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Thursday, June 24, 2010

"Fraud, Waste, and Abuse"

I'm sure you're aware that the plan--the perennial plan--to keep Medicare/Medicaid/Obamacare expenses under control is to stop "fraud, waste, and abuse."

I'm sure there is a lot of that going on, actually. Huge amounts of government money? What kind of people do you suppose might be attracted to that?

But there's more to the story. Because of the nature of my employment, I see certain things that you might not see. For instance, you would not believe--would NOT believe--the number of people in the state of Oklahoma who get, largely at government expense, various incontinence products. That is, we the people buy a heck of a lot of pull-ons and diapers and underpads. Now, obviously, somebody has to supply them. Suppliers, shockingly, are in the business to make money.

The Oklahoma Medicaid folks just gave the suppliers a week's notice that the reimbursement rates for those items are going to be slashed. They were already whisker-thin. The upshot is that some companies will go out of business and some will end up supplying all their clients with crappy, low-quality items, as that will be all that Medicaid will pay for. There will no longer be the option of choosing between, say, Depends and another brand. It will be, "Take what you get."

In the longer run, I expect this will cause some consolidation, as the companies that can order in the largest quantities will get the lowest prices, they will be able to compete, and the smaller companies will end up taking the bullet.

In one respect, that is fine: lowest cost, and after all, beggars can't be choosers. On the other hand, anyone connected with this business knows that the smaller companies are the ones that actually have the flexibility (and often the attitude) to genuinely help their clients.

This kind of thing is rampant. Reimbursement rates for oxygen have been slashed, and already it is very difficult for all but a few companies to make money on it. Same thing with home hospital beds and so forth.

And, of course, you've heard that the reimbursement rates for doctors have to be "fixed" every year (hence the infamous term, "doc fix"), or rather a lot of doctors would simply stop treating Medicare patients.

Now, my personal opinion is that if government had just stayed out of all this from the beginning, things'd be much better off. My point isn't, "spend more money," not at all. It isn't there, for one thing.

No, I'm just trying to tell you that this kind of thing is what your government officials are actually talking about when they talk about stopping "fraud, waste, and abuse." They aren't going to seriously step up efforts to do that, and even if they did, I guarantee you that the crooks would just get cleverer. What they are actually going to do, what they are doing now, is simply demand that suppliers supply services at ever-lower reimbursement rates, driving some companies out of business and generally providing less care and lower quality to the consumers, and they are going to tell you that this is fighting "fraud, waste, and abuse."

So, now you know. Remember that the next time some government official tells you that bullsnort story about "fraud, waste, and abuse."

Oh, and don't forget, while they're cutting the money for Grandma's depends and oxygen, they are still full steam ahead on providing prenatal care for pregnant illegal aliens!

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