patrick.net

Gosh, and private health insurance companies have the cream of the crop. Imagine if they had to cover those expensive folks, like the elderly, the disabled?

I was shocked to hear that only three insurance companies operate in California. In Oregon we have plenty of competition but it doesn't seem to lower costs. Our options: LifeWise, BC/BS, Aetna, United Health, Kaiser, Providence, HealthNet, Pacific Source, ODS and that's just off the top of my head.

A recent example of how personal experiences shape your opinions:

I was visiting the in-laws this weekend in the Puget Sound area. My MIL is 62, unemployed and without health insurance, mentioned her before. My SIL and BIL are anti-universal health care in a big way and would even like to see Medicare and Medicaid shrunk. They recently dropped employer sponsored health care as they started their own business and discovered that individual plans have lower premiums for similar coverage compared to group health which lead them to the belief that uninsured people have no excuse due to the individual plan options.

Well, their 18 month old has numerous food allergies and early signs of asthma. The child has been hospitalized 2x already for breathing problems. This is where you find out how good of coverage you have. Well, they owed nearly $3K out of pocket. When the BIL asked about a payment plan the billing office was able to hook them up with assistance which covered the entire bill not paid by insurance. I was shocked that they qualified considering they have insurance and he makes nearly $100K. And now the latest, their premium got increased 20%.

It will be interesting to hear how the health care conversations go now that they will be frequent users of the system as it is very likely their child will be an asthmatic.

Honest Abe says

The saying goes like this: “Take whatever you want and pay for it”, NOT ‘take what you want and force others to pay for it’. The former represents personal responsibility, the latter represents your typical liberal, do-gooder, free-loader, socialist, elite, dependent, “its nooooot fair”, whiney, the world owes me, cry baby, over-reaching, manipulative, coercive, nanny-state, democratic stinkin’ thinkin…YUCK.

@ABE

If you dont think you will ever need these services then you are lost. Many people in our nation cannot afford to take what they need and pay for it so it is the responsibility of those of us who can to assist them. You need to relinquish the thought that all socialism is bad because its not, and stop thinking that all capitalism is good because the recession has shown that it is not.

-You run to church to give 10% tithes so the church can prosper and spread your hatred of other religions but refuse to spend the same for programs that actually help assist our communities.

- You become infuriated when you hear that we are going to provide health care to the poor because you believe that the POOR are BLACK/MEXICAN when in actuality whites still make up a majority of the lower income families in terms of sheer numbers.

- You become infuriated when you hear that we liberals are attempting to introduce banking legislation, but proclaim your excitement when told we would invade Iraq to destroy another 1 million muslim lives.

- You would rather engage in war with other countries than take care of the problems hear in America

- You and the PARTY OF NO refuse to allow our nation to spend on programs aimed at progressing past a 3rd world education system, health care system, economic system but are openly OK with spending 1 trillion a year on War and Defense.

Leigh:
I liked the diaper head! Does this mean I have to change my icon?

elliemae says

Leigh:

I liked the diaper head! Does this mean I have to change my icon?

No, keep the Aussie:O) The pull-up wasn't keeping the sh!t out so I gotta think of something else.hehehe

She's almost 3 now, might do a grown-up pic. Right now she's trying to herd cats out back. Not working out so well...

Zippy,

>>The Laser/Lasik example is still standing tall at this point

Huh? I completely exposed the fallacy of your example, and you just ignore it.

The Veterans Administration (VA) is real good about helping Vets live a healthier life style. They have a number of programs that do that. Anti-smoking, weight control, etc.

This helps the Vets as well as reducing the cost of healthcare.

ZippyDDoodah says

What happened to bob2356 and his angry demands to “Back up your opinions with facts!”? As soon as said opinions were backed up with linked citations, he seems to have exited out the back door in search of his credibility.

