Major Medicare Fraud Bust Just the Latest Lesson in Problematic Healthcare Spending

May 4, 2012
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Medicare (and Medicaid) fraud seems to be not only occurring with ubiquity, but also appears as a persistent scourge on government spending. It is also the elephant in the room in this entire discussion on healthcare reform. Its absense from the national discourse may say more about the candidates than it does about the problem itself.

Medicare (and Medicaid) fraud seems to be not only occurring with ubiquity, but also appears as a persistent scourge on government spending. It is also the elephant in the room in this entire discussion on healthcare reform. Its absense from the national discourse may say more about the candidates than it does about the problem itself. When the story broke this week on the massive FBI sweep of at least 7 cities across the country involving a price tag of almost half a billion dollars to taxpayers, it was just the latest ho-hum moment in the ongoing saga as to how its spending should be regulated.

Discussions on healthcare reform on the campaign trail from both sides have attempted to address this issue without being entirely “complacent” about its mere existence as somewhat of an afterthought. There could be many reasons for this: in a world of pithy soundbites, Medicare policy is about as interesting as watching grass grow; voters tend to pay attention to healthcare expenses as a personal out-of-pocket issue — subconsciously (or, perhaps consciously) showing little regard to services that are covered unless they have to pay for it; and, perhaps most important, both voters and politicans see this as a necessary evil to be tolerated within the entire scope of heatlhcare delivery.

It is certainly prematurely rosy to think that with each large scale bust on a fraudulent Medicare scheme there will be some major atonement on the provider side that will make the problem more amenable to any perfunctory government intervention; in fact, the potential for fraud could be greater under reform — as more diverse mechanisms for billing and payment will exist in the brave new marketplace of guaranteed coverage in 2014. I do take some solace, however, in the fact that the very public debate on healthcare spending on this country as a perennial election boilerplate is here to stay and is constantly informing the electorate. Perhaps this “knowledge is power” aesthetic will rub off on candidates and lawmakers alike an place a dent into this very serious problem and its constant effect on government spending of healthcare delivery, while reserving equal importance for its sorely needed public discussion.

 

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