Category Archives: Medicare

Obama Embraces the Right-Wing Fantasy of Massive Medicare/Medicaid Fraud

Barack Obama’s Blue Dog Presidency took another step toward Bushist crackpottery yesterday when he actively and enthusiastically reached to to Bushist crackpots by embracing a theme almost as close to their dear little paranoid hearts as voter fraud and SocSec fraud: the supposedly massive fraud in Medicare and Medicaid that has for 30 years been their go-to reason for killing both programs.

President Barack Obama made his case for an overhaul of the U.S. medical system to Missouri voters, emphasizing his efforts to curb waste and fraud in government health programs. obama.jpeg

“The health-care system has billions of dollars that should go to patient care and they’re lost each and every year to fraud, to abuse, to massive subsidies that line the pockets of the insurance industry,” he said yesterday at a high school in the St. Louis suburb of St. Charles, Missouri.

Obama is trying to rally public support for the biggest changes to U.S. health care in 45 years in the face of unanimous Republican opposition. He said his proposals show there are ways to pay for expanding insurance coverage to tens of millions of Americans without running up the federal budget deficit.

“So much of the money currently in our health-care system is being misspent,” he said. “If we can have a smarter health- care system, then yes, we can provide help to middle-class folks who need it and, at the same time, actually reduce the burden on taxpayers.”

His spirited endorsement included some of the same probably bogus figures in the charges Republicans have been making for decades – figures they’ve never been able to back up with evidence. The Pres claims he has such evidence through a pilot program in several states.

Last year, the Medicare and Medicaid programs for seniors and low-income Americans made $54 billion in unwarranted payments to healthcare providers, according to White House.

To combat the problem, Obama has proposed expanding a program to reward private bounty hunters who find waste by auditing government payments through what are called “payment recapture audits.”

The White House reported that a pilot program in California, New York and Texas yielded $900 million in Medicare savings between 2005 and 2009.

Gee, I hate to say it but this all sounds very familiar. Isn’t there someone else who used to be president who made unsourced claims based on interior White House studies we never saw that were supposedly prepared by people who were never named?

Whenever FoxNews or George W or Darth Cheney wanted to beef up their credibility when they made incredible statements of fantasy as if they were fact, they, too, would, like, pick a big number – say, a BILLION – and subtract 100 million or so from it so it would sound real. “$897MIL” sounds so much more believable, like numbers were actually crunched to produce it. Except that we would find out months – or years – later that they’d simply made the numbers up, that those “facts” had never existed in the real world.

So before I get all excited about how badly we’re being ripped of by our elderly parents and grandparents, I’d like to a) know who ran this pilot program, b) see the study numbers that reached that conclusion, and c) find out how exactly these paragons of virtue defined “waste”. After all, to a health insurance company any money whatever spent on anybody over 65 is a “waste” since they’re just going to die in a few years anyway.

None of this information was included in either news report. None. Maybe because it doesn’t exist.

Yah think?

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Bipartisan Blues

Poor Pres Obama. As things stand, he is losing on all fronts. Nothing is working and nobody seems to appreciate that his Grand Sell-Outs Compromises on the Recession (bank bail-outs), healthcare (insurance corpo toadying) and deficit-cutting (say bye-bye to Medicare) are THE BEST THAT ANYBODY COULD DO. Rahm told him so. But there is one success he can brag about: he’s got whacko movement conservatives and liberals talking to each other. It’s bi-partisanship at last!

After a solid year of GOP refusal to help him do anything at all (a refusal any monkey with opposable thumbs could have predicted), Barry’s insistence on bipartisanship has finally borne some fruit, though not exactly the way he meant it to. See, the bipartisan committee on deficit-cutting got rejected by the Senate but the rejection was bipartisan. That counts, doesn’t it?

The Senate Tuesday rejected a plan backed by President Barack Obama to create a bipartisan task force to tackle the federal deficit this year despite glaring new figures showing the enormity of the red-ink threat.

The special deficit panel would have attempted to produce a plan combining tax cuts and spending curbs that would have been voted on after the midterm elections. The measure went down because anti-tax Republicans joined with Democrats who were wary of being railroaded into cutting Social Security and Medicare.

