Health care reform: forgetting fraud

This is why we need health care reform. Some estimates are that 1/3 of the total health care system is waste and fraud.

If you want to FIX healthcare....start with SHOWING US you can fix what you already have including Medicare. Medicaid, the VA. and the Military.

CMS LOSES $50 billion dollars a year due to improper payments including fraud and overcharges. FIX THAT. THEN we will talk.

It amazes me how people can be against something that "helps"us.

Don't you see what you are doing AMERICA!!! YOU ARE LOBBYIST FOR THE SAME COMPANIES (INSURANCE) WHO RAISED YOUR PREMIUMS LAST YEAR, WHO TOLD YOU THAT THEY WOULDN'T PROVIDE CARE FOR YOUR SICK KID, THAT YOUR CANCER TREATMENT WONT BE INSURED.

I for one don't have health insurance because my employer can't afford to provide it, so me and my family don't have health insurance...So why not a public option. I hyper-extended my knee last month, went to the emergency room, they looked at my knee, gaVe me a prescription for a pain killer, put a brace on my knee; then sent me on my way. Weeks later I got a bill in the mail for $1500.00. I can't afford to pay that. If YOU DON'T want gov health care...DON'T SIGN UP FOR IT. And it amazes me because Medicare IS A GOV PROGRAM.. So I guess I'll be waiting, and my family will be waiting to see how this thing plays out. And I pray everyday that my little girl doesn't get sick.

The current "health insurance reform" proposal does not address problems of fraud. This is just another reason why the current bill needs to be trashed and a new one that addresses "health care reform" needs to be passed. Also, the current bill fails to address the problem of tort reform.

If we don't address fraud & tort reform what is the point??

This is a fool proxy. There's nothing to be done about the fraud save random investigations and follow up reports. Though explain to me how a non-licensed practicioner actually makes a claim?

All it takes is a couple lines of code in the government's software to check if a doctor is deceased or not . If anything it's an argument FOR a national health system.

This is why government-run health care is bad. The government does not have much incentive to manage costs or fraud. They can just raise taxes. Even all-encompassing insurance is bad. The best solution is free-market competition, where consumers shop around for the best price. That eliminates most of the fraud. The only reason for insurance is catastrophic coverage.

You are right Larry. Health care reform is needed to end the health care and insurance industries' monopolization. I just don't understand why the other wacky Americans just don't get it. I am for health care reform.

What about patient fraud?

I.E. malpractice suits brought forward by
greedy lawyers and people out to get somethng for nothing?

I guess the Obama administration doesn't want to mention that as a wasteful part of "healthcare reform" It might anger his consttuency,

The people and attorneys that support him.

Yet another argument for reform. I sat down and read through that bill, especially looking for all the 'bad' stuff that the anti-reformers claim is there. Most of their complaints are invalid, and the rest are almost insultingly obtuse interpretations of the text.

*shrug* I've a high income and large net worth compared to most of the country. I don't need health care reform. Maybe I should just stop caring. Let the middle-aged screaming nutters who show up to disrupt town halls get what is coming to them.

They kind of health care reform that will reduce fraud and what Obama is talking about are two totally different things. If Obama would get off the public option and incorporate more tort reform into the package, I think you'd see a vast majority of Americans get behind it.

The other reason health care reform will not be effective is because doctors do not listen or misdiagnose patients. When the doctor do not listen or misdiagnose, the cost to fix the ailment is astronomical!! I was told I had major depression for over 12 years and learned a year ago that it was not major depression but the real issue was that I had thyroid problems, my adrenal glands was not properly working...the cost for me out-of-pocket $450-$600 per month!!

its a good thing private insurance investigates fraud like this. Medicare doesn't. that's 60 BILLION dollars that is wasted in the Medicare system. And we want to get MORE government control??

those people who are busy disrupting the town hall meetings, who are they? i think it would be fascinating to find out where they are getting their health care.... for example, many of them seem to be over 65 so we know they are actually on Medicare (guess who runs that?). those not on medicare- how many are govt. workers getting insurance essentially paid for by the govt. how many have a history of serious health problems so that they can actually see how their health care insurance works? and precisely what are they against? i would love to see the news "investigate" the above questions. chase the protesters after the protest and interview them, poll them, lets see who they really are.

Republican’s will pay! This behavior is rude and Anti-American. Someone is going to get physically hurt! President Obama is trying so hard to help all American's. He is so humble, stating, “ It’s not about him”! Tragedy, the Republican Party cannot accept the fact that they lost! They have turned to ruthless vengeance, that brings out the worst evil in mankind. The vicious name-calling and mob tactics are barbaric. Respect for our fellow man must be our first objective, not mob rule! Secondly, my senators have abandoned our President in a time of crisis. Next election all those who do not have health care should go to the polls and let their elected official know how they feel, because party lines are deafening our elected officials. Of course the only way those people could vote is if they are Healthy enough to make it to the polls.

Americans see this as another take over by this administration in an attempt to control our lives. And now we have had enough. Why is it that whenever a group questions, or disagrees with this Obama administration it is always portrayed as a group of right wing crazies?
Maybe we are just concerned AMericanst

Again, let's blame the doctors. How about we blame the people who at obese and smoke. The ones who's care cost a great deal and is TOTALLY preventable. Wake up. The vast majority of doctor make great sacrifices to do what they do and don't make 500K in 20 hours a week as some would assert. I work 70+ hours a week and get called a way from my family to care for yours. And I make a very reasonable 200K. Stop driving good people away from being your future doctor. Proscecute fraud. But don't pretend it is the root cause. Fix liability and you will remove the biggest cost – defensive medicine.

Any idiot can spend money, and that is what Obama is doing. It takes much stronger leadership to enact CHANGE in the way we spend, and take on real problems such as this. But Obama is doing nothing of the sort.
Agree, there is lots of fraud. But the great health care plan does not address any of the important cost-saving issues: malpractice reform, defensive medicine, fraud, waste, and poor health habits. It wants electronic medical records, but there is no money to doctors to pay for it. It does little to change the complicated coding nightmare that encourages fraud. It creates arbitrary cuts, so that fraud and waste is necessary to keep doctor's businesses open. It creates in its own right "cadilac" insurance that invites fraud, rather than high – deductable plans that encourage patient participation and scrutiny over the health care the get. There is very little regulation over which codes get paid what and why; no reform of CMS (which sets rates to doctors and hospitals) and how private insurance follows CMS. There is little there to put responsibility on patients to stay healthy and live healthy. There is nothing to stop the end-of-life crazy spending by families, doctors, and hospitals, as if there is endless money for futile procedures and treatments.
In the end, this proposal is just another socialist way of bringing everyone into the system, without fixing the system. And the system will bring us all down with its weight. And the system will be so burdensome and annoying that anyone with means will opt out of it - thus two tiered health care which we don't have now.
Obama has good intentions, but there isn't enough political clout to make real changes except spend money. Anyone who spends money can do things, the real challenge is to change the way we spend money. And get people to do different things and go against trends, and strong lobbies. He has FAILED in that. Any idiot can spend money, that is easy. It takes much stonger leadership to change the way we spend the existing money.

Good one, Larry! I'm sure the Gov will streamline things and remove all waste.

Fraud does cost the tax payors money. I have a little different take on health care insurance fraud. I am a health care provider who provides services to BCBS policy holders. I have an insurance clerk I have to pay to review the payments made by BCBS. My contract states that they have to pay $11.80 for a particular service. Every few claims they just arbitrarily leave out a payment. They have it programed in there computers just to not pay the providers every once in a while. I have to hire some one to review the claims, that runs up the cost of health care also. How many poviders get cheated ? Typically we come up with several hundred dollors a week, of fraudulent payments. Who do I call about that. Do you think the states attorneys office will help me out. Not a chance.

Wake UP America. The people lobbying and disrupting town hall meetings are the ones who want to keep the fraud going. We need oversight. Quit selling out to the thieves.

Fraud oversight by the government has one drawback: bureaucrats who uncover it and prosecute it have their bonuses and positive performance reviews predicated on the number, not just quality, of invesitgations and prosecutions. Therefore, it is in the financial and career interest of investigators and prosecutors to go after not only real and obvious cheaters, but to go after, with equal force and tenaciousness, those doctors and hospitals who make minor, inadvertent mistakes, something very easy to do in the highly complex and convoluted world of healthcare and insurance rules and regulations.

And why would fraud go away of the Gov't ran health care? Look at defense contracts. Look at the Halliburton deals, Blackwater etc. The Gov't is big a bunch of crooks as you'll find anywhere.

It's not a debate if one side recites lies over and over. You cannot debate whether health care reform will kill the elderly in the same way you cannot debate wheter or not the Earth is flat. One side of this debate is simply lies that the extreme right propagate over and over. The president does not want a single payer option. Health care reform does not mean mandatory end of life counseling. You will not lose your insurance if you want to keep the plan you have. This reform debate should be about how to fix runaway health insurance costs that affect all Americans. Or the debate would be better served on focusing how many Americans lose their health insurance daily by becoming ill or losing their jobs. Hopefully there are enough democrats that will stand by the president and pass sensible health care reform. The president cannot do this by himself.

Of course the Republicans are the ones causing the turmoil at these town meetings. It's not whats good for the people - it's what's good for the party. And the sad thing is that both parties are capable of this.

in response to some of the against reform emails, it seems to me that the reason people are against reform has nothing to do with the fact that overall health care is good but not great in this country. the republicans feel that reform needs to include further limitations on suing insurance companies or doctors, giving the consumers NO defense against a company that refuses to give people life saving treatment.

there is no doubt that there is fraud, lawyers are greedy, doctors are not perfect and misdiagnose (there is a reason the second opinion mantra is used) and so on, but NO reform would perpetuate a system that refuses treatments for all kinds of reasons, leads to people going bankrupt, a system that is becoming so expensive that people search for less expensive coverage, which always means less care and less choice- meaning that you can only go to specific doctors and god forbid if there was no specialist such as the one you need. Children with developmental delays, learning disabilities, etc. who often need additional services do not get services, and in the mean time Health care companies are making record profits! (how bad can the fraud be if the companies are making such profits!)

You don't fix a problem by throwing trillions of dollars at it. You need to start at the roots, and work up, not at the top & work down.

tim you're right its not JUST the doctors but some doctors are part of the problem too. Do you know that doctors that OWN ct scans perform 3x more ct scans than those that don't?

doctors own surgery centers that take money from the system. there is so much profiteering from EVERYONE, insurers, doctors, hospitals, pharmecuticals etc.

we need regulation of EVERYONE. If you regulated insurers for example that required a medical loss ratio of 80 or 85% you would have almost no profit from insurers and that argument would go away.

oh and costs would still be going up.

70% of amercican children are obese. that needs to be fixed. but why should it be if the government is going to come in and pay for everything??

Re: health care reform, little mention has been made re: the defensive medicine doctors are forced to practice in an attempt to avoid litigation in the event that they miss something. This drives up costs to a degree most of us cannot imagine.

Does GOP understand that in the end, the public will understand what the issues are? Do they realize that with the public finally understand the benefic of healthcare reform they will pay for missleading the public once again?

Skyrocketing healthcare costs? What about skyrocketing, unsustainable cost of GOVERNMENT? At least when I pay my health care insurance premium, I get something in return. What do I get with increased cost of Government? More red tape, less service, longer wait times...oh, and by the way, better health care for illegal immigrants! NOTHING in the health care proposals put forth by the liberal democrats improves ANYTHING! All it will do is spread the pain of a corrupt and bankrupt medicaid/medicare system to all American taxpayers. It doesn't address fraud. It doesn't address malpractice. It doesn't address defensive medicine. It simply takes over yet another (huge) sector of the economy. President Obama gives great speeches about "nobody's talking about government-run health care". Yeah, nobody's talking about it because they want all the "sheeple" to just sit back and believe it won't happen until it's too late. Look at all of Obama's speeches BEFORE he was annointed president...where he tells audiences over and over that it will start with incremental government programs, but must eventually lead to total government control. This is all part of his and Congress' socialist agenda. Fight it with everything you have! Stand up to these morons and defend the republic! Otherwise it's only a matter of time before they change the stars in our flag to a hammer and sickle.

Just because the fraud that exists in the medicare system is there doesn't mean it isn't time to abandon the private delivery of health care. Fraud can be addressed, and as at least one poster observed, it is easier to address through a national data base. Also, don't think for a minute that the same kind of fraud that is stealing from medicare isn't rampant in private health care. If anything, it is also much more in the open, what with $10 charges for aspirin.

As for the poster who asserts that the government has no incentive to root out fraud because it can just raise taxes, the lack of incentive among private insurers to not care about fraud is even greater and its even easier for them to just raise premiums. I have encountered a half a dozen situations where employers have documented workers compensation fraud (employees claiming lifting restrictions, or being unable to move in certain ways, and then being filmed working out at the gym or playing tackle football) and when the evidence is presented to the workers compensation carriers, they ignore it, finding it easier (for them) to just pass on the increases in premiums brought on by the claim fraud.

The fact that fraud exists, or that it might not be adequately addressed at the present time, is a lame argument for not proceeding to fix a system that is broken and that will continue to cost more and more until we get to the point where very few have private health insurance and the rest of us get to be gouged by the supposed "customary and usual" ridiculous charges medical providers and hospitals charge those who are not part of a "discounted" in network group.

