Massive Government Spending Means Fraud (1 Viewer)

Steve R.

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Nothing new here, but it is a topic that needs to be watched. This is one of many emerging stories of fraud, many more will follow. Though the article above pertains to Covid, the possibility of massive fraud with the "Green New Deal", Stimulus Checks, and PPP Loans is very high. Recall the Solyndra Scandal. Also those manufacturing drugs (potentially involving taxpayer subsidies) to combat Covid view as a cash-cow that needs to be kept relevant.

In the background, consider EcoHealth Alliance and integral player in the Covid pandemic. This may not be "bright" fraud, but if one follows the money trail; it appears to have been obfuscated. Peter Daszak’s EcoHealth Alliance Has Hidden Almost $40 Million In Pentagon Funding And Militarized Pandemic Science. Evidently, investigations have been initiated: House GOP calls for DOJ to investigate if EcoHealth Alliance broke law. Too soon to know what the results will be.

This should be a cautionary tale for government staying out of the business "helping" people and businesses. Seems to always result in fraud and waste.
 

CJ_London

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This link from August may be of interest

AstraZeneca price circa $5.66 in the US
Pfizer price $19.50
Moderna price $16.50

AstraZeneca are selling at cost until the end of the pandemic

Appreciate there will be some variation in cost of production, but gives some idea of corporate philosophy
 

Pat Hartman

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I try to review the summaries I get from Medicare regarding who billed what.
1. They are virtually impossible to verify.
2. Three years ago I found an error. A doctor billed for a procedure that was related to a surgery that I never had. I'm sure it was a mistake but the bill was for over $1,000 so I decided to try to rectify it. I spent two hours per month for NINE months talking to the doctor's office, Medicare, and my supplemental insurance company. No person I spoke to actually cared about the billing error and the Medicare people were downright stupid and didn't understand at all why I was trying to save them money. Eventually I gave up.
 

Steve R.

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I try to review the summaries I get from Medicare regarding who billed what.
1. They are virtually impossible to verify.
2. Three years ago I found an error. A doctor billed for a procedure that was related to a surgery that I never had. I'm sure it was a mistake but the bill was for over $1,000 so I decided to try to rectify it. I spent two hours per month for NINE months talking to the doctor's office, Medicare, and my supplemental insurance company. No person I spoke to actually cared about the billing error and the Medicare people were downright stupid and didn't understand at all why I was trying to save them money. Eventually I gave up.
Medical billing is insane. Try to report a deficiency with a potential solution, you get a cryptic "thank-you for your concern" response. They are not interested in fixing anything. In my case, I have Medicare as the primary. As I retired from two jobs, I have insurance from both of them. Insurance "A" and Insurance "B". That is good thing. The problem, Insurance "B" endlessly requests verification on whether they are the secondary or the tertiary. Consequently, I have pages of "rejected" claims. It also takes the medical insurance billing person (at the doctor's office) a long time to get that straightened out. Not surprisingly, when I attempt to see how the billing issue was resolved, I can't find the paper claim trail!!!

Periodically, I call up Insurance "B" as they claim to provide "coordination of benefits", but they never seem interested in actually working with Insurance "A". (Isn't that what computers and data management are for?) The simple explanation, it would seem, is that paying claims costs insurance companies money, but obstructing the process can "save" them money. Maybe not that much for one person, but consider the massive number of claims that they do process. Also consider the extra staffing burdens on a doctor's office where the insurance person has to spend an inordinate amount of time processing unnecessarily complex claims for submission to the insurance companies.
 

oleronesoftwares

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I try to review the summaries I get from Medicare regarding who billed what.
1. They are virtually impossible to verify.
2. Three years ago I found an error. A doctor billed for a procedure that was related to a surgery that I never had. I'm sure it was a mistake but the bill was for over $1,000 so I decided to try to rectify it. I spent two hours per month for NINE months talking to the doctor's office, Medicare, and my supplemental insurance company. No person I spoke to actually cared about the billing error and the Medicare people were downright stupid and didn't understand at all why I was trying to save them money. Eventually I gave up.
The scenerio explained by Pat and Steve, points to the possibility that Healthcare and medical profession is now more about money than saving lives, it might get worse in the future.
 

The_Doc_Man

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With medical insurance companies (like most other types of insurance companies) it has ALWAYS been about money. Saving lives is the pretext to let it go on as it does.
 

oleronesoftwares

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With medical insurance companies (like most other types of insurance companies) it has ALWAYS been about money. Saving lives is the pretext to let it go on as it does.
Do you think this will change in future?
 

The_Doc_Man

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Do you think this will change in future?

