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On Mon, 26 Oct 2009 10:22:39 -0700, "nom=de=plume"
wrote:

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.. .
On Mon, 26 Oct 2009 04:22:26 -0600, Vic Smith
wrote:

On Mon, 26 Oct 2009 00:55:30 -0400, wrote:


Besides, that article has some other gems, such as the there's no
evidence the private insurers do any better with fraud than does
Medicare.


Did you see 60 Minutes tonight? They are talking about billions in
medicare fraud.

No, missed that. But see above. Maybe you missed it.
Somehow the Medicare fraud doesn't bother me as much after seeing
that.
After all, we're paying almost 10 times more to Aetna than to
Medicare.
So for every buck of mine going to a crook cheating Medicare, there's
nearly a sawbuck of mine going to the crook cheating Aetna.
Great system. Pretty equitable for the crooks percentage wise.
Lucky I can afford it. Good luck to those who can't.
They'll need it.

--Vic


I bet Aetna doesn't have near the fraud rate of medicare. They said
the whole Florida medicare department only had 3 investigators and
they called the process "pay and chase". They paid the claim, then
they determined if it was valid. The crooks would start and close the
fraudulent businesses faster than the investigators could look into
the claims.



I'm sure you're right. The "fraud" with Aetna (not singling them out
particularly) is that they're doing all the other bad activities (for
individuals). The problem with the Medicare fraud is that it's partly a
legislative issue. They must issue payment within I recall 30 days. The
investigative arm is underfunded (just got a $200M boost, but that's still
light in my view).


And you're both most likely wrong. As I said, the article I posted
was what seemed like a pretty good examination of Medicare and the
private insurance industry. They said they could find no evidence
that there was less fraud in private insurance than there is in
Medicare.
What is the funding of Aetna anti-fraud?
Don't know, do you?
Well, why should you? After all, 60 minutes isn't doing features
about Aetna. Taxpayers aren't squawking about Aetna.
Furthermore, where is the competitive pressure that would force them
to address it? There's a sweet little oligopoly of health carriers
here, as in most states.
Fraud costs go up? Who cares, raise the premiums.
It's easy to live with mythical assumptions, but it's a lot more fun
to examine them.

--Vic
 
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