$430 Million of False Medicare Claims*

When I heard the arrest of many healthcare providers in many US cities on fraud charges, I had two thoughts come to mind. First I felt sad for the perpetrators who would commit such despicable crime. What they did to the Medicare program is not only criminal. It is also immoral. We always think that only the destitute resolves to crime to survive. But many arrested are professionals, like doctors, nurses, and administrators. My second thought on this massive fraud case came upon the question on how the costs of the government sponsored medical services are determined? Many years ago, healthcare industry started “de-bundling” their services. We all know when a service got de-bundled, invariably not only the cost to the users of the service rises, so is the complexity of the underlying service. Based on this real life experience, it is not hard for me to speculate perhaps the de-bundling of healthcare plays a pivotal role why oversights and abuses are prevalent in a government program like Medicare. - Ayee *“Medicare Fraud Crack Down,” The Nightly Business Report, October 04, 2012