Government

What if government ran your business … or your health care?

It is easy to find examples of inefficiency, fraud and waste in just about anything government does. I doubt many people will disagree. Here is a recent example. Medicare is another. In that case you can find GAO reports going back decades noting the flaws in its claim system and still fraud is rampant. 

Of course, the root cause of all that fraud is some citizens trying to cheat the system. That includes health care providers and indifferent patients. The very fact the money is coming from “government” creates a nobody gets hurt mentality in some people. The size of the bureaucracy and the transient nature of senior administrators doesn’t help either. Actually, on a daily basis hardly anybody cares. If you have a profit motive, if your job is at risk, you care. If you work for government burried in the bureaucracy, your caring is diluted at best. 

Decades ago I had a contract with HHS to write a small book on HMOs. I wrote the draft and submitted it. They had many comments. I met with them, noted the comments and reworked the book several times. I resubmitted the text and never heard a word from HHS ever again… but a couple of months later the payment arrived. I don’t think you got your money’s worth for that $10,000. 

All the endless examples, and yet many people remain convinced Medicare-for-all or a public option in Obamacare will save money. That’s like a student claiming his education was affordable … after he defaulted on loans or had them forgiven. 

And much of this is in the accounting as well. Claims by government, politicians and many on the left use a funny math logic. Have you heard Social Security is generating a surplus? Or, there are plenty of assets in the Trust? Do you recall that Medicare has very low administrative costs? Ever wonder why?

Last week the Health and Hu­man Ser­vices De­part­ment pub­lished an “alert” warn­ing that the im­proper pay­ment rate for Med­icaid in 2016 will likely hit 11.5%. That’s nearly dou­ble the 5.8% rate as re­cently as 2013, and HHS help­fully suggested tools that these joint state-fed­eral in­surance pro­grams sup­posedly for the poor could use to stop squan­der­ing more than one of 10 dol­lars they spend…

Im­proper pay­ments oc­cur as the re­sult of fraud, over­billing by doc­tors and es­pe­cially home health agen­cies, bu­reau­cratic er­ror and many other rea­sons, but also a lack of due diligence by HHS…

In re­cent au­dits of Med­icaid in Ari­zona, Flor­ida, Mi­chigan and New Jer­sey, the GAO un­cov­ered 50 dead people who re­couped at least $9.6 mil­lion in ben­e­fits af­ter they died; 47 providers who reg­is­tered for­eign ad­dresses as their lo­ca­tion of ser­vice in places such as Saudi Ara­bia; and $448 mil­lion be­stowed on 199,000 ben­e­fi­cia­ries with fake So­cial Se­cu­rity num­bers—12,500 of which had never been is­sued by the So­cial Se­cu­rity Ad­min­istra­tion.

Source: ObamaCare’s ‘Improper’ Failure, Wall Street Journal 9-7-16

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