Bob was out of town kitesurfing for a few days. I bow to your superior attitude thank you. You are correct on the average deduction number. My experience was to be distorted by the fact the regional market I worked in was heavily represented by the HMO/POS segment. My experience based on this dovetails very nicely with your cited article by the way. I didn't realize and failed to research the fact the national market was so much higher in the PPO model. Mea Culpa.

I didn't demand anything, angry or not. I just asked for some backup to your strongly worded assertion that having people buy their own insurance would make a major difference in the cost of health care in the United States. A research article on the rates of utilization broken out by the level of deduction would be interesting, but I haven't been able to uncover one. I assumed you did and could provide it. Once we have this data we could extrapolate it against the total health care costs and see what the real savings on a system wide basis would be. Otherwise what you are offering is a theory not a suggestion.

For the record I always thought that making benefits tax deductible to business without being considered income to the employee was a very bad idea. Not because of deductions, but because it means large unfair distortions across the entire tax system.

I question you on this point because I have never bought into the skin in the game article of faith. I don't believe, in my opinion, that there are very many people who wake up in the morning and say "I'm going to the doctor just because I have unlimited health insurance". Going to the doctor is a pain in the ass. You have to take time off work, drive there, and wait forever. People go to the doctor because they are sick, not just because they can. I also question whether there is any real savings in people avoiding going to a doctor until they are very sick. Frequently things are are very easy to treat at an early stage become much more difficult (expensive) if treatment is delayed. Providing your research on utilization vs deductions would be a major help in proving or disproving this THEORY of mine based on anecdotal experience.

At one time many of our hospitals were private charities. At one time almost everyone paid for medical out of pocket. At one time average lifespan was less than 40 years. At one time almost all medical treatment consisted of helping people die in comfort. This time was less than 2 generations ago. We have almost doubled the average lifespan in those 2 generations. The majority of conditions that are routinely treated today were a death sentence prior to the 1950's. Cancer? Here is some codeine, have a nice funeral. Heart disease? Have some nitro and a short life. Diabeties? Been good to know you. Etc. Etc. This additional lifespan is the direct result of very expensive medical treatment. Like a bumper sticker I once saw said "Ass, Gas, or Grass no one rides free".

The question should be how do we balance cost vs results. This is not addressed by a bunch of stick to the wall feel good crap thrown out on an ideological basis. There are real world working examples to look at. Places like the Cleveland Clinic and the Mayo Clinic deliver very good medical care at very reasonable costs (relative to the rest of the US). Excellent utilization of IT, tightly controlled costs, high standards of excellence, constant review of best practice procedures, close management of resource utilizaton are some (but certainly not all) of the things that make this possible. Things that are sadly lacking in the practice of health care across the country. Items that are also sadly lacking in any discussion of controlling the cost of health care.

So my suggestion (if I were king) is to study what works in the real world, like Mayo, and implement it on a national basis, while leaving out the sound bite libertarian posturing. I would even study what those awful socialist furriners are doing to let their people get medical care for half the cost of the US. Things like the no fault medical malpractice in NZ come to mind. Lasik is simply not a viable example of cost savings. It's a elective procedure that has a dirt cheap alternative.

Interesting that the article cited has a 12% denial rate overall with a denial rate of 30% for 60-64 year olds. I would have to wonder who the 12% were, why they were denied, and how they ended up paying for their medical care. I don't know but I would guess many were people who had pre existing conditions (ie the people who were actually sick) and couldn't get medical insurance at all. Which means they most likely ended up being cared for by some government program. Or as you zippippy would like to say, the governments fraud-ridden, wasteful track record in providing healthcare. That would be piss poor substitute healthcare to all the people that private insurance companies won't touch. Wonderful how the all the free markets in America have become privatized profits and socialized losses.

Honest Abe says

The saying goes like this: “Take whatever you want and pay for it”, NOT ‘take what you want and force others to pay for it’. The former represents personal responsibility, the latter represents your typical liberal, do-gooder, free-loader, socialist, elite, dependent, “its nooooot fair”, whiney, the world owes me, cry baby, over-reaching, manipulative, coercive, nanny-state, democratic stinkin’ thinkin…YUCK.