(emphasis added)

Now that’s bipartisanship, right? Working together for a common goal even if you have different reasons for targeting that goal. The Pubs just want to stop everything Obama is doing because he’s not a Republican and they’re against non-Republicans. The liberals want to stop what Obama is doing because it’s essentially Republican.

Wait. Maybe their reasons aren’t as different as I thought….

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Another Moran Moment

Cartoonists and sane people have long noted the cognitive dissonance here but I found it refreshing to see it in their own words. And their own handwriting.


Um. Riiiight.

Bush Agency Tells Truth!

Having successfully politicized previously trustworthy and non-partisan govt agencies like the GAO and the CBO, Karl Rove’s White House crew had a right to feel proud of themselves. Those agencies had remained uncorrupted since FDR, carrying out objective investigations and producing unbiased reports; their numbers and conclusions were always accurate, no matter what the political fall-out, and they were trusted by both sides. Those days are, of course, over now, as we have seen both of them twist the data to fit pre-ordained political goals. But there is, it would seem, one independent govt agency left that they forgot to corrupt.

WASHINGTON, May 3 — The Congressional Research Service says the Bush administration apparently violated federal law by ordering the chief Medicare actuary to withhold information from Congress indicating that the new Medicare law could cost far more than White House officials had said.


Not that this is any great revelation. Most of us figured when it came out that ordering Richard Foster to shut up about the real cost so Rove’s Lackeys could push Junior’s prescription-drug benefit for drug companies through a reluctant Congress was likely illegal. We just didn’t expect to hear it officially. We didn’t realize that the CRS had escaped the Rove/DeLay Orwell-Machine’s relentless obsession with forcing govt agencies to turn facts into illusions and illusions into certainties. Unfortunately for the Bush/Rove Admin, the CRS is still honest.

In a report on Monday, the research service said that Congress’s “right to receive truthful information from federal agencies to assist in its legislative functions is clear and unassailable.” Since 1912, it said, federal laws have protected the rights of federal employees to communicate with Congress, and recent laws have “reaffirmed and strengthened” those protections.

Federal employees have a “right” to go straight to Congress and insist they listen to the straight dope? Ooh, this is bad. No telling where it might lead. Next thing you know, EPA scientists will be parading up to the hill to testify that aresenic is poisonous (the BA raised the acceptable levels of arsenic in water), National Marine Fisheries Service scientists will be swearing under oath that hatchery salmon aren’t the same as wild salmon, and climatologists from the National Meteorological Service will be forcing TommyD and Doc Frist and Sexy Chambliss to actually look at data that says global warming is happening RIGHT NOW, and they won’t like that.

You see, the problem is that the Pubs are so wrong scientifically, so wrong about the numbers, so wrong in their assumptions and preconceived, “revealed wisdom”, that this opens the door to an avalanche of federal employees who actually know what the real facts are to invade the sanctity of BushCo’s carefully-contrived FantasyLand Fun Park. If enough of these motivated, whistle-blowing fact-checkers march on the Hill, the FLFP will come crashing down around Radcon heads like the cartoon it is, and Junior’s faith-based govt will grind to a screeching halt.

Look for lines of tanks blocking Constitution Ave before the Rove Boys let a thing like that happen.

Oh, by the way, Tom Scully, Foster’s boss and the jerkweed who told him to keep his trap shut or he’d be out on his ear, is entirely unrepentant. Even though–

The research service, a nonpartisan arm of Congress, said Mr. Scully’s order “would appear to violate a specific and express prohibition of federal law.” The actuary, it said, has a duty to “make professional and reliable cost estimates, unfettered by any particular partisan agenda.”

–his stance hasn’t changed one whit:

Mr. Scully has confirmed telling Mr. Foster that “I, as his supervisor, would decide when he would communicate with Congress.”

He hasn’t admitted threatening to fire him, however, although as arrogant as these guys are, it wouldn’t surprise me if that was next, accompanied by the usual Radcon fol-de-rol about loyalty to the president’s agenda and how the real numbers were (somehow) a matter of “national security”.

The depressing part of all this is that we must, of course, at this point kiss the CRS’ non-partisanshhip a quick good-bye. Now that Karl knows they exist, their politicization in the coming weeks–if not days–is a foregone conclusion.

