Friday, February 12, 2010

Gingrich & Goodman Idea #9: "Stop Health-Care Fraud"


I guess it's hard to come up with a list of "10 GOP ideas", which I suppose John C. Goodman and Newt Gingrich include non-GOP ideas, ideas at odds with actual GOP ideas, and even Democratic Party ideas in their list. As with "making health insurance affordable", it's rather silly for either party to try to lay claim to fighting fraud.
Every year up to $120 billion is stolen by criminals who defraud public programs like Medicare and Medicaid, according to the National Health Care Anti-Fraud Association. We can help prevent this by using responsible approaches such as enhanced coordination of benefits, third-party liability verification, and electronic payment.
Were the GOP to propose legislation with a serious likelihood of combating fraud, I think it would pass by overwhelming support from both parties. But... this isn't actually a GOP priority and they have proposed no such bill.

Who is making a crack-down on fraud a priority? Well, it's not Newt Gingrich:
"The Obama administration is committed to turning up the heat on Medicare fraud and employing all the weapons in the federal government's arsenal to target those who are defrauding the American taxpayer," HHS Secretary Kathleen Sebelius said during a news conference at the Justice Department with Attorney General Eric Holder.

"But our joint efforts don't just stop at the jailhouse door," she said. "Every dollar we can save by stopping fraud can be used to strengthen the long-term fiscal health of Medicare, bring down costs and deliver better service to Medicare beneficiaries."

The government's job will be anything but easy.

During the past five years, thousands of Medicare fraud offenders have shown that they can outsmart the vulnerable healthcare system for the elderly and disabled. Their weapons: cash kickbacks to Medicare patients, manipulation of medical records to justify bogus charges, and use of different billing codes to get around Medicare's technology to block false claims.
Maybe Gingrich missed the speech?
The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies -- subsidies that do everything to pad their profits but don't improve the care of seniors. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.
Without wanting to diminish the importance of empowering patients, it should be noted that if you restructure Medicare's payment system such that each doctor can "renegotiate and reprice their services" with each individual patient, as Gingrich and Goodman propose, you're significantly increasing the opportunity for fraud.

I'll give Gingrich and Goodman credit for having the President's back on this issue, but I'm surprised they don't know that President Obama is a Democrat.

(Return to Parent Article.)

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