Medicare pays full price for half-empty vials of medicine

this has nothing to do with the government. a number of PRIVATE providers are committing fraud, and you guys are blaming the government for it. it's hilarious.

 

who's "you guys" ? You're talking to me, and I didn't say squat about government.

You blamed "PRIVATE healthcare providers" and i noted that it was select providers/entities, nullifying your lame attempt at broadly implicating a whole segment of society

 

If you can find a post of mine trying to broadly implicate a whole segment of society your post might not be as pointless

 

oh but you did, and you were called on it. And now you try to slither.

 

This is what I'm talking about. Medical insurance isn't the problem. Medical providers over charging is.

 

Yet you can't fine a post of mine saying any such thing, which is why you can't quote me and are looking quite foolish

 

Because private insurers are more ruthless about fraud prevention. Not bc the govt doesn't care

 

your technique is old. You left out key descriptors such as "select" or "a few" or "some" or "an unspecified amount of".
You so clever.

 

Notice the complete absence of the word ALL private healthcare providers.

You're embarrassing yourself

 

I believe promoting the general welfare involves "filling the ounce" whenever possible.

 

yes, it was noticed. Your game is weak.

 

In the case of prescription medication, the government isn't allowed to check or bargain, Conservatives voted to prohibit the government from doing that.

 

Glad you admit I didn't say what you claimed I did.

 

juxtaposition of private and fraud, with the intent of creating a generalization. Bagged, go home.

 

So now you're admitting you made up what I said?

You're not very good at this.

 

i told you from the start, you used a lame technique to create a generalization.
keep arguing, draw more attention to it if you wish.

 

Except I didn't, which is why you can't quote me saying what you made up. It is hilarious watching you desperately hold on to your strawman though.

 

giggles, you're a slow learner.

For the learning impaired : Juxtaposition is the presentation of two or more ideas, characters, settings, phrases, or words side-by-side or in analogous narrative moments in order to compare, create dissimilarity or create melodramatic effect.

But please, do come back for more.

 

Rahl did NOT say what you claim he did. Can a mod kill this noise please?

 

Yes. . .and this is why this administration is addressing the fraud in Medicare.

But, re: the difference in he level of fraud between medicare and private insurance. . .that should HARDLY be a surprise, since the insured under medicare are elderly or disabled, and thus use a LOT MORE care than the "younger, healthier" population that is covered by private insurance, and who had MUCH FEWER NEEDS!

Now. . .if you can provide an ACTUAL comparison between fraud involving two cancer patients, suffering from the same illness, one covered by Medicare, and one covered by private insurance. . .you MAY have a point.

Until then. . .you are (once again) comparing apples and oranges!

 

Oh, I imagine there IS less fraud in private insurance, because they spend more money investigating fraud.

There should be NO fraud ( By no fraud I obviously mean a negligible amount) in either case. Doctors who defraud patients and thus their insurance companies if any, should be prosecuted to the fullest extent of the law.

 

So we're back to you admitting you're making up what I said.

 

I agree.

However, it is OBVIOUSLY easier to defraud medicare than it is to defraud private insurance BECAUSE of the population that is served by the two.
How can fraud be exposed by a patient with Alzheimer locked in a long term nursing home? How is this person suppose to even WONDER how much his/her care cost, if he/she isn't even aware of his/her surrounding?

However, how easy is it to defraud a 35 year old professional who, once a year, goes for a check up with his primary care physician?

How easy is it to bill medicare for the medication given to a terminally ill elderly person, and how easy is it to bill private insurance for the same medication given to a 45 years old man suffering from the same disease (if he wasn't kicked off his private insurance under the pretense of "pre-existing condition" as having smoked 20 years earlier. . that is PRIOR to ACA new clause), and who received (or his family receives) the statements from the hospital and from the private insurance and has to pay the "co-payment" for that fraudulent charge?

That is comparing apples and oranges.

 

I don't disagree with you.

Really the ONLY solution for Medicare would be to assign a worker to every patient and to verify each charge. Hardly fiscally doable.

 

Yes, that is correct. However please note that over the last couple of years, ACA has made a huge effort to catch medicare fraud, and it is has really made a difference.

But there will always be some dishonest providers who will get away with it.

One small example: my husband has had to use a Cpap machine for the last 11 months. Medicare (and his supplemental insurance) are covering 100% of the cost (80% for medicare, 20% for supplemental insurance).
The rules are that, for the first 13 months, medicare "rents" the device from the supplier, and after 13 months, the device is fully paid for and it becomes the property of the insured.
10 months into the "contract," a worker from the supplier came to our door, without notice, to "repossess" the device. We were out of town, so we found his note stating that he had been there for that purpose. When we returned we called the supplier and asked WHY they would take away that device when my husband sleep apnea was being controlled by it, but removing it would cause serious risks of a new stroke, even death, as per his specialist.

Their answer was: we didn't get a report from you in the last 2 months, and therefore we must take the device back, but you can fill out the paper work and we'll give it back to you when medicare approves it again.

Well. . .I did call medicare, and there was NO REASON why the device should have been removed. The authorization and the payment were still valid.

HOWEVER, the NEW device is rented at a much higher cost. . .the "old devices" are basically written off. . .even IF they are still in perfect functioning order.

The company providing the device can take back "old devices" just before they become a patient's property. . .and USE THEM AGAIN, billing them ONCE AGAIN to medicare as NEW DEVICES. . . by simply "exchanging" the serial number between two patients. . .who then EACH receive a new (used) devise…and medicare has to pay for that "new" (old) device for another 13 months before they are paid off. . . rather than for only the remaining 2 or 3 months!

So tricky! How can a disenfranchised person, maybe with Alzheimer or dementia, advocate for his/herself with this kind of trick being played on him AND medicare?

By the way, on a side note: I hate your new avatar! I know you are perfectly in your right to have any avatar you choose, but what is up with all of you guys who choose those pictures of menacing, aggressive men pointing their finger in people's face?

Is this a new trend? It sure doesn't help set a constructive, stable basis for debate!