Saturday, June 4, 2011

If you are looking for Medicaid fraud, go where the money is!

Senator Charlie Scott is apparently seeking higher office. Dissatisfied with Divinely imposed term limits, Charlie believes his legacy would best be fulfilled as the Mayor of Whoville. Like the Grinch who stole Christmas, Whoville Mayor Scott and his dog Max sit high atop the mountain above, watching over the Who-sters knowing they are up to something mendacious and deceitful.
Mayor Scott builds castles in the air colonized by Who-sters who know how to cheat the system. He’s been on that beat for some time now, having chased many of those same Whoville citizens off the public dole, claiming to have seen them drive to welfare offices in their Cadillacs, collecting welfare checks. Charlie used federal welfare reform laws as an opportunity to cut 90% of the Who-sters off the dole. “Get a job,” he told them. And so they did.
Many Who-sters were single mothers with children. Some were two parent homes. Parents put their children in daycare and went to work. What they found were jobs with little pay and no health insurance. So the Who-sters worked two or three jobs when jobs were available in Whoville. Still they took home so little they continued to qualify for public benefits such as Medicaid.
Rather than saying something about low wages and lack of access to affordable insurance, Whoville Mayor Scott knew in his gut citizens of the village have cheating hearts. Regardless of factoids, he was certain of his notions. The “truthiness” of the matter, according to the Mayor, is there are crafty, guileful and duplicitous women in Whoville who quit their jobs upon learning the stork is enroute. Unemployed, they sneak into the local DFS office and sign up for Medicaid. Then those devious Who-sters go back to work, still collecting ill-gotten Medicaid benefits. Who are these cheating Who-sters? The Mayor isn’t saying but, “Damn ‘em all,” the he cries.
His Excellency can’t explain why they would bother to quit their jobs when their wages are already so low they qualify for Medicaid but, hey, Whoville is his jurisdiction and he knows his people. I think if I were Mayor, I’d follow the advice of Willy Sutton. Asked why he robbed banks, Willy said, “Duh! Because that’s where the real money is!”
Last week Whoville’s attorney general announced the real money had been found, not in the off-shore bank accounts of Whoville welfare cheats but rather in the “white collar” hands of pharmaceutical companies. Through a variety of schemes that avoided the Mayor’s detection, these companies bilked Medicaid for so much money that little ole Whoville’s share comes to 1.4 million dollars!  
“There are many factors that contribute to why Medicare & Medicaid fraud is becoming out of control in America” according to USLaw.com. “Two serious contributors are overpriced prescriptions for medications, devices and treatments in addition to overspending by largely unregulated hospitals. Doctors have many incentives for prescribing the most expensive drugs and medical devices mainly including rewards from drug companies. This type of fraud is estimated to account for about 15% of Medicare & Medicaid over-billings.” The report didn’t mention the women of Whoville.

Al Simpson famously said, “Never start a fight with someone who buys ink by the barrel. Likewise, the Grinch who plans to steal health care from the poor knows better than to start a fight with people who buy politicians by the barrel. Yet, Willy Sutton knew what he was talking about. Whoville would be better off if the Mayor followed the real money.

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