Medicare Fraud is only a Prelude to Obamacare Fraud

Posted by PITHOCRATES - October 5th, 2013

Week in Review

It is remarkable how so many people believe the government can do things better.  That somehow fraud just doesn’t happen with government people involved.  This despite those hundred dollar toilet seats the government bought.  Which is a lot for a toilet seat if you’ve never bought one.  I mean, you can buy one for less than $10.  But because the government is so large and handles so much money they attract fraud like fresh dog poop attracts flies.  There are just too many people.  And too much money.  Making it too easy for someone to slip in a bill for hundred dollar toilet seats.  Which is why fraud is rampant in government programs.  Like Medicare (see ‘Death doctor’ accused of misdiagnosing cancer patients to scam millions out of Medicare a ‘serious risk’ to flee the country posted 10/2/2013 on Mail Online).

A Michigan oncologist charged with intentionally misdiagnosing patients with cancer as part of a major Medicare fraud operation will remain in prison until trial, with court officials scared he will flee to the Middle East.

It is alleged Fata received about $35 million from Medicare via his insurance scam over a two year period.

So what’s the difference between private health insurers and the federal government?  People hate the private insurers for refusing to pay for their medical bills.  To prevent fraud.  Someone concealing a pre-existing condition when buying health insurance is committing an act of fraud.  The whole idea of Obamacare is to prevent this kind of fraud.  By forcing everyone to buy health insurance.  Instead of living their lives without ever contributing to the insurance pool until the day they find out that they have a catastrophic health problem.  And then lie to an insurance company to conceal that catastrophic health problem.  So they can get the health insurance pool to pay for their medical care.  Even though they never contributed to that insurance pool when they were healthy.

This is why people hate private insurance companies.  For preventing fraud.  Which is why you don’t see fraud in the private health insurance companies on the scale you see in Medicare.  Because Medicare uses taxpayers’ money.  So the people in charge of Medicare don’t suffer a loss in any fraud.  Unlike the private health insurers.  So the private health insurers are more aggressive in preventing fraud.  While the federal government just raises taxes to pay for the fraud committed on their watch.  That’s the difference between private health insurers and the federal government.

And if you think the Medicare fraud was bad you ain’t seen anything yet.  Thanks to Obamacare.  With the federal government taking over one-sixth of the national economy we will see fraud like we’ve never seen before.  More money.  More people.  An organization so big the left hand won’t know what the right hand is doing.  Making Obamacare a fraud paradise.  Not to mention a gift for hackers and identity thieves.  Who can find out everything on everyone from one location.  Making that $35 million Medicare fraud seem like child’s play.

Don’t think so?  You’re willing to trust the harden defenses of the government’s computer system?  If so, ask yourself this.  How well did the rollout of Obamacare go this past week?  How well did those computer systems do in collecting the data upfront?  Not well.  And knowing how poorly the rollout was are you any more confident that once they have all of your personal information that their system will work any better?  Or do you think it will just make it easier for people like this doctor in Michigan?

Every bad thing that happened in Medicare will be worse in Obamacare.  Because Obamacare is bigger than Medicare.  And as this fraud takes a bigger bite out of the Obamacare cash-flow there will be less money for treating patients.  Meaning longer wait times.  And rationing.  As well as higher taxes to pay for the fraud.  So we will end up paying more for less under Obamacare.  Just like with Medicare.  Only worse.

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FT163: “To cut medical costs Obamacare will pay hospitals, doctors and medical malpractice lawyers less.” —Old Pithy

Posted by PITHOCRATES - March 29th, 2013

Fundamental Truth

Health Care Costs are High because of the Lack of Competition and Medical Malpractice Lawsuits

Obamacare is a pathway to national health care.  They designed it to get as many employers to drop health insurance for their employees as possible.  By making the penalty for not providing it less than the cost of providing it.  As more employers drop their health insurance plans private health insurers will have to raise rates on the fewer remaining on their plans.  Causing more employers to drop their health insurance plans and pay the less costly fine instead.  Once Obamacare destroys the private health insurance industry the government will step in as the insurer of last resort.  And transform Obamacare into a true national health care system.  Like the National Health Service in Britain.  The ultimate goal for those on the left.

