Tag: Medicare

GAO’s 159th Report on Medicare/Medicaid Fraud Finds Anti-Fraud Measures ‘Inadequate’

Today, the Government Accountability Office will release a new report on fraud in Medicare and Medicaid.  By my count, it is the 159th report the GAO has issued on fraud in these programs since 1986.  According to the Associated Press:

The federal government’s systems for analyzing Medicare and Medicaid data for possible fraud are inadequate and underused, making it more difficult to detect the billions of dollars in fraudulent claims paid out each year, according to a report released Tuesday.

The Government Accountability Office report said the systems don’t even include Medicaid data. Furthermore, 639 analysts were supposed to have been trained to use the system - yet only 41 have been so far, it said.

The Centers for Medicare and Medicaid Services - which administer the taxpayer-funded health care programs for the elderly, poor and disabled - lacks plans to finish the systems projected to save $21 billion. The technology is crucial to making a dent in the $60 billion to $90 billion in fraudulent claims paid out each year.

In this article for National Review, I explain that there are reasons why those tools are, and will remain, “inadequate and underused.”

Even the New York Times Wants to Cut Medicaid

From their editorial the other day:

There is no doubt that Medicaid… has to be cut substantially in future decades to help curb federal deficits. For cash-strapped states, program cuts may be necessary right now. But in reducing spending, government needs to ensure any changes will not cause undue harm to millions.

How would the Times cut Medicaid spending? The magic of central planning!

The best route to savings — already embodied in the reform law — is to make the health care system more efficient over all so that costs are reduced for Medicaid, Medicare and private insurers as well. Various pilot programs to reduce costs might be speeded up….

And if government were smart, rather than stupid, that would work.

I’ve got a better idea for cutting Medicaid that meets the Times’s criterion of not causing undue harm to millions.

Ryan Plan Would Reduce Medicare & Medicaid Fraud

That’s the theme of my article in the current issue of National Review:

The budget blueprint crafted by Paul Ryan, passed by the House of Representatives, and voted down by the Senate would essentially give Medicare enrollees a voucher to purchase private coverage, and would change the federal government’s contribution to each state’s Medicaid program from an unlimited “matching” grant to a fixed “block” grant. These reforms deserve to come back from defeat, because the only alternatives for saving Medicare or Medicaid would either dramatically raise tax rates or have the government ration care to the elderly and disabled. What may be less widely appreciated, however, is that the Ryan proposal is our only hope of reducing the crushing levels of fraud in Medicare and Medicaid.

The three most salient characteristics of Medicare and Medicaid fraud are: It’s brazen, it’s ubiquitous, and it’s other people’s money, so nobody cares…

The full article is now available at the Cato website.

Block-Granting Medicaid Is a Long-Overdue Way of Restoring Federalism and Promoting Good Fiscal Policy

This new video, based in large part on the good work of Michael Cannon, explains why Medicaid should be shifted to the states. As I note in the title of this post, it’s good federalism policy and good fiscal policy. But the video also explains that Medicaid reform is good health policy since it creates an opportunity to deal with the third-party payer problem.

One of the key observations of the video is that Medicaid block grants would replicate the success of welfare reform. Getting rid of the federal welfare entitlement in the 1990s and shifting the program to the states was a very successful policy, saving billions of dollars for taxpayers and significantly reducing poverty. There is every reason to think ending the Medicaid entitlement will have similar positive results.

Medicaid block grants were included in Congressman Ryan’s budget, so this reform is definitely part of the current fiscal debate. Unfortunately, the Senate apparently is not going to produce any budget, and the White House also has expressed opposition. On the left, reducing dependency is sometimes seen as a bad thing, even though poor people are the biggest victims of big government.

It’s wroth noting that Medicaid reform and Medicare reform often are lumped together, but they are separate policies. Instead of block grants, Medicare reform is based on something akin to vouchers, sort of like the health system available for Members of Congress. This video from last month explains the details.

In closing, I suppose it would be worth mentioning that there are two alternatives to Medicaid and Medicare reform. The first alternative is to do nothing and allow America to become another Greece. The second alternative is to impose bureaucratic restrictions on access to health care—what is colloquially known as the death panel approach. Neither option seems terribly attractive compared to the pro-market reforms discussed above.

Here We Go Again: ObamaCare’s Preventive-Care Subsidies Aren’t ‘Free’

In press release, a new video, and an elusive new report, the Obama administration is boasting about the “free” preventive services that ObamaCare provides to Medicare enrollees.

Here we go again.

First, these preventive-care subsidies are not “free.” They are costing taxpayers dearly by adding to America’s $14 trillion national debt.  There is no such thing as a free lunch.  And there is nothing “free” about ObamaCare.

Second, ObamaCare supporters have claimed that more preventive care would reduce health care spending, but research shows that it will not.

Third, I hope someone is keeping track of all the taxpayer dollars this administration has wasted trying to convince the American people that they’re wrong to dislike ObamaCare.

Finally, if the $250 checks that ObamaCare sent to millions of Medicare enrollees didn’t make this law popular among seniors, I doubt these indirect subsidies will.

ACO Debacle Exposes Obamacare’s Fatal Conceit

That’s the title of my latest Kaiser Health News column. Excerpts:

Obamacare’s number-one idea for improving health care quality and reducing costs is to promote something called “accountable care organizations” in Medicare. That effort is sinking like a stone, because it – like the rest of this sweeping law – is premised on the fatal conceit that government experts can direct the market better than millions of consumers making their own decisions…

The only way to improve quality while reducing costs is to give patients the incentive and the power to say “no” to inefficient providers. The Medicare reforms that passed the House don’t go as far as they should, but they are a good start.

For one thing, they would do a better job of promoting [accountable care organizations]. The House reforms build on Medicare Advantage, which already gives one fifth of Medicare enrollees the freedom to choose their own health plan.  Kaiser Permanente CEO George Halvorson says the new law’s ACO program “is not as good as” Medicare Advantage when it comes to promoting accountable care.

And he should know something about that.

That’s Not Healthy: Poverty Is a Salve for ObamaCare’s Individual Mandate?

Some tidbits from the health care policy world:

  • Philip Klein is perhaps too kind to the Obama administration’s latest defense of ObamaCare in “Obama solicitor general: If you don’t like mandate, earn less money.”
  • The Obama administration launches a hospital payment reform effort that, rather than promote high-quality, low-cost medical care, will demonstrate once again why Medicare is incapable of such.
  • The physicians lobby, having thrown its support behind ObamaCare with the expectation that Congress would jack up Medicare’s physician price controls, is still begging Congress to do so.
  • The Obama administration launches a lame effort to reduce medical errors in Medicaid, decades after markets devised far more powerful deterrents.