Keeping Your Eye Off The Ball, or How Congress Plays

I don’t want to be hard on Congress, but could they possibly be any worse at their job? Let’s pass a Health Care Reform bill that protects Americans and insures that they have access to basic medical care. OK, good idea; now what’s your plan? Oh, the plan is to make everyone have to get insurance and conveniently make it cost less. Sounds like a Plan!

And to support their plan, Congress has worked out estimated costs and figured out how to pay for it, sort’a. There may have to be some extra taxes here and there, and mandated obligations on employers to provide a plan for their employees. But not to worry, Congress has arrived in their shiny armor astride their war chargers, and only need to collect the harvest from us peasants to ensure that they can pay for the war they have decided to wage.

As we all agree that having 30 to 40 million Americans unprotected by some insurance system is bad, and given we have a $420+ Billion annual Medicare and $200+ Billion annual Medicaid programs plus all the private and commercial insurance plans, we are clearly spending a ton of money on health care. To make things more interesting, the Coalition Against Insurance Fraud (a bunch of insurance companies, non-profit groups and agencies, and community organizations) have estimated that these programs provide $60 Billion a year in fraud funding. That’s one dollar out of every ten being wasted, and even worse than wasted, it reduces the support and services that the rest of the funding can effectively deliver through work and effort spent on handling and processing illegitimate claims and supporting non-productive tasks.

That 10% of fraud ($60B) would be close to what the uninsured would need to provide the health care that they need. Interestingly, we are already close to funding the uninsured. Our only problem is that we are spending it on the wrong group of people (well there may be some overlap but only a small one).

Makes you wonder if Congress considered that their biggest problem, how to fund the act, would be virtually solved if they worked on a plan to prevent most of the fraud, waste and abuse that is already being funded. Now don’t worry, there are some initiatives in the Health Care Reform bill to reduce abuse/fraud. And we can expect the same brilliance and expertise from Congress on these efforts that we have always relied upon to solve all our other problems. You can almost taste the victory, can’t you?