Healthcare Daily Digest for Wednesday, 20 March: Why Fending Off Medicare Fraud is Good for Healthcare

In all this talk about what/if/how-much/too-much healthcare will cost, one of the solutions that’s rarely discussed is better safeguarding the programs that distribute the money. Medicare, for instance, seems especially prone to fraud. One would think that if one could simply, you know, keep others from pilfering money from these healthcare systems, one might realize a tidy savings.

Not to say that stopping fraud alone will bring down the costs of healthcare.

In a blog post up on TheHill.com, Billy Tauzin looks at what effect our current Federal Government Sequestration (and Country Bear Jamboree) is having on governmental fraud-fighting programs. “While no one wants to see such…programs minimized, alternative anti-fraud approaches have surfaced that would add no additional cost to the federal budget. In fact, viable solutions exist that can generate savings without requiring additional HHS or law enforcement resources.”

Tauzin sees hope in “comprehensive program integrity reform” — for instance, the government’s current “pay and chase” policy where fraudulent providers “have been routinely reimbursed for their assumed services, while government – sometimes years down the road – spends even more money to investigate, prosecute and attempt to recover precious, squandered healthcare dollars intended for the nation’s elderly.”

The blog is essentially: Medicare is in some ways a money-pit that needs to be fixed. And Medicare has proven itself time and again to be vulnerable to fraud. If we’re going to build a solid healthcare system, we need to make sure we’re not building it on a leaky foundation.

Wednesday headlines:

Prison Healthcare: “Gov. Jerry Brown’s contention that California has fixed the problems of delivering medical care in its prisons collides with the first reviews of some of those prisons by court-appointed medical experts.”

What if Medicare is Behind Closing the U.S. Budget Gap?: “New evidence that the slowdown in health care costs over the past five years is happening not only because of a weak economy comes from the Economic Report of the President, released last week by the President’s Council of Economic Advisers. If the slowdown were to continue in the future, the report shows, Medicare spending would basically remain flat as a share of the economy.”

Now it’s Time to Point Fingers at the Democrats: Because finger-pointing is helpful! “Patient groups and conservative activists pushed back Tuesday against renewed calls for Medicare to negotiate the prices it pays for prescription drugs.”

Washington Post Fact Checkers: Are people getting $3 in Medicare benefits for every $1 in taxes?: “We need to accomplish the big jobs now of making sure that Medicare and Social Security are there, not just for people today, but for the next generation. You know, people have paid into these programs, and for every $1, people have paid in, they’re getting about $3 out in benefits in terms of Medicare.” — Sen. John Barrasso (R-Wyo.), speaking on CNN, March 14, 2013