Subscribe to Common Dreams News Updates
Most Popular This Week
Popular content
Today's Top News
Loose With Numbers: Medicare Fraud Report a Fiction
I haven't watched CBS' "60 Minutes" in years. But it was one of those stories that stops you in your tracks: Medicare fraud is "a $60 billion crime." Medicare is the $456 billion government health insurance program serving 46 million elderly Americans. Its credibility as a government-run program is at the heart of the health-care reform debate. If Medicare isn't doing the job, the government certainly can't.
Except that the fraud claim is not true. "60 Minutes"' amateurish journalism wouldn't get past your average small-town copy editor's fact-checking.
The first thing I did after watching the show was get in a big funk: Maybe conservatives are right. Government can't run anything. And this is "60 Minutes," not some tabloid sap like "Dateline." The second thing I did was apply the first lesson of the trade: verify the facts. It didn't take long for the story to unravel. There are no facts. "60 Minutes" doesn't know how much Medicare fraud there is. You don't know. I don't know. The federal government doesn't know. Nobody knows, because Medicare fraud as a whole isn't tracked. That's why "60 Minutes" correspondent Steve Kroft said fraud is "estimated now to total about $60 billion a year." Estimated. Fine. By whom? You'd think Ed Murrow's ghost at the Columbia Broadcasting System might still compel his descendants to attribute colossal estimates to a reliable source. Not this time.
I called "60 Minutes." I asked to speak to one of the two producers of the segment. I was patched through to a spokesman instead, who said the $60 billion figure came from Kirk Ogrosky, a Justice Department prosecutor in charge of Medicare fraud. But it didn't. Nowhere in the "60 Minutes" broadcast or its written report does Ogrosky mention the figure. Nor is the figure attributed to him or Attorney General Eric Holder, who makes a cameo on the show. The spokesman's best explanation: Ogrosky was cited in the piece, "60 Minutes" got the figure from him, and the Justice Department didn't call the next day to dispute the figure (as if the Obama administration were going to start a credibility war with yet another network). I was welcome, the spokesman said, to check with Ogrosky's office at Justice.
I did, asking if Ogrosky or anyone at the department had given "60 Minutes" that $60 billion figure, and if it stood by it. After cutting through the initial bureaucratic hurdle, Charles Miller, one of the Department of Justice's spokesman, wrote me: "This sounds like a good question for HHS," meaning the federal Department of Health and Human Services. I let Charles know the buck-passing was getting old. He tracked down Ian McCaleb, the spokesman for the department's criminal division, who worked with "60 Minutes" on the segment. McCaleb's answer: "The estimate range in the Attorney General's Q and A was $27 to $90 billion, but that is using National Healthcare Anti-Fraud Association and General Accounting Office estimates on total federal expenditures."
McCaleb and the attorney general were wrong, too. GAO has never estimated total Medicare fraud. It investigates targeted programs within Medicare, finding fraud in the millions, not billions. And it's not total federal expenditure that those estimates McCaleb referred to are based on. It's total public and private expenditure on health care. The National Health Care Anti-Fraud Association, a partnership between private insurers and the federal government, says that it "estimates conservatively that 3 percent of all health care spending -- or $68 billion -- is lost to health care fraud." The association bases that figure on 2007 total health care spending of $2.27 trillion in the United States. It's an unscientific, very dubious way of making estimates. But even if you go with it, well over half that spending is private sector. Medicare in 2007 was a $436 billion program. Applying the association's 3 percent standard, that works out to an estimated $13 billion in Medicare fraud. For argument's sake, throw in Medicaid's $191 billion spending in 2007. You're up to $19 billion in fraud.
Steve Kroft and his producers never bothered to trace their facts to the source for viewers, relying instead on the slob-journalist's cheapest cop-out: attribution by estimates. Nor did they make the equally important point: Insurance fraud isn't unique to Medicare or government-run programs. If anything, it affects the private sector more. Shame on "60 Minutes" and the Justice Department for throwing around wild numbers. Those are the numbers -- the fictions -- shaping public opinion across the country and public policy in Washington.
