Opinion

[Print]  [Email]        

Fraud plagues government health care

Examiner Editorial
October 27, 2009

Attorney General Eric Holder says he doesn't have the resources to fight Medicare fraud.

Two recent headlines convey a disturbing contradiction: "Medicare fraud: A $60 billion crime" ("60 Minutes"), and "Reid to announce push for public option" (Politico). The former is the latest in a long parade of similar articles about Medicare, the government's biggest health care program. The latter updates liberal Democrats' continued effort to expand government health care despite its long and dreary record of waste and fraud.

Indeed, Medicare corruption has been so extensive for so long that the terms "federal health care spending" and "waste, fraud and abuse" are virtually synonyms. In May 1986, for example, Department of Health and Human Services Inspector General Richard Kusserow reported that in the prior six months 65 people were convicted of attempting to defraud Medicare, Medicaid or Social Security, with savings of more than $50 million as a result. During his long tenure as the department IG from 1982 to 1991, Kusserow unearthed hundreds of millions of dollars in fraud and helped gain convictions of thousands of people.

Nothing much has changed in the 23 years since Kusserow's 1986 report. Last Sunday, "60 Minutes" broadcast a devastating segment featuring a depressing progression of government and private lawyers, law enforcement officers, auditors, investigators, and people convicted of Medicare fraud explaining why and how ripping off Medicare has become one of the easiest and most profitable crimes in America.

One of the criminals explained that Medicare management was so lax that he got $150,000 by claiming reimbursement 10 times for a "gas-powered prosthetic arm." The same criminal said there are "thousands" of companies in the Miami area being paid for such fraudulent claims every day. A lawyer with extensive experience defending those accused of Medicare scams told "60 Minutes" that Medicare fraud is bigger than the drug trade in South Florida.

Predictably, Attorney General Eric Holder told "60 Minutes" the government needs a bigger budget and more employees before it can stop the fraud. But HHS has worked for more than two decades to clean up Medicare fraud and currently has more than 63,000 employees. If, after working all those years -- with the Justice Department, FBI and state authorities -- HHS still can't stop Medicare fraud, why is hiring more people and fattening up the department's budget going to do the trick?

Kusserow told the San Francisco Chronicle in 2003 that every time the government nailed one abuse, three new ones soon took its place. We hear a lot these days about companies that are "too big to fail." We should worry even more about government that has grown too big to do anything but fail.



beltway confidential

In response to the attention we gave him for his old column on how Washington has "anemic winters" because of global warming, Robert F. Kennedy Jr. tells NRO's Robert...

By a vote of 52 to 33, the Obama administration nominee to the National Labor Relations Board, Craig Becker, just failed to get the 60 votes needed for his nomination to proceed...

The highest form of flattery! Robert, declare yourself! (ap photo) Beltway Confidential knows a crush when she sees one. How else to explain the relentless mocking and...

You're beautiful, Chuck Todd. I mean that. (ap photo) On a day when many White House reporters (ahem) stayed away from the White House for snow or early-deadline...






Most Popular Headlines





To view this site, you need to have Flash Player 8.0 or later installed. Click here to get the latest Flash player.


 


 



 

Reader Comments

All comments on this page are subject to our Terms of Use and do not necessarily reflect the views of the Examiner or its staff. Comment box is limited to 250 words.

Tyrese T.

Oct 27, 2009

Occasionally, people see an advertisement for a short term loan, and wonder what that is. Sometimes people can really use a short term loan. A short term loan is pretty much what it sounds like – a loan that you pay back quickly. Usually it's the kind of funding option that someone would look into for emergency expenses, like a flat tire or something along those lines. People with bad credit can apply, and are still qualified applicants, as lenders require applicants to have a checking account and a job as the requirements. A short term loan could also be called payday loans, and as a financial tool it is something to be used only when absolutely needed.

 

jeanneb

Oct 27, 2009

Ask yourself this: How many have been fired for the failure to stem fraud?

None, of course. No, their answer is to hire even more people.

And remember this the next time you hear the president or Harry Reid brag about Medicare's "low administrative costs" and how they don't "deny claims" like the private insurers. Well, duh! If all you do is write checks to all comers---without checking their veracity---then, of course your admin costs will be low.

 

depaz

Oct 27, 2009

I wrote a loooooong letter to Babs Mikulski in reply to her form letter. I highlighted each item she mentioned with my take on it. One of the things she said was "lower administrative costs". My reply on that: "Are you kidding me?!?!?!? Anytime the government is involved administrtaive costs go UP!!" Ever seen the forms you're required to fill out for the bureaucrats? They expect an accounting from everyone but themselves!!

 

Mark W. Paris, Ph.D.

Oct 27, 2009

Conveniently neglected facts would have served your readers well.

For example, it's a simple fact the fiscal year 1986 Medicare Budget was $180,000,000,000 ($180 billion).

This means that with fraud at the $50,000,000 ($50 million) dollar level, the percentage of known fraud is about 0.03% of the total expenditures.

