Dear Elton Gallegly and Members of the United States Congress:
I got your phone call today. Thanks for calling to let me know how you feel about health care reform in America. I really appreciate your taking the time to have someone else record a message for you and have an automated system call my cell phone while I was out shopping.
If you haven't listened to your own recorded message, let me remind you that you called to tell me that you do not support a public health insurance option for average American citizens. This would be an option that no one would be required to have, but if it was affordable enough and offered quality care for Americans who either couldn't get health care from somewhere else or preferred a public option, then they could get it.
I've heard the arguments: socialized medicine is bad, we'll have government doctors, health insurance companies won't be able to make $4.3 Billion in profits each year, and I noticed while looking at your employment salary and health benefits information online that you have access to every regional, state, and national insurance program available today. In addition, I noticed several public health insurance options to which you have access .
I'm just so darn confused these days about all of this health care reform business everyone's talking about. I understand that you've received over $1.2 million from health care providers and insurance companies. I also can see how increasing competition would be bad for the few giant insurance companies left. And I even understand how the AMA, which limits the number of people who can become doctors in order to create a "scarcity effect" and keep salaries high, would oppose health care reform.
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Article comments
— go to most recent comments1 - Bill Watson
Hundreds of billions of dollars of annual savings could be realized for Americans, while eliminating debilitating financial burdens for individuals and businesses by using these health care reforms. This would also be the best economic stimulus package ever. Ask OMB.
1. Set up a civilian, VA style, public health care system for delivering all government funded health care and medications free to everyone choosing to use it, no restrictions, rich, and poor, Medicare, Medicaid, etc everybody who wants public care has it free, all services, all medications, free period.
2. Pay for it with a national sales tax.
3. Let private insurers and care providers compete for everyone who wants private care, unfettered by government mandates, dictating who must be served, at what level, for what price, and totally unregulated but for safety.
4. Businesses that choose public care for their employees will have no financial obligations or any other responsibilities concerning health care.
5. Dispensing health care efficiently, and collecting the money to pay for it cheaply, that's the purpose of the exercise, and no one can compete with the government at these two tasks.
2 - Arch Conservative
"And I even understand how the AMA, which limits the number of people who can become doctors in order to create a "scarcity effect" and keep salaries high, would oppose health care reform."
Makes it kind of hard to take you seriously when you make such [Edited] assertions Foffer, but it's 6:49 in the Am and I aint got shit to do for the next ten minutes so I'll humor you.
"I deserve to have access to exactly the same health insurance options that you have."
You do? Why? Because you said so? Show me any other industry where we deserve the products and services that that industry provides regardless of our ability to pay Foffer.
Oh but healthcare's different right? It's all touchy feely. It's a right right? You're entitled to it. I gotcha.
If you want to engage in a serious and comprehensive discussion of our healthcare system, while your bashing insurance companies and the AMA you might want to think about these two points.......
1. illegals cost the system and those of us who pay for our care billions of dollars every year in care that they don't pay a dime for. We're subsidizing the care they receive to the tune of billions but no one ever wants to talk about that because it's not PC. It's much easier and much more PC to villify drug companies and insurance companies.
2. Way too many Americans are willingly choosing to succumb to the modern lifestyle of fast food and sedentary behavior. The obesity and diabetes epidemic we're experiencing is our own fault. The insurance and drug companies aren't forcing to gulp down big macs and sit in front of a computer screen 10 hours a day without ever getting any exercise. The AMA isn't keeping people from getting off their fat asses and going for a jog, bike ride or walk. We'd rather blame anyone but ourselves for the very unhealthy lifestyle choices we pretty much decided to make en masse. This is so typical of the liberal mindset that is advocating government controlled healthcare.
Make no mistake about it Foffer.....if we choose the path of socialized medicine, you WILL be paying much more than you currently are for you healthcare.
3 - Brian aka Guppusmaximus
"Set up a civilian, VA style, public health care system..."
Oh man, have you ever been to a VA hospital?? No f*cking way! I'll stick with paying for health care.
4 - Bliffle
Good article: brief and to the point.
The current private health insurance system costs the USA about 18% of the GDP, about $2.5trillion per year.