Medicare fraud is a serious problem. But singling it out and exaggerating it beyond credibility won't fix it, although it may help doom any government expansion of health care. In that regard, the "60 Minutes" segment did its death-panel best.
33 Comments so far
Show AllOh my God, don't tell Barack....he is going to pay for a lot of his girl's health care bill with the exact fraud monies you say aren't true! Oops!!
Odd response. The point of the article was that CBS was not practicing good journalism in its reporting of Medicare fraud. It had nothing to do with Obama, liberals, or his girls healthcare bills. Maybe, just maybe, before responding to a piece, it would be better to ask "What, exactly, is being said here?" rather than making irrelevant comments.
That was about as pertinent as it gets. His point was that they were wrong in their reporting...sure....but why were they talking about it? What was the point of their investigation?
It has everything to do with exactly what I commebnted on I'd say....but of course thats my opinion...yours is just as valid if you care to disagree.
They're testing the waters on weakening Medicare. The biggest attack on Medicare will come in the form of seriously defunding it to pay for bailing out Big Insurance/Pharma in the form of Obamacare ! Guess which party seniors will be fighting for when that is about to happen?
They got one thing right:
"Medicare fraud is a serious problem."
But then again, the whole concept of "money for medicine" is the root of the problem...and I don't think they could cover that topic in one lone show.
I've thought for decades that the potential for fraud is the relationship between the doctor and the pharmacist because if you think about it they really don't need the patient, or they can work through a fictive patient. Just sign here.
-30-
What does one expect if one believes information that is presented on TV without researching it yourself?
The only time I watch television news, is to have a good laugh at the lies, spin and propaganda. It is a great source of satire, just ask Colbert and Jon Stewart
Thank you, Pierre Tristam. When I see your byline, I always read your commentary.
This health care reform theater is so frustrating, as Tristam writes, and corporate media is trying its hardest to confuse and obfuscate this issue.
Besides this "60 Minutes" debacle, today's Dubuque newspaper carries the news story from Associated Press on p 3A, "Public health plan would cover few," and writer R. Alonso-Zaldivar cites a figure of 6 million people signing up for public option.
Huh? Sources I've read lately cite a figure of 88 million, including myself, signing up for the public option. Any polling that's been done puts support for Medicare-like coverage at 60-70%.
As you put it, socialist, we're up against "lies, spin, and propaganda."
Bill in Dubuque
Yes, SHAME on "60 Minutes". I used to enjoy watching, who I think of as the most palatable and trust-worthy reporter, Mike Wallace, (in my opinion) but anymore there is BS writing and questionable facts....this story proves that! Thanks for this research on the story. I am sure I will need it when I am out championing SINGLE PAYER in the coming weeks as I seek another arrest for trespassing on some private recidivist "sick" care corporation like BC/BS or Wellpoint.
My advice.....KILL YOUR TELEVISION!!!! STOP PAYING FOR PROPAGANDA!!!
Don't kill it, its probably a very good crt or lcd very useful for playing gorgeous movies, delicious music, historical and educational materials and a heat-less fireplace in the middle of summer and i swear it brings up the inside temperature in the winter by at least 10 degrees and they're all pretty. You just don't have to hook it up to anything, i don't....try well-loved movies as background music while you do other things...or maybe even movies that you new existed but never saw, like those racy 1920's silent films before the Hayes Commission and Fanny Arbuckle....people have looked through the movie lens with different eyes and seen different things...drink deep and prosper....
it's not the medium, it's the use...you can use the dai katana to hack your way out of a terrible thicket or to cut your neighbor in half, is it one of those days?
Piece...
