Posted on 11/01/2009 5:53:50 AM PST by navysealdad
As 60 Minutes reported last week, Medicare fraud is rampant and has now replaced the cocaine (ahem) business as the major criminal activity in South Florida. Both 60 Minutes and the Washington Post report that Medicare fraud now costs American taxpayers roughly $60 billion a year. That may sound like a lot of money, but surely it pales next to the extraordinary profits of private insurance companies, right?
Well, let's see.... Last year, the profits of the ten largest insurance companies in America were just over $8 billion -- combined. No single insurance company made even five percent of what Medicare reportedly loses in fraud.
(Excerpt) Read more at weeklystandard.com ...
I post at a number of left wing blogs and I was amazed few of them either had watched this, heard of this, or admitted that fraud is a huge issue with Medicare.
I contacted both my Senators and my Rep in Congress staffers and none of them had heard this report.
Our left wing media at work; Stephoupolis, Gibson, and the other “news” anchors never even brought it up.
Abt 15 years ago, I watched a Congressman on one of the network news program. He was being asked about SS/Medicare fraud and why the Govt didn’t do more to combat it.
His response: It would cost more to combat the fraud than the actual amount of the fraud is.
[Hey, Congressman, that’s OUR money! But, that is governmenthink.]
So -essentially, government fraud in the health care system is nearly 10 times the annual profit of the insurance industry... nice.
There is no evidence that government has ever succeeded in getting rid of waste, fraud or abuse -- and plenty of evidence that government doesn't even try.
When Obama makes claims like that, he ought to be laughed off stage. Hey! Why don't you get rid of the waste, fraud, and abuse NOW. Then, in a few years, after achieving astounding success, why don't you come back and try to sell us on the idea of healthcare reform? It's a "Step 1, Step 2" concept -- and I want to see Step 1 completed before I contemplate Step 2.
“It would cost more to combat the fraud...”
I don’t get it, really, I mean...isn’t half the ‘homework’ done if they’ve done enough to determine how much it’s costing?
That is because profit oriented insurance companies have a vested interest in fighting fraud, whereas the govt. spends next to nothing to combat it. The government has no motive.....it ain’t their money being squandered. It’s OURS!
This is all very important stuff, but let me tell you about the MISTAKES that the GOVERNMENT makes, all the time, in Medicare:
1.) Medicare Part “B” late enrollment penalties. There is a penalty of 10% of the base, Part B Premium, for every year that a qualified beneficiary does not sign up for Part “B” of Medicare. This Penalty is WAIVED for those who have group insurance, through an employer or spousal coverage. The government ROUTINELY charges Medicare beneficiaries who do NOT owe this “penalty” -— primarily due to incompetence on the part of the officials who sign people up for Medicare.
2.) Part “D” Prescription Drug coverage has a penalty for late enrollment, as well. That penalty is 1% of the base, average premium, for every month the beneficiary did not have Part “D” or “credible coverage” with a group health insurance plan. Those who retire at age 66 or later ROUTINELY have to fight this penalty, even if they never went a day without Prescription Drug coverage.
3.) Your government at work: I have had clients receive letters, from the government, which denied a medical claim due to Medicare being “secondary” and not “primary” -— This means that the government thought a group plan was STILL in force for this person. -— IN THE SAME WEEK, this client ALSO received a letter from CMS, the Center for Medicare and Medicaid Services, saying that this client would have to pay a PENALTY on Part D, due to A LAPSE IN DRUG COVERAGE!
Get it? The Left hand of government slaps them for having group insurance, though it does not exist anymore, while the Right hand of government slaps them for never having the group insurance that a previous letter, from the government, CLEARLY documented that they HAD! This person never missed a day of health coverage, never went “uninsured” but had to spend a couple of hours on the phone, with my help, to clear this up. THIS HAPPENS ALL THE TIME!!
Yes, I am a health insurance agent.
Pray for me!
That’s why Washington pushes “comprehensive” everything. So they can “get what they want”, while patting the little people on the head with something else. Reference: “comprehensive immigration reform” rather than close the border, cut off the money and come back to us in 5 years.....
hh
RE: Part D penalty.
Once it is applied, the penalty continues as long as the recipient lives, even if the recipient later enrols in an approved drug program.
Medicare benefits are disbursed by private insurance carriers, under government contracts.
Contracted Insurance carriers have no pressure to monitor income vs. outcome. It’s not their money, their policy holders’ or investors’ money - it is just *tax payers’* money.
The fraud or accounting mishaps are perpetrated by careless claims payment, gimmee patients, over-worked physicians, hospital ER burdens, scooter vendors and drug companies in the form of overly cautious testing and over-billing. Plus, Government bureaucracy & oversight is pathetic or non-existant.
The government lies about the profits of insurance companies in order to demonize them and turn the American people against them so they can ram their public government run option down the throats of the American people. The profits being made by the insurance companies are in line and far below the profits made by companies in many other industries.
Interesting. This just happened to my mom. She has a supplemental policy along with medicare.
Bureaucrats are only concerned about shoveling money out the door
They really could give a flip about fraud and they are not paid too
Not enough are assigned to fraud investigations because the Feds treat our tax money like a joke. Like Monopoly money
Most Federal bureaucrats are Democrats who don't care
Time are great in the DC area
Housing prices are stable or rising
It's a party for the Congressman and Senators in DC
Life is great for them
Federal workers in DC are very well compensated
No recession
Their attitude is "The rest of the USA can go hang itself"
How does an individual defraud medicare? I can see doctors, health care providers and insurance companies being able to but how does the patient do it?
excellent - my thoughts exactly.
and you would think that some journalist somewhere at some point would ask that question... NOT
I expect those people are in the process of getting a very real lesson in what it is that makes a country able to stay safe and sound.
These numbers are eye-opening. I wonder, though, how much insurance fraud is there committed against the top ten companies. The fraud numbers make a case for patients paying there own bills, at least for routine office visits. Why can we no longer get hospitalization insurance that covers only the big bills?
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