The overhead cost of the current private system is about 27% to 40% of gross revenue, while the overhead of the Medicare program is about 3%.
Thus, there is as much as $1trillion savings available to Americans by switching to a Medicare type system for everyone.
5 - Clavos
bliffle sez:
The current private health insurance system costs the USA about 18% of the GDP, about $2.5trillion per year.
Writing in The Washington Post, Robert Samuelson notes that Obama's Council of Economic Advisers reports that:
-- Health spending, which was 5 percent of the economy (gross domestic product, GDP) in 1960 and is reckoned at almost 18 percent today [as bliffle points out], would grow to 34 percent of GDP by 2040 -- a third of the economy.
The report goes on to say:
-- Medicare and Medicaid, the government insurance programs for the elderly and poor, would increase from 6 percent of GDP now [already a third of all medical spending] to 15 percent in 2040 -- roughly equal to three-quarters of present federal spending.
Samuelson notes that:
The message in these dismal figures is that uncontrolled health spending is almost single-handedly determining national priorities. It's reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs. Worse, much medical spending is wasted, the CEA report says. It doesn't improve Americans' health; some care is unneeded or ineffective.
***
The central cause of runaway health spending is clear. Hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, either private or governmental. The open-ended payment system encourages doctors and hospitals to provide more services -- and patients to expect them. It also favors new medical technologies, which are made profitable by heavy use. Unfortunately, what pleases providers and patients individually hurts the nation as a whole.
That's the crux of the health care dilemma, and Obama hasn't confronted it. His emphasis on controlling costs is cosmetic. The main aim of health care "reform" now being fashioned in Congress is to provide insurance to most of the 46 million uncovered Americans. This is popular and seems the moral thing to do. After all, hardly anyone wants to be without insurance. But the extra coverage might actually worsen the spending problem. (emphasis added)
***
The one certain consequence of expanding insurance coverage is that it would raise spending. When people have insurance, they use more health services. That's one reason why Obama's campaign proposal was estimated to cost $1.2 trillion over a decade (the other reason is that the federal government would pick up some costs now paid by others). Indeed, the higher demand for health care might raise costs across the board, increasing both government spending and private premiums.
No doubt the health program that Congress fashions will counter this reality by including some provisions intended to cut costs ("bundled payments" to hospitals, "evidence-based guidelines," electronic record keeping). In the past, scattershot measures have barely affected health spending. What's needed is a fundamental remaking of the health care sector -- a sweeping "restructuring"-- that would overhaul fee-for-service payment and reduce the fragmentation of care.
In other words, contrary to bliffle's assertions, switching to a Medicare-type system would increase, not reduce, costs for health care.
Additionally, neither bliffle nor Samuelson have taken into account the staggering amount of fraud perpetrated on Medicare, which the government has thus far been totally unable to even slow down, mush less eliminate. According to The Miami Herald, Medicare fraud in South Florida alone amounts to $7 million dollars a day, every day of the year.
6 - Dr Dreadful
Arch:
You do? Why? Because you said so? Show me any other industry where we deserve the products and services that that industry provides regardless of our ability to pay Foffer.
National defense?
Also, have you considered the possibility that Mr Fofanoff's salary may be higher than that of a member of Congress?
There's nothing in the article to suggest that it isn't.
So perhaps he is not arguing from a sense of entitlement.
7 - Bliffle
Clavos says:
"...the staggering amount of fraud perpetrated on Medicare, which the government has thus far been totally unable to even slow down, mush less eliminate. According to The Miami Herald, Medicare fraud in South Florida alone amounts to $7 million dollars a day, every day of the year."
I don't know where the Miami Herald gets its figures, but I find it hard to believe.
Medicare REQUIRES that EVERY state receiving Medicare have in place and working certified anti-fraud software that analyzes the claims and payments databases and discovers fraud. Those programs work very well and constantly mine fraud cases from the data. I happen to know the vendor of the FLA analysis system, and I can assure you that it is certified and constantly captures attempted fraud. Not only does it catch patient and doctor fraudsters, it also catches crooked program administrators, and in a separate southern state sent the state Fraud system administrator to jail.
