Scrivener.net

Wednesday, August 06, 2008

Government-run health care in action 

How many times have you heard people who want nationalized health care say: "It will save money, because private insurers waste 15% of medical costs screening claims to keep people from receiving benefits."

But don't government-run health care programs have to screen claims too?

Apparently not!
New York is wasting tens of millions of dollars annually by paying the medical expenses of thousands of former residents who have long since moved out of state, an explosive new audit has found.

The scathing -- and still-secret -- audit determined that nearly 30,000 people in New York City alone were improperly on the state's Medicaid rolls from November 2006 to November 2007, even while they were enrolled in the Medicaid programs of other states...

...nearly 13,000 of the former city residents "should have been investigated" for violation of New York's Medicaid regulations, according to the audit ... but only 207 cases were investigated...

The audit concludes that investigations of out-of-state residents improperly receiving Medicaid, as well as efforts to recover the cost of their medical care, are virtually nonexistent ... "There are no efforts to recover inappropriate payments," it says.

"This is a totally devastating study which shows that there are no real meaningful controls on who is getting Medicaid," a state Health Department official said.

The official called the audit's findings "the tip of the iceberg" of Medicaid abuse...

New York's $45.4 billion Medicaid program serves more than 3.6 million people and is regularly described by top state officials as rife with fraud and lax management.... [NY Post]
It's not like all this massive waste in this Congressionally created national government-run health care program is news. It's been amply reported before from sea ...
Of $34 billion annually spent by the Medi-Cal program for health care for some 7 million poor Californians, state officials estimate that as much as 40 percent, or nearly $14 billion, is stolen in fraud.
to sea...
New York Medicaid fraud may reach into billions ... "It's like a honey pot," said John M. Meekins, a former senior Medicaid fraud prosecutor in Albany who said he grew increasingly disillusioned before he retired in 2003. "It truly is. That is what they use it for."...

James Mehmet, who retired in 2001 as chief state investigator of Medicaid fraud and abuse in New York City, said he and his colleagues believed that at least 10 percent of state Medicaid dollars were spent on fraudulent claims, while 20 or 30 percent more were siphoned off by what they termed abuse, meaning unnecessary spending that might not be criminal. "So we're talking about 40 percent of all claims ..."
In response to which, the responsible politicians and government officials have gotten right on the case fixing things ... um, right?

Politicians slashing claims-checking expense ... Yeah, that's the way to keep medical costs down!