Even if actual fraud were 100 times more than is currently known it would still constitute a small fraction (3%) of the overall Medicare budget.

Sincerely,
Mark W. Paris, Ph.D.
Washington, D.C.

 

shiela

Oct 27, 2009

The federal govt. which so poorly administers Medicare, which covers a but a fraction of the population, that millions in fraud is rampant and they can't control it; nor track it, nor prosecute the many bcriminals engaged; this same govt. wants to expand that fraudulent decades old legacy to the whole population?
Are the politicians crazy, or just drunk with the prospect of power?

 

Chris

Oct 27, 2009

Fraud on this scale could be much reduced if a computer jock were allowed to get in there and tweak the Medicare Reimbusement computer programs to prevent it. Adding thousands of new government agents and other employees is the typical liberal solution to a problem easier fixed with a little thought.

 

David, Professional Engineer

Oct 27, 2009

Dr. Paris, please read more carefully. $50M savings, just for 1982; along with hundreds of millions over 9 years. That was 27 years ago.

If there are even a single thousand (the article claims multiple thousands) scamming for $150,000 each, that is $150M. Multiply that by your 100 for the unknown and you get $15B; or 8.3%.

You seem to hint that since it's just a 'small fraction' of the budget that maybe it's not a big deal. Well I'll tell you that I'd rather not have criminals making claims to the money I put into the pot. I'll get my share back and you can fund the fraud...it's only a few hundred dollars to each of us.

 

Caduceus

Oct 27, 2009

The fraudsters can't wait until HR 3200 is enacted so that they can dip their filthy hands into the graft pot, whilst the government looks the other way.

This is the result of permitting stupid people to vote. There should be an intelligence factor tide to the right to vote. Imagine what will happen when the illitertae illegals will have the right to vote.

Fraud: It's going to get bigger and better.

 

Mark W. Paris, Ph.D.

Oct 27, 2009

All wrong, "David" No-Last-Name. All wrong.

Ironic, given your admonition to "read more carefully." The relevant
text is in the paragraph beginning with: "In May 1986,..."

Clearly, the year discussed is 1986, not "1982" as you seem to think. The
"savings" is due to the fraud detected. It gives an order of magnitude
estimate of total fraud. It's highly unlikely that the total fraud is 100
times this number even with abysmal enforcement.

Your estimate of $15 billion relies on the extreme that each case of 1000's
of frauds occurs at the $150k level. Also highly unlikely. Engineers are
supposed to know how to make order of magnitude estimates.

On thing is certain -- the decimation of the Medicare fraud oversight that
occured during the Bush administration certainly has made fraud easier as
the GAO reported in 2005. Less than 10 FTE positions are dedicated to this
effort across the nation. Thanks again, George.

 

Bernie In Omaha

Oct 27, 2009

What a laugh riot - government is taking over health care to save money - this is better than "Whos on first?"

 

Stimul

Oct 28, 2009

Every day, the Center for a Just Society compiles interesting and timely articles from around the web and makes them available to our readers as the "Word on the Street." These articles are intended to encourage discussion and reflection about faith cheap sildenafil, law, and policy. They do not necessarily reflect the views of the Center for a Just Society, or any of its employees.

 

Andrew

Nov 2, 2009

So Your estimate of $15 billion relies on the extreme that each case of 1000's
of frauds occurs at the $150k level. sildenafil online Also highly unlikely. Engineers are
supposed to know how to make order of magnitude estimates.

 

jerome

Nov 5, 2009

If you are older than age 65, or have serious liver or kidney problems, your doctor may start you at the lowest dose (25 mg) of viagra
. If you are taking protease inhibitors, such as for the treatment of HIV, your doctor may recommend a 25-mg dose and may limit you to a maximum single dose of 25 mg of VIAGRA in a 48-hour period.

 

iscount Christian Louboutin Sandals

Dec 5, 2009

Christian Louboutin
Christian Louboutin Sandals on sale
Christian Louboutin Pumps
discount Christian Louboutin Shoes
cheap Christian Louboutin Pumps
replica bvlgariwatches

 


Post a comment


Email:
(This will not be displayed or shared. Privacy Policy)

Your Name:

Comment:




Local

Another snowball fight planned for Dupont Circle

The Official Dupont Circle Snowball Fight facebook fanpage has over 6,000 fans now, and it looks as if snowed in DC'ers will return for another battle. Full story

Politics

GOP winning war over Miranda rights for terrorists

Even as the administration defends its decision to grant accused Detroit bomber Umar Farouk Abdulmutallab the right to remain silent, the president himself is hinting that things might be done differently in the future. Full story

Local

D.C. region braces for up to 20 more inches of snow

The National Weather Service has the entire D.C. metro area, from Prince William County north, under a winter storm warning for 10 to 20 inches of snow. Forecasters have had their eyes on this storm for days, but the projected snow totals were bumped up late Monday. Full story