I'm sure that if you have explicit knowledge of specific successful frauds against FLA medicare that my contacts, MC and GG, would be glad to know of it.
8 - Clavos
I don't know where the Miami Herald gets its figures, but I find it hard to believe.
***
I'm sure that if you have explicit knowledge of specific successful frauds against FLA medicare that my contacts, MC and GG, would be glad to know of it.
Tell 'em to read the paper.
It gets its figures from an in-depth investigation lasting six months, conducted by a team of their top journalists and published over a span of several installments, for which they are under consideration for the Pulitzer prize.
The Miami Herald is widely regarded as one of the nation's top liberal newspapers.
Here's a link to the first installment, which among many other facts, notes:
...during a policy forum to confront the crisis, federal lawmakers said Medicare fraud costs taxpayers nationwide at least $60 billion a year. (emphasis added)
Sixty billion taxpayer dollars a year! 2.5 billion annually in South Florida alone! Sounds like the software that "works very well" ain't worth shit -- come to think of it, that's typical of the government: getting ripped off trying to stop ripoffs.
From the article:
Still, the medical equipment and HIV-infusion schemes alone add up to at least $7 million in Medicare fraud daily in South Florida, where a sprawling cast of illegal HIV-therapy clinics, bogus suppliers, inner-city patient recruiters, complicit doctors and devious billing companies have even used the names of dead doctors to bilk the U.S. government out of billions of Medicare dollars.
''I knew Miami was bad, but I was shocked when I got here,'' said Timothy Delaney, assistant special agent in charge of the FBI's office in Miami and the head of the bureau's national healthcare fraud program from 2000 to 2004. ``There is fraud here like nowhere else in the country. Los Angeles is second, but nowhere like it is here.''
If, after reading this article you want more, it's easily Googled, bliffle.
Have a ball. Show it to your software purveying friends...
9 - Dave Nalle
Bliffle, any fraud detection software is only as good as the people using it and the willingness to pursue and enforce what it highlights. I'll bet that this human element is where things come up short in Florida.
Dave
10 - Clavos
Except that, as the article spells out, it isn't just Florida, although this is the worst area. LA also is bad, and the fraud is nationwide, according to the FBI.
Sixty billion dollars a year worth of nationwide.
11 - M a rk
A 60B transfer of public money into private hands yearly...so, what's the complaint?
And what the hell -- we all know that corruption is innate in the European character.
12 - Clavos
A 60B transfer of public money into private hands yearly...so, what's the complaint?
Unfortunately, that's not the case. It's really a $60B illegal transfer of what was originally private money (taxes paid by citizens) from one set of private hands to another, with the government as the middle man, facilitating the illegal transfer.
And what the hell -- we all know that corruption is innate in the European character.
WTF? How does that apply to corruption in the USA?
13 - Ma rk
...a $60B illegal transfer of what was originally private money (taxes paid by citizens) from one set of private hands to another...
As is all government spending. (sans the 'illegal' thing) And you got something against doctors and health care bureaucrats?
WTF? How does that apply to corruption in the USA?
If you don't 'get it' right off then I fear that the answer to this could be communicated only through a series of, at a minimum, 4 convoluted articles, 5 pages each.
14 - Cindy
How dare they take all that money without paying off politicians first.
15 - Ma r k
Hey, politicians (and agency bureaucrats) are private citizens too...they deserve their cut.
16 - Cindy
Yes, true...but what about the decorum? All the other thieves have to lobby first, then make campaign contributions.
It's hardly fair to them.
17 - ma r k
You're right. Everyone's gotta make a living...thank goodness for that 60B. If only it were more.
18 - Clavos
If only it were more.
Not to worry, just ask Obama for more.
Trolls gotta get their cut too...
19 - Cindy
Well, at least Monopoly won't be boring any more. There is a new State of the Union Edition
Play as Barack Obama, flush with $1.5 trillion in cash to spend. What will you pay for next? Now who needs a bailout? Will you force the currency into hyperinflation? Roll the dice to find out!
20 - mar k
And yer right too, Clavos! Where the hell is my cut?
21 - JP
Though i don't believe a government-run solution is best, it would be easier to debate it without charged language.