Private health care has only itself to blame for the coming government take over of health care. It has failed so miserably and so often that it no longer provides a credible method for delivery of and access to health care.

No way these bozos can handle health care, they can't even keep their Ponzi scheme (social security) afloat much longer. And if they pass the Cap and Tax plan, what businesses will be left to pay for these big $ agendas? American companies can barely compete now with all the EPA programs they have to comply with cutting into productivity.
And they say Bush made a mess? If B.O. gets his wish list our economy will be sucking as bad as the U.K.'s.

Out of the thousand pages of legislation, there isn't a single sentence that addresses the costs of fraud, nor the costs stemming from the ambulance chasing lawyers. It's going to do nothing but turn all our healthcare into something that resembles VA hospitals.

I have no confidence in congress' ability to come up with a plan worth having. They don't want to live under the plan they're concocting so their trying to tell us it's a good thing is a joke.

With their recent ad-hominem attacks on anyone who dares to say anything against the plan, it sealed the deal for me. I don't want the plan, I won't vote for anyone next cycle who supports it and no, I'm not carrying a nazi sigh, nor a radical, nor an extremest, nor was I paid to post this by some rich insurance company. I like, have an opinion. Evidently that's not allowed, unless it's the same opinion that Obama has. What a joke.

And don't forget the fraud that Blue Cross commit many thousands of time each day against substance abuse & mental health agencies. BC/BS pays programs $28 per day for a service they should be paying $135 for 3 hours by denying they reimburse for the service...even though it is in their plan.

Blue Cross also tells providers, and I quote: "just because it is a service we cover, doesn't mean we pay for it!"

These are documented facts.

I think the Americans are dummies when it come to helping the poor. Its all about the rich keeping all they can. There are people who spend more on an outfit that they are only going going to wear one time, than lending a helping hand. I used to have insurance now I'm disable as millions of Americans, we paid into the system for years. I only want everyone to watch Michael Moore's "SICKO" So these nuts can see how stupid the really are.

I love how people think that those opposed to health care 'reform' are against improving things or helping people. Don't be ridiculous. People want change and improvement but this reform bill is NOT it. Insurance premiums are so high already and keep going up BECAUSE of government control and regulations. Adding more, will not help the situation. More and more freedoms and choices will (are) be taken away. Less doctors will want to become doctors because of lower wages and then.... Ahh I'm sick of typing. If you don't know by now whats REALLY going on then you need to do your research. Its scary. Reform yes. THIS reform bill? NO!

This is to: Bob August 7th, 2009 8:30 am ET, who wrote...
"You don’t fix a problem by throwing trillions of dollars at it. You need to start at the roots, and work up, not at the top & work down."

So tell me how trickle down economics worked out for everyone? Oh that's right, we ended up with "too big to fail" and multi-million dollar bonuses to crooks and thieves.

If you read the bill, it recuses itself of operating within the Constitution.

pg 53 – SEC. 155. SEVERABILITY
"If any provision of this Act, or any application of such provision to any person or circumstance, is held to be unconstitutional, the remainder of the provisions of this Act and the application of the provision to any other person or circumstance shall not be affected.

So we should allow a bill that excuses itself from protecting people's right to life, liberty and the pursuit of happiness?

roland,

i'm sorry but you're wrong. Private insurance DOES have incentive to investigate fraud. they're in a competitive situation with other insurers. if they don't investigate fraud they will lose market share to another carrier.

government has no competition in medicare. that is why there's no incentive to investigate fraud.

How can they talk about health care reform when they haven't even mentioned tort reform?

ANY kinda health care is a Charlie Foxtrot. When my husband retired in Jan. 08, his health care "retired" with him. But, not to worry as he gets S.S. which, pays better than the last several PRIVATE plans he had. My "rellies" in Australia have a socialized medical system & none of them are ging bankrupct. Funny how THAT system is never mentioned nor N. Zealand's.

So, I have no medical insurance since I was turned down when I gave several companies my medical history which ONLY includes mild hypertension which is TOTALLY controlled with meds. Get this: I listed a hysterectomy I had 22 YEARS ago for non-cancerous reasons & they even listed THAT on my rejection form. Basically, they put EVERY sugery-2 c-sections included-that I had EVER had as a reason they didn't want my $ even tho I was just applying for catastrophic insurance.

Personally, as a retired nurse, I hope they ALL "crash & burn."

These people are killing me with laying all this crap at the President's doorstep. Where were you people to storm Town hall meeting the last 8 years? Oh I forgot lapping up every lie that spewed out of bush and Cheney's mouth. if we just had the wasted cash on this two failed and ill-adviced wars we could insure every citizen! Malpractice is every patient's right to pursue if they have been botched up by a doctor, nut.

Americans don't want to have open discussion screamed down by hired fanatics and there is a growing movement of health care reform protesters meeting these hired nuts when their buses roll into town. We will have our own crowd meeting them today in the small town I live in. This movement, our side, is real grass roots. America wants health care reform so the numbers are on our side.

Yet another article that pushes healthcare reform that is totally one-sided. MOST providers, including doctors and hospitals, would never intentionally submit fraudulent claims. However, they are penalized everyday, adding up to annual penalties in the millions in some cases. I would make the case that the government and some commercial insurers are OVER-vigilant about coding fraud. The penalize the system up to 3 times the amount of the false claim, even though the claim could be undercoded, meaning the provider charged less than they should have.

This article doesn't mention that. CNN chooses once again to simply advocate FOR reform in any way possible. You know there is more to this story Mr. Chernoff...let America know about Medicare's new RAC program. Let them know how much more providers are penalized for ridiculous reasons such as undercoding and misusing a certain modifier. That's the true injustice.

Just make all health care providers give an estimate of billing prior to getting the patient to authorize treatment. I fully believe that IF any American could actually SEE what it will cost before hand they would make better decisions about their care. Obviously immediate care for a heart attach (or something of that nature) would not be addressed that way, but for the most part those are not the types of claims you see fraud on. Its usually something just a little extra. Another minor procedure combined with the one that was actually done. Or the more blatant, billing Medicare for scooters of people that have not gotten them. Duh.
As far as those "triggers" in the billing code to prevent things like invalid payments to dead doctors, or for dead patients, nearly every insurance carrier has them built in now. For the most part they do not stop a claim in its tracks, instead it sends a report so that someone at the carrier can then send an EOB saying it is denied for X reason.

This morning report on Fraud is a wake up call on how little the media (including CNN) has done to provide real facts. To assume that reducing fraud will be significant enough to improve health care is a misconception. How about health care equipment providers overcharging (10 times the actual cost) on items such as wheel chairs. Health care fraud is a tip of the ice berg. We need a comprehensive health care reform including public option.

The Democratic leadership has had to spend a great deal of money to keep our economy and markets from totally collapsing. (don't forget the TARP was created by a Republican administration. ) All this talk about the democrats spending tons of money needlessly is ridicules. We are sitting here today able to discuss a subject like health care because the economy as a whole is much more stable the it was six months ago.

Health care needs to be reformed and Obama has taken the harder road by choosing to make the changes now vs later. The Republican and the health care lobby only care about their own selfish interests. The people showing up to scream down rational discussions going on are just tools of the lobbyist and the far right mentality of selfishness.

All families and individuals that work hard should have the ability access health care at an affordable fee period.

As a former employee of a government contractor for Medicare, there is billions in dollars of fraud in the government program. Ask the someone at CMS if they have ever heard of the Russian Mafia's durable medical goods schemes in Florida. I will believe a government run heathcare system will work when Medicare is fixed.

This is such a corrupted country! I worked in healthcare for over 20 years, and I could see all the crap going on. It's healthcare, and Insurance companies that keep it going. the fraud that goes on needs to stop, and needs to stop NOW! thats why president obamas healthcare reform is having a tough time getting through to pass. all these greedy, corrupted idiots are taking away from us to cater to themselves, and I am sick and tired of these people taking, taking and taking! sure they like their healthcare, because it's so easy to steal from !! I hope they change this stupid american healthcare, or I feel like moving to paris,france for my golden years !! I'm beginning to dislike america, it's so out of hand with greediness, and drugs !! and nobody cares about much of anything anymore !

Well if the government DID try to do something about Doctors defrauding insurance companies, will the GOP say they are "getting between you and your doctor?"

what is fear of reform,ceos of insurance co.not making 100 million dollar pay per year

I am one the "lucky ones" I have heath insurance. I pay about $50 a month for the premium, nice right!. The fact is that in the first 3 months of this years I have paid about $2500 out of pocket. Most of this is for minor things, colds, flu twisted ankles. A public option would make it more affordable. I HATE that I have to worry about taking my children to the doctor because I may not be able to afford it, when I have insurance.

Reading through the comments I see someone stating protesting is "Anti-American" activity. This couldn't be more incorrect. The voter communicating with their elected official is what should be happening. This is in line with the republicans stating protesting war is anti-American.
The fact remains, fraud in current government programs is so expensive, the order of magnitude with a total government system will be in the trillions of dollars. With the debt we are carrying, the country cannot afford this. We need to address fraud and tort reform (loser pays). Many countries with a national health program have caps on tort claims. Unless this is address, we are not truely talking about medical reform at all. Also, why do employers have to provide coverage? Why did the responsibility for our own well being become the responsibility of the employer? How much would cost drop if individuals purchased their own insurance (even across state lines) and were able to do it a la carte (why do I as a male pay for child birth)?

but they let all of them keep their licences
isn't that funny ???
i wonder how much they make under the table

The insurance companies are not good, and we should work to fix that problem. However, using the government as the only provider is bad. I say only provider because they will undercut normal insurance costs and everyone will adopt it. When this happens (and it will because nobody can compete with free) several things will occur: 1. Medical care will become commoditized and stagnate at the current state of affairs. 2. Pharmaceutical companies will go out of business and not create new drugs. 3. The cost of medical coverage will skyrocket and will either be paid for by much higher taxes or inflation. One thing everyone on here is forgetting is that medical care is also more expensive because it is BETTER than it used to be. Would you rather get treatment for cancer now or 10 years ago or 20 years ago? Answer that question. I bet if you get the treatment from 10 or 20 years ago, it isn't nearly as expensive as the current treatment. Consider antibiotics. How expensive is penicillin now? Not very but it also isn't very effective for a lot of stuff. Well, take a govt system and you will see very little new developments in the medical world from then on unless it is done in a country that has free markets.

Bottom Line – The GOP would rather have a facist-style healthcare system that benefits the privatized insurance companies and stockholders rather than a public option that would benefit all. I seriously have to laugh at the sweet, little ol' lady who was on TV yesterday adamantly opposed to healthcare reform because of it being labeled 'socialized' medicine and how it may potentially affect her Medicare. This was simply HILARIOUS !! Just what in the heck do you think Medicare is, for cryin' out loud? The answer...SOCIALIZED Medical Care !!

For those of you whom are opposed to healthcare reform legislation – I only hope the reality sets in for all of you one day if heaven-forbid you are diagnosed with cancer, heart disease, asthma, multiple sclerosis, etc. You will then WAKE UP and realize the mistakes you made pleading with the facist GOP / Republicans to tear down healthcare reform legislation.

Oh, I want my America, my sweet, sweet America back too !! The GREAT America that we once had under the likes of former Presidents Franklin Delano Roosevelt, John Fitzgerald Kennedy, Lyndon Baines Johnson, William Jefferson Clinton, and our current exemplary President Barack Hussein Obama !!

The Republicans need to go SIT ON AN EGG !!

steve pearlstein has a great article in the washington post today.

tort reform would save in many people's estimation $200 billion.

but that would hurt the administration's co-horts in the trial lawyers association.

The third party payer system in the form of health insurance paying for first dime, and Medicaid and Medicare are all due to government intrusion into the markets. Funny how fraud in a government run and warped system is interpreted as proof that we need to turn over our medical care to a governmental central planning committee. Some people are so ignorant of economics.

Only the rich ones and their doctors, the insurance companies, and the people who are into the illegal business of so-called health care (Miami the capital of this type of practice) would not want a national health care for all.

My family (including my children) was not and is still not able to go to the doctor since (me) the bread winner got sick and unable to work. Medicare covers 80% of my cost, but I am not able to pay the 20% because the clinics rack up the bills with items that I have not had in treatment. I sent a complaint to the Medicare people, but it seems as if that went on deaf ears, for the Sunrise Medical Clinic in Pembroke Pines and their therapy department is still functioning normally.

There are thieves in our system who steels from the poor to make themselves rich; this goes on in the school system, the health care system, the police system, and everywhere around you (come to Miami to see how much of this type of practice is going on. Come see the illegals flocking here and getting all the benefits that born Americans cannot even dream of getting. Come see the corruption at Florida International University, Miami-Dade College, and the Dade-County School Board – the minority of Hispanics getting all the jobs, the students coming in from Cuba and other Latin countries illegally (yesterday) and getting all the help they need from their people. They do not have to speak English or be qualified, but are getting all they need without working a day here. All other minorities are ignored, cast aside, not given jobs and eventually will have to leave the newly formed Cuba.

SOMETHING NEEDS TO BE DONE TO STOP THESE ILLEGAL ACTS. THE IMMIGRATION SHOULD BE MONITORED MORE STRINGENTLY.

I reported a case of medical equipment fraud to the national, state, and insurance company's hotlines and on-line forms. At all three informed me that they would not be pursuing the issue (worth thousands of dollars).

