Invest in ending Medicare fraud

On July 25, 1965, and after a long and contentious battle in Congress, President Lyndon B. Johnson signed the Medicare program into law.

        Those witnessing the ceremony included former President Harry Truman, whose administration — as have others since then — tried but were unable to accomplish significant health-care reform. It was a monumental day in the nation’s history.

        Fast forward 44 years. Medicare is not the major part of sweeping health-care changes that have been passed in the U.S. House and are pending in the Senate. However, Medicare fraud is a troubling aspect of the current federal insurance plan that covers more than 44 million senior citizens. By the year 2030, that number could reach 79 million.

        It’s important to recognize that any major people program, in the private as well as the public sector, can be adversely affected  by waste, inefficiency, scams and other misdeeds.

        In this month’s AARP Bulletin, there’s an eye-opening investigative article by Jay Weaver, an award-winning reporter for the Miami, Fla., Herald. Weaver is a specialist in Medicare fraud. On the cover of the publication are photos of 10 individuals who have been accused of swindling nearly $100 million from the program. These cynical people allegedly have used their ill-gotten gains to live lives of luxury.

        The crooks set up fake storefront clinics and submit phony claims, many of which are paid routinely.

        The federal government estimates that patients, doctors, pharmacists and others steal $60 billion from Medicare each year.

        “Those billions of dollars,” remarked U.S. Attorney General Eric Holder, “represent health-care dollars that could be spent on medicine or care or hospital visits, but instead are wasted on greed.”

        Indeed, federal examiners are aware that the taxpayers’ money is squandered — from overblown or fraudulent medical bills, payments to misidentified or non-existent patients, doctors or institutions.

        AARP shows that one example of cost problems is the power wheelchair, whose use and costs have rocketed as the population has aged. Under Medicare, hundreds of suppliers buy wheelchairs from manufacturers, then lease them to beneficiaries. In 1997, Medicare paid just over $100 million to buy or lease power wheelchairs. Today that figure is more than $1 billion, and swindlers are lining their pockets and dragging down the reputations of honest and reliable medical supply companies.

        The good news is that Congress and the Obama administration have stepped up their efforts to combat fraud. It’s about time.

        Meanwhile, we should not lose sight of the fact that Medicare — despite the charges of “socialism” and other complaints — is not only a widely popular program among seniors, but also a vital one. Sure, there are valid opinions by many citizens that the government has become too deeply involved in their lives. But rare is the politician who would dare to advocate scrapping the program. Without it, most of our elderly would be in deep financial trouble at best or in poverty and without coverage at worst.

        Medicare fraud is a serious problem, and ending it should be a part of the debate over health care reform. The AARP article says that every dollar spent investigating fraud returns about $17 to the system. Sounds like a wonderful investment to us.