Unfortunately, it's easier to score political points in the age of the soundbite by doing people's thinking for them in the form of..charged language.
22 - Bliffle
I started reading the Miami Herald article referenced by Clavos in #8 and it looks like sensationalist crap to me. YMMV. Has anyone else read it?
Unattributed sources and some weird uncheckable story about some guy named McCray.
I've been checking FBI reports and find nothing related to this.
This is a pretty poor citation.
Has anyone else read the article? Has anyone looked for citations and sources? Does anyone believe this story?
I'm guessing that it's the typical shock story intended to increase circulation.
But I'll continue to investigate and dig upe REAL citations and REAL quotes from REAL people.
All you have to do is google "florida medicare fraud". (which, by itself, is not an adequate citation).
23 - Clavos
How's this for a "real quote" from a "real person," bliffle?
''I knew Miami was bad, but I was shocked when I got here,'' said Timothy Delaney, assistant special agent in charge of the FBI's office in Miami and the head of the bureau's national healthcare fraud program from 2000 to 2004. ``There is fraud here like nowhere else in the country. Los Angeles is second, but nowhere like it is here.'' (emphasis added)
Here's a quote from Part 1 of a two part story by NBC News:
After visiting the region, and seeing the extent of the fraud, Michael Leavitt, the U.S. Secretary of Health and Human Services, said, "In a decade and a half of public service, this was the most disheartening, disgusting day I have ever spent. We have to fix this."
Real quote. Real person. Presidential Cabinet member no less.
From the FBI's Annual Financial Crimes Report for 2007:
All health care programs are subject to fraud; however, Medicare and Medicaid programs are the most visible. Estimates of fraudulent billings to health care programs, both public and private, are estimated between 3 and 10 percent of total health care expenditures. The fraud schemes are not specific to any area but are found throughout the entire country.
***
The most recent CMS [Medicare Billing Agency] statistical estimates project the total health care expenditures for Fiscal Year 2007 will total $2.26 trillion, representing 16.2 percent of the Gross Domestic Product (GDP).
Real quote. Real report. Real FBI.
Do the math, bliffle. The FBI Report statistics mean that as much as $226 billion a year of Medicare billings are fraudulent.
The Miami Herald was being sensationalist? On the contrary, they underestimated the extent of the problem on a national scale.
24 - Bliffle
Clavos,
Even given the (unsubstantiated, just guesswork) numbers you quote you can't justify your conclusion.
You say:
"... Estimates of fraudulent billings to health care programs, both public and private, are estimated between 3 and 10 percent of total health care expenditures. ...".
"The most recent CMS [Medicare Billing Agency] statistical estimates project the total health care expenditures for Fiscal Year 2007 will total $2.26 trillion, representing 16.2 percent of the Gross Domestic Product (GDP)."
"Do the math, bliffle. The FBI Report statistics mean that as much as $226 billion a year of Medicare billings are fraudulent."
Nonsense. You've got one "estimate" and a projection:
"... Estimates of fraudulent billings to health care programs, both public and private, are estimated between 3 and 10 percent of total health care expenditures. ..."
So you cherry picked the high estimate and applied it ONLY to medicare, neglecting that the estimate was for combined public and private (of which 'public is about 1/4 of the total) and then applied that to the $2.26Trillion annual total healthcare cost.
Bad math, Clavos.
At best, you could claim 1/4 of the total $226billion, or about $56billion. That's when you cherry-pick the HIGH estimate. Of course, if you pick the 3% figure you only get about $16billion.
Still a high number, but not reinforced by a secondary source.
Going thru the FBI reports dealing with actual prosecuted fraud I've found nothing, so far, to support that big number. But I'm still digging.
25 - Clavos
Amazing, bliffle.
First you tell me the Herald is "sensationalistic," so I give you the report from the FBI's special taskforce, which focuses only on health care fraud -- in particular on (their words) Medicare and Medicaid, and you scoff at the FBI's estimates.
Given our inept (and to a significant degree, crooked) government's penchant for reflexively sweeping all bad news under the rug in order to hide it from we, the taxpayers, I think it's fair to say that all the figures so far discussed are probably under estimated.
Either way, I'm reminded of Ev Dirksen...