Sunday, October 25, 2009
Medicare As An Example For Public Option
Amazingly, some supporters of the public health insurance option are pointing to Medicare as support to back up their position. While there might be some arguments for a public option, the use of Medicare as an example makes as much sense as using Octomom or the Gosselins as examples of good parenting. It's bad enough that Medicare is on track to go bankrupt due to its unfunded obligations. However tonight's 60 Minutes show contained an horrifying segment on Medicare fraud that even shocked me. I know how doctors game Medicare to supplement their reimbursements, and I've heard about clinics "hiring" homeless people for the purpose of performing unnecessary medical procedures and getting fat Medicare reimbursements. What I was unaware of is how Medicare pays scam artists billions of dollars for phony claims for medical products. These payments are made to "providers" of medical equipment and prescription drugs, who often set up shop it what turns out to be empty storefronts. All they need is the name, address, birth date and social security number of a patient (available for purchase for $10 per name), and they are free to submit claims for the cost of wheelchairs, artificial limbs, prescription drugs, etc., with reimbursement guaranteed within 15 to 30 days. Yes, there are after the fact audits, but by that time the scam artist has folded up his tent and opened a new one. One such scam artist interviewed said he had received $20 million in reimbursements from Medicare. A pharmacy was routinely reimbursed for an amount of prescription claims equal to six times the volume of the largest Walgreen's in Florida. Patients who receive these "benefits" do see them show up on their Social Security statements. Some even report these items to Medicare, but these receive little if any follow up. This is such easy money that street criminals have migrated to Medicare fraud. Sadly, this is just another example of government inefficiency. Politicians are always talking about weeding out government waste and inefficiency, about cutting the fat and preserving the meat. The trouble is that by its nature, government is incapable of operating efficiently. Government has no shareholders to watch the bottom line. If they're lucky, there may be watchdogs to reduce some of the waste. But that's the best one can hope for.