My insurance company continues to pay and I continue to receive bills for hundreds of dollars per month for a $540 wheelchair that I returned after paying more than $1,500 to rent it.

The equipment provider originally charged both of my insurance companies the full rate and billed me $145/mo. When I lost my job and only had one insurance company, the provider started the billing over from scratch. When I asked they said that they do that because the new insurance company doesn't know what's already been paid.

Now, they're continuing to bill my insurance company and me for a chair that has been returned. I have to pay them or risk a negative entry on my credit report and none of the agencies I've contacted will take any action.

Is this a problem? I'd have to say "yes."

I'm just worried about the amount of money that is being spent on insurance. I agree with all the comments about fraud. My dad (85) was told he had liver cancer and was treated for several years as an outpatient. It took him 15 minutes to get to his "treatment room" (nurse lounge) get his shot and return to his car. He was charged for a hospital room (which he never saw) and was given 2 asprins to control the fever which he got from the medicine. He was charged more for 2 asprins than he could have bought a whole bottle at the pharmacy. I called Medicare and reported the "fraud" (hospital room and astounding price for the asprin) and was told "that falls within the guidline for medicare charges" – the government can get away with this? Also why is it someone on medicare and I can go to the same doctor, have the same treatment, and be charged different prices. The medicare patient pays 600 dollars(Medicare pays) and I get billed the full amount ($2000.00). The doctor writes off the balance for the medicare patient (he takes consignment) and between me and my insurance company we pay the whole amount. My wife works in the insurance office for a doctor so I know this happens.

It's great that the insurance companies are working to protect themselves from being ripped off. However, these are the same health insurance companies that Deny, Delay, Decrease and Distort (the 'D's that these companies live by) the legitmate claims of their premium paying customers. These companies over bill, double bill and under pay. If there "D's" are not challenged, the premium paying customer is the victim of a rip off fraud. If these health care insurance companies don't like being ripped off, then imagine how us customers feel when you make it a standard operating procedure to rip us off.

lots of people on here cant understand how someone would be against this health reform. first off its a sham, you can not have real cost control in health care without tort reform. the dems are protecting trial lawyers and there is no way around that. second, it doest pass the smell tesst. you dont spend a trillion dollars in order to "save" money. you cant require small businesses to cover their employees without losing jobs. these 3 things do not pass the smell test and they make this so called health care reform stink.

We need Healthcare reform. United Healthcare reported a 155% increase in profits this quarter in a horrible economy. There business plan is to deny until they either break the patient or they can't deny anymore. Actual EX: the brain tumor isn't life threatening yet so we can't pay for it. And before someone says it we have to wait in our current system and we more for people without insurance now than we will in a public plan. Also we are number 2 in medical spending and number 37 in quality of care. Open you eyes. Also, check the huffington post there is a interview with one of major organizers who is staging the much covered protest. CNN time to do some report for once.

Democratic Healthcare Reform = 'Socialized' Healthcare (ex.: Medicaid, Medicare, etc.)

GOP / Republican Healthcare Reform – 'Facist' Healthcare (ex.: privatized insurance & stockholders getting RICHER & RICHER at the lower & middle class workers' expense. Bottom Line – The GOP / Republicans would put a REAL BIG SMILE on Adolf Hitler's / Benito Mussolini's / Joseph Stalin's / Nikita Kruschev's face[s].)

How about this for an idea:
Let the insurance companies and hospitals not only perform services but also let them govern themselves completely? Let the hospitals and doctors govern themselves.

Absurd.

How about this for an idea:
Let the government perform services and govern themselves completely?

Absurd.

There is a reason the government is called GOVERNment – to govern. Not perform services. How well would the government stand up to their own Sarbanes-Oxley act were it applied to themselves? Separation of duties EPIC FAIL would be the grade.

I am no expert on this health care issue. From what I hear it sounds like some people have healthcare and some don't. It also sounds like that when the people that don't have coverage need medical attention they go to the ER and the bills don't get paid. That seems to drive the cost of medical care up for those who have coverage. It seems to me that providing some type of coverage for everyone would be the right thing to do and would help to drive medical costs down. Our President told us when he was campaigning that he could not do it alone. I both believe and trust that he knows what he is doing, but he needs our help. Call your congressman or representative and tell them you are FOR getting the healthcare bill passed NOW!!!!! Getting him elected is one thing, backing him up is A WHOLE OTHER JOB!! Let's get busy...

BTW, I forgot to mention that most people don't know that private insurance companies contract with hospitals/surgi-centers w/o many times the bennies of a lowest bidder situation. Could ur HR dept. in ur company b " on the take?" Does "kickbacks" ring a bell? Also, not known, but some meds. r literally only 1 molecule different from other, newer, competing drugs. I had a drug rep. admit this to me.

Can reform in health care work? Well, just look at what happened after AARP got on their backs about Medicare prescription bennies: COMPETITION in the drug companies & we ALL now have $4 scripts at many places including even our local, small, privately-run pharmacy for many of the most commonly prescribed meds. I switched to one after hubby retired since the one I was on was much more expensive. Dr. wasn't too sure the cheapo would work but surpirse-LIKE A DREAM! Can u say: "$4 a month vs. $63?"

Tort reform would help also, but since most lawyers r Dems., ain't gonna happen. A number of yrs ago, in Pa., we ALMOST lost all our OB/GYN's due to stratospheric practice insurance. Funny how that got solved quickly when they began leaving the State in droves. Some came back, but others had had enough of Pa.

Basically, I KNEW that this crises was coming for over 20 yrs. Remember how HMO's were going to "solve" the problem back in the 80's? It just slowed things down a bit. Wish I had a solution as it is affecting good, nursing care along with medical practioners' plan of care.

I bet this doctor was a staunch Republican and opposed to health care reform. Now all the seniors on Medicare will be out yekking and screaming about the helth care reform.

Fraud control is little discussed BUT medical insurance and the associated legal reforms get no real discussion let alone anyone find any legislation, hearings on the tort reform matters?

Wake up people! I am a physician, I don't commit fraud.But if this garbage single payer system goes through, we are in for a world of hurt. Physicians will no longer be able to practice if they don't get paid-think 200K debt at the end of medical school, we won't have quality health care or doctors after a few years. Tell them to get a tighter clamp on fraud- because a podiatrist (not an MD) defrauded blue cross of a couple hundred dollars does not make a reason to pass a trillion dollar senseless bill for obama's socialist agenda that will bankrupt america. And here's another thing-all the uninsured people already do get coverage in the form of emergency medicaid and doctors get paid literally pennies on the hundreds of dollars of charges and are still liable for anything that goes wrong. How about tort reform- why haven't we heard about that- probably because obama's left hand is in the pockets of the lawyers.

I'm a certified health care compliance officer and have worked in health care administration for 17 years. I've seen facilities closed and docs licensed pulled due to Medicare fraud. Fraud is rampant and must be addressed, but the other contributor is illegal immigration. Tort reform should be left to the states and many, if not most, have passed tort reform laws in recent years. Illegal immigrants drain our health care system of more dollars than anyone knows. Illegals crowd our ERs and are the reason those of us with insurance or money in our pockets to pay are sitting in ERs for endless hours waiting. We can take care of our own, but not the world.

And to that Fat sean who says shrug, and doesnt have a problem for his Insurance, I say, I dont care how rich you are because healthcare and insurance companies feed off your money. they love the rich, so the fatter you get, the more they care for your diabetes, heartcare, high cholesterol, arthreosclerosis, ect,ect,ect, until you drop dead. it's like drug addicts, the dealers use them until there is nothing left to take, usually deasth is the reason! you will find a nice crowd of people around you , but it's not for you , it's for money.

First of all, I wouldn't consider a podiatrist a physician. Secondly, one dishonest health care provider does not represent the entire health care field. Finally, how will reform solve this problem? There will always be thieves and cheats in EVERY profession! No getting around it.

Our government can't keep themselves honest and yet they want to try to fix health care? How many of the Obama appointees have had to step away because they themselves were found to have not paid taxes, while the rest of the hard working Americans pay their taxes? I should not have to pay for health care for someone who is fully capable of working, but is too lazy to get a job. I work for a living, and am provided with insurance through my company. Having our government try to fix this is like repairing a hole in your boat with the fish net...

This comment is directed to "Steve" who tells us we don't have to sign up for government health insurance if we don't want it. How do you think the government is going to pay for this plan? The answer is THE TAXPAYERS! The same taxpayers that are paying for Social Security, Medicare, the salaries of all the government workers and all the other programs the federal government comes up with. The TAXPAYERS already know the fiasco MEDICARE is and has been for decades with all the fraud and abuse and we don't want another program SHOVED DOWN OUR THROATS! If you think your 1500.00 knee injury is too much money, just wait until you get the tax bill to pay for government health insurance. Just ask yourself, if this insurance they're pushing is so good, why don't the Congressmen and women sign up for it for themselves and their families? Believe me, they won't.

i'd love to see ACTUAL statistics as to how many claims from insurers get denied.

to me its kind of like the top news stories on the 11pm news.

yes murder gets the highlights but 99% of people aren't committing murder.

Is murder still wrong, absolutely yes. Doesn't mean that everyone's doing it.

Which is it? Are insures paying too much (ie costs going up) or are they denying everything?

If they were denying everything there'd be no costs.

If you are so naive to think there will be less fraud when the govt oversees healthcare then you should bow out of this debate. Also I find it very irresponsible to throw around statistics without a source. Who exactly says 1 in 3 claims are fraudulent???

The insurance companies love articles like this,it makes them look like victims and while it does happen- doctor/hospital fraud, how about fraud from the insurance co-if the goverment really wants to reform health care, start by regulating the INSURNACE COMPANIES. The last thing we all need is the govt's say in our health care, the insurance companies already dictate how doctors should treat partients especially BCBS. Why are insurnace co's telling Dr how to treat patients by limiting what procedures they will pay for? How much profit did the health care insurnace companies make last year?!!!

Hey Obama. Stay out of my housing, and out of my doctors office.
Use my taxes to pave the roads, repair the bridges but STAY OUT OF MY PERSONAL BUSINESS.
My money is mine to spend as I wish.

Read every word of the so-called-health-care-reform bill and listen to the people who pay your salary rather than to the lazy loud mouth bums who expect others to carry their load.

And by the way, you will never stop fraud, it is part of some humans makeup.

Now the trial lawyers are the boogie men and women right? Last I checked they have to eat and live and provide for their families just like you and I. Now they are friends of this Administration.
Let's see who were the friends of Bush Adm., oil companies, health companies, Blackwater, Enron, Saudi empire, and on and on!

I am a physician (salaried, working for a large HMO). There IS fraud; but there is also tremendous waste in the system even as it stands. This is due largely to defensive medicine, inefficiencies of the practitioners themselves, and, I believe most of all, to a proliferation of middle management in the health care system that is meant to be "supervisory" but in effect constitutes a self-sustaining bureaucracy of people with no interest in patients and no knowledge of medicine making hospital, corporate, and government policy decisions. Obamacare will make ALL these things worse.

Tort reform is an absolute must. But, we also need to make medicine focus on patients and their physicians again, and on the business of health care rather than on the health care business. There are plenty of us who will work for flat salaries, profit motive removed, if we can practice medicine, rather than being data entry clerks and scapegoats for bad managerial practice.

what we need in this country is simple.

REGULATION OF INSURERS.

forget about setting up a trillion dollar government run plan. set up the co-ops without federal backing.

many states have regulations that require insurers to pay a set percentage of their premiums in claims so that they can't make egregious profits. My state of NJ is 75%. It should be 85% ACROSS the country. then we'll see profits shrink.

plus everyone should be required to be insured. car insurance costs went down when this was made law. People shouldn't be able to game the system to their benefit.

how many people out there now don't have insurance because they've just had the light bulb go on in this debate by finding out that they can't be turned away from the ER when they go.

Well let me save $300 a month in premium and it i get sick they need to take care of me is their rationale. Sorry its wrong. We all should pay and we all should be responsible.

Why isn't anyone talking about lawyers? Maybe because Washington is full of them and it would be against their interests to limit lawsuits? Take away the monetary incentive and punitive punishments for lawyers and doctors. Then cases that have merit will be prosecuted and pursued. Why can't lawyers have a "bundled" rate as well? When I have the construction guy work on my house, I don't ask " how much do you pay by the hour". I ask "how much will it be to fix the sink". Doctors, lawyers, everyone should have a" bundled rate".

I think most people just want to know they'll have affordable health care and have freedom in choice of doctors, etc. However, I think most Americans are being misled on "socialized medicine". It DOES NOT have to mean government control of the health care system. It does mean health care will be NON-PROFIT... doctors will still be highly paid etc.

What is wrong with non-profit health care? The problem with the current system IS the for PROFIT component. The whole point of a for profit company is to increase profit each year and is NOT to make you all better/healthier (that is really just a byproduct).

How does a hospital make more money? Treat more patients, sell more expensive options, etc.

How does an insurance company make more money? Increase premiums and deny claims. Unlike life/home/car/etc insurance, most people (except maybe for say the young "Invincibles") can't say no to health insurance.

If you really want real health care reform, stop being afraid of "socialized medicine" and start yelling "non-profit health care system". While you are at it, demand end to fee for service. Doctors still can be highly compensated with a good base salary and a bonus system based on how many satisfied patients they treated. A salary would prevent this kind of fraud at least...

