8/13/1981: “A Federal grand jury in Manhattan indicted a psychiatrist and a psychologist on charges of filing false Medicare claims in a 15-month period at the Beacon Hall Home for Adults in Beacon, N.Y.
“The defendants filed the claims after asking mentally disabled patients at the home to sign blank Medicare forms, …”
12/10/1981: “DOCTOR CALLS MEDICARE PLAN EASY TO DEFRAUD
“A cardiologist who has pleaded guilty to filing more than $1.5 million in false Medicare claims told a Senate hearing today that the Government health program for the aged was ‘fairly vulnerable’ to abuse.
“‘The problem is that nobody is watching,’ Dr. XXX told a hearing of the Senate Finance and Aging Committees. When asked if the Department of Health and Human Services’ Inspector General, a post created by Congress in 1976 specifically to combat fraud in the Medicare program, had ever got in touch with him, Dr. XXX said he had never heard of him.”
“At the same session, Senator John Heinz, Republican of Pennsylvania, chairman of the aging panel, asserted that the Government ‘continues to squander billions of dollars through its inability to stop this abuse’ of Medicare…”
Yes, Heinz used the correct term: “inability.” It literally cannot prevent this squandering without incurring untenable costs of monitoring.
By the way, Medicare brings about a squandering that is not even counted under fraud, which consists of excessive visits to physicians and their excessive prescriptions and procedures. Medicare provides an incentive for doctors to introduce costly procedures and get them reimbursed by Medicare.
Regarding fraud, I am not even mentioning the basic fact that the incentive structure of government medical bureaucrats is inferior to that of a profit-making doctor, hospital, or medical service provider, or even to a non-profit charitable hospital. The bureaucrat has no “bottom line” to focus on that bears a direct relation to the welfare of medical customers.