Since caring for a medically fragile child is damn expensive, abortions should be performed soon after that 18 weeks ultrasound demonstrates the abnormalities: Down's, Fragile X, Spina Bifada? And any baby born prior to 28 weeks gestation should be left to die due to the complications and long NICU stay?

Since chemo therapy is damn expensive one should check into hospice with a confirmed diagnosis?

My delivery, an uncomplicated vaginal birth was $20K in 2009. Let's say your changes brings health care costs down 50%. Could I come up with $10K to pay for delivery? How's that for birth control?!

Top rated medical care comes from countries like France, Germany, Norway, etc. All cheaper per person than the US, all end up superb care, and everyone is covered.

The US system is like communism. Show us one country where communism thrived and succeeded. It didn't. The US system is in the same boat. It's the only country left hanging onto a system that doesn't work. Ugh.

I read somewhere that 60% of bankruptcies where from medical costs and those people HAD coverage. That says something right there.

Bob, you coward, don't go running off kite surfing again when you have zippy to answer to. Do I have to tell you kids everything?

elliemae says

Bob, you coward, don’t go running off kite surfing again when you have zippy to answer to. Do I have to tell you kids everything?

Sorry, it's coming into winter here in the southern hemisphere. I need to get my days in NOW.
Damn, PKennedy took my last argument on the subject. How does the rest of the first world provide health care at half the cost without any charges to the patients at all? They should be totally overrun by people using up that free health care because they can. I was saving that.

Isn't there a Wii game that you can do, kite surfing-wise? Stand in your living room, put a fan on and put in a DVD or something. But stand by your computer. You have an obligation that you shouldn't be shirking.

ZippyDDoodah says

What happened to bob2356 and his angry demands to “Back up your opinions with facts!”? As soon as said opinions were backed up with linked citations, he seems to have exited out the back door in search of his credibility.

Unless you were searching for your credibility on the water. That's cool - if OJ could search for the "real killers" on every golf course in Florida, you certainly can choose your search location. But next time clear it with us.

There is no crying in patnet ball!

Leigh says

Honest Abe says

The saying goes like this: “Take whatever you want and pay for it”, NOT ‘take what you want and force others to pay for it’. The former represents personal responsibility, the latter represents your typical liberal, do-gooder, free-loader, socialist, elite, dependent, “its nooooot fair”, whiney, the world owes me, cry baby, over-reaching, manipulative, coercive, nanny-state, democratic stinkin’ thinkin…YUCK.

Since caring for a medically fragile child is damn expensive, abortions should be performed soon after that 18 weeks ultrasound demonstrates the abnormalities: Down’s, Fragile X, Spina Bifada? And any baby born prior to 28 weeks gestation should be left to die due to the complications and long NICU stay?
Since chemo therapy is damn expensive one should check into hospice with a confirmed diagnosis?
My delivery, an uncomplicated vaginal birth was $20K in 2009. Let’s say your changes brings health care costs down 50%. Could I come up with $10K to pay for delivery? How’s that for birth control?!

Damn, thought I'd get a staunch Conservative to admit that there are certain conditions that would justify abortion....shoot.

I had an interesting case the other day, a younger man in his forties suffered from an auto -immune condition that wreaks havoc on his vascular system. The belief is that his 20 years working in the Texas oilfields contributed to his condition. Well, he is on his 5th amputation, this one a below the knee job. So now he has both lower legs gone along with a few digits. And is dialysis dependent. He sure as heck couldn't afford the care without Medicare/Medicaid to get him through the rough spots. Using Honest Abe's beliefs he should have been dead a few years ago but yet he continues to be a productive member of society, running an internet business.

Abe, I think my hospital would be 95% smaller if we didn't help each other out.