I think the heart of the matter is the government does not want to get its hands dirty and solve any of these problems. They simply want to either take over, or provide a huge competitive block to private insurance, neither of which solve the problem. They simply allow government to do what insurance companies are doing, but in a way that is unfair to private business.
Let's not be so quick to assume all insurance companies and doctors are fradulent. The same can be said for any industry.

Let's fix the problems causing health care to go up. Health Insurance companies still have to pay the high costs of health care, so if the problems that are causing health care prices to go up are not addressed, then provided a public health care option is going to do nothing. Notice how Steve went to the ER for a hyperextended knee. What?!? Come on people, the ER is for serious injuries that cannot wait, not for minor cuts and pulled muscles (or hyperextended knees). There was $1500 dollars that Steve has to address now where is could have be closer to $80 to see a nurse practitioner. People abuse and doctors abuse the system and everyone else has to pay. If you smoke or overeat, shouldn't you have to pay more for insurance? I think so. Why should I have to pay the same amount as a person who has no interest in taking care of their body? Will the government do anything about that? Nope, everyone will have to pay the same. That is not fair and I will not stand for it. I already pay enough taxes to people who abuse the system. Let me set this straight, I have no problems paying taxes to help people who real need it, but it angers me when I see people abuse that tax money that I help provide for them. Health care is such a big issue because it deals with people's well being and because of that, it is the easier to fraud and manipulate. For profit health insurance companies are going to be much stronger and well suited to defend against those attacks. Plus, health insurance companies are not just the high up people making big money. Alot of hard working Americans work for these companies. What happens to all those jobs when the government takes over? And that WILL happen if a public option is created. The government WILL make sure that happens. More people on the street and more people to cover health care costs on. The unemployment rate is already unacceptable. It is not worth putting all our eggs in one basket. Why is it such a hard concept to pass little parts at a time and make sure each part works? Why must we try to push through such a HUGE bill all at once? I don't understand it. That is project management 101!

Carl – First, I would rather have a Hammer and a Sickle on my Flag than a SWASTIKA, which is precisely the direction the GOP / Republicans would love to take this nation !! Secondly, you stated, "At least when I pay my health care insurance premium, I get something in return." REALLY? You actually get something in Return? Like what? Have you ever been diagnosed with cancer? heart disease? asthma? multiple sclerosis? alzheimer's? I would like to witness what your wonderful 'privatized' insurance company will do for you then !! Do you know the answer? You want me to tell you what they'll do? They'll tell you, "Sorry sir, the treatment plan for your disease is not covered..." WAKE UP AMERICA, JUST WAKE UP !!

I have great insurance and have all my working life. Why would I want the government to tell me when I can go see a doctor and when??? That makes no sense. I'm not a rich person. I'm barley middle class. I also am a registered Dem since 1987 when I turned 18. What gives with my party??? I loved Clinton, Didn't care too much for Bush but Obama scares me.

We have great insurance. Both of us needed chiropractic care after we fell on ice last winter. Since we moved we went to a new chiro. Like most people we didnt really look at what we were charged but when we did we were shocked and angered. Normally we pay $50-$70 per treatment, but she was charging us over $200, or the maximum allowed under our insurance. She was double billing, and billing for services she didnt perform. My husband contacted our insurance. I wonder if they will do anything? Why should they if all the private insurance companies have to do is pass the fraud along to the insured. OTOH, medicare (run by the gov) is notorious for prosecuting and jailing those committing fraud. Maybe that is one reason medicare is so cost effective compared to private insurance.
BTW, I worked in Canada in the early 70s, covered by the national health care and absolutely loved it. Those trashing Canadian health care are lying.
How many people know how long can they be sick before they get fired and lose their insurance?

Everything the government touches invites fraud. But there is one type of fraud that government won't do anything about. That is malpractice lawsuits. One particular political party will not do anything to anger the lawyers. Take a guess.

"This is why we need healthcare reform." We do, but I think part of the point of this article is that healthcare "reform" being proposed will do little to address the fraud which so often occurs with government programs such as Medicare or Medicaid. If anything, a larger public plan, administered by officials who feel free to spend taxpayer money, will do little to ensure that the claims are not fraudulent.

I might be wrong but I think that too many people want something for nothing out there, and they want something from the government now. Remember now that the government wouldn't have any money if it wasn't for the working people. Quit trying to mess over the working people.
We have plans in place but they all have loopholes in them that need to be patched. I progressed through several jobs until I finally landed one that had good health insurance. The key here is that I progressed and didn't stay stagnant. I just don't believe that this bill will help out in the long run. I think that it will just cause the taxpayers to pay more into a system that takes care of illegals and people that just don't want to work. I know that there are a few people out there that try hard and are just having some bad luck but that is the minority.

Reference was made to a 2 -tiered system. Don't you get it? There already is a 2-tiered system – those with insurance and those tens of millions who don't have any coverage at all, who are pushed to bankruptcy by hefty medical bills. Do you really enjoy a healthcare system where the Insurance companies dictate whether or not they are going to pay for a life-saving treatment, and that is only after you pay your healthy deductible?
Get real, Folks! The system IS GOOD – NOT GREAT. It needs Healthcare Reform.

The current health care bill does nothing to bring down costs. Persuing fraud is one of the ways to help with rising costs. The others are meaning tort reform (health courts) so doctors don't have to practice defensive medicine and closing the loopholes on physician self referral for tests and usage of physician owned hospitals/centers (this ones huge, if your getting extra money for using a CT scanner you bought, how many more scans are you going to order? you do the math)

First: I suggest to rename "Public option" to "NON-PROFIT OPTION", which is all it is about.
Second: I suggest to implement "MEDICAL POLICE" to fight medical fraud.
Third: It is time to open to american people, who actually stands between them and health care providers-It is insurance company!
Every so called HMO insurance requers doctors to recieve PREAUTORISATION for a proposed by him medical treatment, which a) should be covered by person's insurance plan, and b) should be aprooved by insurance medical experts, (which are mostly nurses).
Fourth: It is absolutely neccessary to open USA for foreign coutries medicine. Money for FDA to test them will tenfold be payed off to american people!

why not allow private non-profits to sell coop insurance across state lines...that way the gov't is not involved (except for regulation), the taxpayers aren't on the hook, and there will be competition with the for profit enterprises. It's like the credit union movement vs. the bank.

The current proposals for health care lack several key things:
1) Any discussion of Tort reform. Extravagent and frivolous lawsuits, outrageous jury awards, and the legal defense costs and defensive medicine costs (unnecessary tests, using the legally proscribed procedure whether needed or not, etc) are a HUGE driver in increasing health care costs. Yet, these huge drivers are willfully overlooked because:
A) Many congressmen/senators are lawyers, made their fortunes that way, and don't want to hurt their buddy's lucrative livelihood, and
B) Trial lawyers are a HUGE democratic constituency.

2) Sufficient depth on fraud, as discussed
3) Realistic cost analysis. I, for one, do NOT believe that this will ONLY cost $1.6 TRILLLLLLION over 10 years. Congress has downplayed the costs and overstated the largely-illusory savings. I suspect the real bill will be 50%-100% higher, meaning more taxes for us all.

If I get my car repaired I get an estimate based on a book that says how it should take. I can probably go to 3 car repair places and it will be about the same (depending on their hourly rate of course). In other words – it is very "transparent". In health care it is a complete disaster.

My son broke his arm in 2008 and the cost total $15,000 from about 8 different providers – some of which I could not even identify. There were charges of $20+ for a liter (1/4 gallon) of water. The above charges were only discounted by only ~15% based on the insurances contract!? As it happened on another persons property our insurance blamed the other party an only paid half. I am still fighting with the insurance and the other parties to get the rest paid.

In 2009 he broke his other arm in a school/sport accident and of course we went to another hospital. Charges here came to over $17,000 from about 9 providers. Our NEW insurance discounted ~75% down to only ~25% of the original charges and than paid most of it while the schools "access insurance" paid the rest. It was quick and simple.

Just looking at these too cases I can just shake my head. I have two folders full of paperwork and spend month handling the claim – but I am still not sure what was done and what all the invoices actually were.

Back to the car – you normally sign an estimate and once you are done you sign the invoice, which states what was done. Why would it be so hard to do this in the health care industry? At least they should present the customer with one invoice (or at least summarized services provided) and let the customer sign off. To make sure that the actual customers signs (and not another doctor) a biometric system should be put in place to uniquely identify the actual visitor. It is easy to do and the insurance companies should be waiting in line to put the system and requirements in place – as it would safe them billions of dollars. Fraud is in every organization – not only in health care – but innovative technology can reduce it tremendously. View some educational info at http://www.fraudmitigation.com

The Republican party has been hijacked by guys like Rush who have no concept of what "free market capitalism" is.

Conservative economists do not subscribe to the view that government is the enemy. Conservative economists are wise enough to realize that regulation is often necessary to protect the citizenry from criminals. Policing Medicare fraud and abuse is no different than policing violent crimes. We do need to be protected from "bad people", whether they are hurting us or simply taking our money.

I agree that the motivations of this "distorted laissez-faire" wing of the GOP are a bit frightening. Guys like Rush and Hannity seem to want to preserve a political and social order that is hospitable to criminals.

Government is the enemy?

Only if you are Bernie, Allan, Bernie II, Richard, or one of the countless petty criminals who parlay anti-government sentiment into ill-gotten millions.

The rule of law must prevail, or we are all doomed.

As long as physicians and hospitals earn their money per each visit/procedure, there will be corruption and fraud.
Pay doctors and hospitals a fixed yearly wage to see up to one patient every 30 minutes (turning down nobody) and 99% of the waste/corruption/fraud we are currently seeing will be eliminated. They will no longer have a financial incentive to bill as much as they can. Also, it will eliminate the wasteful billing process so doctors can have less overhead.

As for those on this comment page that decry the disruption of the health care town halls, I agree with you about 25-33%, because:
1) It is unfortunate that we can't have civil discourse. That's almost always going to produce a much better exchange of ideas than shouting and name-calling. Our inability to maintain civil discourse has made it impossible to really address/resolve many issues.
2) As we should all be aware, these town halls are NOT designed to elicit voter input - they're designed as a media event for the congressmen to put out what they intend to do and act like they want to hear from their constituents (and be filmed doing so).
3) Those disrupters are not all on one side of the debate. The Democrats have certainly marshalled their forces to chant, clap, or scream at all the appropriate points.
4) Even if the disruptions were all one sided (against the Democratic proposals), it would be a case of "the chickens coming home to roost." Democrats/liberals have used screaming and name-calling to limit discussion and any diversity of thought or opinion for decades.

Well, let’s just face facts here people. This healthcare plan is a BAD idea. First off, the fact that the president is trying to rush it through should be your first clue. Then you have the congressmen actually telling others not to bother reading it. When the details finally do get out to the public, people are going to be upset naturally. If you really think this is a good idea, go talk to a 50 year old Canadian. Luckily, Americans are finally starting to wake up and pay attention. Hopefully we are not to late.

All Obama haters need to do their homework...nowhere does his health reform bill state that there will be healthcare for every american. The only people that will receive care are the ones that cannot afford health care. the idea is that this government involvement will drive down costs due to competition in the market. no totally government run health care. I agree that fraud is a major issue and it needs to be addressed, but Obama is the first president in decades to have addressed this issue. We need to start somewhere.

so its not the end of the world, the sky is not falling. grow the hell up and stop whining. if my tax dollars are going to make sure a homeless man gets the medical attention he needs, then i'll sleep soundly.

To fix the health care system in America, you will have to "fix" the Department of Justice FIRST. For over 6 years I have tried with the help of my attorney to expose a common scheme used by the big hospital corporations to give "kickbacks" to their hospital based physicians. I've spoken to at least five active U. S. Attorney's and three "Special Agents" of the Department of Health and Human Services. To no avail.... I've been told that the fraud we've reported is "too complex, hard to investigate and the US Attorney's are not interested in this fraud." The people charged with these investigations are, in my estimation, just too lazy to look into the fraud committed by the large hospital corporations and possibly intimidated by their political power. Hospitals are willing to "skirt" the law and many doctors are more than willing to take these kickbacks. It is great to watch Americans come out to these "town hall meetings" and refuse to accept their Congressman's lame explainations of our ailing health care system. As a country, we are all frustrated by the fraud, abuse of power and out and out theft of our monies by our elected leaders and corporate executives. Thank you CNN for pointing out the fact that this $200 billion dollar PER YEAR theft from our healthcare system demands attention.

Perhaps the president and his minions would be best to direct congress in this effort. The supposed proposal now is over 1000pages and many of the congress and even the president have not read it all. It seems they just want anything without looking at what is included in this bill and the additional cost to people and business.
The congressional budget office has already said that the savings dont come anywhere near to the new costs.
Are all the present labor unions going to switch their members to this new public program? Will the members of congress and even the president put themeselves and their families on this program? Until the lead by example how would they dare expect anyone to go along with this?
Does using Nazi and McCarthy area tatics of reporting people to the white house who disagree with this further their cause?
If you want to improve things talk to the lawyers, medical liability insurers, hospitals, doctors and finally ordinary people not with agenda.
The government right now cannot handle the cash for clunckers program what makes anyone think, that the government can handle 135million people on health insurance.

Just another case of big business fraud. If you think that's bad just wait until the ultimate big business (aka: the federal government) takes over.

