Monday, June 16, 2008

$60 billion would provide a lot of health care to the people who need it!

The candidates all are talking about making the health care system available to everyone. I wonder if any of them have considered that a lot of tax dollars are already being handed over to crooks scamming the current system providing free healthcare to the general public? Some estimate that this costs the taxpayers up to $60 billion a year.

$60 billion would go a long way to helping people, who need medical attention and can't afford it.

Carrie Johnson of the Washington Post writes:

All it took to bilk the federal government out of $105 million was a laptop computer.

From her Mediterranean-style townhouse, a high school dropout named Rita Campos Ramirez orchestrated what prosecutors call the largest health-care fraud by one person. Over nearly four years, she electronically submitted more than 140,000 Medicare claims for unnecessary equipment and services. She used the proceeds to finance big-ticket purchases, including two condominiums and a Mercedes-Benz.
And while law enforcement efforts are admirable in going after this, it is is being described as a game of "Whack a Mole."

The article sums up the problem rather nicely:

A critical aspect of the problem is that Medicare, the health program for the elderly and the disabled, automatically pays the vast majority of the bills it receives from companies that possess federally issued supplier numbers. Computer and audit systems now in place to detect problems generally focus on overbilling and unorthodox medical treatment rather than fraud, scholars say.

"You should be able to spot emerging problems quickly and address them before they do much harm," said Malcolm Sparrow, a Harvard professor and author of "License to Steal," a book about health-care fraud that advocates for greater federal vigilance. "It's a miserable pattern, a cycle of neglect followed by a painful and dramatic intervention."


Southern Florida was targeted by the authorities because a large amount of money seemed to be going up in smoke there, according to the Washington Post article.

Miami became a focus for Medicare fraud after investigators realized that a good portion of the medical suppliers weren't even open during normal business hours and didn't even have working telephone numbers (?). Even worse, the Government Accountability Office has been calling out that these programs had weak oversight for about a dozen years (?).

Southern Califonia is also one of the targets in the latest efforts to correct this problem:

The strike force recently established a base in Los Angeles, another area rife with fraud. Prosecutors announced criminal charges last month against two medical equipment company owners who are accused of falsely billing Medicare more than $2 million. Plans call for a similar rollout this fall in Houston, another potential fraud hot spot.

The political candidates can promise free health care for everybody -- but unless we start exercising a lot more due diligence spending this money -- any system is likely to go broke in a short time. I'm all for better health care for all, but we need to start making sure the money is being spent on the people receiving the care.

Spending even more money on law enforcement task forces to combat a problem described as a game of "Whack a Mole" isn't very proactive, either.

What is needed is a little more common sense in running these programs. If the programs are this mismanaged, I would propose investigating the enablers of this problem (the program managers) and find out why they are wasting so much money. By doing this, we might start spending the money where it should be spent, or on people who need medical attention.

This might go a long way to having the means to provide care to the people, who the money was earmarked for in the first place!

Washington Post article, here.

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