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Defrauding Medicare for fun and profit.

by Paul 7. August 2009 07:44

It shouldn't be a joking matter. Medicare fraud hits all of us in the pocketbook, and distracts us from streamlining and modernizing our decrepit healthcare system. Ironically, I remember when Medicare was first proposed, and there were those who screamed about "socialized medicine" then as now, who predicted that millions of larcenous seniors were going to abuse the system. Maybe they meant getting five more minutes with a physician than they were entitled to, but there was always that hint that somehow Grandpa would turn his physician's bills into a condo on the Riviera.

Sorry. It's not those cagey old codgers. It's physicians and other healthcare providers. I haven't heard recently of any hospital corporations defrauding Medicare, but since I know from personal experience that some routinely defraud their patients, I won't be shocked to learn that they victimize the taxpayers as well.

So, why shouldn't they? It's easy money, with very little risk. Just recently an Arizona man got two and a half years behind bars for stealing a quarter million. He had to pay it back, and after he serves his thirty months with however much time off for good behavior, he'll have a few years of probation. Still, when you compare that with the twenty years you can get for stealing $100 with a gun, or the life sentence you could get for a drug offense, it's a pretty high-profit low-risk business.

Another example from some years ago: A certain psychiatrist, who worked part-time in the same court-support agency with me, used to spend a few hours a week doing his private practice billing on his county payroll job. No problem, since it was during downtime. Then it turned out that some of that billing was to Medicare, and over $300,000 of it was fraudulent. Federal charges were filed and he was fired immediately by the circuit court, but it wasn't a great job anyway. I'm sure he had to pay back what he stole, and let's say he was fined a half million bucks (I don't know), but to my knowledge, he never spent a day behind bars.

To other successful psychiatrists whose total honest incomes might be a half million a year or more, that might not seem like a terrible risk. Just like, to the kid in the ghetto, a little time in prison might not seem so much worse than life on the streets.

Truthfully, I wouldn't do it, no matter what. A few years back I got a couple of louvred glass storm doors from a home center, without having paid more than a small deposit. I took the trouble to go to the store, insist they find the record of the sale, and let me pay what I owed. There was a time in my distant past when I certainly would have done no such thing! If you don't know what I'm talking about, check out my other website, going-straight.com For the last fifty years I don't take things that aren't mine, I don't steal from people, and I consider paying what I owe in taxes a patriotic duty. I hope that's true of you as well. But for anyone who is easily tempted, who just happens to have an MD or Psy.D. or RN after his or her name, or happens to own a hospital or medical supply company, or for any other reason submits charges to Medicare, the risk is too low.

I liked the guy down the hall, and it would be hard to think of him in a cell, but logically, I know that's what he deserved. When politicians talk about getting tough on crime, they usually mean getting tough on poor people who hurt rich people. I say it's time to get tough, very tough, on rich people who hurt all of us. Maybe in China they'd get a bullet to the back of the head. I don't advocate that. I do advocate giving them seriously long vacations at the Crossbars Resort.

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Government Action and Inaction | Morality Defined | Stuff I've Learned

Comments

9/15/2009 6:39:05 AM #

Harold E. Kenley

Wouldn't it be nice if we could get back to the days when people became doctors because they wanted to help others, not because they wanted to become as rich as possible while doing as little work as possible? Your former coworker should have been employed for the next ten years breaking rocks.

Harold E. Kenley United States

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