Wisconsin Rep. Paul Ryan's Voucher plan, as a replacement for Medicare, could be compared to the so-called "siding salesman" who comes along with some sort of scheme to change the appearance of your house to mansion like proportions and when you question him about the cost he says "Trust me - you'll love it!" Accordingly, backers of Ryan's plan are saying "This voucher system should unleash a wave of competition that wrings waste out of the health care system and delivers quality care at affordable prices." Really?
Medicare billings are subject to review in accordance to pre-determined costs which limit medical billings to predictable amounts; however, the "voucher system" merely provides a fixed amount of funds so participants can buy insurance off the open market - or instead, select a federal plan modeled on Medicare (whatever that means). So how does that "wave of competition" hold down medical costs? And who prevents hospitals and medical providers from charging outrageous fees which the insurance carrier will not pay thus rendering you on a path to ruin? Or what happens if health insurance costs grow faster than the amount the government provides? "Trust me . . . you'll love it!"
On the other hand, President Barack Obama promised that his national health care plan would actually reduce medical costs because he was going to eliminate the $-billions being spent on Medicare fraud.
Referring to an Associated Press article (Oct.17, 2011) by Elli Kennedy who points out that Medicare fraud is estimated at between $60 billion to $90 billion per year. "Medicare fraud," according to Kennedy, "has grown so lucrative and so easy that drug dealers and organized crime rings are tapping into it . . . because it affords greater payoffs and carries shorter prison sentences than drug trafficking or robbery."
Current enforcement, under a 1996 program, allows Medicare to hire separate sets of contractors to seek out fraudulent claims. This has become known as the "pay and chase" method and is alleged to be a boon for criminals, allowing them weeks of lag time to bill for fraudulent claims, receive payment and skip town before authorities catch on. It turns out the fraud unit is also broken down into "Contractor A" who inspects the provider place of business and "Contractor B" who ultimately decides whether to revoke a Medicare license. Sometimes one subcontractor, without first-hand knowledge of the case or the necessary medical expertise will overturn a suspension made by the other contractor who had direct evidence of fraud. Here, once again, is the guiding principle that the right hand does not know what the left hand is doing.
A revocation does not necessarily lead to a criminal investigation - that's also a separate process. If a provider appeals a revocation, this leads to an independent third party or hearing officer who makes another ruling. If the provider disagrees with that decision, the appeal can be kicked up to an administrative law judge. According to this article, it's at this point that truly fraudulent providers tend to walk away - they often simply obtain a new license under an associate's name and keep right on operating. But even if the appeal goes forward, Medicare does not send lawyers to defend the revocation decision so the judge hears a one-sided story thus guaranteeing a government loss. In the event of an actual indictment, Federal Authorities seize assets, but what's left is usually only a fraction of what was taken.
Gee Mr. President, since the Attorney General's Office comes under your authority, and since you promised to put an end to Medicare fraud, why are these crooks not being prosecuted under the direction of Federal Authorities instead of private contractors? Meantime, Congressman Ryan's "Trust me - you'll love it" Federal voucher plan sits in the wings as an alternative to medicare.
It was Will Rogers who said, "I don't make jokes. I just watch the government and report the facts."