I also hardly ever watch "60 Minutes" because it is usually just a sideshow, intended to rile up opposition to small-time criminals and, occasionally, a public official who has already become a pariah and so is beyond redemption. This limited repertoire of reportage has served a very useful purpose: distracting the public from the underlying structural and systemic issues that are the real problems we face. They have never taken on improper military or corporate influence on the government, for example, or the outright corruption of our election system.
That is all bad enough, but this show on Medicare fraud was something worse. It was clearly intended to influence the current public debate on health care reform to the advantage of the for-profit health insurance giants. It was, no doubt, very compelling to uninformed individuals who are worried about changes to their health policies--and that's what makes it so shameful.
Compare this report with the recent fawning interview with McCrystal that appeared on "60 Minutes." He was presented as a virtual modern-day philosopher-king, who had the perfect failure-proof master plan to solve all of the US problems with its military occupation in Afghanistan. On that episode, there was not a single statement offered seriously challenging McCrystal's assertions. It was an equally shameful broadcast, also intended to warp public opinion about a controversial issue facing the public and the Congress.
CBS News may have deserved a reputation as a decent news source at one time, but that time is long past. Now, they operate roughly
along the same lines as FOX News, only exercising a bit more subtlety. And actually, their subtlety and no-longer-deserved positive reputation allows them to do much more damage.
I think these two "60 Minutes" episodes had a definite negative impact on the public debates on the issues they covered, to the detriment of our entire country.
Everybody is lying in different amounts for different reasons.
I remember when they were talking about a homeless residence in DC that they said was costing the city a million dollars a week to oversee (they were citing this figure this in connection with closing it down). I checked and it turns out how they came up with that dollar amount was they had to park a firetruck there every night. And they were counting the cost of a new fire truck every week, and not just a one time cost (and it didn't cost them anything because it was just a regular fire truck parked there, but it was still available for calls.) If you were to believe them, there should have been 52 firetrucks parked outside of the homeless shelter by the end of the first year.
I do believe that there is medicare fraud, but most of it is conducted by the doctors and clinics doing the billing, not the consumer who is receiving treatment.
And Obama is a liar, about health care and the war. And so is the media, and democratic party leadership.
Single payer or single term.
Public option is not an option.
Right on. I like it. Single payer or single term. Let's force it.
As an accountant, how much fraud is there in the official Pentagon budget? and how does this compare with the Medicare fraud you mention? How much fraud was there in the so-called "bailouts", including the "liquidity injections" by the Fed, TARP, and letting the Banks borrow from the Fed at virtually no interest?
Socialist, you are so right on in most of your postings it almost makes me want to be a socialist.
'People' were always concerned about welfare fraud because they thought blacks were taking the money. But the truth is that more white people are on welfare. And the amount that is wasted by the military can pay for health care.
Of course, another term for waste is 'profit into the greedy hands of the power elite.' It is not by mistake that the government 'wastes' money. The government doesn't do anything that the power elite doesn't dictate they do.
just another commie pinko wanting peace
Thanks NotOneMore, notice the accountant has no reply. I agree, it is a self-fulfulling prophesy for the rightwing. A set-up for the discourse for further plundering and privatization of the public sector. There is not much left of it to salvage. Folks like the accountant here somehow are unwilling or unable to see the larger picture.
Here's some gringo language for you to translate my racist friend: je kent niet wat je zeg, je komt niet vanuit de vereinigde staaten, maar je haat alles vanuit dat land. Waarom? Ik haat haat.
60 minutes. Glenn Beck.. Easy answer. Kill your television.
A friend of mine was a doctor who treated cancer patients. His medical license has been revoked. He was charged with medicare fraud. The Bush government went after this Iraqi born , U.S. Physician with a vengeance for breaking the economic sanctions against Iraq. When I asked why he was not charged with medicaid fraud I was told that he treated patients regardless of their ability to pay and never dropped patients because they did not have insurance.. His wife who was his office manager had to pay back to medicare $62,000 although 90% of the money was spent on chemotherapy medicine this left 10% of the money for the Doctors time, the nurses time and the blood work.He had a difficult time understanding the medicare system and had notes where he had asked for help figuring out the billing system. He tried to play by the rules but if the Bush government wanted to get you for medicare fraud they had ways to present misleading information against you.