He sure as heck couldn’t afford the care without Medicare/Medicaid to get him through the rough spots. Using Honest Abe’s beliefs he should have been dead a few years ago but yet he continues to be a productive member of society, running an internet business.

Sounds like a sad situation, although your assertion about it being "believed" that working in TX oilfields contributed to his condition needs a bit more support, as many folks live their entire lives working on drilling rigs with no adverse effects. Also, if he is so "productive" with his internet business as you say, then why couldn't he buy his own health insurance?

Top rated medical care comes from countries like France, Germany, Norway, etc. All cheaper per person than the US, all end up superb care, and everyone is covered.

If "top rated" is defined by cancer survival rates, then every country you named sucks badly in comparison to our healthcare system since they don't even come close to our track record in that respect.

I haven't been sick in France or Germany, but I have been sick in Norway. Did you know that their restrictive system prevents you from buying any over-the-counter medicine beyond aspirin? Incredibly restrictive and inefficient. Norway for years also got away with paying their doctors and nurses peanuts compared to other western countries. Not sure what their comparative pay scale is these days

ZippyDDoodah says

He sure as heck couldn’t afford the care without Medicare/Medicaid to get him through the rough spots. Using Honest Abe’s beliefs he should have been dead a few years ago but yet he continues to be a productive member of society, running an internet business.

Sounds like a sad situation, although your assertion about it being “believed” that working in TX oilfields contributed to his condition needs a bit more support, as many folks live their entire lives working on drilling rigs with no adverse effects. Also, if he is so “productive” with his internet business as you say, then why couldn’t he buy his own health insurance?

Ever heard of that 'pre-existing condition' issue? Denied! But now that is by the way side, we'll see if he can afford the premium and deductible of a private plan, ,especially when they see his health history.

BTW, there are lots of cancers and disorders linked to the environment but it's very difficult to link cause and effect. Some folks are susceptible to cancers and disorders due to genetics. Multiple Myeloma, various leukemias. and disorders of the bone marrow are linked to pesticide and herbicide usage. I grew up in Iowa, every one of my relatives that farmed soy beans /or corn died of cancer. My dad died of MM at the age of 65. There are communities along the Missouri that pull water from the river due to contaminated ground water from farm run-off.

Sure, some farmers live to a ripe old age, then there are some that don't.

The concern with the oil industry is the benzene exposure. Next time I'm at work I'll search for some articles.

Leigh says

Ever heard of that ‘pre-existing condition’ issue? Denied! But now that is by the way side, we’ll see if he can afford the premium and deductible of a private plan, ,especially when they see his health history.

He paid into Medicare while he worked - and he's paying $100 a month for his part B premium. I'm willing to bet he buys Medicaid on a spenddown on those months he has outrageous co-pays. Amputations and dialysis aren't cheap, nor are the complications caused by dialysis. And Leigh - you left out R.A. & Lupus as auto immune diseases that are suspected to be caused by exposure to chemical agents. You're correct that no insurance would pick him up, but if he could find one that would his premiums would be in the thousands each month.

I guess in Zippy's world, the guy should have saved his money while he worked so that he could pay for such an event. Most of us will never make enough in our lifetimes to pay for the care that he has already received.

ZippyDDoodah says

If “top rated” is defined by cancer survival rates, then every country you named sucks badly in comparison to our healthcare system since they don’t even come close to our track record in that respect

Actually, that's not true. The study I saw compared 3 types of cancer in men and women. US was best in a couple of the categories, Japan was best in a couple and France was best in at least 1.

US is good at treating cancer, but so is France.

I guess in Zippy’s world, the guy should have saved his money while he worked so that he could pay for such an event.

That's a rather dishonest way of framing my position ellie. Paying for health insurance when you "don't need it" is to cover for catestrophic future injuries and illnesses.

ZippyDDoodah says

I guess in Zippy’s world, the guy should have saved his money while he worked so that he could pay for such an event.

That’s a rather dishonest way of framing my position ellie. Paying for health insurance when you “don’t need it” is to cover for catestrophic future injuries and illnesses.