Fedup wrote at 8:46 am:
"If you read the bill, it recuses itself of operating within the Constitution.

pg 53 – SEC. 155. SEVERABILITY
“If any provision of this Act, or any application of such provision to any person or circumstance, is held to be unconstitutional, the remainder of the provisions of this Act and the application of the provision to any other person or circumstance shall not be affected.

So we should allow a bill that excuses itself from protecting people’s right to life, liberty and the pursuit of happiness?"

It's amazing that you could read something and get the exact opposite of what the paragraph means. Read it again. What is stated is that if any part of the bill is considered to be unconstitutional, that part would be removed, but the whole bill does not have to be thrown out because one provision is struck down. This is actually fairly standard language for bills and even many business contracts.

If you are going to fear-monger don't put the proof that you are a twit right in your own post.

For a licensed doctor to throw away his career for a few extra bucks (by doctor standards) should tell us something about the motivations of people pursuing this career. MDs are one of the most highly compensated professions in the country, if not the most highly compensated and yet it isn't enough. As we have found in corporate executives, the level of compensation does not yield the best results, it only draws greedy short-cited people to the profession.

Ok, all you liberals who think the government can stop this fraud are once again uninformed. Medicaid has more fraud than anywhere else. Now that system is bankrupt and who runs it???? That's right the government is to be trusted, NOT!!!! Here's some great news, our wonderful government, under this bill, will go directly into your bank account and remove the funds to pay off your bill. Who the heck do they think they are??? And what about the illegals, where will the government go for those funds??? Oh, that'll be the taxpayers. Yes, you CNN junkies can now flag me!!!!

"I for one don’t have health insurance because my employer can’t afford to provide it, so me and my family don’t have health insurance...I hyper-extended my knee last month...Weeks later I got a bill in the mail for $1500.00. I can’t afford to pay that."

So I should be forced to pay it? You seem to think that anyone but you, whether it's your employer or the taxpayer is responsible for the costs of YOUR healthcare. That's why freedom is the big loser in this debate over whether employers or the taxpayers should fund healthcare, and that's why whatever we get from this debate is doomed to fail, just as other forms of communism did in the last century. Here's a radical idea: How about letting the customer pay his own bill instead of using governmental force to foist it on someone else?! Now if you'll excuse me, I have to go pay someone else's mortgage and subsidize his new car.

It's funny how people let their emotions rule them and completely overrun logical thought.

First of all, I don't think that anyone would dispute the need for health reform. However, you'll be hard pressed to find a reasonable person who honestly believes that the Government can do a better job running a medical program when a majority of the officials creating these programs have little to no background in the subject matter being legislated (i.e. very few doctors in congress).

No one disputes that Medicare and Medicaid are governent run programs, however, as our own President proclaims: "Medicare and Medicaid are broken, broke and unsustainable". I would like to know for one, how he reconciles this constantly repeated fact with the fact that the Health Care Reform act ADDS 18 million americans to the Medicaid system (by expanding the Medicaid eligibility to 300% of poverty level). Also, last time I checked, Medicaid is administered and funded mostly at the state level, and most states have already used a large chunk of their "stimulus" to plug the Medicaid shortfalls.

While i am not opposed to a health reform per se I question the ability of a gov't entity to run such a system and don't advocate for a bigger gov't. Especially one who so frequently says one thing and then quietly does another (i.e. "those making less than $250,000/yr won't see taxes raised one dime" and yet the cigarette tax increase most heavily affects lower and middle income individuals who do the most smoking and a tax on your tax free insurance payments thru payroll soon to be a thing of the past in order to pay for a group of americans who are uninsured, despite the fact that a large number of them CHOOSE to be uninsured).

I work hard to earn my insurance each week. If the president wants to come up with a public insurance, find a good way to pay for it that doesn't increase our taxes, fine. But don't force it on those of us who already have insurance. Give us the choice.

Unfortunately, people on both sides of this issue are confusing things and lumping things together that don't belong.

Those that are against government control of your health care are NOT against reform. When you say they are, that is known as a "false dichotomy", look it up.

Those, mostly politicians, that are trying to have the government run your health care are using a misleading "uninsured" number as the crisis, when it isn't, because the true number is only about 3% (but rising). The real problem is COST, not coverage. Coverage does NOT solve cost, cost DOES solve coverage.

Please, America, take a minute to THINK about what you're getting us all into. Reform, YES! Government run, NO!

So, why would there ever be the assumption that government run health care or health insurance would not be susceptible to fraud? It's not like all the criminals would simply go away. Indeed, isn't our welfare system as well as medicare and medicaid already taken advantage of professionals and those that it is meant to service all the time anyway. I dare say yes. In fact, I dare say that a government health care or insurance system is probably MORE likely to be vulnerable to fraud simply because of the beauocratic way that the government works. Investigating and attacking fraud would probably be a "taxing" and highly ineffecient process just as 99% of all government run programs are already. Why should this be any different???

alan,

sorry but you get no sympathy from me for trial lawyers. you are about as useless as insurers.

also those that touted the 155% increase in profit from insurers are kind of silly. its because they were down so low.

last year's profit margin (2%) look it up on fortune.com there is not this windfall profit they'd have us believe. its all smoke and mirrors.

the actual dollar amount United made in profit i believe was 750 million. is it too much, YES.

that amounts to about $20 per insured person per year. sorry that's not windfall and i don't know how you regulate that out and yet still have people that want to work in healthcare. maybe if you could you'd force them all to be non-profit. not sure you can do that though.

what you need to do is regulate the system better. allow purchasing across state lines.

For all of you who spout hatred toward healthcare companies- you are, for the most part, incredibly ill-informed.

For example, Donna, I work for a health insurer, with the unit who helps people manage their diabetes. Health insurance loses money when your diabetes is uncontrolled, because that drives claims that drive costs that cost us business. Healthcare insurance companies are more successful when you are healthier, and have every incentive to help you get there.

My compensation is actually impacted by whether our members become healthier. Not one US government employee, not even the Surgeon General, has their compensation based on how much they help people get healthy.

Far from being the obstacle to reform, the Healthcare Insurance industry has been using our lobbyists to push for reform. Nobody sees the impacts of high costs or the uninsured more than us. No one sees the impact of healthcare fraud more than us. When the Democrats stalled on reform earlier this month, it was our lobbyists that kept it front and center.

I know I will get flamed for standing up for Blue Cross- I do everytime on this page. But our profit margines are lower than most other industries. Healthcare insurance profit represents only about 1 1/2% of the cost in the system, and is less than half of the cost driven to you by Medicare cost-shifting. US health insurance companies pay millions of claims a day- we approve a million claims for everyone we deny.

87% of our members are happy with the service we provide- how many government entities can claim that? Certainly not the president or congress.

We were fighting to help people manage chronic disease, help people address lifestyle issues that affect cost, help to fight healthcare fraud and abuse, decades before Uncle Sam and Medicare showed any interest in these things.

Please, stop villifying an industry that employs hundreds of thousands of dedicated professionals who work hard for you everyday and help us find the solutions that will allow us all affordable quality care.

Fraud may be one of the excuses for the ridiculous cost of health care in this country, but that in no way explains why a tablet of Tylenol doled out at the hospital is $10, while the pills you buy at Walgreens are pennies a piece. Walgreens also suffers from theft issues and fraud, and somehow they keep the cost of Tylenol down. I work in the medical industry and I am so sick of hearing these, in my opinion, criminal health insurance companies and drug companies complain that they can't possibly give the American consumer a break because otherwise they'd be going broke. I've seen the volume of garbage drug companies can afford to give away for free, I know the salaries of the slimy drug reps I deal with on a daily basis, and I know people who can't afford important medical care because their insurance won't cover enough of it. I think anyone who thinks any part of the current system is a good one is either a fool or a criminal.

It basically boils down to "FACIST" GOP / Republicans vs. "SOCIALIST" Democrats, "RICH" vs. "POOR", "GREED / POWER HUNGER" vs. "SATISFACTION"...

I would love to see what would happen if the US Government would COMPLETELY ELIMINATE other NECESSARY, WONDERFUL "SOCIALIZED" Programs such as Social Security and Medicare !! Even the FDIC – Does anyone have any idea how bad it was during the Herbert Hoover years prior to Social Security, Medicare, & the FDIC? In those days, when a bank folded, so did your life savings !! Thank Heaven for FDIC !!

Yeah folks, let's strip all the eldery, retired people in this country of their Social Security and Medicare benefits and then let's see what happens !! That's what the GOP / Republicans want to do !! THERE WILL BE ANOTHER REVOLUTIONARY WAR !!

Those of you who are opposed to healthcare reform legislation are either blinded by the GOP, GREEDY Because of ALL the Profits you are raking in via the Stock Market, or just plain IGNORANT !!

I have also reported insurance fraud to my insurance company and the state of Florida. I had discovered almost twenty prescription claims billed under my step-daughter ( who was 8 at the time) for drugs such as painkillers and anti-depressants as well as a third party claim for a visit to a hospital that my insurance had paid previously. Although the Attorney General's office investigated our claim, it was turned over to DCF to handle because it was considered public assistance fraud. In the end, DCF refused to prosecute, no reason given other than they didn't find any proof ( despite the existence of a fraudulent medicare card under my step-daughters name and social security number). However, it is obvious to my husband and I that they are NOT prosecuting because a:) they were paid by our insurance company for the money they shelled out and b:) why prosecute when your own employees can't do their job and allow people to fraudulently open accounts for people who don't qualify?

There is rampant fraud in all government funded programs- Medicaid, Medicare, Welfare, Food Stamps- and everyone looks the other way. Sure they go after the big insurance companies and medical facilities to make an example of them, but who polices the actual programs to ensure that all steps are being taken to eliminate fraud committed by the recipient? Florida, for example, doesn't even do in person qualification meetings anymore- it is all done over the computer! If you don't believe, google it " Access Program".....

I've personally had enough- its time someone has the courage to step forward and admit that this country is going to hell in a handbasket and we're sitting by allowing it to happen by being complacent and feeling sorry for people who work off the books and make more money than most.......

What about fraud from patients? I agree that there are fraudulent claims filed by healthcare entities, but why is all the blame put on them? As a medical office manager, I am confronted by patients asking us to "buff-up" the charts and change diagnosis codes after the fact to improve the reimbursement (which we would never do)...this is also fraud. Stop blaming the good people (99%) in the field who do the work and are the ones who are caring for the patient.

Why doesn't Congress let all of us join their insurance plan? I have read several articles about their plan and while we are at it we could join their retirement plan also. They do not pay social security taxes and therefore do not have to rely on SS as their retirement plan. No wonder they do what they want, as they want, when they want to these programs since they do not reap the benefits of their actions as we the common man does. I will glady join if invited as most other Americans would. Do we ever hear them talk about their insurance plans or worry about their Social Security – NO – they are taking care of – by us the taxpayer.

Why isnt anybody talking about GUNS!?!? untill this bill specifically guaratees that everyone gets to keep there guns it does not make any sense and should be tossed out!
And what about tort reform? Trial lawyers and Dems and in bed and thats why fraud leads to high taxes in socialist health care.
There is clearly no problem with health care because I have never seen one for myself, and all these stories are just made up and dont represent the real health care system. Fraud is right!
Just look at Communist Canada. They pay 75% of their income to taxes. That is a FACT! and it all goes toward their socialist Health care where people wait in line for years to get signed up for a physician. Any reform of our system is just an excuss for Obama to make it like Canada, beacuse everyone know he's Kenyan, And Kenyan's love lines!
Just say No (because having a conversation and asking questions requires thought)

What ever happened to common sense and taking a level of responsibility for ourselves. Of course we need reform. Fraud is rampant, overpricing for services is rampant, and worst of all BLAME IS RAMPANT. If our shining examples of government run programs are any hint to how the current system would be run then common sense tells us that putting them in charge is not the smart thing to do (especially as we all sit here and lay blame on the other, do you really think that will go away once the government has a plan in place, look at social security, I think not). I read a comment about grass roots and I strongly believe that that is the essence of America. We the grass roots have high levels of credit card debt yet truly show no restraint with our finances (see every shopping mall in America) and we want everything OUR WAY AND NOW, we don't save money, we don't prepare for disasters we just wait till they happen and put out our hand. I am a 8+ generation American raised by people with work ethic and pride. I don't need a handout, I need an opportunity and the rest will happen. Americans must look in the mirror and start there before any TRUE reform will take place. I am not in favor of a government run healthcare system, but make no mistake REFORM IS NEEDED.

Boy oh boy, aren't you Obama followers living under rocks. This government is playing Chicago politics, threatening, ignoring and lying to those of us who pay their fat paychecks. Did you ever think to ask why they don't want to be put on this plan but are pushing it on us? Have you ever heard the stories, one after another, about the horrible socialized health care in Canada and England? Why do they come here for their care? Of course only if they can afford it. They can't even pay out of pocket in their homeland to get treatment immediately for their illness/injuries. One more thing, go back to the last administration and let's ask ourselves how many times we endured the stories of the horrors of the Iraq war and now, even as it continues there and now Afghanistan, NOTHING. Could it be that the liberal media refuses to report on anything that will hurt this President? DOUBLE STANDARD and the American people are waking up and NOT going to take it anymore!!!!