To many people are getting rich off of health care to allow it to be seriously changed in anyway that really benefits the public. The bills the Dinocrats have de-constructed just further enrich the same cast of characters while doing a half-assed attempt of confusing the public into believing it's the greatest product since rice crispies. The truth is the Dinocrats have labored long and hard to squeeze a smelly turd taco ( AKA HCR) out of their collective asses. DC is a waste of time it's totally bought.
www.NotOneMore.US November 1st, 2009 6:16 pm
Single payer or single term.
Pass it on. Its got legs
Good detective work by Tristam! Can we clone an army of two hundred Tristams and put them onto all kinds of investigations?
There is no doubt that the capitalist-elite employ Medicare as an instrument to drive greater "GDP growath". Its role in driving market trajectories of electric scooters and wheelchairs, mechanized recliners, etc, etc is well-known. At the same time the capitalist-elite keep their boot to Medicare's neck. They probably treat their spouses like that too. If we're going to have Medicare for All, we'll have to first send the capitalist elite to the middle of the Potomac to tread water.
The article really messed things up for Medicare. Because now that all this has been brought to light, Obama and Eric Holder will have any information from there placed under "State Secrets". Which means the communist are still at work.
A couple points. First of all Medicare does pay in a timely way. Secondly it uses the simplified billing practices of paying suppliers and providers according to their accounts rather than monitoring and breaking down expenses of individual clients. This makes administration of Medicare much simpler and efficient. Where Medicare falls down is in auditing its providers and suppliers. It should hard to become a supplier and periodic audits should be mandatory. So should cross checks to see if individual account holders get what they were billed for. That takes more auditing manpower than Medicare now has--according to CBS only two field agents for 3000+ suppliers in Miami. That needs to be fixed but the general mechanism of Medicare billing since it is efficient and saves money should be kept.
What Medicare amd Social Security demonstrate is that government can be efficient (despite specific weaknesses imposed by corrupt members of Congress). We can't have that.
As I have suggested earlier, half the jobs in the U.S. are worse than a waste of time. This goes esp. for the insurance industry.
Stop "working." Start working.
-30-
as "friend/advocate" and rep.payee for a 55 yr old disabled man,the "SSA" requires me to see to the wellfare of my "friend" Robert,["no" there is no pay] he was placed on "part-d" and from the first week drugs began to be added to his ID# for medicationed not "prescribed",the drug "Zyprexa"began to be charged to his account to the tune of "$939.13"for 60 doses, in a later month this drug was added four times at a cost of "$2,350.82"...to get this rectified i finally went to my Rep. in congress for help [CW,Bill Young [R-FL]over "$9.000+" was reversed,from over "$11.000" to less than "$1,900"...
needless to say another company was appointed for Robert,a few days ago this new company informed me that inorder to stay with it,i would have to report "so" when i recieved a "blueletter" from Medicare...
im 84yr's and know when im being scrwd,,therefore i immediatly called "Medicare",and they put Robert with a new company because Robert's Medication was just [$87.00] and not $347charged by the "expelled" company,the differnence between $87.00[brand] and [$347.00 says to me that some outfits are stealing from Medicare and finally got "caught",BTW medicare has found 47 new company's that will not charge outragious prices for "Medications"...Jim St,Petersburg FL..P.S.maybe Medicare got wize and starting to do its job and not trusting these outfits any longer,
Just the sort of thing I imagined.
How have we come to this?
What is to be done?
We have all been paying into this via paycheck deductions and now they call it an "entitlement." Just go die. That'll solve the health care debacle. The elderly suck anyway. Especially the ones who can remember things. Like me.
-30-