So “Good-bye, CRS, we hardly knew ye, but you did damn good work there for a minute.”

The Truth Can Be Dangerous If You Work For the Bush Administration

Tony Pugh of Knight-Ridder reports that Richard Foster, the BA’s top expert on Medicare costs, was told he’d be fired if he revealed the actual price of the drug benefit.

When the House of Representatives passed the controversial benefit by five votes last November, the White House was embracing an estimate by the Congressional Budget Office that it would cost $395 billion in the first 10 years. But for months the administration’s own analysts in the Centers for Medicare and Medicaid Services had concluded repeatedly that the drug benefit could cost upward of $100 billion more than that.Withholding the higher cost projections was important because the White House was facing a revolt from 13 conservative House Republicans who’d vowed to vote against the Medicare drug bill if it cost more than $400 billion.

Rep. Sue Myrick of North Carolina, one of the 13 Republicans, said she was “very upset” when she learned of the higher estimate.

“I think a lot of people probably would have reconsidered (voting for the bill) because we said that $400 billion was our top of the line,” Myrick said.

Five months before the November House vote, the government’s chief Medicare actuary had estimated that a similar plan the Senate was considering would cost $551 billion over 10 years. Two months after Congress approved the new benefit, White House Budget Director Joshua Bolten disclosed that he expected it to cost $534 billion. (emphasis added)

So not only did the BA knowingly lie about the cost, they threatened to fire anyone who knew what the real cost was and said so publicly. This, campers, is what is known in legal parlance as a “cover-up”. It’s also intimidation. But here’s the horror: there’s nothing new about this. It’s SOP for the BA. The Center for American Progress has been keeping track of such cases, and the list is intriguing.

***Larry Lindsey, WH budget advisor, was fired when he said the Second Gulf War would cost $200B. After a year, and no end in sight, we are at over $100B and climbing.

***When Gen Anthony Zinni (see Kiatkowski’s Salon article; scroll down to “The New Pentagon Papers”), who was Junior’s Mid-East negotiator at the time, said the Second Gulf War would take longer and be harder to resolve than Rumsfeld’s rosy scenario would lead one to believe, he was dropped from the team.

***If you’re wondering where that anonymous soldier quoted in Intervention Magazine (scroll down to “American Soldiers Refused Thanksgiving Dinner…”) got the idea that military freedom of speech was only allowed to Bush supporters, here’s where: Gen John Abizaid, Bush-appointed commander of the forces in Iraq. Gen Abizaid declared, “None of us that wear this uniform are free to say anything disparaging about the secretary of defense, or the president of the United States. Whatever action may be taken, whether it’s a verbal reprimand or something more stringent, is up to the commanders on the scene.” (emphasis added) Here’s a guy who’s trying to shut the whole damn Army up. Free speech and turkey dinners for Bush supporters, reprimands or the brig for Bush opponents.

***When ABC News reporter Jeffrey Kofman put soldiers in Iraq on the air talking about how the equipment the BA had promised (boots, night-vison goggles, flak-jackets, etc) never arrived and that they had to buy their own and weren’t too thrilled about it, somebody from Rove’s WH Communications Dept tipped Matt Drudge that Kofman was gay.

***When Junior got nailed after the SOTU for claiming that the CIA told him that Saddam was trying to buy nukes when what they had actually said was that there wasn’t any evidence to support that supposition, Bush and Condi Rice promptly blamed CIA “intelligence failures” for their cooked conclusions, and off-the-record “administration sources” started talking about firing Tenet or forcing his resignation.

***And of course we all know what happened to Joe Wilson when he said he had told the Admin weeks before they used them to justify the war that the Niger documents were forgeries–and obvious forgeries at that: somebody in the BA (the investigation is centering on Scooter Libby and John Hannah in Veep Cheney’s office) outed his covert-op wife to Bob Novak, blowing her cover and causing her to be removed from her assignment–tracking WMD’s.

