When Its Not Your Money
Stanley Feld M.D.,FACP,MACE
No one should be surprised at the money wasted by federal government programs. President Obama has been the biggest offender of wasting taxpayers’ money in my lifetime.
He increased the national debt from 10 trillion to 20 trillion dollars.
The volume of regulations, the creation of bureaucratic agencies, bureaucratic czars and the lack of enforcement of existing laws have served to create much of this waste.
However the public is unaware of the amount of taxpayers’ dollars spent because of the lack of government transparency. Congress ought to be standing on every mountain screaming about the waste.
I have observed the opposite. All we have to do is remember how congress marginalized Tom Coburn’s efforts to eliminate waste by eliminating duplication.
Obamacare is no exception to immeasurable waste while it destroys the healthcare system.
Improper payments for Obamacare are soaring because of a defective law and government inefficiency and incompetence.
A study by HHS shows that the improper payment rate for Medicaid will be 11.5% for 2016. It means that more than one out of every 10 dollars spent is wasted on either fraud, errors in payment or accounting inaccuracy.
The pre-Obamacare improper payment rate was 5.8% or one in 20 dollars spent. In 2015 it was reported that the improper payment rate was 9.7%.
This is the waste rate for only 10 million people added to the Medicaid roles.
I would suspect all three reports are an underestimate of the real improper payment rates.
The actual dollar amounts of improper payment rates are increasing because Obamacare has expanded Medicaid enrollment.
As the number of Medicaid recipients increase the wasted dollars will increase.
With President Obama’s new executive order to expand the eligibility of illegal immigrants for Medicaid coverage, the rate and amount of dollars improperly deployed will skyrocket.
To my amazement a lot of intelligent people are ignoring this simple arithmetic.
Medicaid eligibility is increasing rapidly. In 2015 Medicaid enrollment increased by 13.8%. One in five Americans as well as all illegal immigrants are entitled to Medicaid coverage.
I guessed that HHS would blame physicians for the waste. I was correct.
Medicaid reimbursement is so low that physicians have figured out ways to see more patients per day. They are using physician extenders extensively.
These physicians are accused of running Medicaid mills. They are accused of Medicaid fraud.
Then these physicians are put through a costly audit and are penalized. Many get fined for fraud and abuse due to overbilling.
There are many other reasons for this waste. Most important is HHS’ lack of proper diligence in administering the program. It smacks of reasons similar to the VA Healthcare System scandals.
“There’s no particular reason the error rate should be spiraling upward other than overwhelming incompetence.”
On closer look, home health agencies are probably the biggest abuser along with an ineffective bureaucracy that becomes more ineffective as the program grows.
“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.”
The problem is not discussed by the traditional mass media. The public has no idea this is occurring.
Medicaid is a single party payer system completely controlled by the government. Patients have no control over which doctors they will see for an illness.
Medicaid is another clear example of the lack of concern or incompetence by government agencies for spending other peoples’ money.
Even worse, the system does not work for patients or physicians. Patients are the most important stakeholders in the healthcare system. They are treated like a commodity.
Medicaid is inefficient and costly.
Twenty percent of our population is now in this system. There is limited access to care and rationing of care.
There is a better way. It is a consumer driven healthcare system using my ideal medical saving account.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
All Rights Reserved © 2006 – 2016 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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