IN THE CASE OF THE WART REMOVAL IT'S OBVIOUS THAT THOSE
IN BC WHO AUTHORIZED PAYMENT FOR THAT PROCEDURE WERE SLEEPING AT THE WHEEL. ANY GOOD COMPUTOR PROGRAM SHOULD HAVE FLAGGED IT AT ONCE.
THE BC PROGRAM IS NOT FAILING,IT IS THOSE INEPT
INDIVIDUALS THAT ADMINISTER IT. WE NEED TO FIX THE PROBLEM,NOT REPLACE THE OTHERWISE GOOD PROGRAM.

george from destin FL,

Massachussets is considering that type of reform now and it has significant backing. I agree that would reduce the cost substantially but you'd have a hard time convincing doctor groups of that.

As I watched the movie SICKO in Flint, MI, I felt badly that Michael Moore did not have the time or means to compare the countries he used as examples of different healthcare systems for the prevalence or degreed of FRAUD perpetrated within those systems.

If such a figure for a country can be achieved – with acceptable reliability and validity – the next step would be to correlate these national figures with a) murders per year, and b) death by gunshot. That would result in a table three colums wide and as deep as the number of countries compared, and compare national cultures.

But that might be unnecesary. When the Medicare program became a reality, CBS investigative program, 60 Minutes, began investigating fraud – - and found that schemes to milk the system had been in planning before the ink was dry on the Presidential signature establishing the program.

America's crooks live by the "can do" motto, they are second to none , but they live shorter lives than crooks of other nations.

as a former directtor of child support enforcement and fraud investigations, i can tell you that in the county where i worked, we investigated 455 cases for the department of Health and Human Services in 2008. 46% of those cases had fraud associated with them. we saved $350,000.00 in benefits not paid out illegally. we also recovered in excess of $30,000.00 from those we prosecuted. we began a fraud program in 1986 and have saved the state and the feds hundreds of thousands if not millions of dollars thru these investigations in food stamps, medicaid/medicare, daycare, etc.

Sick that many of you think this is a Republican attack on the Democrats. Untrue, I like many of my Libertarian brethren, just don't want more government waste and fraud in a system that is currently rife with just those things. Not to mention the plethora of failed social programs currently and previously run by the government: did everyone conveniently forget that Social Security is a gov't run program about to get tanked into the ground? No, why would anyone bother to read about history so as not to repeat is so suddenly. Now the administration wants people reporting their fellow citizens for being AGAINST this health care "reform"? McCarthy-era scare tactics? Who is stooping to unimaginable levels now?

i also love the fact that they're talking about taxing insurers now to pay for some of this reform.

who pays that tax? not the insurers. they pass it onto policyholders.

you know the ones that are making under $250k per year that Obama PROMISED he wouldn't tax as recently as last week.

typical washington bait and switch that i would have HOPED would have CHANGED with this administration.

same as usual. its one thing with most politicians but Obama came in on a platform of change and isn't changing anything. SAD.

Here's an idea. Rather than wholesales replacement of the current system, which WORKS for MOST Americans just fine, how about identifying the problems and FIXING them? Maybe, just maybe, that would allow, I dunno, medical costs to go down, insurance rates to go down, and more people to be covered. Sound like a plan? We KNOW from long experience how government plans are rife witrh fraud – remember the $600 hammers for the Pentagon? Anyone REALLY believe there will be less fraud with a government program? Fraud. Malpractice reform. Regulatory reform to streamline processes. Lots of things we CAN do, that everyone agrees SHOULD be done, but yet the liberals want to force feed us a government plan without even TRYING to fix the current one? I wonder why...

Roland's comment: "the lack of incentive among private insurers to not care about fraud is even greater"

I totally disagree with his assumption. I am employed as a fraud investigator with the largest health insurnace company in America (not Blue Cross/Blue Shield). We have a staff of literally hundreds of investigators and fraud analysts. We are currently in negotiations with other insurers to provide training to them in how to detect fraud and prevent claim payments to known fraudulent providers. So far this year, our company has saved over 430 million dollars by preventing claim payments to known fraudulent healthcare providers. The 430 million was and is used to reduce premiums.EVERY report of alleged fraudulent activity is taken very seriously.
Part of my job is to notify other insurance companies when a provider is suspected of fraud. I recently contacted Medicare to report a provider (they were the primary payor, we were secondary). Their response: "we're too busy to worry about that, but thanks for calling".

Fraud also includes many health care vendors and the GPO's

When Lab companies get fined 300+ million dollars you can bet they took a billion or more and don't want other things uncovered. The lawyers say it's to avoid litigation but we know what BS that is. They find work arounds like bundling and paying doctors for office space for blood draws which guarantees them all the business and volume.

the GPO's claim to get hospitals and regions the best price and that they do for a few select expensive items then the rest sell at very high cost protecting some healthcare giants margins by squeezing other companies. These giants in the background limit the choices of vendors and bidding. If cherry picking was done and it can be done easily with technology then hospitals could reduce supply costs 20-50%.of existing contracts

We need a walmart or someone with deep pockets and distribution to level the field and all the greasing.

When all of the goverment signs up for the same care they are offering you and I then it will be time to talk. Until that happens there is little hope that the same people managing social security and medicare which are a total mess can manage health care. Remenber the democrats have controlled congress since 2006 , Hope is not a plan.

How about when you report things to the insurance company....and the insurance company DOESN'T CARE!!!!

Like the insurance co getting billed for 2 choppers, 2 chopper piolots, 2 chopper nurses, 2 incubators, 2 O2's, etc when, yes there were 2 babies, but it was a shared incubator one 1 chopper, with 1 pilot, 1 nurse, 1 incubator with 1 O2 tank!

Steve,

What you are failing to realize is that if there is an el-cheapo government option available, most companies would probably opt to go that route rather than pay the employer-side premiums for private insurance.

Then we will have NO choice, but to take the government option.

It isn't as simple as "don't want it, don't take it".

If Obama won't sign his own family up for it, why on earth should I?

Why do we need this bill for 'reform'. Why doesn't the government just give the people the option to buy healthcare that the government ALREADY offers; MediCare? Why do we need to create an entirely new system and have to raise taxes? A program already exists, it's already funded and regulated. Wouldn't that make the most financial sense? That's not the real issue though is it.

So far they have not even discussed how much taxes would need to be raised to support this proposal and yes taxes will be raised. They have not discussed reducing ones ability to win outrageous lawsuits.

Healthcare costs are incredibly expensive but that's because the few spoil it for the many. A new healthcare plan is not going to fix that unless those particular issues are addressed and in this bill they are not. Not all healthcare agencies are bad, not all hospitals and doctors are bad.

They are also forgetting frivolous lawsuits, malpractice is a huge expense, and defensive medicine cost money and uses up resources ,equipment and time that could be spent healing people. Lawyers must also be "regulated" . If they are willing to "access" a patient's condition and "access a cost to outcome" on a patient, then they certainly could do this with medical malpractice outcomes,,,access injuries ,,,what is blindness worth? loss of use of legs? This is not cruel,,,they already intend to make these judgments with our medical care...what is bypass worth on an 80 year old,,,,it is in the democratic bill.

One must be careful with what is called fraud by our government. If a physician tells an elderly patient who cannot afford care that he will accept only what Medicare pays and forgive any co-pay,he is committing fraud.Does that sound like fraud or an act of kindness?

Steve with the hyperextended knee...............please understand why I don't like what's being proposed.

I am a charitable person, wanting to help those in need. I just don't want an inefficient, wasteful government taking my income to provide that charity, totally removing me from the equation and giving more charity than I would, deciding who gets charity and who doesn't. The government will be making the same hard decisions being made by insurance companies. It's socialism any way you slice it.

I also don't want to pay for abortions or sex change operations.

To inform the very uninformed regarding healthcare reform: while tort reform and malpractice insurance should be a part of healthcare reform in general, it is not the most pressing part of the problem. Out of the 2.5 trillion dollars per year floating around in US healthcare, only 1% is involved in malpractice insurance, lawsuits, and patient awards and settlements. While it's no small amount of money, it's not the primary problem.

We need to have coverage for the uninsured and under-insured. We need to have a system that looks at effective outcomes rather than whatever the latest techno gadget is that looks great, but does not produce cost effective outcomes. We need to stop spending billions on patients who are not going to have a reasonable quality of life.

My suggestion would be for all govenment employees including the president and congress to try out President Obama's public option first. If it works – great – then the rest of us will feel better about it. Instead President Obama, members of congress and government employees crafting the bill will keep their current health care with private carriers, but use small business as the guinea pig.

A government option would be fine – as long as no tax dollars are used to support it. We will see if the government can run things more efficiently than private enterprise. We have an example: Post Office vs. FedEx and UPS.

I have dealt with BCBS many times where I have tried to save them and myself money but found that they were not interested. Something they didn’t cover or was not in my policy, but was cheaper, had been denied in favor of a procedure that was more costly to the both of us. Also all of the fighting that I have to do to prove necessity of a procedure that I have had done which was eventually covered never compensated me for my time. Morally I know this is wrong but BCBS has taught me a valuable lesson. I will take “their” attitude and unless my policy stipulates that I am required to review my bills and must report this to the proper authorities I will let it occur. Maybe insurance companies should offer a type of “reward” for reporting, leading to a conviction of fraud to get people to see what is in it for them. I don’t believe the “it adds cost to everyone’s insurance” as much as I believe ending fraud adds more to the insurance companies profit and bonus’s for their execs. They would not lower costs to the member’s just find another excuse to raise costs.

Folks tend to look at one issue, and not the whole picture.

For instance, the health care payment system needs reform. We have the best health care in the world, why can't people access it? Expense.

So, we need to reform the cost, and some of the service. Why is it so expensive? One of many issues: Greed. Health care insurers are making billions in profit. Fraud. Lawsuits.
From this we need to change our legal system in tort reform. Yes a person was injured, but should they as an individual receive millions in compensation? How does that hurt our system? How do the hundreds of thousands of frivolous lawsuits hurt, not only health care, but every facet of our lives. Our legal system – notice I don't use the word justice – must be reformed.
Profits must be regulated and limited. Fraud must be controlled.
The government should not be in any business; it is there to create and enforce a level and fair playing field for business and capitalism to exist.
Name one program -one government program that functions efficiently, and accomplishes the task for which it was created. Yet somehow we expect it to run healthcare? No. It needs to reform health care laws, and stay out of the business. Further, it needs to get out of the banking and auto industries, and get back to the job it was intended; creating fair and just laws that give everyone a fair shot at the "pursuit of happiness".
It does not matter if you're Democrat or Republican, Obama hater, Bush hater, whatever. We're all Americans; united we stand divided we fall. Our leadership on both sides of the isle have failed us, and not just in the past decade, but decades. We the people need to stop repeatedly electing lawyers to government who consistently support their own. All of these people are celebrities; they don't have to worry at all about day to day income or expenses that they are so far out of touch with us real folks as Hollywood.

Thank God there's no chance of fraud or overspending within a Gov't run program. I'm feeling much better knowing that Pelosi, Reed, Dodd, Franks, Rangle, Geitner – such upstanding and honest and reputable politicians will be looking after my best interests.

There's certainly no chance that they would stoop so low to take money from Insurance Companies, the AMA, AARP, or any other organization that tries to buy influnce.

Pass the Bill today!!!!! errrr.. .then wait in line tomorrow for your Kool-Aid tomorrow... even that will probably rationed shortly...

On a positive note – you guys are giving me hope.. I didn't know that there were so many guillable people in American... time for me to start selling snake oil... there' s obviously a HUGE market for it..

Insurance is the main cause of the broken health care system. The best solution is having the consumer pay the health care provider directly. If you are paying with cash out of your pocket, would you pay a hospital $10 for a Tylenol? But what if the insurance company is paying for it? Then you don't care.

We need healthcare reform based on a public option. My healthcare and my family’s healthcare must not be based on profit making ideology. This ideology and the monopoly of the Insurance companies is what drive the prices sky-high. The “market forces” and “self-regulation” stories that we are told will drive down the costs, are bedtime stories, a bad joke, and do not work – see the meltdown of the financial market, no market forces, only greed – as long as there is no independent regulatory function. It is not conceivable in our times to have people that do not have health coverage, under-covered, etc.
It is not conceivable to be denied health care for pre-existing conditions it is not conceivable to receive treatment base on what is most profitable procedure instead on what is the most effective, and is not conceivable to pay out-of-control services. Just to mention a few from my personal experience: 10 miles with an ambulance having paramedics doing nothing of real help – $1700. Equivalent to about 80 taxicabs. One bandage wrap in the doctor’s cabinet called “surgical care”, 5min, $85.00. This would be equivalent to $1020/hour. This is not medical care. This is simply robbery.

I saw sicko but, I am also cuban. That gives me a uniquely different perspective, because I know what is really going on in socialized medical systems. As much as liberals want to critique capitalism and republicans, they don't want to live in Cuba, even with its universal health care. Maybe because there are no medications there...or CT scans or anything else, including food or decent housing. When the government takes over, they will turn healthcare into a rationed program where only certain groups get this or that and personal choice will be history.

Fraud and fraudulent legal actions ought to be managed; however, a complete overhaul of the system is unnecessary. We do not want a single payer program.

Lance that's just the problem, you work for the insurance company. Like you are one we would look to for honest responses. These insurances copmpanies are out for blood and profit.

