In an e-mail exchange last week with a colleague, I complimented him on a recent column he wrote for the Texas Press Association on the future of the community newspaper business. I explained that I had made copies of his piece and placed them as centerpieces on the tables at our employee Thanksgiving luncheon. In what has been a somewhat difficult year for employees, I thought they needed to hear some optimistic news, and my friend wrote it more eloquently than I could say it.
In his reply to the e-mail, he wrote things have been somewhat tough on the employee front for them as well. He said they got notice last week that their company’s overall health insurance program is going up 28 percent for next year. Gene Deason, the Bulletin’s editor, wrote in an entertaining column recently about him and his wife using some coveted vacation time to clean out their garage. In with some old materials, he discovered a memo from 1993 to all Bulletin employees regarding changes to the group health insurance. In comparing the rates quoted on the memo with the rates just announced for employee and dependent coverage in 2010, the cost has increased 300 percent.
The debate over health care reform continues and the emotions of the populace continue to escalate and the most vehement sticking point is the role government is going to play in whatever bill being discussed becomes law, if indeed one does. I read a quote recently by a Dallas attorney who works in the justice department, “Any time you dole out billions of dollars in a federal program, there’s going to be fraud and abuse that takes place.” I wonder why that is and more to the point, why do we accept it, and take it for granted?
Much is being made of the enormity in size of the bills being discussed and voted on. One would think that with 2,000 pages in a proposed bill every possible loophole would be addressed. However, should that be the focus of the bill writers and policy makers? Is it the failure of the government if the legislation that is passed fails to prevent those who would use the ambiguity in the language to work for their personal gain and at the expense of the general public?
In the health care debate, the Medicare program is often raised by both sides. For some, it is seen as a success, and for others it is an example of administrative incompetence. It may be both of the above. Aside from the issue of its long-term costs, the intent of the program to provide for medical care to the elderly and the vulnerable in our society has been accepted. However, it has also become an enormous target for the scam artists, fraudsters and career criminals. Take for instance the 300 cases in the state that led to the recovery of nearly $1 billion in fiscal 2009 under the Health Care Fraud Prevention and Enforcement Action Teams (HEAT). It is part of a nationwide crackdown on Medicare and Medicaid fraud that experts say costs taxpayers as much as $60 billion a year.
The evidence of fraud cases reads like a Medicare supply and service list. Abuses include expensive rides in ambulances for patients who could drive themselves to treatment. There was the North Texas medical supplier who eventually pleaded guilty, along with five others in a $2 million fraud scheme involving wheelchairs and scooters. In September an investigation led to a national pharmaceutical company, Pfizer to agree to pay more than $1 billion, including $55 million to Texas for providing incentives to physicians who wrote off-label prescriptions which Medicaid paid for.
The Obama administration says it is stepping up investigations of Medicare fraud. The Health and Human Services Department is asking seniors and Medicare beneficiaries to watch their billing statements closely to be sure their identity has not been used improperly. The increased enforcement and investigating by government agencies and diligent monitoring by recipients may help, but we have to make it clearly understood by all that when someone steals from Medicare they are stealing from all of us. Equally important is that collectively we stop tolerating it.
Robert Brincefield is vice president and publisher of the Brownwood Bulletin. His column appears on Sunday. He may be reached by e-mail at bob.brincefield@