Today, Anton Gunn brings to our attention the HHS Most Wanted Health Care Fugitives List, so you don’t have to go to the Post Office any more.
This is for Doug, who loves to talk about fraud and abuse in government health care programs. What I think Doug ignores, of course, is that the reason he hears about such cases is that this is the public sector. Government programs, unlike private ones, are directly accountable to the public, and there is therefore greater transparency. That’s why you have an Office of the Inspector General. (You don’t tend to find, say, an Internal Affairs division in the private sector — that’s very much a gummint thing.) What I suspect he also misses is that these are not cases of the government defrauding private citizens (which might argue against having such programs). They are cases of private citizens, and private companies, trying to defraud the government. At least, the ones I called up were. And in these cases, being detected doing so.
Still, Doug should thank me for giving him this today. In fact if you click on one of the newest cases on the list, you find that this Etienne Allonce is not only the head of a private company that is allegedly defrauding us, but he has been charged with being an illegal alien! A twofer, Doug! Of course, he’s not from Mexico, but you can’t have everything. I mean, whaddya want, eggs in your beer?
But whatever political points y’all derive from this, I thought it was interesting. So thanks, @AntonJGunn!
Related Posts
Hey, wait a sec — ALL of these folks have foreign-sounding names, and some (if not all) of them are actually foreigners… Tarek Wehbe… The Benitez Brothers… the Guilarte sisters… Susan Bendigo… Leonard Nwafor… Eduardo Moreno…
Either the OIG is profiling foreigners, or this is a coincidence, or guys named “Joe Smith” never try to defraud the system.
Next time, Anton, tell ’em to throw in a few WASPs for balance…
I am continually amazed by those who think it’s fine to defraud the gov’t, when they’d be furious if such a thing were done to them.
They are probably all from Florida, Arizona, New Mexico, Texas, or California. Medicare/caid are easy to scam because the are complex and dysfunctional. These are only the guys/gals stupid or slow enough to get caught.
When it gets to New York and California, you start seeing bunches of Russian and East European names. Really. Medicaid/Medicare fraud appears to be a favorite of those groups. Read the LATimes and NY/Region section of NYT. They will pop up on a regular basis.
It’s no longer “give me your tired, your poor”. It’s come on over and scam us into bankruptcy.
@Brad
Tip of the iceberg, Brad.
Tell me – how many times when working for McClatchey did you hear of employees being terminated for embezzlement that could be measured in millions or even tens of thousands?
You don’t see it in the private sector as much because there is a built-in system of checks and balances driven by profit motive to ensure that type of fraud doesn’t happen.
I worked for ten years as a consultant for the US Postal Service and spent a significant amount of time working with their Office of Inspector General on fraud cases. It would take years to gather the evidence and bring the offenders to justice. And the OIG was too understaffed to pursue anything but the largest cases.
There are BILLIONS being stolen from Medicare. How come that doesn’t happen as frequently to all the private insurance companies? Easy – they care about where the money goes. The government needs separate agencies to serve that purpose because the accountability doesn’t exist institutionally.
You don’t see it in the private sector as much because there is a built-in system of checks and balances driven by profit motive to ensure that type of fraud doesn’t happen.
-Doug
Employees don’t need to resort to fraud. Top level management is legally compensated through pay and bonuses that go far beyond any
real contribution they make to the welfare of society. Besides there are plenty of Enrons out there to dispel any notion that private companies are restrained by the profit motive from stealing from the public. Private enterprise can be just as corrupt as government. The profit motive just doesn’t have that much ability to prevent awful behavior. And even when it’s not blatantly corrupt private companies such as BP can do the public tremendous harm just by cutting corners in the name of pursuing profit.
@bud
We’re talking about people stealing from the government not about unethical private business practices.
Here’s a simple comparison: how much money do you think is stolen from Blue Cross by people setting up phony medical businesses to create fake bills? Blue Cross isn’t going to allow millions to be stolen because they are going to be careful about what money goes out. Medicare is a cash cow for thieves because there isn’t the profit incentive to monitor the spending.
Do you see the difference? The best solution is an ethical private company (which is the majority).
Doug— I doubt that Blue Cross is anywhere near as vigilant as you think it is. Health care in this country is so full of slush and cushion, that they don’t have to slice and dice like government does.
and since Blue Cross does administer the State Health Plan, it is in loco governmentis!
I have sat in amazement in doctors’ waiting rooms while babes in scrubs play at office administration/chit chat. I know if it were my dollar, things would be run a lot tighter–but in fact it IS my dollar, just at several removes.
Today’s The State op ed about the dox in the Upstate who don’t take insurance and have bare-bones posted rates because of it illustrates the fallacy of efficient private insurance!
@Kathryn
All you have to do is prove your theory about Blue Cross. You think they could cover up millions in fraud? How about billions?
It is estimated that Medicare fraud in Miami exceeds a billion dollars a year alone.
How about this, Doug? How about YOU prove your thesis that this is because it’s a public program. You believe that (unless I misunderstand you), but you can’t prove it.
Me, I think these PRIVATE individuals and businesses steal from us for the same reason Willie Sutton was said to have robbed banks: Because that was where the money was.
If something’s way bigger than BCBS, I would imagine it would be a more tempting target to thieves.
@Brad
What do you want me to prove? What specific data do you want?
Medicare fraud isn’t so large just because of its size – it is because of its lack of institutional control and oversight. It is the ultimate “drunk guy walking down a dark alley with $100 bills hanging out of his pockets”.
All I’m asking for you to provide is some examples of multi-million (not even billion) dollar scams that have successfully targeted private corporations.
They don’t call it fraud when it’s just not sharpening your pencil or keeping a close eye on your staff.
I have worked for corporations and for partnerships. Corporations tend to be a lot like The Office, inasmuch as the actual owners aren’t usually on-site. Partners tend to watch stuff far more closely, unless it’s something they like a lot, like cute but ineffective female staffers.
It’s like the SEC. Spending money to police the industries that are making the maximum allowable campaign contributions just doesn’t seem important to people appropriating the money that pay to do the policing.
And, yeah, lots – probably most -of the Medicare and Medicaid fraud comes from pure scams, but it also comes from the doctors and hopsitals down the street.
Did you keep up with the Tuomey Regional Medical Center federal case last year and the McLeod Regional Medical Center case several years before that? If nothing else, if you follow cases like that, you get a good idea of why health care costs are out of control – fees handed out aka kickbacks from hospitals to doctors, inflating prices on both ends. Right here in Sumter and Florence. Just think of all the places where a whistle hasn’t been blown yet.