It’s an impressive list: a former ambassador, a couple of Generals, the entire CIA, the entire occupation Army in Iraq, and two top-level advisors. And these are just the ones we know about. The FBI investigation of the Plame leak is picking up stories about how frightened everyone in the WH was of Rove, some reporters who complained that WH restrictions in press conferences were leading to scripted sessions were reprimanded or removed from the Washington beat when Dan Bartlett denied their press credentials, CIA analysts said that Cheney’s frequent visits to berate them for not going along with the bogus information Chalabi was “supplying” (read: “inventing”) convinced them to keep their mouths shut, and so on.

There’s a pattern here. Recognize it? If you don’t, then you’ve likely never worked in a big corporation because it’s SOP for corporate execs. Disagree with the Boss and suddenly you’re posted to the Outer Aleutians. Point out an obvious fallacy or weakness in the Boss’ plan and shortly after that find you’re branded as “negative” and “not a team player” and all your assignments are going to somebody who said in that same meeting that he thought the Boss was a genius. Talk to the press without permission and the next day you’re shit-canned no matter how positive what you said was. I personally know of the case of a man who was ordered to talk to the press at a press party arranged by his company and still got fired because he talked to a reporter who wasn’t on the company’s list–a list he didn’t know existed because no one had ever shown it to him. And this despite the fact that everything he said to her was stuff he had been saying all day.

Get the picture? This is what comes of taking inexperienced corporate honchos who don’t believe that anything they say or do should ever be questioned by anyone and putting them in positions of power in govt where questionable policies need to be questioned: they just can’t stand it. They freak when they aren’t obeyed instantly. They want to exact the kind of revenge they’ve always been able to exact on subordinates at home. They throw hissy-fits and toss threats around like Christmas cookies.

Corporate executives don’t believe they should be accountable to anyone, least of all their subordinates or customers (you should hear what these guys say to each other in private about what stupid, annoying, pains-in-the-ass their customers are; it would be an education). So let this be a lesson to us:

NO MORE CORPORATE CEO’S IN GOVERNMENT. PERIOD. Really, they’re not worth the aggrevation they cause.

Citizen Editorials

One of the reasons I like the Atlanta Journal-Constitution is its practice of giving ordinary citizens space on its editorial page. It allows voices to be heard in full that would otherwise be relegated to the truncations of the Letters box.Today’s AJC has two Citizen Editorials worth reading, one poignant and one rather angry.1. A bankruptcy of caring amid America’s riches

Ralph Parker, an operations manager at a financial services company, is wondering what happened to our compassion and generosity.

We dwell on the so-called moral issues to the point that we ignore the moral values taught by all religions and for which all people are accountable. The lack of acceptance of those who are different flies in the face of morality and pure decency.We condemn loving individuals who contribute to building families and society because they are gay. How does looking at the Ten Commandments or praying in school really help one become a better person?


We destroyed the welfare system because a minority of recipients were abusing it, and we created a new monster, the perpetually underemployed, barely eking by.

Why should people not earn a living wage?

What is so wrong with slightly higher taxes for those who have resources, so as to provide a living wage, health insurance and retraining? Where has compassion gone?

Good questions, Ralph.

2. Seniors must pay plenty for free care

James Coomer, a professor of Political science at Norcross College, is about to retire. He just found out what Medicare is going to cost him on his fixed income thanks to the Republican distaste for “socialized medicine.” He adds up what this “free care” is going to cost him in payments before he even gets sick.

Therefore, upon retirement, when I am on a fixed income, I will be required to pay $262.72 per month for health care for myself. This is more than I ever paid during my working career to cover my entire family. This is not exactly what I expected from Medicare. I suspect it is not what most retirees expect. Is it any wonder that nearly 40 million Americans cannot afford even the basic health care options? Tax credits are useless to people who cannot seek medical attention because they cannot afford to pay up front.

A simple observation that seems to have escaped the Republicans who insisted on that provision. I’m sorry it took Mr Coomer’s own retirement to wake him up to what’s been happening to Medicare in the name of “fiscal responsibility” while he was busy elsewhere, but that’s a normal occurrence, isn’t it? We ignore the alligators as long as they’re in somebody else’s yard. Only when they wander into ours and snap at our legs does it dawn on us that we should have been paying more attention to what was going on with our neighbors.

Mr Parker is right–we should have noticed before. We should have cared. We should care now. Do we? Or are we going to continue the Republican presciption of “looking out for #1” and wind up like Mr Coomer, over a barrel because we couldn’t be bothered? It’s up to us, you know.

