Crooks Grow Fat on Government Health Care Programs
A Brooklyn dentist billed New York State Medicaid for treating 991 patients in one day. New York State paid maternity claims for 150 men! These are just two of the egregious examples of the pervasive fraud that plagues the Medicaid program, according to a new book edited by the Center for Health Transformation’s Jim Frogue.
Yes there is tremendous fraud out there and it certainly needs to be squashed everywhere it occurs and the perpetrators prosecuted and sent to jail.
That includes that guy that started the “conservatives for patient rights”. That man admitted that he charged the government for MAJOR medical practice when the actual medical treatment was minor. He should be thrown in jail as well. Insurance geeks that have overcharged the government for treating medicaid/medicare patients should be thrown in jail. In fact every insurance person that isworking now and has worked scince 1997 should be thrown in jail because they are breaking the law everytime they drop coverage on a person because that person gets ill. Fraud occurs mostly where there is more profit to be made—— INSURANCE!
Brian,
The post is about Medicaid. Medicaid is not health insurance. If it were, there would probably be far less fraud.
Brian, get a life. We are talking about real crimes here. Not imaginary crimes.
New York State has the worst Medicaid system in the nation. Its Medicaid budget is around $50 billion — half of which comes from the federal government. When I wrote about New York State Medicaid several years ago, counties were not allowed to investigate or prosecute suspected cases of fraud. And Albany had little incentive to do so because every dollar saved was 50 cents less in federal funds coming into the state. Also, Medicaid providers are politically powerful. Allowing Medicaid abuse was a way to favor constituents at a 50% discount.
These are not imaginary crimes. If it is true, (according to John Goodman), that droppping coverage because someone becomes ill is a crime scince 1997, then insurance has perpetrated 12 years of criminal activity.
Also when a person admits that they charged for a major medical practise when treating minor issues—- that is fraud. That is also not an imaginary crime but a real crime. Just because you refuse to admit that insurance does break the law frequently doesn’t mean that it doesn’t ahppen. It does mean that insurance has paid enough money to ensure that the legislators turn a blind eye. You are always hearing of the fraud and medical abuses by medicare/medicaid but suggest even once that insurance does not practice fraud is rediculous. It shows a clear bias and unwillingness to view trhe reality of the situation.
Insurance has stopped any reforms in the past and they are spending customer premiums on more lobbying (bribery) when those premiums should actually go for medical coverage as contracted.
It is jusrt yet another example of the power of insurance over the lives of American citizens and also the power of insurance over government. Next time you need to see your doctor you might as well book that appointment with your insurance agent, have those agents prescxribe medicines and order medical treatment. That is the main reason I wouldn’t sign that petition, (which I think is a great idea in general), but scince the petition only targets government interferance and ignores the status quo of insurance interferance, I cannot sign it. To sign that petition doesn’t “free our healthcare because healthcare isn’t “free” now. Insurance has it hands in every aspect of healthcare and decisions are NOT patient-doctor oriented but is oriented to what insurance allows.
I am not the one with my head in the sand, I am fully aware and able to admit the reality of insurance interferance. If the petition had insisted that in addition to freedom from government interferance, we could also be free from insurance interferance, the signatures would be at least double what they are now.
I may not know much of economic terminology but I do know that book-learning and big terms, (requireing a college master’s degree to understand, often doesn’t translate to real world application.
But then again I also know that I am fighting a losing battle and am probably getting worked up for nothing scince I am already assured that nothing effective will get done. I have lived for over 22 years without insurance and I admit that thoughmy life is incredibly tough, I have managed (against the odds), to stay alive. That won’t chnage for me…. I will continue to get by and if I get sick I will revert to the operating mode that has seen me through.
1) Unless I have a fever of 103 or higher for more than 3 days—- then I get medical attention.
2) As an HIV+ person I have appetite issues but not until I haven’t eaten a bite in 10 days, will I seek medical assistance
3) Unless I have bloody diarrhea for over 7 days I will not seek medical attention
4) Unless I drop more than 40 pounds in a month will I seek medical attention.
5) If I get a perscription for anti-biotics I will take about 2 days of the 10 day regimen and save the rest for a later day.
6) As for HIV meds, (which runs about $25,000 a year for one drug— and I usually take 3 drugs= $75,000 a year), I go without uintil my t-cell count gets below 50 T cells. Then I will get in contact with other HIV people and get some of their meds and take themfor about 10 days or so then I will have no choice but to stop.
