At the the start of a new year, it’s traditional to hope for changes that would improve on last year. And yet, some very dysfunctional aspects of our lives are bound to stay the same, even deteriorate — and the same happens to be true of government.
Take Medicare and Medicaid, which make huge, outsized amounts of improper payments every year. The media repeatedly published stories about doctors and other health-care providers pocketing millions in taxpayers’ money in exchange for services rendered to fake patients in fake facilities — the Wall Street Journal had such a story a week ago about Medicare:
John and David Mkhitarian found a soft spot in Medicare’s defenses against fraud: Inspectors aren’t required to visit medical providers deemed to present a lower risk of fraud and abuse.
So the cousins used exchange students to create some 70 bogus laboratories, clinics and physician practices, then enrolled the companies in the program with the stolen identities of doctors, prosecutors assert. Medicare paid out $3.3 million over about two years.
That’s just $1.5 million in fraud out of the $47 billion in Medicare’s improper payments in FY 2011. Improper payments for Medicaid total roughly $20 billion. And yet almost nothing is done. Why?
It’s not all fraud, for one: Much of the waste comes from doctors’ billing Medicare for potentially unnecessary but lucrative procedures. Very little is done about that, as I’ve reported, and not just out of laziness. In many cases, members of Congress are actively blocking anti-fraud measures because health-care providers oppose them.