Why Not Eliminate Fraud?

Of all the debate being spit out in Washington, of all the lies and misinformation flying out the butts of pundits….why is there very little mention to the fraud that occurs in the health care system?

In an article written in the Huffington post by Sen Bernie Sanders:

What we have seen over the last several decades is the systemic fraud perpetrated by private insurance companies, private drug companies, and private for-profit hospitals ripping off the American people and the taxpayers of this country to the tune of many billions of dollars.

The rampant fraud is another reason why our current health care system, dominated by private insurance companies, is the most costly, wasteful, complicated and bureaucratic in the world. Its function is not to provide quality health care, but to make huge profits for those who own the companies. With 1,300 private insurance companies and thousands of different health benefit programs designed to maximize profits, our country spends an incredible 30 percent of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying and campaign contributions. Public programs like Medicare, Medicaid and the VA are administered for much less.

In recent years, not only have we seen massive fraud by the health care industry, but we also have been paying for a huge increase in health care bureaucrats and bill collectors. Over the last three decades, the number of administrative personnel has grown by 25 times the number of physicians. Doctors and nurses in Vermont have described to me in painful detail the amount of time and money they are forced to waste negotiating with insurance companies about how they can treat their patients.

Just a little fraud that has been found and prosecuted:

In 2004, Warner-Lambert, a division of Pfizer Inc., pled guilty to two felonies and agreed to pay $430 million for fraudulently promoting the drug Neurontin.

In 2003, GlaxoSmithKline paid $88 million in civil fines for overcharging Medicaid for its anti-depressant Paxil.

In 1999, Hoffmann-LaRoche paid a $500 million criminal fine for leading a worldwide conspiracy to fix prices for certain vitamins.

In 2009, UnitedHealth, a leading insurance company, paid $350 million to settle lawsuits brought by the American Medical Association and other physician groups for shortchanging consumers and physicians for medical services outside its preferred network.

On the personal side….when I had my accident that shattered my leg….I was put into an ambulance and when I got the bill I was being charged for a cervical collar and a gown…a total of $80…neither of which I got in my ride to the hospital….I informed the Insurance company of the add ons and they paid it anyway.  Now using a little math, one ambulance overcharging riders on 3 shifts a day comes to if they have the average pick up of 8 people a day, comes to $430,000 a year….and that is ONE unit in ONE town…now if you take it further to a state we are talking millions and in the country billions….maybe that should be addressed.

And let us not go into the fraud with Medicare…that would make you sick.

My point is while all the cowards are bitching about the cost of the program, the industry is fleecing the public…but to them that is somehow okay.  Fraud is rampant and for the most part accepted….maybe that should change and savings could be a boom to offsetting any expenditures.

So my question is…why do not these concerned politicians actually go after the fraud instead of looking the other way while accepting their contributions for the re-election fund?

Oh wait!  The Repubs have this idea of tort reform as a way to make the uninsured more likely to get insurance…..tort reform?  Yeah, you know those frivolous lawsuits that lead to an increase in the insurance that doctors pay for protection from malpractice?  I will agree that some of the lawsuits are outrageous, but that accounts for about 1% of the total cost of health care…I do not beliueve that controlling 1% of the costs will help anyone to get health insurance.  As Det. Joe Friday always says,  “Yes facts, sir”.

Tort reform is a typical ploy to keep everything the way it is…….

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