Replace "Zippy" w/ "Honest Abe" and she would be accurate.

ZippyDDoodah says

That’s a rather dishonest way of framing my position ellie. Paying for health insurance when you “don’t need it” is to cover for catestrophic future injuries and illnesses.

What do you do when your insurer drops you because you've become too expensive?

What do you do when your insurer drops you because you’ve become too expensive?

If you've been paying your premiums, then to my knowledge they cannot drop you as long as you're under the lifetime cap of coverage. If they're able to find a loophole, such cases attract negative publicity causing customers and potential customers to switch policies away from the non-paying company to health insurance companies who do pay for legit claims, causing financial pain for the non-paying insurance company

Even if they don't drop you, raising the premiums will have the same effect.

Leigh says

Even if they don’t drop you, raising the premiums will have the same effect.

Not only that, but endless denials can mean death long before a procedure is approved.

ZippyDDoodah says

At one time, many/most of our hospitals were private charities. Private charities are better suited than the government to weed out the ‘truly needy’ from those who are gaming the system. With $60 billion/year in Medicare fraud alone, there are plenty of companies and individuals gaming the system now.

Zippy, you say that Medicare fraud is a government issue - but it's perpetrated by private companies, and private contractors to Medicare are the ones authorizing the payments. So it's a private thing too. Medicare helps a hell of a lot more people than it hurts - but these private companies make more money by processing each bill rather than by questioning it. Sure, the system needs to be changed - but just like the housing bubble was (in part) created by companies running rampant, so is Medicare fraud.

A single payor system would take care of that. Less of a chance to game the system when it's one agency paying the bills.

BTW, our local hospital is non-profit. Every year they give bonuses to staff because they make too much money. They could spend those bonus dollars on healthcare, but they're not required to. And they have a "foundation" that visits wealthy old people, do the hard sell and tries to get them to leave their money to the hospital. Some family members have found out the hard way when auntie dies and the will was changed.

Zippy, you say that Medicare fraud is a government issue - but it’s perpetrated by private companies, and private contractors to Medicare are the ones authorizing the payments. So it’s a private thing too

By your own admission in other threads, Medicare's "system" gives no incentive not to pay, so it's not "equally" the fault of private industry as you suggest. Medicare is responsible is for the fraud in their own program, period. In fact, private medical insurers would go bankrupt if they permitted only tiny fraction of the fraud which takes place under Medicare every year. Quit making excuses for the massive fraud

A single payor system would take care of that. Less of a chance to game the system when it’s one agency paying the bills.

That's as absurd as it is unsupported. A single payer health system would give more control to the government, which has already proven that it cannot control fraud or waste in the least. On what possible basis can you make the assertion that there would be "less of a chance" to game the system? Single payer does not = single provider. The fraud has occurred in paying out to health care providers

ZippyDDoodah says

If you’ve been paying your premiums, then to my knowledge they cannot drop you as long as you’re under the lifetime cap of coverage. If they’re able to find a loophole, such cases attract negative publicity causing customers and potential customers to switch policies away from the non-paying company to health insurance companies who do pay for legit claims, causing financial pain for the non-paying insurance company

Zippy--you're technically correct. What they do is jack up the premiums, making it impossible to keep the coverage. It's calling purging. Here's what Wendell Potter, former head of corporate communications for Cigna says about the practice:

“What we have today,” he told journalist Bill Moyers recently, “is Wall Street-run health care that has proven itself an untrustworthy partner to its customers, to the doctors and hospitals who deliver care, and to the state and federal governments that attempt to regulate it.”

Potter went into detail about how increasing corporatism, dwindling competition, and the slavish need to meet investors’ and Wall Street’s profit expectations has distorted the traditional role of health insurance. He said the game, today, is all about controlling what’s known as the “medical loss ratio,” an industry term for how much of a premium dollar the insurance company pays to actually cover medical costs.

