Since the beginning of the healthcare debate, many things have been said about how healthcare reform will help all of us. Lower premiums, a ban on pre-existing conditions and affordable care for those who don’t have insurance are just a few. Many of the provisions don’t kick in until 2014, but the extra taxes have already started. Our elected officials have decided in their infinite wisdom that 10 years of income collection vs. 6 years of benefits somehow makes this bill budget neutral, but they didn’t even get that right. We all know that the new healthcare law will cost far more than they have told us, but who is really benefiting from our additional expense?
People with pre-existing conditions can no longer be denied for health insurance, but they will be placed in high risk pools with subsidized and high premiums. This is a good thing for those that couldn’t get health insurance previously because of a health condition, but everyone else will have to make up the difference in cost. Regardless of how you feel about income redistribution, this provision is good for about 15% of the population at the expense of the other 85%. They say the costs will be partially offset by government subsidies, but the government’s money comes from the same people in taxes; so one way or another everyone will be paying more. Still, most people agree that something needed to be done to help these people and this seemed like the only real choice.
Children up to the age of 26 can now remain on their parents health insurance as long as they are in college or still living at home. By the age of 26, Alexander the Great had already conquered all of Persia and assumed control of one of the largest empires in history. I don’t believe a person in their twenties can be considered a child, and there are many other options for young adults in college. Parents still have to pay more to have their children on their policies, so this is more about additional income for the insurance companies from a portion of the population that hardly ever needs to use it. This will help keep everyone else’s premiums down, but again, we are back to the income redistribution issue that most people don’t want.
About 16% of the American population falls below the poverty line and these people don’t typically have health insurance. There is a mandate that starts in 2014 that will force people to purchase health insurance if they don’t have it, and Americans below the poverty line will be exempt. Congress believes that the additional customers will bring premiums down to a level that will make it affordable for those below the poverty line, but most believe that this mandate is unconstitutional and will be thrown out; so where does that leave us? A healthcare exchange will be formed in 2014 that will put people into pools and make it cheaper to purchase a policy; but again for most people below the poverty line, premiums will still be too expensive to get. The idea is to make it possible for 16% to get insurance and mandatory for the other 84%, but what does that say about the America we live in today?
The new healthcare law does help some people without a doubt, but it hurts almost everyone except the politicians. This is yet another great example of the government trying to “help” us by telling us how to live our lives. In 2014, the rest of our “help” will kick in and really corrode the level of our healthcare system. It won’t be budget neutral for the first 10 years, and it will skyrocket in cost the 10 years after that. All this when companies like Ameriplan and others already had good alternatives to solve the problem. All or part of the healthcare law may be repealed at some point, but we still need to address the needs of those that fall through the cracks.
Medicare Fraud And Abuse – The Most Profitable Healthcare Crime In The U.S.
Medicare fraud and abuse cost taxpayers approximately $60 billion a year. It’s one of the fastest and most profitable crimes in the U.S. The government health insurance program that covers 46 million elderly and disabled Americans is being hijacked by opportunists preying on patients, doctors, suppliers, and lack of oversight of the system itself.
According to President Obama, Medicare fraud and abuse is fueling enormous federal budget deficits. He recently explained that we could pay for healthcare reform if we could eliminate Medicare fraud, abuse, and waste altogether.
Although completely eliminating Medicare fraud isn’t entirely realistic, curbing the growing crimes could provide healthcare to many more Americans and stop lining the pockets of the individuals, crime rings, and corrupt healthcare providers that steal a huge amount of the half trillion dollars in Medicare benefits each year.
The instances of Medicare fraud and abuse are as diverse as they are widespread. One recent high-profile case involved an Armenian-American crime syndicate that stole patient and doctor identities to setup dozens of fake clinics. The operation, which is one of the largest Medicare fraud schemes in U.S. history, resulted in over $35 million in illegal billings.
In another Medicare fraud and abuse case, nine hospitals in seven states were ordered to pay $9.4 million in fines for keeping patients overnight after undergoing what is typically an outpatient back procedure. The hospitals fraudulently billed Medicare for the unnecessary services. In still another case, eight nurses in Florida carried out an $18.7 million Medicare fraud scam in which they forged patient files to make it appear that they required home health care services that they didn’t need or receive.
