his distaste for facemasks as a way to slow its spread.
In fact, Trump so appreciates Ingraham’s commentary on the coronavirus that she has twice visited the White House to advise him and top members of his administration on the federal response. And on one of those appearances, she brought along another familiar face from Trump’s television: Oskoui.