I’m all for cutting fraud out of our healthcare system. From huge corporations more interested in the shareholder than the patients, to schemers who defraud the government, to individuals who misrepresent their qualifications. Show me the wrongdoers and let’s go after them.
Our government has done a weak job of doing this. There have been some prosecutions on the federal level. Indeed, a clinic I know faced a Medicare audit. It was an eye opener.
Sometimes the codes submitted for payment are wrong. This is not fraud, it’s a mistake. And it should be corrected.
Knowingly taking the taxpayers money for false services is fraud. It’s difficult to prove in court, but it happens. Sometimes, the government can make it stick.
In 2019, Philip Esformes from South Florida was finally convicted of Medicare and Medicaid fraud to the tune of $1.3 BILLION dollars. It was a slog, but the Feds got him.
At the end of his first term, our President Trump commuted his sentence.
About that time Trump also commuted the sentence of John Estin Davis. He had been convicted of taking illegal kickbacks to the tune of $4M. At the same time Trump commuted his sentence, his own Justice department was investigating other allegations in the $10M range.
More recently, just days ago, Trump pardoned another nursing home magnate who falsified workers tax records. It appears the convict’s mom was a strong Trump supporter.
Now before you go all Hunter Biden on me, let’s be straight with each other.
Do you want to clean up the mess we’re in?
It took me a bit, but after the anatomy and physiology, I learned how to bill for my services. And, while driving home from a long day, I could imagine how to game the system. It was tempting.
I’m willing to bet some docs and more clinic administrators has such insight.
But I didn’t set up an LLC and get Medicare and Medicaid billing numbers and start the fraud. Nor did anyone I know. But I’ve now read about the big fish in the papers. I’m glad somebody brought down the hammer.
Now I’ve read about how our President has let them off.
I’m confused.
These Medicaid cuts proposed are based on the claims that some of the folks getting these benefits are fraudsters.
All while Congressional Republicans are making these claims, they are supporting a President who gives convicted big time Medicaid and Medicare fraudsters a get out of jail free card?
What about you Republicans out there? Does this make sense to you? Help me out. I can’t really understand this.
Well, that’s not true. I can understand it, but it doesn’t make you look good.
Speak up if I’ve got this wrong.
And, honestly, I understand the sentiment. I have had it. When my dollars were dear, taxes rubbed me wrong.
Some of us think that everybody should just go out and work for, earn, what they need to survive.
I thought that after a summer of fighting fires and filling out my 1040.
I thought that when I owed six times my annual income in debt, and I had to pay.
I resented taxes.
But I paid them. And it worked out.
The system I lived under back then when I was starting had interest rates you can’t imagine. But I had conviction, that if I did the work, lots, I could pay it off.
I didn’t scheme an LLC medical device to defraud my fellow citizens. I could have.
I guess it comes down to our values.
Can we accept that some folks need our help?
Can we accept that we can all help?
Isn’t this the more perfect Union?