7) Bush consistently reduced funding for the Ryan White bill that provides services for the HIV infected that have no medical resources. No eye exams (CMV retinitus will kill you but those screens are out of the question), no phyciatric support, no dental support, and no more food for the indegent.
So I do happen to know what I am talking about, maybe not in economic double-talk but certainly with plain english and I have been on the recieving end of the so-called compassion of conservbative4sd who would rather I hurry up and die and get out of their hair. ( I too wish that I had already died instead of having to fight for everything that others enjoy and take for granted. I happen to know just how insecure insurance is. Not just for me but for the MILLIONS of HIV sufferers.
These are not tirades or rants but based in asctualy REAL experience which accounts to nothing as gfar as conservatives are concerned. Healthcare reform just isn’t that important according to conservatives. They have their health insurance guaranteed for life. They don’t have to pay a dime for that insurance—- we do.
I may be a lot of things but irrational isn’t one of them.I will take first-hand knowledge and give it MORE value than some insurance or government issued report. I can easily tell that what looks good on paper hardly ever works in practise. Why? Because people are not cut and dry. People are more than just words on a peice of paper.
Just because I am willing to see that most proposals made by republicans look great on paper and that on paper these proposals certainly would lower costs for buisness, and through saviongs tobuisness, that those savings would be passed to the consumer. BUT reality intervenes and history shows that the idea of “trickle down” NEVDER works. Insurance will not pass savings to consumers either through reduced premiums or expanded coverage. History shows the opposite. That insurance, (or most every buisness), pass costs to consumers but pocket savings for themselves. That IS reality and reality trumps any peice of paper every time.
I do have a life, BTW, and it is a full life because I, better than most, have to live every day as if it is my last day. That is commonplace when you are given a terminal diagnosis. (HIV IS a terminal condition with 100% mortality rate).
Just talkto a child with cancer and you’ll find that “child” to be more mature than healthy adults. The little things aren’t important but healthcare reform is hardly a little thing. Not just for me but for the MILLIONS of people with terminal illness who have either been turned away from insurance or more often those who have been dropped by thier insurance company.
But then again real life experience counts for nothing and should never eneter into discussion concerning healthcare beacuse what possible bearing could real experience have? For conservatives—- real experience counts for nothing.
It isn’t my fault that conservatives have thir heads in the sand. BUT let one of these people contract HIV through whatever method, and they will swiftly find out that real experience carries more weight than any peice ofpaper and any amount of statistical evidence which is by its very definition un-realistic.
These are the rules by which I MUST live. If I have a prescription for anti-biotics
Sorry about your condition Brian, but John Goodman is the author of Patient Power, a one of its kind book that promoted allowing doctors to be unfettered agents of their patients 15 years ago. Have no idea why you are so down on “conservatives.” Most of the signers of the petition believe as Goodman believes.
By contrast, most liberals believe in letting government ration your health care.
Healthcare is already rationed for profits by insurance. Its not like rationing would start happening only because of government, (as portrayed by conservatives).
Its not like choices would be suddenly be altered negativly under government control. In fact common sense will tell you that if you can go anywhere (hospital), and see any doctor of your choosing (rather than the “approved doctor only” that is insurance NOW), that your choices INCREASE. Not decrease as conservatives claim.
Its not like new technology would suffer under a government plan, (we already pay the tab for MOST R&D by grants). That won’t change although conservatives try to tell you that it will.
Its not like people will start dropping like flies while waiting for transplants, (50% of people 60+ die while waiting for kidney transplant under the present system). People already wait an average of 12-15 hrs in the ER and people do die while they are waiting for treatment. BUT conservatives don’t want us to know all that because it gives them the lie.
Pre-existing conditions? Conservatives claim that we will be covered but that’s not true either. We would be accepted for insurance but certainly NOT covered.
The reason I am so “down” on conservatives is because of the lies they tell, the in-difference they have shown about reform, the terrorizing and demonizing of the sick and the elderly, and the complete refusal to look at the reality of the situation and plan accordingly.
Patient power? Great but a complete myth under private insurance. You don’t get to choose your doctor, hospital or treatments…. those choices are dictated to you by insurance.
Medicare has a higher satisfaction record than does private insurance. Medicaid has a higher satisfaction rating than does private insurance.
AND for all the private insurance what do we have to show for it? The third lowest life-expectancy, the third lowest approval rating, and one of the highest un-insured levels in the entire world. We get a system that while great tech-wise, is only great if you can afford it. America is 37th in healthcare world-wide. That is what we get under private insurance.