There is support for Obamacare and the national health care it will evolve into.  Especially those who hate doctors, hospitals and the pharmaceutical companies getting rich on the suffering of others.  Who will sue them at the drop of a hat.  And there is a large and prosperous medical malpractice legal community getting rich by helping these people sue.  Helping the little guy get justice from these rich people and rich companies.  Who put profits before people.  Which is why so many people want national health care.  To get the profit incentive out of health care.  And limit the outrageous salaries of those in the health care industries.

What these people don’t understand is that it’s just not their high salaries that run up the costs of health care.  Two large reasons for the high cost of health care are the lack of competition and the cost of medical malpractice lawsuits.  Obamacare will address one of these issues.  But probably not the one those who hate the profit incentive in health care would expect.  Or want.

When the Government pays for Health Care they also pay Medical Malpractice Damage Awards

They are still writing the law for Obamacare.  So anything we say will be conjecture.  But we can see where Obamacare is going by looking at where it will end.  National health care.  And there are numerous examples of that in the world.  Such as the National Health Service (NHS) in Britain.  Here is how they address medical malpractice (see Medical Malpractice Liability: United Kingdom (England and Wales) posted on the U.S. Library of Congress website).

Given that damages awarded could reach millions of pounds, which would negatively affect the budget of these Trusts in providing healthcare to the population, a number of programs (known as “schemes” in England) were established to address claims for medical negligence…

Part of the mandate of the NHS Litigation Authority is to avoid litigation, where possible.  Its Framework Document notes that it aims to “maximise the resources available for patient care, by defending unjustified actions robustly [and] settling justified actions efficiently.”[28]  Furthermore, the Litigation Authority notes that it “encourage[s] NHS bodies to offer patients explanations and apologies.[29]  We seek to avoid formal litigation as far as possible and our historical data show that only about 4% of our cases go to court, including settlements made on behalf of minors, which must be approved by a court.”[30]

The mandate of the NHS Litigation Authority further requires it “to minimise the risk that patient care in a particular community is jeopardised by a large settlement against a local NHS body.”[31]  It thus aims to “to spread the costs of settlements more evenly over time”[32] through the use of periodical payments made to the claimant throughout their life, as it considers that this is the fairest method of settling the costs of personal injury claims when costs are significant.[33]

When the government pays for health care they also pay medical malpractice damage awards.  And anything they pay in a medical malpractice award is money they cannot spend on providing medical services to sick people.  So the mandate of the NHS is to fight medical malpractice claims robustly.  By throwing out frivolous lawsuits.  And settling out of court legitimate lawsuits.  Such that only some 4% make it to court.  And a jury trial.  The ultimate objective of malpractice lawyers.  Who want the sympathies of a jury to award massive judgments against rich doctors, hospitals and pharmaceuticals.

Medical Malpractice Lawyers will be the Big Financial Losers when Obamacare evolves into National Health Care

Medical malpractice lawyers get rich from winning big lawsuits.  That have a big cash award.  Which is how they want their money.  In a big lump-sum.  Because that’s how medical malpractice lawyers get rich.  Quickly.  And that’s not going to happen with settlements paid out over time over the life of the claimant.  Like in the NHS.  They don’t want a stipend.  Stipends don’t buy mansions, luxury cars, private jets, yachts and exotic vacations.  And if their clients are so inconsiderate to die too soon they will selfishly deny these lawyers a portion of that income stream.  However meager it is.  If they even get a piece of that income stream.