I think that physician fraud is part of the problem, but a small issue compared to insurance company profits. Before people gang up on the "rich doctor" one should realize that most primary care doctors don't make close to 200k, let alone more. One must also look at the years and debt accured before gaining a full salary. Most physicians leave med school 150k in debt and work 80+ hours for 3-5 years at 35k/year before they even get to make their final salary. Once making 150k per year they have to pay off their debt (which grew during those 3-5 years) and alot 30-50k per year to repayment of debt. After all is said and done take home is closer to 80-90k for that primary care doctor who answers your calls at all hours. I think greed is part of the problems, but for the most part I think physicians are trying to do right by you.

Lance,

thank you for doing what you do.

I do realize that insurers are the forefront on cost cutting measures like wellness initiatives long before Obama started touting them. Disease case management like you do before they started talking about them.

i love how their "comparative effectiveness research" on drugs is nothing more than step therapy that insurers have been doing for years.

These are cost saving measures that insurers try to do to save POLICYHOLDERS money, you know why? because al of us who work at insurers or in the industry have a stake in it.

And if you destroy the industry that has 2.5 million jobs how bad will the economy be then?

But yes we can all go get government work. that lately seems to be the answer to everything.

The answer should be why Mr Obama isn't talking about the 70% of american children that are obese.

That figure is staggering and NEVER gets talked about.

I have a hard time when people say "Look at Sweden, look at Australia, etc" about health care. The problem with that is the population size. I can see how government run health care is affective and successful in small populations where costs can be kept down. But to try to provide it in a system the size of the United States is a completely different story – look at Canada – competition makes for better service. I fully agree we need reform and maybe reform isnt' the correct word. I agree that insurance costs are out of control – so control it. Put limits on insurance costs, regulate medical costs and expenses, add some oversight. I have a problem with the taxpayers, "myself," paying for the healthcare of others, those who are making unhealthy choices that lead to their need of the healthcare. I support healthcare for those who cannot support themselves, ie children. If our children are healthy to begin with, many of our health problems as they become adults are simplified or eliminated.

Why not regulate insurance and medical costs and provide incentives to be healthier. Like they are doing with the CARS program, why not provide rebates or stimulus for becoming healthier, give a reason for people to get that way....if we become a healthier society, costs will naturally go down.

These are all certainly random thoughts and ramblings, fleeting ideas, thoughts to ponder. I am for change, but it needs to actually be change and not just a quick fix.

Today's Wall Street Journal has an interesting article on the health care system in France. The French system is rated number one in the world, By comparison, the US system is rated 37th. The French system, however, is not without problems, the main one being high costs that are forcing the government to cut services. A universal single payer government system like that in France, Canada and much of Europe would help to eliminate fraud by providing greater transparency. In addition to being universal, it would also be cheaper and more efficient. But there is room for the private sector too. For example, in Canada where there is a government system, hospitals are privately owned and operated. Americans, however, are afraid of the Canadian type system because waiting time and lack of services there are a problem. One solution might be a small user fee which would add substantially to the revenue, and eliminate many unnecessary hospital visits, and fraud. It is hoped that we will soon get past the bickering in Congress and do something. 37th place is pretty poor!

Larry, the current health care "reform" debate is not about reducing fraud. It is about getting non-Obama voters to pay for the government-run health care for Obama voters. If the legislation being advanced in congress were about reducing fraud, and not about a government takeover of medicine, then everybody would be happy.

It is pathetic to hear people blame doctors and health care providers for the problems with our healthcare system... I know there are corrupt people in every industry (including doctors) but the real story is that physicians must battle constantly to get reimbused enough to pay salaries, licenses, malpractice insurance, and all the other regulation fees and all the other BS that goes along with trying to run a straight practice and really help people who are sick... Keep in mind that physicians and providers provide many services throughout the day that they never get paid for such as calling in refill prescriptions, writing letters to patients or other physicians, sending med records to other physicians, and the list goes on... there are no codes to bill for these services so they are provided for nothing... My attorney charges me $68 to OPEN AN EMAIL even if it is 1 line... he charges $68 to send me an email, and $68 for a phone call even if it is 20 seconds long... If doctors (who are really trying to help people) could charge what attorneys charge... there would be few, if any, problems with healthcare at all...

If people would pay doctors instead of insurance companies there would be NO FRAUD because the patient would have the say so as to whether he or she wants to have the services recommended...
If there were no insurance companies, people would pay for services just like they do for a haircut or an oil change... Does healthcare cost a lot? absolutely!!! Doctors go to school for at least 8 years, sometimes 12, to acquire the knowledge necessary for their profession. Now, people act like the doctors are the problem and that they are always ripping off t heir patients... Keep thinking that way... soon there will be no doctors to take your sick kids to, or to refill your prescriptions for free, or to perform that surgery on the malignant tumor you have... NOBODY WANTS TO BE A DOCTOR ANYMORE!!! Why should they? the insurance companies and lawyers get all the money..... If people would count up all the money that they spend in insurance premiums (including businesses who pay for employee premiums) everyone could pay for their healthcare directly...
The only people who want healthcare reform are those who want someone else to pay for their healthcare... Until all the insurance companies in this country are gone, and people can start paying doctors for their services again, healthcare problems will do nothing but increase, and I promise you, from a healthcare providers POV, the plan that NOBAMA has is ridiculous... what doctor wants to get 8 -12 years of education and then have to scrape to get reimbursed from some government healthcare policy... What will happen is that all the crappy doctors who dont give a rats butt will be the only ones to take the socialistic insurance, so all you people who think that govenment healthcare is the answer, you can go see all the crappy doctors... I mean, lets be realistic... if you go down to your local health clinic or to the ER at the county hospital, they have to treat you whether you have insurance or not... if you cant pay for it, the govenment does...! what kind of doctors do you see in these places? All the ones who cant get jobs at decent practices or hospitals.... And guess what? because they have to live on medicaid reimbursements (which are almost nothing) or wait to get reimbursed from the government, THEY DONT GIVE A CRAP ABOUT YOUR HEALTH!!!!!

As for us, we will never take it, and we will continue to provide EXCELLENT healthcare to our patients who are willing to pay for it... and for those who say they cant afford it... THIS IS AMERICA... you know... FREE ENTERPRISE!!!! that means that you have to work harder to have more... You get what you pay for... Healthcare included....!!!
Again, my opinon is that insurance companies are the entire problem and as soon as they are gone this country will have fewer healthcare problems... People will want to be doctors again when they know that they can make GOOD money for providing GOOD medical care to patients who are wiling to pay for it... !!!!!!!!

I am a nurse, or rather I was one. I worked at a great hospital in labor and delivery. I carried my families health ins. ,which was expensive ,but terrific coverage. I am 58 years old and planned on working many more years. I was like all these people who are happy with their coverage. How quickly things can change. My headaches drove my quest to find a cause and accendently discovered an aneruysm in my brain. One month later I had surgery and it ruptured as they were putting me to sleep. I had a severe SAH, which has left me unable to be a nurse. this was Jan. 2008. My husband lost his job caring for me. I am on LTD and SS disability which doesn't cover our expenses. I chose cobra for myself and not my family because of cost. Now with only 2 months cobra left I can find no company to cover ME for less than 1200.00 a month and a deducitable of 3500(thru hippa). I had trouble with the 500.00 for cobra!. My husband has no ins. and my daughter loses her fl. healthy kids early next year. my husband still has no job, we rent and can't afford to move... you just never know when it could be your turn to become uninsurable. I never imagined how quickly my circumstances could change. All healthcare without an agreement with an ins. company is so expensive I guess we will be among the ER visitors. So those of you out there who yell about health care reform beware...you could be next.

I have reported some fraud to BCBS of NC. The company I work for is self ensured and that come cost come out of their bottom line. That will cause my rates to go up and even reduce raises. Fraud hurts in many ways.

insurance companies profit margins in 2008 were 2%

pharmecutical industry profit margins in 2008 were 18.5%

exactly WHO is the devil here?

billy tauzin that's who

Get over it conservatives. You are going to lose this one just like you lost the election. You can organize and disrupt the town hall meetings. You can, along with your Fox news station, cry out in agony as the wheels of change roll forward and fix the problems created by your president and your congress that were for the most part voted out of office. No matter how much Rick Scott and his minions at Conservatives for Patients Rights or Dick Army and his minions at Freedom Works want to kick and scream, the American people will get an improved healthcare system. You have screwed this country and the world long enough. We are taking it back.

TAlk about fraud? Medicare health providers such as mail order suppliers of durable medical equipment are the biggest perpetrator!
Medicare is a open door for anyone to grab in pull out tons of money! The government needs to clean up it on act before it say that the private sector should . It's no wondeer medicare is loosing so much money!

I love when people talk about personal choices which supposedly free market system provides comparing to Cuba or Canada, or even maybe USSR...

But we do not have any choice at all!

People! My employer pays to insurance company $20,000 a year for my family plan. And my family is pretty healthy (we spend barely $1000 a year for doctors visits).

Why cannot my employer increase my salary for that $20,000 a year and give me REAL ABILITY TO MAKE MY OWN CHOICES, or even save this money for future when I'll be older and sick!

No, "free market" system of this country made health insurance manadatory for employers.

When you understend how real free market works we'll be out of this mess.

lyn,

your story is horrible and i hope for the best for you and your family.

have you attempted to get medicare because of your disability? that may be the best of bad situations?

Also what about ARRA? Have you used the COBRA subsidy by the government??

I expect that program to continue as long as unemployment is as bad as it is. Pretty soon many people using the 65% subsidy will reach the end of their 9 month period and will either lose coverage (due to not being able to pay expensive COBRA premiums) or see those costs skyrocket to amounts no one could afford.

something does need to be done. its been needed for years and now its at the forefront. Its just sad it all had to come to this to get it out in the open.

This is exactly what government does nothing about, and why government health care is a very bad idea. The UK NHS is a prime example of the problems in national health care.

Michael Menzel, You have hit the nail on the head... the hell with paying insurance premiums... As a healthcare employer with 38 employees, I pay over $120K out of my pocket every year to insurance premiums for my employees... If I could I would pay that money directly to the employees and let them decide where to spend it... the problem is ... PREXISTING CONDITIONS.... Insurance companies are nothing more than a legal mafia. they can make any rules they want and they have everyone by the b-s!

It always surprises me to see the constant "with us or against us" stance presented by everyone ranging from politicians down to commenter on this post. Just because you want to reform healthcare doesn't mean your solution will work. Most Republicans aren't against healthcare reform, they're against a reckless policy proposed by the Democrats. I believe that we need health care reform, I just don't trust our government to do it correctly by going deeper into the insurance business beyond Medicare. Why do we need a public option when we can simply pass laws and more rigorously enforce laws. You can eliminate the insurance industry's disgusting practices such as rescission, pre-existing conditions, and other abuses by simply identifying the abuses and passing laws to eliminate them. If the insurance business wants to continue, they'll have to comply. Then give the federal government power (not the states) the tasks of enforcing those laws, and rooting out fraud. Finally, I'll gladly pay more taxes to cover the under-insured and the un-insured, I just don't want to pay for the bureaucratic overhead that it will take to administer a public option. So expand medicaid or allow the government to broker a health plan with private insurers for the un-insured using our tax dollars. I don't see why our politicians are making it more difficult than that.

It is truly appalling that they do not read the bills they sign though, no wonder our tax dollars go to waste in earmarks.

Yes, their is fraud committed with doctors, but the way insurance refuse to pay for medical services is also fraud, but it is legal fraud.

Yes we need to fix these problems, but if you think things are bad now turning Health Care over to the Government will be worse. Name one program that the Government runs that is a success? Our Health Care is not perfect but it is the best in the World, so why change it when 80% of the people are happy with their Health Plans, and the 48 Millions who don't have Health Care either don't want it or don't want to pay for it or are illegals who are getting it free anyway.

Medicare and Medicaid work well.. anything can be 'improved' though.. but this view that they 'don't work' is a myth.. they're extremely low cost especially when considering they are providing health care for the most expensive segment of society – the elderly and the low income.

This is a huge complex problem, there is no answer that will solve everything and please everyone...that doesn't mean we shouldn't try. This issue has been around for decades but for 8 years we didn't talk about it and its gotten worse. Now we have millions of Americans out of work and out of health care for the first time...its easy for the insured to be resistant, but I can tell you as one of the newly uninsured it is a very scary and expensive thing, nobody in America should have to go through this when we spend more than this on wars

I believe that most doctors commits fraud to some extent. They use wrong codes when charging the insurance company to squeeze out a little money. It sickens me to see people going into such a profession for money.

Andra..

in your long spiel about how it takes 'real leadership to change the way we spend existing money' you fail to realize that much of the reform is going to effect the way we spend at the root.

Getting everyone covered by health insurance will allow them to have affordable regular checkups – and is the most important 'preventative' measure of all. If any of you feel that 'defensive' medicine / 'preventative' medicine is the key to reducing costs – this is the first line of defense.

Not only does that reduce costs by preventing later illnesses... it increases economic stability by keeping these people in the work force. It also means people will not end up in emergency rooms over a relatively small problem..

This is only one aspect... but to give an example I've recently gone to the dentist – I haven't had health insurance of any kind for a long time.. if I had been getting continual checkups – I would have saved myself significant money – and also sick time. To repeat my main point – the most important cost reduction of all is getting people insured and into the doctor's office regularly.

