jkapp
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Post by jkapp on Oct 12, 2015 8:41:39 GMT -5
If every American citizen is insured from cradle to grave with single payer, then nobody will have to resort to fraud. That being said, you have illegals coming out the wazoo. Not to worry, though. Trump will deport them all. Humanely. Tranquilizer dart, then they wake up in Mexico.
Exactly. If everyone is covered, there won't be a need for fraud. How can people miss this? There's only fraud because people aren't covered.No there's fraud because the government does not administer benefits worth a shit. They have no controls on the money being spent. It is an open checkbook to every shady character in the country. It's akin to leaving the doors on your house unlocked, and advertising the fact that you do it.
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djAdvocate
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Post by djAdvocate on Oct 12, 2015 11:32:55 GMT -5
i am seeing something far less tangible, and far simpler. There is no such thing as a simple government program...you should know that by now i don't even think of it as a "program", any more than i think of a checking account as being a "program".
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Deleted
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Post by Deleted on Oct 12, 2015 18:14:07 GMT -5
Exactly. If everyone is covered, there won't be a need for fraud. How can people miss this? There's only fraud because people aren't covered.No there's fraud because the government does not administer benefits worth a shit. They have no controls on the money being spent. It is an open checkbook to every shady character in the country. It's akin to leaving the doors on your house unlocked, and advertising the fact that you do it. You don't have a clue how far off that analogy is... do you? It'd be more "akin" to having a "bake sale" where everyone from [Group A] gets free baked goods because they pay a membership... but everyone else ([Group B]) has to pay because they don't pay for a membership... then leaving it up to the honor system (not having an attendant checking membership cards / collecting money).
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fishy999
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Post by fishy999 on Oct 12, 2015 20:59:54 GMT -5
Exactly. If everyone is covered, there won't be a need for fraud. How can people miss this? There's only fraud because people aren't covered.No there's fraud because the government does not administer benefits worth a shit. They have no controls on the money being spent. It is an open checkbook to every shady character in the country. It's akin to leaving the doors on your house unlocked, and advertising the fact that you do it. So no such thing as insurance fraud in the private market exists? Also why are so many companies being prosecuted and/or fined over medicare/medicaid fraud? Weak argument- there will always be fraud no matter who runs it. Somehow there are never any fraud complaints when defense contractors sell us $800 hammers or go over budget on modern jets that are worse than those built in the 60's.
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jkapp
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Post by jkapp on Oct 13, 2015 8:12:58 GMT -5
No there's fraud because the government does not administer benefits worth a shit. They have no controls on the money being spent. It is an open checkbook to every shady character in the country. It's akin to leaving the doors on your house unlocked, and advertising the fact that you do it. So no such thing as insurance fraud in the private market exists? Also why are so many companies being prosecuted and/or fined over medicare/medicaid fraud? Weak argument- there will always be fraud no matter who runs it. Somehow there are never any fraud complaints when defense contractors sell us $800 hammers or go over budget on modern jets that are worse than those built in the 60's. Yes there is fraud in the private sector too...but not even nearly as much as in Medicare. Why? Because of Medicare's much-touted 3% administration expenses...those expenses obviously do not go much towards fraud prevention (something the private industry is multitudes better at applying).
And who has been taken to task for Medicare's overwhelming fraud/abuse payouts? Who got fired for Medicare/Medicaid spending $84B more than it should have last year? Anyone? So what's to stop it from getting even worse this year? Considering those fraudulent payments have only been increasing year after year, I would say nothing will stop the fraud from growing.
And this is the system we should put EVERYONE on? Wow, some people must LOOOOOOOOOVE fraud to want to triple it with such a move as that...
And are people being prosecuted for it? Yes...and Medicare gets back, oh, about 1-2% that fraud. Whew...great job they're doing, huh? Such a great job that the fraud just continues to grow!
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jkapp
Junior Associate
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Post by jkapp on Oct 13, 2015 8:20:08 GMT -5
No there's fraud because the government does not administer benefits worth a shit. They have no controls on the money being spent. It is an open checkbook to every shady character in the country. It's akin to leaving the doors on your house unlocked, and advertising the fact that you do it. You don't have a clue how far off that analogy is... do you? It'd be more "akin" to having a "bake sale" where everyone from [Group A] gets free baked goods because they pay a membership... but everyone else ([Group B]) has to pay because they don't pay for a membership... then leaving it up to the honor system (not having an attendant checking membership cards / collecting money). Your analogy is on something compeletely different than mine. You are looking at the "who has insurance" side, I'm looking at the "who Medicare pays" side. Medicare is the one pissing our tax dollars away on fraudulent payments, to the tune of $80B+ a year. They have ZERO accountabililty for our dollars and fraudsters know this, which is why the fraud grows in dollars every year.
