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Monday, Aug. 29, 2016

Change is needed to put stop to fraud

Thursday, March 10, 2005

The question of government waste and fraud doesn't always mean an unscrupulous consumer. All too often, it means a crooked provider. Thus was the case this week with a St. Louis doctor involved in renal-dialysis clinics.

The government says the doctor and his North County Radiology clinic submitted fraudulent bills for Medicare services. That clinic is part of a larger problem with Gambro Healthcare that has been an ongoing investigation since 2001. That national firm has already been fined $350 million as part of an earlier fraud case. There's apparently more to come.

It's easy to focus on consumers who lie to gain government benefits. Medicaid in Missouri appears to be an example where lax enforcement has allowed many consumers on the rolls who truly do not quality. And Medicare is similar.

But an unfortunate aspect is that there are also some health care providers who understand how to manipulate the system to their own financial benefit. In the end, it costs taxpayers billions of dollars and we don't seem to have a handle on the problem thus far.

There's one plan being offered that would hire a thousand more state employees to investigate health care fraud. That may be the only solution but I fear it will only create yet another bureaucracy with questionable results.

The bottom line is simple. Adequate and effective health care should be a promise to everyone in this nation. Some are able to provide their own finances through private health care plans. Others are unable and rely on government-funded programs. But the only way this system will work is to eliminate fraud and abuse by consumers and providers alike.

No one wants more red tape and paperwork. But at some point, we must accept that there are those who would abuse the system to their own benefit and take money away from those genuinely in need. It is past time we put a stop to this abuse and demand accountability. We must also put a punishment on those who abuse the system that is sufficient to change that behavior.

And the time to make these changes is now.

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