And one of the chief ways insurance companies control the ratio is by purging employer accounts, he said.

“If a small business has an employee, for example, who suddenly has a lot of treatment, or is in an accident, and medical bills are piling up, and this employee is filing claims with the insurance company, that’ll be noticed by the insurance company,” he explained.

“And when that business is up for renewal, and it typically is up once a year, up for renewal, the underwriters will look at that. And they’ll say, ‘We need to jack up the rates here, because the experience’ — when I say experience, the claim experience, the number of claims filed — ‘was more than we anticipated.’

“Often they’ll do this, knowing that the employer will have no alternative but to leave. And that happens all the time,” he explained.

Medicare pays companies to tell it what to pay to providers. These companies tell Medicare it's okay to pay a bill that's fradulent - and it's 100% Medicare's fault? I think not.

ZippyDDoodah says

Single payer does not = single provider. The fraud has occurred in paying out to health care providers

If all of the medical care payments ran under the same rules, we wouldn't have asinine rules & denials. If healthcare weren't a massive for-profit system and was patient-based, rather than profit-based, we would have better care for all.

Right now, with all the cutbacks at the state level, providers aren't being monitored. Payments are processed and no one's watching. Private companies are the ones that are perpetrating fraud, private companies are the ones that are authorizing payment, but it's the govt's fault?

I'm gonna agree to disagree with your sadly misinformed posts.

"Often they’ll do this, knowing that the employer will have no alternative but to leave. And that happens all the time,” he explained.

I'm sure it's happened. In some cases such raising of rates may be justified, in other case not. I'd be interested to see statistics which quantify the "all the time" claim. Without facts, it sound like too much like unsubstantiated emotional blustering

If all of the medical care payments ran under the same rules, we wouldn’t have asinine rules & denials.

Yet Medicare payments are all made out under the "same rules" and we have have $60 billion in fraud every year as a result. Please explain how a single payer system would be any different

elliemae says

I’m gonna agree to disagree with your sadly misinformed posts.

You're late to the party. I will say that private companies, when spending their own money, are tight as hell and don't care whose life they destroy as long as the profits continue to roll in. When dealing with the government's money, they approve everything possible because that's how they make their money. If they were required to pay half of the fraudulent claims back, they'd certainly change their tunes.

Btw, it's an "estimated" 60 billion in fraud - because if they actually knew it was fraud it wouldn't happen now, would it?

Btw, it’s an “estimated” 60 billion in fraud - because if they actually knew it was fraud it wouldn’t happen now, would it?

Did it ever occur to you that fraud is discovered AFTER payments are made? http://ur.lc/iya What a surprise!

I will say that private companies, when spending their own money, are tight as hell and don’t care whose life they destroy as long as the profits continue to roll in. When dealing with the government’s money, they approve everything possible because that’s how they make their money. If they were required to pay half of the fraudulent claims back, they’d certainly change their tunes.

But the administrators paying out Medicare money are simply following Medicare's rules, no? They pay the bills within the rules of the Medicare payment system.. Unless you have evidence otherwise. The vast majority of Medicare fraud, to my knowledge, is coming from fraudulent payment claims from providers. Medicare has no incentive to stop the massive fraud because they just take more $$$ from taxpayers. Private health insurance companies with their survival at stake could never survive with a tiny fraction of the fraud that Medicare lets slide every year

ZippyDDoodah says

Did it ever occur to you that fraud is discovered AFTER payments are made?

Sure. But there's plenty of ways to find it beforehand, if anyone's looking. A few examples:

-companies that solicit customers for jazzy chairs and scooters, insisting that patients won't have to pay out of pocket. I've seen a lot of unnecessary ones handed out. And there's no payment for used models - if a lesser amount would be paid for a used model we'd save a substantial amount. These chairs cost $6,000 or more new, while a used one goes for $500 +/-.

-hospices that sign anyone on, and if the patient improves they keep the patient on service for 3 months before discharging. It costs you and me $12,000 for this little scheme. And they'll keep patients on service forever.