Even if everyone had insurance, Medicare would still be paying out billions in fraud every year. Let me repeat that so it sinks in: Even if everyone had insurance, Medicare would still be paying out billions in fraud every year.
Who does and does not have insurance does not play into Medicare's fraudulent payments AT ALL.
Now want to try reviewing my analogy again?
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Deleted
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Post by Deleted on Oct 13, 2015 19:10:56 GMT -5
You don't have a clue how far off that analogy is... do you? It'd be more "akin" to having a "bake sale" where everyone from [Group A] gets free baked goods because they pay a membership... but everyone else ([Group B]) has to pay because they don't pay for a membership... then leaving it up to the honor system (not having an attendant checking membership cards / collecting money). Your analogy is on something compeletely different than mine. You are looking at the "who has insurance" side, I'm looking at the "who Medicare pays" side. Medicare is the one pissing our tax dollars away on fraudulent payments, to the tune of $80B+ a year. They have ZERO accountabililty for our dollars and fraudsters know this, which is why the fraud grows in dollars every year.
Even if everyone had insurance, Medicare would still be paying out billions in fraud every year. Let me repeat that so it sinks in: Even if everyone had insurance, Medicare would still be paying out billions in fraud every year.
Who does and does not have insurance does not play into Medicare's fraudulent payments AT ALL.
Now want to try reviewing my analogy again?
No need to re-review your analogy. It's still wrong. If everyone was covered, there wouldn't be fraud... because no non-covered people would exist to need to commit fraud for coverage.
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fishy999
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Post by fishy999 on Oct 13, 2015 22:11:20 GMT -5
So no such thing as insurance fraud in the private market exists? Also why are so many companies being prosecuted and/or fined over medicare/medicaid fraud? Weak argument- there will always be fraud no matter who runs it. Somehow there are never any fraud complaints when defense contractors sell us $800 hammers or go over budget on modern jets that are worse than those built in the 60's. Yes there is fraud in the private sector too...but not even nearly as much as in Medicare. Why? Because of Medicare's much-touted 3% administration expenses...those expenses obviously do not go much towards fraud prevention (something the private industry is multitudes better at applying).
And who has been taken to task for Medicare's overwhelming fraud/abuse payouts? Who got fired for Medicare/Medicaid spending $84B more than it should have last year? Anyone? So what's to stop it from getting even worse this year? Considering those fraudulent payments have only been increasing year after year, I would say nothing will stop the fraud from growing.
And this is the system we should put EVERYONE on? Wow, some people must LOOOOOOOOOVE fraud to want to triple it with such a move as that...
And are people being prosecuted for it? Yes...and Medicare gets back, oh, about 1-2% that fraud. Whew...great job they're doing, huh? Such a great job that the fraud just continues to grow!
Really- can you back that up? Any figures on how much fraud prevention is spent by government programs vs. private? Any figures on who does a better job of it? I think you are pulling this out of your ass with zero proof- so maybe start with your statement 'private industry does a better job and how they are applying it 'multitudes better'. Of course due to a lack of interest does anyone want to blame or prosecute private businesses for fraud? You want to blame Medicare for the fraud? It is the government's fault that private companies screw taxpayers? You really buy this?
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jkapp
Junior Associate
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Post by jkapp on Oct 14, 2015 18:04:51 GMT -5
Your analogy is on something compeletely different than mine. You are looking at the "who has insurance" side, I'm looking at the "who Medicare pays" side. Medicare is the one pissing our tax dollars away on fraudulent payments, to the tune of $80B+ a year. They have ZERO accountabililty for our dollars and fraudsters know this, which is why the fraud grows in dollars every year.
Even if everyone had insurance, Medicare would still be paying out billions in fraud every year. Let me repeat that so it sinks in: Even if everyone had insurance, Medicare would still be paying out billions in fraud every year.
Who does and does not have insurance does not play into Medicare's fraudulent payments AT ALL.
Now want to try reviewing my analogy again?
No need to re-review your analogy. It's still wrong. If everyone was covered, there wouldn't be fraud... because no non-covered people would exist to need to commit fraud for coverage. You are still so incredibly missing the point I am making...people with insurance ARE NOT COMMITTING THE FRAUD. The Medical industry is committing the fraud because they are the ones being paid by Medicare - they are the ones overbilling and billing for services not performed.
So again: even...if...everyone...had...insurance...Medicare...would...still...be...spending...BILLIONS...in...fraud...every...year.
The fraud is not being committed to make up for non-insured people - it is being committed because government has ZERO accountability on the tax dollars being paid out. It basically pays on an honor system - meaning whatever gets billed, gets paid first and scrutinized later (MUCH later). Look it up!
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jkapp
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Post by jkapp on Oct 14, 2015 18:08:04 GMT -5
Yes there is fraud in the private sector too...but not even nearly as much as in Medicare. Why? Because of Medicare's much-touted 3% administration expenses...those expenses obviously do not go much towards fraud prevention (something the private industry is multitudes better at applying).
