The further to the left or the right you move, the more your lens on life distorts.

Monday, February 29, 2016

50 Times

Progressives often defend Bernie Sanders suggestion that we move to a government run "universal" health care system by saying, "Well, look at how well Medicare works for older people. That's how universal health care would work."

Medicare does work reasonably well today, but here are a few things to ponder: (1) Medicare is rapidly going broke as health costs and the population of senior citizens escalate; (2) part of the reason that health costs escalate is because there is no competition among providers; (3) because costs are hidden from the consumer, Medicare patients are given millions of unnecessary tests, medications, and procedures, escalating Medicare costs for taxpayers, and (4) fraud and abuse are rampant.

But how much fraud and abuse? Ethan Barton comments:
Don’t ask the top congressional watchdog how many tax dollars are lost each year to Medicare and Medicaid fraud.

“It would be really nice to know how much fraud there is in Medicare and in other healthcare programs,” Government Accountability Office Health Care Director Kathleen King said in a WatchBlog podcast Wednesday. The GAO is Congress’ chief oversight investigative tool for monitoring executive branch spending and management.

“Part of the reason that we don’t have a reliable estimate at this point is because providers could do things that look legitimate on their face,” she said.

A properly enrolled Medicare provider, for example, could submit a “claim that looks perfectly legitimate,” but bills for services that were either never provided or were more complex than the actual service, King said, which is “very difficult to catch.”
Hmmm. So health care providers can cheat and no one in the government can tell?

The Feds spent $845 billion on Medicare in 2015. Medicaid Fraud Control Units across the country recovered about $745 million. Let's assume that the Medicare equivalent found an equal amount of fraud. Are we, therefore to believe that fraud and abuse are under 2 tenths of 1 percent of overall expenditures? That. Is. A. Joke.

Countering this ridiculously low number, Politifact suggests that Medicare fraud and abuse hovers around 8 to 10 percent. In real dollars, that would be about $80 billion. The Journal of the American Medical Association agrees. That means that fraud and abuse are about 50 times greater than the amounts uncovered by the feds. 

Big Intrusive Government demands that taxpayers account for every nickle of income, keep detailed records and receipts for 7 whole years, and file yearly detailed tax returns delineating all of that. Yet, BIG has the unmitigated gall to tell us that (1) they can't determine the level of Medicare fraud and abuse, and (2) they find less that 0.2 percent of overall expenditures when they try, when the amount should be 50 times more.

But no worries. Many progressives are perfectly okay with all of this. After all, what's a few tens of billions when Bernie tells them that the "rich" will pay for it all?


Americans for Tax Reform notes that Obamacare is not immune to fraud and abuse. They write about a recent GOA report that indicates that "the government has made billions of dollars in Obamacare subsidy payments to individuals that may have been committing fraud." They write:
As the report notes, the system used by the Centers for Medicare and Medicaid Services (CMS) relies on data sent by three government agencies – the IRS, SSA, and DHS – to check eligibility for Obamacare. However, the system used by CMS is unable to verify many inconsistencies in the data.

This inability to properly verify enrollment has meant billions of dollars have been sent out to enrollees without verifying whether the applicants were fraudulent. As the report notes:
“According to GAO analysis of CMS data, about 431,000 applications from the 2014 enrollment period, with about $1.7 billion in associated subsidies for 2014, still had unresolved inconsistencies as of April 2015—several months after close of the coverage year.”
While CMS has information that could shed light on fraud, it has not developed any procedure to utilize it. As the report notes:
“CMS foregoes information that could suggest potential program issues or potential vulnerabilities to fraud, as well as information that might be useful for enhancing program management.”
These latest findings should not be surprising. Time and time again, watchdogs have sounded the alarm over Obamacare exchange verification and controls.
So ... Obamacare fraud is rampant, but Universal health care will be pristine. Yeah ... right.