Republicans are for a business-friendly environment.  To generate economic activity.  And that business-friendly environment includes low taxes and low regulatory costs.  As well as tort reform.  To limit the high cost of frivolous lawsuits.  Something the trial lawyers vehemently oppose.  So they throw their support behind Democrats.  Who are generally for a less business-friendly environment.  And have no problem with suing ‘greedy’ corporations.  For the richer the trial lawyers get the more campaign donations they get.  So there is a special relationship between the Democrat Party and trial lawyers.  They take care of each other.  Until, that is, Obamacare becomes like the NHS.

The Democrats and their supporters, including the trial lawyers, attack the profit incentive in health care.  Together they have helped to bring Obamacare into law.  Which will begin the long process of removing the profit incentive from health care.  As well as destroying the private health insurers that the medical malpractice lawyers have grown so wealthy by suing.  It will be interesting to see if they will continue their special relationship with the Democrats as health care moves more towards a system like the NHS.  As the medical malpractice lawyers will be the big financial losers when that happens.  Because they just won’t be able to sue the federal government like they have sued the private insurance industry.

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The US has 5 times the Population of Britain while Spending 15 times on Health Care than the NHS

Posted by PITHOCRATES - September 23rd, 2012

Week in Review

The British are successfully cutting their health care spending.  The NHS is stronger financially.  Even running at a budget surplus.  But it wasn’t easy getting there (see NHS trusts in debt double in year by Nick Triggle posted 9/19/2012 on BBC News Health).

The Audit Commission report said 31 trusts posted a deficit – more than one in 10 of the hospital, mental health and community trusts in the NHS.

The figure is up from 13 the year before.

However, overall the health service posted a £2bn surplus – about 2% of its budget.

The development comes amid an unprecedented savings drive.

The health service has been told to save £20bn by 2015 – the equivalent of 4% a year.

If you crunch the above numbers and convert into US dollars the NHS annual budget comes to about $162 billion.

According to Kaiser total American health care spending came to about $2.6 trillion in 2010.  Most of which the private health insurance industry paid.  Which is about 15 times what the British spend on health care.  Even though we only have about 5 times the population of the UK.  That means that either the British are much better at delivering cost-efficient health care.  Or a lot of people go without health care in the UK.

One would have to assume that once the Americans turn over all health care spending to the government their spending will have to be brought into line with British expenditures.  Because few can do national health care as well as Britain.  So based on population US spending should be 5 times the British spending.  Or $810 billion.  Which would call for a cut of $1.79 trillion in annual health care expenditures.  Or about 69% of current spending.

Standard and Poor’s said the US needed to cut spending by $4 trillion over 10 years to prevent a downgrade of their sovereign debt rating.  Or $400 billion a year for 10 years.  And they couldn’t do it.  The government could not make these spending cuts.  And S&P downgraded their sovereign debt rating.  If they couldn’t cut $400 billion they will not be able to cut $1,790 billion.  Which means when the private health insurers stop paying these health care costs they will go straight to the deficit.  Perhaps doubling or tripling our current trillion dollar deficit.  Resulting in a handful of new credit downgrades.  And completing the transformation from world’s number one economy to banana republic.

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National Health Care Budget Deficits force Hospital Closures in Wales

Posted by PITHOCRATES - July 21st, 2012

Week in Review

People have the misperception that a national health care system provides quality health care to everyone for free.  But health care is not free.  Someone has to pay for it.  In the United Kingdom that’s the taxpayer.  And when they can’t raise enough in taxes to close budget deficits they have to cut costs.  Close hospitals.  And make people travel farther for their health care needs (see Betsi Cadwaladr proposals: Flint and Blaenau Ffestiniog hospitals may shut posted 7/19/2012 on BBC News Wales).

Two community hospitals could close and minor injury accident departments may shut at others under a major health service shake-up in north Wales…

Among the areas under scrutiny are older people’s mental health services, neonatal intensive care and vascular and major arterial surgery.

The board is the first in Wales to outline plans for balancing the books.

It predicts a gap of £64.6m, the second highest in Wales…

Speaking before the meeting at St Asaph, Christine Evans, chair of patient watchdog Betsi Cadwaladr Community Health Council, said: “The local communities will be very upset.”