Tommy Thompson Plots to Kill Medicare

Phaedrus has the skinny on the latest Publican scam to kill Medicaid, or at least force many of its recipients into private care. This is a new dodge, though, that claims states have been embezzling money from the thrifty Feds, money to which they’re not entitled. Ex-Wisconsin-Gov and now HHS-Sec Tommy Thompson, not noted for either his generosity or his accounting skill, is accusing the states of using accounting procedures to shift the burden of Medicaid payments to the Federal govt without, he says, paying “their fair share.”

In one example described by Tommy G. Thompson, the secretary of health and human services, county nursing homes borrowed $1.5 billion from a commercial bank. The money was transferred to a state account, then to the counties, which paid the loan. The state, which Secretary Thompson did not name, claimed it had spent the full amount on medical care and drew down more than $800 million in federal payments.

Actually, as a veteran local-govt-watcher and sometime inside man, this sounds to me like the kind of robbing-Peter-to-pay-Paul maneuver that state and local govts find themselves forced to in order to meet their obligations. By itself, there’s nothing particularly fishy about it. In order to stretch every dollar to its limit–and often to satisfy the requirements of the funders–public money is frequently shifted through various accounts as it slowly makes its way to the people who will use it. The Bush Admin has decided to call that “phantom money.” The states, quite rightly, disagree:

[T]he Bush administration says…states have paid their share with “phantom dollars,” instead of state or local tax revenues.State officials acknowledge their desire to make the most of federal Medicaid payments at a time when health costs are soaring. The National Conference of State Legislatures advises its members on “Medicaid maximization” strategies and says such techniques are legitimate and desperately needed to avoid cutting benefits for poor people

What Thompson and the BA have decided to attack as “gamesmanship” is the practice of borrowing money from banks or shifting it temporarily from one program to another in order to cover shortfalls that are usually the result of late Federal or State budgets, or promised money that has been withheld by the govt funders because if you can delay dispersing it, the money that’s supposed to go out instead stays in a bank and gathers a few months more’s worth of interest–an accounting trick of theirs. The Feds play that game with the States, the States play it with the counties, and the counties play it with the towns. It’s a long, drawn-out stall that nets each stage of govt its pound of flesh and forces each downstream stage into an ever more complicated dance to cover their obligations until that money eventually reaches them.

It sounds very much to me as if that’s all that’s going on here, but the BA wants to cut Medicaid and can’t because it’s a politically popular govt program, so it’s looking for an excuse, trumping up charges of “fiscal malfeasance.”

Melanie M. Bella, the Medicaid director in Indiana, said she had been negotiating with federal officials for nearly a year on a proposal to increase payments to doctors from the Indiana University School of Medicine who care for Medicaid patients at the county Wishard Memorial Hospital in Indianapolis.The county is willing to pay the state’s share of the extra cost. But the Bush administration says it wants to curb such “intergovernmental transfers” because they have been abused in the past to gain what the budget described as “inordinate amounts of federal Medicaid funds.”

“It would be a real hardship if we cannot use county tax money,” Ms. Bella said. “This is headed down a path that will increase the number of uninsured. With the proposed restrictions on our use of state and local revenue, states will have to cut services, reduce payments to health care providers or eliminate groups of recipients.”

“This is headed down a path that will increase the number of uninsured.” Now why would the Bushies want to do that?

In his new budget, President Bush said he could save $1.5 billion next year and $23.6 billion in the coming decade by restoring the “fiscal integrity” of Medicaid.

There you go. Bush wants to lower the deficit he created by cutting the taxes of his rich friends and contributors, and he wants to do it by forcing the old, the infirm, the poor, and the disabled to fend for themselves again, just like in the old days before FDR. He’s using this bogus “fiscal integrity” canard to excuse and cover up what he’s really after–the systematic destruction of a program the rich hate and have hated for 60 years, whatever name it went under. Phaedrus nails them:

If you’re a hard-hearted bastard who wants to fuck over the poor, the elderly or the disabled, fine. You gotta right. But say so. Say it out loud, ya sonuvabitch! Quit hidin’ behind “principle.”

Amen, brother.