Health Care Fraud – The Perfect Storm

Now, health care fraud is all over the news. There undoubtedly is certainly fraud in health care. The same is true for every business or simply endeavor touched by human hands, e. g. banks and loans, credit, insurance, politics, etc . There is no question that physicians who abuse their position and our trust of stealing are a problem. So are those from other professions who the actual same.

Why does health care fraud appear to get the ‘lions-share’ with attention? Could it be that it is the perfect vehicle to drive agendas pertaining to divergent groups where taxpayers, health care consumers and medical service providers are dupes in a health care fraud shell-game operated by using ‘sleight-of-hand’ precision?

Take a closer look and one finds that is no game-of-chance. Taxpayers, consumers and providers always eliminate because the problem with health care fraud is not just the fraud, but it surely is that our government and insurers use the fraud dilemma to further agendas while at the same time fail to be accountable and carry responsibility for a fraud problem they facilitate and allow that will flourish.

1 . Astronomical Cost Estimates

What better way to document on fraud then to tout fraud cost offers, e. g.

– “Fraud perpetrated against both general population and private health plans costs between $72 and $220 billion annually, increasing the cost of medical care and health insurance and shorting public trust in our health care system… It is no longer your secret that fraud represents one of the fastest growing and the majority costly forms of crime in America today… We pay most of these costs as taxpayers and through higher health insurance monthly payments… We must be proactive in combating health care fraud and also abuse… We must also ensure that law enforcement has the tools who’s needs to deter, detect, and punish health care fraud. in [Senator Ted Kaufman (D-DE), 10/28/09 press release]

– The General Accounting Office (GAO) estimates that sham in healthcare ranges from $60 billion to $600 billion per year – or anywhere between 3% and 10% of the $2 trillion health care budget. [Health Care and attention Finance News reports, 10/2/09] The GAO is definitely the investigative arm of Congress.

– The National Health Anti-Fraud Association (NHCAA) reports over $54 billion is normally stolen every year in scams designed to stick us along with our insurance companies with fraudulent and illegal medical prices. [NHCAA, web-site] NHCAA was created and is financed by health insurance companies.

Unfortunately, the reliability of the proposed estimates is dubious at best. Insurers, state and united states agencies, and others may gather fraud data related to their missions, where the kind, quality and volume of data made varies widely. David Hyman, professor of Law, Higher education of Maryland, tells us that the widely-disseminated estimates of the number of health care fraud and abuse (assumed to be 10% of total spending) lacks any empirical foundation in anyway, the little we do know about health care fraud and abuse is actually dwarfed by what we don’t know and what we know that is not hence. [The Cato Journal, 3/22/02]