Although these are just a few of the many types of Medicare fraud and abuse scams occurring each year, they show the urgent need to be vigilant about preventing Medicare scams. From charging for durable medical equipment (DME) never received to using a deceased doctor’s information to continue to bill patients, common Medicare fraud and abuse schemes include:
* Advertising “free” consultations to patients with Medicare, and then recording and using their private information for monetary gain
* Offering healthcare services or DME for free in return for a person’s Medicare number for “record keeping”
* Setting up fictitious clinics with people impersonating doctors to steal private information and commit medical identity theft is another common Medicare fraud and abuse tactic
* Using real patients’ data, but without their knowledge, to steal their identities
* Not adhering to the FTC Red Flag Rules that alert the carriers paying the bills
* Fraudulent billing for a wheelchair, specialized hospital bed, or other DME is also a form of Medicare fraud and abuse
* Falsifying claims for expensive procedures is another common tactic, such as the $5.8 million fraudulent HIV infusion scheme in Miami in which a husband and wife team defrauded Medicare by submitting unnecessary HIV injection and infusion claims
Remember that when fraud happens to Medicare, it happens to all of us. Don’t let your organization become a victim. Put your employees on the front line to spot Medicare fraud by hiring a healthcare fraud and abuse expert that provides “Lunch and Learn” presentations to help avoid, recognize, and respond to Medicare fraud.
Health care in the U.S. is perhaps the best there is anywhere in the world but as in other countries health care is still not attainable for all United States residents and the U.S. Government is trying to implement changes that will help bring health care to all of its residents equally. Unfortunately there are many different camps on this subject and while some are looking forward to the government’s proposed health care plan, others are struggling with the idea that they will be left holding the bills for this new plan.
For those people who currently aren’t on a health plan due to lack of funds or having pre existing conditions, they are looking for the passing of this bill to be their savior. It is a way for them to finally have coverage they have been seeking for a long time. On the flip side, there are people who know that implementing this bill into action will be a costly endeavor and they don’t want to be the ones that are footing the bill for those unable to afford health care coverage.
Those who are worried about the plan and how it will affect not only their ability to get doctor’s appointments and be seen in hospital emergency rooms but also how much they are the wealthier American’s are going to be forced to pick up the slack for all those who are unable to pay health insurance premiums. They are concerned, and rightly so, that the sole support of the proposed health care plan will rest firmly upon their shoulders.
Unfortunately there will be little help from the government on paying for this plan and many of the new government restrictions that will impose stricter rules that will benefit those who are receiving this coverage but in the long run will wind up costing everyone more. Something must be done to not only ensure that everyone can receive the health care coverage that they need but also to reduce the overcharges by insurance companies on the issues of medical malpractice and treatment costs to help bring down the overall cost of health care.
Over the next year, the healthcare plan will be under review to see if it solves a majority of problems or just promotes several new ones. Everyone is hoping that the government will not be implementing a system that benefit less people but cost a lot to many individuals.
Well, there is a lot of talk as well as sincere efforts being made by the Federal Governments in the U.S. to put the health insurance reforms in place before it gets too late. The critics may say that it is already too late, but the speed and the sincerity of the proposed reforms can surely uplift the health insurance sector in the U.S., consequently, the general level of health care across the country.
The facts and figures point out that the problems being faced by the U.S. health insurance sector is perennial and deep-rooted. The situation is grim with only a ray of hope for the health care scenario currently prevalent in the U.S. The sorry state of the facts and figures emanating from the U.S. health care sector in the last decade surely calls upon the legislators and statesman to act swiftly.
Various reports indicate that a vast chunk of Americans go uninsured every year – a problem that equally affects working families as well as the non-working class. A 2004-2007 report by Rhoades JA and Cohen SB on the long-term uninsured in America reveals that 32 per cent of the working-age adults and their families had a gap in their health insurance coverage for at least one month in 2006 and 2007.
The financial and health consequences of this gap can not only be devastating for the general public, but may also have far reaching repercussions on the U.S. economy as well. The health insurance premiums for the employer-based policies have shot up twice since 2000, a rate that is thrice the growth in wages during the same period.
Amid the various pieces of legislation and health care reforms on the anvil, one of the most effective steps to improve the health care sector in the U.S. can be the health care and health insurance education at its very best. The consumer awareness and consumer education on a massive scale can surely speed-up the positive changes that the entire nation is striving for.
There has been huge uproar about the healthcare bill passed by Obama’s government. Lots of states have risen against it but at the same time, this issue has brought healthcare reforms to the national level where a lot of brainstorming is going on. It goes without saying that there was never such a focus on healthcare issues.
At the same time, there is another bill that enforces state government’s authority to put a check on the increase in premium that insurance companies are allowed to make. This bill gives the state governments to have control over this hike; and in case state governments fail to act, the federal government can enforce its authority.
Another issue has come to fore. Telemedicine coverage was never on the national bill passed by the government. But individual states have passed the bill that forces the insurance companies to provide complete coverage for all telemedicine costs.
So, overall, a lot of issues are propping up. With a little wait on our side, we will be able to see some reforms implemented for US healthcare system.
