Tuesday, September 15, 2009

Waste and Fraud

I have been in several discussions about the waste and fraud in the Medicare and Medicaid programs (in just about every program in the US Government, but mostly in the Social programs)...
One of the thing that some do not realize is that we already have a Social Program designed to get medical help to those that need it. This is Social Security - which includes things like VA Benefits, Medicare, Medicaid, Disability, etc...
It would cost far less than $900 BILLION to fix this system and build in checks and balances to eliminate (or control) the amount of waste and fraud.
(another topic I might discuss here is the alternatives, like privatizing the whole Social Security program...)

But we suffer waste and fraud in any Insurance Program. You either get claims denied that shouldn't be, or you get things happening on the other end of the spectrum...

Insurance Won't Cover Smartphones, When Pricey Alternatives Exist
This article talks on the problems in the Insurance Industry, where a hand-held computer (or smart phone) can be used to accomplish the SAME TASKS as specialized equipment that might be Larger, Heavier, and (definitely) more expensive.
Yet, they are not willing to pay for the LESS EXPENSIVE option if the MORE EXPENSIVE option exists.

"... Kara Lynn has amyotrophic lateral sclerosis, or A.L.S., which has attacked the muscles around her mouth and throat, removing her ability to speak. A couple of years ago, she spent more than $8,000 to buy a computer, approved by Medicare, that turns typed words into speech that her family, friends and doctors can hear."
"...the PC...ran ordinary Microsoft Windows software"
"[but]...Under government insurance requirements...[it]...had to block any nonspeech functions, like sending e-mail or browsing the Web."
"...Dismayed by the PC’s limitations and clunky design, Ms. Lynn turned to a $300 iPhone 3G from Apple running $150 text-to-speech software."
"...Medicare and private health insurers decline to cover cheap devices like iPhones and netbook PCs that can help the speech-impaired, despite their usefulness and lower cost."
And the reasoning given?
"Insurance is supposed to cover medical devices, and smartphones or PCs can be used for nonmedical purposes, like playing video games or Web browsing."


DO WE REALLY WANT TO GIVE THE FEDERAL GOVERNMENT CONTROL OVER OUR HEALTHCARE WHEN WASTE AND FRAUD ARE THE NORMAL??

(This Excerpt is provided for informational, educational, and discussion purposes only. It is Copyright "The New York Times", for the full article search The New York Times' web site or Google with the title of this article)

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