The saying that “the devil you know is better than the devil you don’t”— describes the approach of conservatives. They would rather try to nickel and dime reform. Bit by bit. Law by law, thus INCREASING the complexity of the situation. Any change can be scary, admittedly, but it is MORE terrifying to sit back and do nothing substantive. It is more terrifying to trust politicians that have shown time and again they don’t care, that we the people (who they supposedly work for), aren’t worth the time nor the trouble and we certainly aren’t worth rocking the insurance boat.
you’re forgetting the difference between voluntary contracts and government coercion Brian.
A few points to mention
Your choices will decrease because the amount of care that can be afforded by the collective will be reduced per patient, so you can’t afford certain doctors, treatments.
Insurance companies do something similiar because it’s based on the same premise — collectivized financing.
as for competition, yes government plans will eventually compete with private insurance in the same way public schools compete with private schools.
Jack-
You are talking about coercion as if it only exists under a government program but that is a false belief. While it is understandable that government,be3cause of its size and available resources can lead to coercion, insurance also is coersive. Insurance says—“Either you do what we say, pay what we tell you to pay, go where we tell you to go, take what medications we tell you to take, or you go without insurance.
Now when the reality of being un-insured is accepted, no-one in their right minds would choose to go without insurance unless you are ultra-rich and can afford to pay all expenses out of pocket. If I were earning 500k a year I could afford to pay the 5 or 10 thousand for a hospital stay. BUT the majority of Americans are not uber-rich, the majority of America CANNOT afford a cash for healthcare existance.
As for contracts, when has it ever been legal for buisness to take your money for services and then refuse those services? That is the way that insurance works right now. People pay a premium and through theircontract expect certain coverage. Insurance can and does change the terms of the contract unilaterally and again you have a choice either accept it or do without. Insurance will take premiums for years and as soon as you become a drain on profits, you are dropped and blacklisted. That is the coercion of insurance now.
We hear about doctors who refuse to see patients that are cash patients or are medicare/medicaid, oftenb that is because they are warned by insurance that taking these patients will result in the doctor’s elimination from the insurance program. Doctors are NOT free under insurance and patients are NOT free under insurance, you do what you are told or else. Can’t make it any plainer than that. That is the essence of coercion and blackmail.
sure if the business abuses their contracts they should be held accountable for it. that is the proper role of government. But you have to look deeper
Like Moataz said we have collectivizied financing whether it be the insurance model or the government “public option” which is being touted as an alternative when it really is more of the same.
the situation for doctors today is mixed, but already pretty bad. All the “public option” means is that doctors/patients will answer to bureaucratic thugs. There is no freedom but more coercion this time under a different entity.
More importantly I don’t believe nor agree that we have rationing in the current health care system. On the contrary we have entitlements like Medicare today We effectively do not ration at all. A look at the GDP tells the story.
over and out
Wellyou can believe that we don’t ration, contrary to ALL evidence, that is your right.
However rationing does exist. When facing a transplant issue, there is rationing based on age, race, prior health and above all whether you are insured or not. Patients with private insurance are often abused by PROLONGED and un-needed hospitalization. The Un-insured are most likely to be booted out as soon as possible. In the ER, there is a rating system determining the order of being seen with the un-insured at the very bottom. True that emergencies always takes precedence but if there is an un-insured in the waiting room for a couple of hours and an INSURED patient comes in, that insured patient will be attended to first regardless of the severity of the illness.
Doctor’s are regularly told who the can and cannot see in their buisnesses, turn away cash patients or patients on medicare/medicaid, (more often to those on medicaid than on medicare), that is rationing. Rationing is a fact of the healthcare delivery system right now. Everytime the insurance company cuts service due to illness that is to minimize loss and therefor care is “rationed” based on profits.
You have a right to your belief but I would rather pay attention to the reality of the situation, because the first step in any EFFECTIVE reform, is to understand the reality of a problem and not the idea of the problem.
That’s why I keep saying that if the Republicans came up with a reform that stood a 10% chance of really working I would be on board. Unfortunatly evry proposal benefits only buisness.
It makes sense that if the cost of doing buisness goes down then everyone benefits, that everyone’s costs go down. That is the idea and it would seem to be correct.
The reality is that healthcare is not driven by what SHOULD happen, or the RIGHT thing happening, Healthcare is about profit. Any reduction in their cost of buisness will be profit. The consumer will not benefit. We’ll just continue to pay the same high premiums and services will still be determined on profit considerations.
Sorry but reality show quite clearly that there is rationing. It shows that the disconnect is not just in the Democratic party or liberals, Republicans ALSO don’t have a clue. I would rather do something based on the facts and not do something based upon how it looks on paper.