Other Democrats, such as former Vice President Joe Biden, would allow private insurers to continue in business, but would set up a single-payer “public option” as an alternative.
Americans have debated the merits and demerits of Medicare and its Medicaid subsidiary since 1965, but one thing has been clear for decades: Waste, fraud, and inefficiency are hallmarks of government-run medical care.
- Two Connecticut Physicians Pay Over $4.9 Million to Settle False Claims Acts Allegations.
- Sanofi Agrees to Pay $11.85 Million to Resolve Allegations it Paid Medicare Kickbacks Through a Co-Pay Assistance Foundation
- Physician Charged for Alleged Role in $120 Million Health Care Fraud and Money Laundering Conspiracy
- Five Defendants Sentenced in South Florida to Prison Terms for Their Roles in Tricare and Medicare Fraud Scheme
- New York Made Unallowable Payments Totaling More Than $10 Million for Managed Care
Since its inception, the MFTF has filed 2,829 indictments and generated nearly $3.5 billion in “investigative receivables,” that is, fines, repayments, and restitutions.
And the Medicare crime wave goes on.
Asked March 4 by The Epoch Times about the endemic corruption in the program, he pointed to three factors:
“First, Medicare (and Medicaid to a lesser extent) is the largest payer in the American health care system. So it is a natural target of the criminal element.
“Second, the Medicare payment system, governed by thousands of pages of rules and regulations, is enormously complex and is thus equally difficult to comply with on the part of practitioners and to police on the part of Medicare officials.
“This byzantine system provides the perfect paperwork jungle cover for bad actors, and also ensnares honest practitioners in clerical errors and mistakes. Much of Medicare’s waste is not fraud, but improper Medicare payments to practitioners and medical institutions.
“Third, because the Medicare system is basically a claims-paying, or government check-writing operation, those writing the checks are not directly impacted financially from either improper payment or their failure to effectively police waste, fraud, or abuse.”
On the latter factor, Moffit added that “in that case, Medicare is exactly unlike a private health insurance company where there is a powerful economic incentive to police the system and to monitor claims, for administrative failure directly impacts the company’s bottom line.”
Overall, Moffit characterized Medicare’s corruption and inefficiency problems as “a failure of administration, and this failure of administration incurs an administrative cost, though government officials never categorize the tens of billions of dollars lost annually through waste, fraud, and abuse as an administrative cost, and it doesn’t show up on the Medicare books as an administrative cost. But it is.”
“Physicians, hospitals, labs, and other service providers would have to be approved and payment rates set. The government would need verification that approved services were actually provided, and there would need to be an even greater need for safeguards against fraud and abuse.”