Why are Medicare and Medicaid less efficient and more costly than private plans?

Why are Medicare and Medicaid less efficient and more costly than private plans?

The U.S. spends more than $2.2 trillion on health care, including more than $800 billion on Medicare and on Medicaid, the joint federal-state program set up exclusively for the poor. The sheer size of the health-care system makes it prone to fraud and abuse.

Given its sheer size, can we actually expect "Obamacare" to be any different or be managed any more effectively or more efficiently?

Studies have shown that Medicare and Medicaid are more expensive than private plans even though both taxpayer funded programs have implemented very strict, very low price controls.

Perhaps the reason is both of these government programs allow waste, fraud and abuse that private company will not tolerate. The private plans have developed and implemented proprietary fraud detection software programs that the government programs are seriously lacking.

 

Dingdingding, we have a winner. The government doesn't even consider the medical community as perpetrators of fraud, so they don't even investigate legitimate reports of the fraud they commit, yet they commit the largest majority of it.


What else would you expect from the best government corporate money can buy?


Add the illegal alien invasion to the equation and you have just about accounted for about 99.9% of the fraud, waste and abuse, that is committed regularly/annually.

 

You are very wrong, BuckNaked.

The private corporations are not stealing the money from Medicare and Medicaid.

The doctors and patients in poor communities that vote for the Democrats are stealing the money!

"The suspects charged in the Detroit operation allegedly submitted bogus Medicare claims for care that was medically unnecessary and often not provided at all. In some instances suspects paid patients to go along with the scheme, the Justice Department, the Federal Bureau of Investigation and HHS said at a joint news conference."

 

People often defraud the government. It tends to be fairly easy to do because bureaucrats have little vested interest in saving the government money. No motivation to stamp out fraud makes it easy for less-moral people to commit it.

On the other hand, people working for private companies are given motivation to stamp out fraud, so it is far less likely to be allowed to continue.

 

Like Enron?

 

So the republican governor of florida wasn't responsible for medicare fraud?

Anyways this is another post of yours once again rallying against medicare.

What is it you do for a living?

 

How many customers defrauded Enron?

 

How does one fraud medi-whatever without a doctor/hospital/clinic/pharmacy's approval?? The government doesn't even investigate "professionals" who are involved in these schemes. Obviously they are not held accountable for their part. The money doesn't go to the patient until services have been rendered.


Anyway I follow the money and most of that money winds up in the pockets of corporate elites, not poor people.

 

Medicare is a Federal Program, what does that have to do with the Governor?

 

Oh its a shady story and shows the stupidity of the public voters.

Rick Scott ran a company that defrauded medicare. The company had to pay $1.7 billion for defrauding the federal Medicare and Medicaid programs. He pleaded the fifth 70 plus times in his deposition.

He is as bad as they come.

[ame="http://www.youtube.com/watch?v=LIYad3TvY6Q"]Never-Before-Seen Rick Scott Deposition Video - YouTube[/ame]


[ame="http://www.youtube.com/watch?v=Gyc0CPpyddA&feature=related"]Rick Scott Two Hour Fraud Deposition, Never Before Viewed - YouTube[/ame]

 

This is just like the news today that the federal government is paying dead government workers $600 million per year! This is something they have known about, something that has been discussed, Obama knows about it, yet absolutely nothing is done! Same with all the unpaid and past-due IRS taxes owed by Americans!

Regarding Medicare and Medicaid, when the government somewhat forces these patients on the private medical industry, then will only pay 10-15% of the normal medical costs, those doctors and medical institutions who do allow Medicare find it easy to over-bill, over-test, etc. etc. etc. in order to make up for the other 85-90% of the fees. Why would a legitimate doctor, who normally earns $250K settle for $25K from Medicare?

Any time government forces government programs into the private sector, then tries to do this on the cheap, pretty much guarantees there will be some level of fraud...

 

You are funny, Silkheat.

I am not, as you unwittingly say, "rallying" against Medicare.

Medicare for the elderly and Medicaid for the poor are both good programs and I want to see them made much better.

One way to do this is to do what the Justice Department, the Federal Bureau of Investigation and HHS all three did and that is to expose waste, fraud and abuse in the system when it is practiced by unscrupulous doctors who serve the poor and their willing and dishonest patients!

It is as simple as that.

 

There is no incentive whatsoever for a govt run entity to operate efficiently. This is why we see the cost of college skyrocketing much faster than the rate of inflation in general.

 

You are very correct, Whaler.

Many liberals hear the work “profit” and they literally become apoplectic. They believe it this the government’s role to over regulate our economy until they can squeeze every ounce of profit out of it.