Given human nature and the effectiveness of the profit motive, I don't see any major changes. Abraham Maslow's pyramid of motivations clarifies the psychology of this greed motive. It is a low-level need to assure individual survival.
 

oleronesoftwares

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This article is worth looking at.
 

Isaac

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This link from August may be of interest

AstraZeneca price circa $5.66 in the US
Pfizer price $19.50
Moderna price $16.50

AstraZeneca are selling at cost until the end of the pandemic

Appreciate there will be some variation in cost of production, but gives some idea of corporate philosophy
I'm not really knowledgeable in this, but isn't AstraZeneca vaccine connected with the whole Cambridge University and more associated with not-for-profit academia in general?
Maybe connected & explains some of it?
 

Pat Hartman

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The media let us down yet again regarding Obamacare. The House was presented with a bill of over 2,000 pages and I think only about 24 hours to read it before they had to vote on it. So that means that no one who voted for or against the bill had anything but talking points to make their decision on. Fairly typical for the House of Nancy. Her most famous quote became "you have to pass the bill to know what is in it". How's that for left wing logic. The media could have had people reading drafts and reporting on it but no, that would mean the public would be too informed and might then put pressure on their representatives to vote against the bill since it would actually increase their costs rather than give them the $2500 per family savings that Obama promised.

Obama got up on national television and lied and lied and lied. And he knew he was lying because his advisors admitted that he knew how much the bill was going to cost the public but it was really good for insurance companies. I understand that Presidents and politicians cannot always tell us the truth but they should NEVER lie about things like this which affected all of us at a personal level. That was downright evil. Obamacare was downright evil.

Personally, the year before the bill was proposed my husband and I were paying $600 per month for really poor health insurance. We were on a Medicaid plan and paying the top rate because we were certainly not poor but we had lost our insurance and had two years to go before Medicare. A private policy was going to cost us $30,000 per year with an $8,000 deductible so being basically healthy, just getting old, we decided to risk bankruptcy for two years by using the state's Medicaid option. By the month before we were eligible for Medicare, our monthly bill for MEDICAID - which paid a maxim of $75,000 for any illness/accidents during any year was up to $1200. I can't imagine how poor people survived. I guess they just did without. My daughter's insurance doubled and of course went up every year from there. We were lucky to get to Medicare that year and have our insurance go back down to about $400 a month for the two of us with a drug plan.

So, who benefited from Obamacare - some people who didn't have coverage got coverage for free. Of course, the way hospitals work is they treat whoever walks in the door and then worry about collecting so in theory, hospitals benefited because they had fewer "free" patients to treat. The big winners were insurance companies as you can tell by how their stock prices rose after Obamacare became law.

-But the insidious thing about the way for-profit insurance works is that insurance companies have no incentive to lower costs. They work on a cost + basis so the more dollars they pay out, the more dollars they get in because 10% of $150 is better than 10% of $100 and they just raise the rates as needed to cover the actual costs. Once we went all in on the HMO model, people stopped knowing what providers were charging for any service. so they just cared about what their co-payment was. They don't know that the doctor is billing the insurance company $300 for a 10-minute visit. All they know is that it cost them $25. So people don't understand just how much we are paying for medical under the current system. Yet, there are parts of he country were doctors charge $125 for that same 10-minute visit. This isn't particularly relevant for PCP's because you're not going to drive to Arkansas to see your PCP, but it becomes really important when you get to important but not emergency services like knee replacements and cataract surgery. Some insurance companies are actually taking advantage of medical tourism within the US. It is cheaper by a lot for them to send you to Arkansas for a week with a companion so you're not alone than to have the surgery done in your local hospital.

Who was hurt, people like my daughter. Her premiums went up dramatically but she earned too much money to qualify for one of the Obamacare plans. Given that we live in one of the most expensive counties in the entire country and she's a single mother of two it's not clear how that could be true. I guess they used the average income for people in Alabama as their basis.
 

Steve R.

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"When money from the government is in the news, we know scammers are about to run their standard playbook," FTC consumer education specialist Lisa Lake wrote in a June blog post.
Many more such stories to follow.
Government programs, welfare for the scam artists.
 

Steve R.

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We knew months ago that this would happen. Now that there has been some time to reflect on this, the extent of fraud is now emerging.

Democrats doubling down on creating more opportunities for fraud.
 

Pat Hartman

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Makes you wonder how incompetent the IT people developing these systems for the government are. Surely it is not hard to locate "bubbles" of fees.

Companies don't bother to ensure SSN's are unique for each employee. The IRS doesn't bother to track down multiple people using the same SSN, and Medicare is just as bad if not worse. The data bubbles generated by the pill mills in Florida should be like Rudolph's red nose lighting up the night sky for Santa Claus.
 

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