And who has been taken to task for Medicare's overwhelming fraud/abuse payouts? Who got fired for Medicare/Medicaid spending $84B more than it should have last year? Anyone? So what's to stop it from getting even worse this year? Considering those fraudulent payments have only been increasing year after year, I would say nothing will stop the fraud from growing.
And this is the system we should put EVERYONE on? Wow, some people must LOOOOOOOOOVE fraud to want to triple it with such a move as that...
And are people being prosecuted for it? Yes...and Medicare gets back, oh, about 1-2% that fraud. Whew...great job they're doing, huh? Such a great job that the fraud just continues to grow!
Really- can you back that up? Any figures on how much fraud prevention is spent by government programs vs. private? Any figures on who does a better job of it? I think you are pulling this out of your ass with zero proof- so maybe start with your statement 'private industry does a better job and how they are applying it 'multitudes better'. Of course due to a lack of interest does anyone want to blame or prosecute private businesses for fraud? You want to blame Medicare for the fraud? It is the government's fault that private companies screw taxpayers? You really buy this? Who collects Medicare tax? Who pays the tax money out to the medical industry? Who is responsible to make sure the money is handled properly and efficiently?
For some reason, you think it should be the criminals? Then again, maybe you're right that criminals are the ones doing all of the above...
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Deleted
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Post by Deleted on Oct 14, 2015 18:42:55 GMT -5
No need to re-review your analogy. It's still wrong. If everyone was covered, there wouldn't be fraud... because no non-covered people would exist to need to commit fraud for coverage. You are still so incredibly missing the point I am making...people with insurance ARE NOT COMMITTING THE FRAUD. The Medical industry is committing the fraud because they are the ones being paid by Medicare - they are the ones overbilling and billing for services not performed.
So again: even...if...everyone...had...insurance...Medicare...would...still...be...spending...BILLIONS...in...fraud...every...year.
The fraud is not being committed to make up for non-insured people - it is being committed because government has ZERO accountability on the tax dollars being paid out. It basically pays on an honor system - meaning whatever gets billed, gets paid first and scrutinized later (MUCH later). Look it up!
I'm not missing the point at all. The fraud exists to cover shortfalls from treating the uninsured. If there are no uninsured, there would be no shortfalls due to them.
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jkapp
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Post by jkapp on Oct 16, 2015 18:04:32 GMT -5
I'm not missing the point at all. The fraud exists to cover shortfalls from treating the uninsured. (FALSE! AGAIN!!) If there are no uninsured, there would be no shortfalls due to them. (This is actually true...but the fraud would still be there. That's the point you are missing entirely.)
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Deleted
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Post by Deleted on Oct 16, 2015 18:22:00 GMT -5
I'm not missing the point at all. The fraud exists to cover shortfalls from treating the uninsured. (FALSE! AGAIN!!) If there are no uninsured, there would be no shortfalls due to them. (This is actually true...but the fraud would still be there. That's the point you are missing entirely.) True, again. (I do agree with the emoticon... I am getting a headache from figuratively beating my head against the wall of your ignorance about the issue) The fraud exists because the non-covered are required to be treated. Period. End of story.
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jkapp
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Post by jkapp on Oct 19, 2015 18:02:02 GMT -5
True, again. (I do agree with the emoticon... I am getting a headache from figuratively beating my head against the wall of your ignorance about the issue)
The fraud exists because the non-covered are required to be treated. Period. End of story. The most ironic statement of the year...or at least the week
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jkapp
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Post by jkapp on Oct 19, 2015 18:14:25 GMT -5
True, again. (I do agree with the emoticon... I am getting a headache from figuratively beating my head against the wall of your ignorance about the issue) The fraud exists because the non-covered are required to be treated. Period. End of story.
www.forbes.com/sites/merrillmatthews/2012/05/31/medicare-and-medicaid-fraud-is-costing-taxpayers-billions/
Federal officials set up the Medicare Fraud Strike Force in 2007, which visited at random nearly 1,600 businesses in Miami, ground zero for Medicare fraud, that had billed Medicare for durable medical equipment. Officials found that nearly a third of the businesses, 481, didn’t even exist, yet they had billed Medicare for $237 million over the previous year, according to National Public Radio.
-->So what treatments were these non-existent businesses providing the non insured?
money.cnn.com/2015/06/19/pf/medicare-fraud-doctors/
In total, 243 people were arrested in 17 cities for allegedly billing Medicare for $712 million worth of patient care that was never given or unnecessary.
-->So here they were giving treatments that never happened or wasn't needed. So they weren't treating anyone, non-insured or otherwise.
Four people are charged for mass-marketing a talking glucose monitor and sending the devices to Medicare patients across the country who didn't need or request them. They billed Medicare for the devices and received more than $22 million.