The UK, like the US, has an aging population.  And that’s a fact.  There are fewer people entering the workforce than are leaving it.  And those who are leaving the workforce tend to consume most of the health care services.  So you have a huge transfer of wealth from the working young to the retired seniors.  But because there are so many more of those retired seniors it is difficult to tax the working young enough to pay for them.  And if they can’t generate the tax revenue they have little choice but to cut costs.  Such as closing hospitals and minor injury departments.  And there’s probably more to come.

In the U.S. the private health insurers were vigilant in controlling health care costs.  For they were the only ones who were.  Doctors are reluctant to order tests that aren’t absolutely necessary because health insurers may not reimburse them.  And if they have a relationship with their patient, which most of them have, they don’t want their patient to get stuck with the bill.  So they won’t order a test if it’s not absolutely necessary.  Unless the patient insists.  People hate the insurance companies for this.  But one thing the private health insurance companies never did was close hospitals.

This is the future of Obamacare.  Health care will still cost.  Someone will still have to pay for it.  So they will do like they do in the UK.  Raise taxes.  Transfer wealth.  And then close hospitals when all of that fails to close budget deficits.  It’s just the nature of a national health care system treating an aging population.  With about 5 times the population of the UK those budget deficits will probably be about 5 times worse under Obamacare.  With 5 times the hospital closures.  Making the local communities about 5 times as upset.

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The Obamacare Architects are either Devious or Ignorant

Posted by PITHOCRATES - July 14th, 2012

Week in Review

Now that the Supreme Court upheld Obamacare our health care will be everything we ever hoped it to be.  It will give us everything we want.  And it will be inexpensive.  Granted nothing else in the world works like this.  Where customers get more by paying less.  And no national health care system has ever been everything the planners said it would be.  Unless the architects of these plans said they were going to introduce high taxes, long wait times and rationing of health care services.  Which I kind of doubt.  Because people typically want the opposite of these things.  Yet this time it will be different.  The Americans will be able to provide that ever elusive health care utopia.  Why?  I can only think of two possible reasons (see Repealing the Affordable Care Act Will Soon Be Considered Absurd by Ron Pollack posted 7/10/2012 on U.S. News and World Report).

Under the law, it will be illegal for insurers to discriminate against women by charging higher premiums simply because of their gender. Nobody—male or female—will be denied coverage or charged higher premiums because of a pre-existing condition, like asthma or diabetes. No one will live in fear of their insurance being canceled. People will no longer be subject to arbitrary lifetime or annual caps in what insurers pay out, thereby denying coverage when it is needed the most.

The act also comes with much-needed direct help for middle class families. They will receive substantial subsidies to make health insurance premiums affordable. Seniors will no longer fall into the huge prescription drug coverage gap in Medicare euphemistically-named the “doughnut hole.” Comprehensive preventive care will be available at no cost for women, including mammograms and contraception.

So in other words insurers can no longer recover their costs.  They have to provide more benefits while at the same time charging less in premiums.  Sort of like forcing McDonald’s to replace the Big Mac combo meal with steak and lobster.  While at the same time forcing them to lower the price for that combo meal.  There’s a name for an economic formula like that.  Failure.

This cannot work.  Unless your goal is to put the private health insurers out of business.  If that is the goal than, yes, Obamacare will work very well.  For no business ever remained in business by selling their product or service for less than their costs.  That’s just not how business works.  So it is clear that they designed Obamacare to put the private health insurers out of business.  Unless those who wrote Obamacare into law are just very ignorant about things economic.

So there it is.  Take your pick.  Devious.  Or ignorant.  This is our government.  Whichever it is it doesn’t make a difference for the American people.  For unlike what the president promised us we won’t be able to keep our health insurance if we like it.  Because Obamacare will put all of the private health insurance businesses out of business.  By forcing them to sell their policies below their costs.  Guaranteeing that they will all fail.  And giving us high taxes, long wait times and a rationing of health care services.  Just like everybody else that tried national health care.

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