-hospice in a nursing home paid at the same rate, when nursing homes are providing a much higher level of care than the patient would have at home. The hospice receives the same amount of money while the nursing home is penalized 5% of reimbursement rates under Medicaid.

-equipment sent to people in the mail because they answered the phone.

-companies that advertise they'll provide diabetic supplies for low or no cost to patients. They send the most expensive items and bill Medicare.

...and on, and on, and on...

A single payor system would take care of that. Less of a chance to game the system when it’s one agency paying the bills.

ellie, you made that claim and I asked you to back it up with any citations because it sounds ridiculous. As of now, I guess you simply made it up. I mean, paying to the same "system" is like Medicare's "same system" which allows for $60 billion in fraud each year. Too many liberals like you are wedded to a narrative instead of acknowledging the obvious massive shortcomings in the types of systems (Medicare being a prime example) that you are advocating.

I appreciate your concern with waste and fraud, although you seem to be oblivious to the fact that government has no incentive to control it. Unless a person perceives that his job or his bonus will be lost if he doesn't personally crack down on fraud, nothing will be done. In government, no such incentives to crackdown on fraud exist, because there is no profit/loss motive. Hence, massive fraud. It's inherent to the system.

ZippyDDoodah says

Too many liberals like you are wedded

No, I'm divorced but I am in a relationship. Thanks for your interest in my personal life.

Zippy, you know not whereof you speak. I owe you no citations, you're late to the party and you're ill informed if you think that all "liberals" think the same.
On the other hand, it seems to be easier for you anti-dentites to label people according to your narrow views than to admit that individual people are able to think for themselves. I happen to have my own opinions - they're real and they're fantastic!

-Mulva

Zippy, the reimbursement rate for Medicare is about 1/2-3/4 of private insurance. So what's the savings rate for Medicare pt's/government when compared to private insurance reimbursement?

Ever wonder why doctors limit the number of Medicare patients they see?

ZippyDDoodah says

Zippy, you say that Medicare fraud is a government issue - but it’s perpetrated by private companies, and private contractors to Medicare are the ones authorizing the payments. So it’s a private thing too
By your own admission in other threads, Medicare’s “system” gives no incentive not to pay, so it’s not “equally” the fault of private industry as you suggest. Medicare is responsible is for the fraud in their own program, period. In fact, private medical insurers would go bankrupt if they permitted only tiny fraction of the fraud which takes place under Medicare every year. Quit making excuses for the massive fraud

Let me see if I understand this. Committing fraud is not the fault of private industry who plan and perpetrate it because Medicare doesn't always catch it. That's simply the most amazing use of logic I have ever seen. I always thought that the cornerstone of conservative thought was taking responsibility for your own actions. I didn't realize there was an "except when participating in criminal activity against the government" clause.

bob2356 says

Committing fraud is not the fault of private industry who plan and perpetrate it because Medicare doesn’t always catch it.

Don't forget that CMS pays bills that private contractors have determined should be paid out of medicare dollars. But it's Medicare's fault. Wait, I need another hit... Okay, it makes sense now.

Let me see if I understand this. Committing fraud is not the fault of private industry who plan and perpetrate it because Medicare doesn’t always catch it.

Many of the private industry Medicare providers are most definitely guilty and should be punished with heavy fines and jailtime. But because they're dealing with Medicare, they know that they're dealing with a bureacracy which finds it "easier to pay" the fraudsters rather than crackdown as would a company in private industry. As a result, we have $60 billion in Medicare fraud every year (and growing?). Medicare is responsible for this fraud. Incredible to see so many leftists on this thread defend it because the massive scale of Medicare fraud makes clear that large scale govt. "solutions" to healthcare can never be anything but wasteful and fraud-ridden

Those who are administering the payments, the 'accounts payable' group of subcontractors to Medicare like insurance companies are simply following Medicare's rules, doing what Medicare tells them to do.