-->Here they were charging Medicare for equipment the patients (insured or uninsured) didn't even ask for.
"In these cases, we followed the money and found criminals who were attracted to doctors offices, clinics, hospitals and nursing homes in search of what they viewed as an ATM," said FBI Director James B. Comey.
-->So is the fraud still having to do with treating the uninsured?
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Deleted
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Post by Deleted on Oct 19, 2015 18:28:13 GMT -5
My apologies. we were talking about different types of fraud.
You got me on that one. I'll admit I was wrong.
(see... I do admit I'm wrong when I am and actual facts are brought up to back up the claim... previously you hadn't posted any examples of the fraud... you just kept saying "fraud" and I thought we were talking about billed fraud for patients who should not have qualified for medicaid/medicare)
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Deleted
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Post by Deleted on Oct 19, 2015 18:29:52 GMT -5
However... that admitted... If everyone was covered, it would be easier to uncover (and eliminate/prosecute) that kind fraud, because all the resources that used to go into investigating COVERAGE fraud could be put to bear on that kind of fraud.
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Miss Tequila
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Post by Miss Tequila on Oct 21, 2015 19:06:39 GMT -5
It should by all means. After all it works all over the world doesn't it? Nobody, and I mean nobody in this world spends the kind of money that we do( government wise) on health care- subsidizing, Medicare, Medicaid etc. At this point if we just remove -as I already mentioned- the middle man, and set some kind of tax-fixed or otherwise- on income, we could come up with what's missing. And will work, there is no reason why it shouldn't. so fiscally, we can do it. Socialy, I don't see why not? Are people going to complain about better health care? Politicaly... That's a different animal. There we might have a problem and will not be easy solving it. we used to be a "CAN DO" nation. now we are a nation of pathetic whiners, complaining about problems that are too hard to solve. i want my country back. Me too...I want the country where people were embarrassed to take government handouts...now it is a way of life for many and it sickens me
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djAdvocate
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Post by djAdvocate on Oct 21, 2015 20:22:30 GMT -5
we used to be a "CAN DO" nation. now we are a nation of pathetic whiners, complaining about problems that are too hard to solve. i want my country back. Me too...I want the country where people were embarrassed to take government handouts.. that is a "family value" for me and my 15 year old son.
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wvugurl26
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Post by wvugurl26 on Oct 21, 2015 20:26:14 GMT -5
True, again. (I do agree with the emoticon... I am getting a headache from figuratively beating my head against the wall of your ignorance about the issue) The fraud exists because the non-covered are required to be treated. Period. End of story.
www.forbes.com/sites/merrillmatthews/2012/05/31/medicare-and-medicaid-fraud-is-costing-taxpayers-billions/
Federal officials set up the Medicare Fraud Strike Force in 2007, which visited at random nearly 1,600 businesses in Miami, ground zero for Medicare fraud, that had billed Medicare for durable medical equipment. Officials found that nearly a third of the businesses, 481, didn’t even exist, yet they had billed Medicare for $237 million over the previous year, according to National Public Radio.
-->So what treatments were these non-existent businesses providing the non insured?
money.cnn.com/2015/06/19/pf/medicare-fraud-doctors/
In total, 243 people were arrested in 17 cities for allegedly billing Medicare for $712 million worth of patient care that was never given or unnecessary.
-->So here they were giving treatments that never happened or wasn't needed. So they weren't treating anyone, non-insured or otherwise.
Four people are charged for mass-marketing a talking glucose monitor and sending the devices to Medicare patients across the country who didn't need or request them. They billed Medicare for the devices and received more than $22 million.
-->Here they were charging Medicare for equipment the patients (insured or uninsured) didn't even ask for.
"In these cases, we followed the money and found criminals who were attracted to doctors offices, clinics, hospitals and nursing homes in search of what they viewed as an ATM," said FBI Director James B. Comey.
-->So is the fraud still having to do with treating the uninsured?
Love that FBI took credit for that data analysis. Pretty sure they wouldn't know what the hell they were looking at. My favorite strike force takedown involved some suspects already being in jail in California state prison. They were literally running the fraud scheme from prison. I said we should have billed California for that because they let these guys have illegal cell phones and it went on for quite some time. The saying is you can't swing a dead cat in Miami without hitting Medicare/Medicaid fraud. It's rampant. Organized crime is big into it because it's easy money for them. A lot of Miami's problem is caused by immigrants from Cuba. And the money is sent back to Cuba or the Caymans never to be seen again. As for stopping it, pre-payment edits, enrollment screening for providers, more enrollment moratoriums in trouble spots and throw people in jail. Including complicit beneficiaries. But DOJ doesn't like to do that, bad publicity to throw grandma in jail. Well maybe grandma shouldn't have been committing fraud!!
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