In reading all of the comments made about this issue, no one has ever said what "affordable" means. Obama says he wants health care that is affordable to everyone. What does that mean? Tell me a dollar amount that I can fit into my budget. There is no way we are going to get more health care for less than it is costing today. Nothing is free. With health care reform some of us may end up paying less, but a lot of us will pay more! How can anyone listen to this debate and not wonder where all the money is going to come from to provide health coverage for all? And now Pelosi is calling the health insurance companies immoral villians! Listen, if you had a claim denied for a service that was covered by your plan, get a lawyer and sue. Most of these complaints are from people who did not bother to read their coverage details.

Larry, did you not read the article, Obama is not going to fund fraud prevention enough to make a dent. Look at the Medicaid program. Why do you think the government will fight fraud better than insurance companies

If our president and politicians (senate & House) are under the same program as we the people then I will consider what they have to say, but not until!

I agree we should fix the fraud first. I think anyone who has ever been to a dentist's office has been the victim of fraud. Dental Assistant: "Your TWO insurance programs don't cover this bridge...so you have to pay $2300, EVEN WITH TWO INSURANCE PLANS!"

Patient(me): "Is that your way of saying the dentist needs me to help him with his downpayment on his BMW?"

Fixing Fraud is important and tort reform are important, and you have to give some credit to Republicans for seeming to care more about this than Democrats. Insurance is mostly regulated by states, and most tort cases are brought in State Courts. There are no shortage of states which have been governed by Republicans exclusively for the past 10-20 years. Have they enacted tort reform? Is fraud lesser in Republican dominated states than Democratic ones? Why might that be. I'm actually asking the question because I don't know the answer. I do know this: Republicans controlled the House, Senate and White House for periods of time over the past 20 years and I don't recall a bill introduced on the subject. I'm starting to worry about whether or not some of this talk is more excuse-aking to not reform the system.

This is why we need government supported public options, run much like the FAA to insure our safety. It may not be a perfect bill, but after reading it, looks to be a major improvement. As for wasted money's, man I worked in the purchasing department of the 3rd largest Ins. company in the world, and what a mess. They bought and tossed stuff out like there was no end to thier customers money. If you think they're well run, just take a look at how long it takes, and how accurate your bills really are. We need this reform! People with pre-existing conditions, and the list for this is growing, are dying everyday for no reason. The commercials on TV stating really low rates like Health One, never point to the deductibles or condition exclusions. They state starting at 63 dollars, it almost fraud the small print. Let's see them Insure me for that amount! NO WAY

IT LOOKS TO ME LIKE THERESA NEEDS TO COME BACK TO MICHIGAN TO VISIT HER FRIENDS AND FAMILY!!!!!

There are many more of us who have discovered that our health care professionals were commiting fraud with our medical benefits. Once I was absolutely sure that the medical claims filed to my insurer were
fraudulent, I reported to my insurance company. They encouraged me to report to the state professional board which I did. They acknowledged many complaints about the same physician. After a long investigation I was told that the case had been elevated to the State Dist Attorney's office. The doctor is still in business and nothing has been done about the fraudulent business activities. This doctor
still refuses to return over $5000.00 of a deposit for services not performed. I did not feel confortable to continue seeing the doctor after finding out about the many complaints and dishonesty . Is there anyone who can assist me to reveal this situation so others will not be violated by this doctor as I was?

Healthcare is not the only thing out of control. This could be fixed by regulating the insurance companies as they have so freely done with the banks, aig, gm. We do not need everyone under one restrictive plan. Fraud? Medicare, medicaid, va, all private health insurance co. have a fraud unit. I suggest they put them to work for their paychecks.
Torte reform for all the lazy non compliant people that want to just get rich off their Physicians.
The way this bill is structure is if there are anychanges what so ever in your coverage or premiums you will have to go to the government coverage. Now if they can't handle medicare, medicaid and the va how the hell are they going to take care of 50 million more applicants?
I am still reading the bill. Waiting to find the part where all of Congress is exempt of these rules. It has to be in there or they would all be willing to carry the same coverage they are offering us.

Disney World has 45 million people every year who enter the park to see Mickey by putting their finger on a biometric (fingerprint) device. Over 1 million elementary school children pay for school lunches using the same technology. A huge percentage of fraud is physicians billing for services never rendered where the patient never physically entered the office for treatment. The biometric would confirm patient presence (eliminating fraud) protect the honest (99%) physicians from liability and medical ID theft (can't pretend to be another patient to use their benefit card) and patients from unknowing medical ID theft. Other countries use this technology all the time. The fingerprint is not stored like in a police fingerprint, it is converted to a computer template which can't be reverse engineered to protect patient privacy. When we go to the dr, we are representing we are at the medical office anyway, why not "Give Fraud the Finger" and use biometrics?

C'mon people. Educate yourself. Fraud will never be completely stopped. Just like banks will continue to be robbed, cars will be stolen, people will be murdered.... You would have to eliminate greed first, wouldn't you?

Pre-existing is an essential insurance concept. Why would you ever buy insurance unless you were sick? Because of pre-existing. Otherwise, you could wait until you were sick. You wouldn't expect an insurer to sell you a life insurance policy after you died, would you? Why should an insurer sell you a policy after you are sick? (Unless it is group health under your employer).

I always find it interesting that opponents to health care reform argue that it will be the "death to all of us" or "it will restrict our choices" or "medical decisions will be made by bureaucrats".

It is the current unregulated capitalistic private insurance companies who are actually fulfilling their worst nightmare right now. "Death to us all" – private insurance companies are literally killing patients right now by denying lifesaving care like in the case of Cigna's denial of Natalie Sarkisyan's care.

"It will restrict our choices" which is exactly what our private insurers are doing. I have private coverage myself as a medical professional through my hospital who employs me. I'm restricted to a list of doctors I can see and also to only 4 hospitals in the local Tampa Bay area and if I seek medical care outside of this my insurer will put a majority of the financial cost on me so if I want somewhat affordable medical care I'm forced into their restrictive measures.

"Medical decisions will be made by bureaucrats" – in the private insurance market medical decisions aren't made by myself or my doctor but rather by bureaucrats (executives and internal business analysts) from my private insurers when they decide what is covered and what is not.

Healthcare reform would put a stop to all this and I've actually researched for hours on what the best way to achieve this is. Here's my solutions – http://bit.ly/9QLV8

Reform in our healthcare system may be warrented and there is no need to overhaul the whole system when a national healthcare system already exists, Medicare and Medicaid. Instead of constructing a system that still leaves millions uninsured, lets implement changes in our current system to control costs and cover more people. Additionally, we need to return to regulating the insurance industry rather than regulating American citizens ability to access with efficiency the best healthcare the world has to offer. ( How about going back to regulating gas prices as well. ) If and how this is all done, it must be done in such a way that provides for the needs of those unable to work for coverage due to disability and eases the financial burden of high deductible coverage on the working class which essentially leaves many of us that support the financing of the entire system with little more than catastrophic coverage. Those people that choose to spend their life sitting, watching TV and collecting government checks must be held accountable somehow rather that sucking the life out of the rest of us.

You know we hear lots of BS from the radical right wing domestic terrorists about health care , especially keeping government out of it. But Medicare and COBRA are Both already under government control or policies . If you say NO TO COBRA just think How many more will be without insurance. I'm on it now after being laid off the 2nd time in 8 years of work at Cessna . The 1st time was caused by failed Bush policy post 9/11 ,that kept us unable to fly & sell our aircraft for weeks. The 2nd time also due to Bush falied policies or lack of regulation of BIG OIL, HOUSING AND BANKING INDUSTRIES causing the economic meltdown . No body speaks the truth of why, just like the auto industry we have been sunk By Bush in aviation twice in 7- 8 years.

The FBI only recovers about $1 billion a year in health care fraud because they are under staffed and lack the skills to electronically audit billions of health care claims. If we stop health care fraud, we can provide coverage to all the uninsured without raising anyone's taxes. I would rather pay for 10,000 more FBI agents than $100 billion a year in fraud.

What can ordinary citizens do about fraud? File a False Claims Act case if it involves government dollars – Medicare, Medicare Advantage, Medicaid, SCHIP, Worker's Comp. If you have a good case, you can get a lawyer without up-front fees and the fraudlent party will have to pay triple damages.

There are many unfavorble matter in our life.However,your case is one of the most complicated issue among group of them.Medicine is one of the most important carreer in our society and doctor is also one of the most important person.For me,the more improving the society is,the more difficult the medicine need to try.So,in my understanding,i am always convinced that,doctor will be try so hard to satisfy and save the human's life.

Stop the fraud totally, but don't destroy the best medical system in the world! There went our jobs! There went our auto industry, there goes the medical? Come one and wake up! Most are now! EDUCATE YOURSELVES QUICKLY! As Americans, we have way too much to lose, and I have lost way too much since this administration has taken office ALREADY!

[...] Health care reform: forgetting fraud “We don’t actually know the dollar amount being lost but we know the order of magnitude. It’s hundreds of billions of dollars. We just don’t know how many hundreds of billions of dollars,” said Harvard Professor Malcolm Sparrow, author of License to Steal: How Fraud Bleeds Americas Health Care System. [...]

Supporters of President Obama's healthcare reform were out in numbers at the St. Petersburg, Florida Library. No screaming, just real people who understand the need for healthcare reform.

Strangers willing signed petitions in support of healthcare reform, all seem to understand the need and that the time is now.

We can not allow premiums to increase with less coverage each year. A public option will force insurance companies to compete for our business.

Medicare will stop paying insurance companies billions for failed management, making more medicare money available to Americans.

People like my disabled daughter will be eligible for healthcare coverage under a public option.

Do not let the lobbyist kill healthcare with lies. America does not kill the elderly or deny healthcare to the sick.

NOW IS THE TIME, CALL OR VISIT YOUR REPRESENTIVES OFFICE IN SUPPORT OF HEALTHCARE REFORM.

We have laws against fraud.

Saying that we should not pass health care reform until all fraud is eliminated is like saying we should stop building any roads and highways until drunk driving is eliminated.

What makes a priest differ from a doctor? A congressman from a CEO? A cop from a felon?....well, my friend it's hard to find one so we need to have a reform in place and keep reporting to the media which I
trust a little bit better than the Congress and the Senate!

Don't pretend you have something in your pocket, it doesn't make sense......

The protester that are showing up at these townhall meeting are being sent by the mob, the Republican mob.

Unfortunately, the healthcare issue has sparked significant debate. Most of which has been dishonest information intended to incite the less informed people in our society. The facts are, the United States ranks 30th in the world in terms of life expectancy. Most of the countries that have government supported healthcare have longer life expectancies, e.g. Canada, Great Brittan, Germany, Australia and many others. Most of the countries that have government supported healthcare spend a fraction on healthcare was we do in the United States. The healthcare problem continues to grow in this country and costs continue to rise.

I am also appalled at the comments that try to draw NAZI parrallels to this issue and inferring our president is a NAZI. This again shows complete ignorance. NAZIism is the ultimate form of conservatism not liberalism yet many try to draw inference to the democrats and NAZIs. I am concerned about this because it is inciting the less informed in our society.

I encourage people to read and learn about both of these issues as they are critical to our country. Something has to be done about healthcare in this country. Legitimate debate is not only necessary but helpful in resolving this issue, however, we need to remove this type of misinformation and down right ignorance from this debate.

As a health care provider I believe medical costs are rising not so much because of fraud on the part of the health care providers, but as previously stated because of the defensive medicine that we must provide to avoid the attorneys. Just look at the ads on TV now for one drug or the other. Costs of these medications skyrocket due to product liability. Uneccessary testing is not that so much but merely to prevent another thing the attorney can bring out if and when a malpractice case comes around. 9 times out of 10 we know what the problem is, but if we don't order that expensive MRI, or full blood panel the attorney will surely jump on that. They will also easily find a so called "expert" who is hired to attest to it at $1500 per hour or more. Then you will have to find your so called "expert" to refute that at the same price. Finally it will go to a jury being paid $30 per day +lunch to decide who is right or wrong.

Great system we have isn't it? The attorneys laugh all the way to the bank and we as health care providers have to take it. Why is that......simple, we are easy targets!

You know, the more that I think about this, what if the government subsidized malpractice claims? Free med-mal insurance, no more defensive medicine. Sort of like the FDIC? I'll just bet costs would go down that way as soon as the lawyers saw they would have to go to the government for claims. It surely would cost less than the health care bill.

Hey if they can spen 2 Billion dollars on "cash for clunkers" what about this? I'll bet you would see costs drop dramatically.

Health care in the United States is filled with fraud and the people at the townhall meetings are "ringers" brought in to try to keep it from passing. They are rude bullies that have much to lose if the government takes it over. They are groups that bilk the government everyday and citizens need to realize you are being robbed. Insurance companies decide what healthcare you should receive, it is certainly not the doctor treating you. Many say, 'we have the best care in the world, people we are ranked 37th in the world and spend more money than most of them. Wake up, next they will be after your medicare and social security.

I been watching town hall meeting across the state on tv seam like to me that peoples are getting mad with each other for nothing, because every american need healthcare. If the america peoples dont come together on one issues, we are sitting a bad example to the other countries. Because we are going to start a war among each others, and that is bad for the America Peoples. Instead we sending troops to Afqhanistan we are going to need thems here at home, because the america peoples are getting out of control about the issue of healthcare.

[...] (CNN amfix) “We don’t actually know the dollar amount being lost but we know the order of magnitude. It’s hundreds of billions of dollars. We just don’t know how many hundreds of billions of dollars,” said Harvard Professor Malcolm Sparrow, author of License to Steal: How Fraud Bleeds Americas Health Care System. [...]