Month: December 2017

Universal Healthcare The Pros And Cons

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Universal Healthcare is being strongly considered in the United States. Universal Healthcare basically means that every citizen will be eligible for health coverage, regardless of their ability to pay for it. There are pros and cons of such a system.

First of all, let’s take a look at the pros of Universal Healthcare (also known as Socialized Medicine). The benefits are fairly obvious. If we cover each and every citizen with affordable or free health insurance, they will be able to maintain their health regardless of their income.

One major advantage of such as system is that it can literally save lives. People die in our country each day because they cannot afford healthcare. And that includes working Americans. That is a travesty! It’s heartbreaking that there are millions of people who are contributing tax dollars to our national economy who are not in turn given their most basic need: maintenance of their health.

It almost seems obvious that it’s time to take the cue from Canada and implement Universal Healthcare. Their citizens seem to be fairly happy with the system, and it has been saving lives there on a daily basis.

However, as is true with any system (no matter how good a system it is), no healthcare solution is without fault. There are some notable disadvantages to Universal Healthcare which are worth acknowledging.

One negative side effect to providing universal healthcare is that spreading something too thin causes it to lose its inherent value. If we try to spread out our healthcare, it is possible that the quality of care will go down. Why? Because the hospitals and doctors offices will have more patients to deal with!

Naturally, no doctor would deliberately decrease his or her quality of care. Unfortunately, however, if your patient count multiplies, it can be hard to keep up. This could be overcome by the increased funding from the government under a socialized system, since that could cover a boost in medical staffing.

The other disadvantage that could result from Universal Healthcare is a lack of availability of care, causing a decrease in access to healthcare for everyone, including those who could afford to pay for it. There could be waiting lists that could prevent people from getting the care they need.

At the end of the day, we have to decide if the few drawbacks are worth it, in order to help out our fellow Americans who cannot afford to have any care whatsoever.

Medicare Fraud and Abuse The Most Profitable Healthcare Crime in the U.S.

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Medicare fraud and abuse cost taxpayers approximately $60 billion a year. Its 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 isnt 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 didnt 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 doctors 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 persons 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. Dont 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. Visit www.TheIdentityAdvocate.com. or call 310.831.4400 to learn how to prevent Medicare fraud and medical identity theft.