What many people do not realize is the profit motive associated with capitalism is good in that it forces a business to streamline its operations and deliver its consumer products to its customers at the least expensive possible price. This is of particular importance to poor Americans and senior Americans who must live each day on their limited retirement incomes.

Wal-Mart and The Apple Stores are two very good examples. Because of innovations such as computerized inventory management, just-in-time product delivery and their ability to purchase large volumes of commercial products from their vendors, Wal-Mart is able to sell its products at the lowest possible cost to its customers.

If the government provided these same services to the public, they would do so with much less efficiency and with a much higher cost to American consumers than does Wal-Mart. The reason for this is the government is not concerned with making a profit or streamlining its operations and operates its “business” as if it were a monopoly.

Consequently, there are no stringent cost savings considerations or strict accountability to its “shareholders”(the taxpayers) when it comes to how a government entity performs its functions. They consequently would purchase more products then they could possibly sell to their consumers, saddle their vendors with costly and unnecessary contractual specifications and paperwork (adds greatly to the cost of the commercial products), hire too many people, pay them too much money and pass these unreasonable costs on to the consumer. The U.S. Post Office, the Walter Reed Army hospital (now closed) and Am-Track are three perfect examples of government entities with these kinds of avoidable and unnecessary inefficiencies.

These inefficiencies and costly requirements do nothing more than drive up the cost the public has to pay for these commercial products. As a result, Wal-Mart is able to sell these same products to the public (the consumers) at half the price as the government even when Wal-Mart’s profit mark-up is factored in!

 

Lay defrauded Enron and he ran the thing.

Doesn't happen in government.

But if you're actually claiming that private businesses aren't subject to fraud, you've got to be joking. Fraud happens. It has no relationship to the provider of the service. People defraud private insurance companies all the time.

 

It isn't. Your OP doesn't make the case for Medicare being less efficient than private plans. It is well known that the US has the most inefficient health care insurance system in the world, due to for-profit insurers, who have the perverse incentive of not providing the service patients pay for.

Every other business in the world wants to provide more service to make more money. But since insurers get paid up front, they have the perverse incentive of NOT providing the service. Indeed by denying claims they make money.

So by any standard for profit health insurance is a vast failure and is the most inefficient way to provide health care in the world.

 

I agree with you.

 

You can't be 'very' correct in the same way you can't be 'very' pregnant. You're either one or the other; correct or incorrect, pregnant or not pregnant.

Grammar lesson for today. Always happy to educate.

 

I can tell you one problem why money is wasted in Medicaid is that the recipients do not have to follow the same rules as those who have private insurance. People with Medicaid can go to the ER for anything and cannot be turned away or denied care. They clutter the ER's around here with non-emergencies because they can. If the child has the sniffles or a belly ache, and it's after hours, they can go to the ER. I have private insurance and most companies will not pay for an ER visit that is not an emergency. I cannot take my child to the ER for a cough. I cannot take my child to the ER for acne, but the medicaid recipients can. Now why is that? We all know ER visits cost 10x more than a regular dr. visit. This is also why the waiting times in the ER have become so outrageous and those of us who are there for a true emergency have to hold on so the medicaid recipient can get acne medicine. I have heard some of the reasons they go to the ER and yes, acne is one of them, because they can. I, as an insured person, cannot do that. This is costing taxpayers too much money.

 

Because it is run by the govt so nobody cares. Nobody has any personal stake or vested interest in it being run well. They just want the money it hands out and the no work jobs it creates.

 

You do the doctors, nurses, surgeons and ancilliary staff a huge disservice by suggesting that the years of training and dedication to their profession is, somehow, of no interest to them.
This is base ignorance, but I guess by 'vested interest' you mean the profit motive. The UK has enjoyed a nationalised healthcare system since 1948, and to suggest to the population, and the people who care for them, that they have no 'vested interest' in providing clinical excellence is enormously insulting and, frankly, wrong.

 

Come now, Snake!

You know for a fact I never made these statements.

As usual, you are just trying to start a silly fight.

You need to work on not being so transparent!

Ha-Ha!



Unfortunately for Obama and his ardent fans, many liberals in America are now feeling this way!

 

Because Medicare covers only the senior population which uses more health services than than the general population. Private insurance has a lower risk and, hence, cost because it deals with the general population. Medicaid is more costly because it is operated by government which is inherently wasteful, inefficient and incompetent. It seems pretty clear to me.

 

exactly, it's not their money and they know that they are going to get paid no matter what.

If you worked for a small business and knew that if you give away too much, there won't be any to pay yourself, you would watch it a bit closer!

 

are you saying that NO government officials defraud the government??

let me introduce you to Charlie Rangel