And we wonder why Americans look bad overseas.
BBC is running this article about an American guy who allegedly shot his lawnmower when he couldn't get it to run, noting that he appeared to be inebriated at the time.
I see a lot of folks doing the equivalent of shooting at lawnmowers lately. And it seems to result from an inability or unwillingness to think outside the box to fix problems.
We might all agree, for example, that the grass needs to be cut. One broken lawnmower shouldn't prevent that. Nor does shooting at the lawnmower do any good.
If only we could think outside the box. Get the mower fixed. Hire a kid to cut the lawn in the meantime. Borrow a neighbor's lawnmower. So many possibilities.
Shooting the lawnmower is just downright dumb, isn't it?
Yet we do this with social issues. We talk about eliminating social programs when a few things go wrong. We make cuts in Medicare that hurt those who are most vulnerable when we discover that there are people leeching off of the system.
And, sadly, as a society we see one broken lawnmower as the culprit when the real problem is that we failed to plan, failed to think outside the box and failed to act before the situation was out of hand. Of course, it's not as obvious as some guy standing in his yard shooting at his lawnmower. Instead we legislate, moderate, procrastinate - and debate. We pass amendments and pass judgment.
But in the end, if we don't look at the whole picture, if we're not willing to accept that it's going to take resourcefulness and time to fix longstanding problems, all of these things don't matter.
The grass still won't get cut.
"Congress estimates that Medicare loses $70 billion per year to fraud. CMS says $700 million in DME payments are improper, due to billing errors or fraud. So less than one percent of Medicare fraud can be attributed to DME. While our industry has zero tolerance for fraud, the $70 billion number begs the question: Where is the more than $69 billion in non-DME fraud occurring? You have to wonder whether the focus on DME is designed to shift attention away from the failure of CMS to use its existing authority and tools at its disposal to ferret out and stop fraud against Medicare."
Tyler Wilson, CEO of AA Homecare
4 comments:
That makes me sick.
Oh, and glad you're feeling better, Ruth.
I ragged-on an attorney in my post today. You are welcome to come over and defend him. I'm sure that all attorneys are not like him - just like - only a (small) portion of the population regularly imbibes enough to make poor decisions on malfunctioning home equipment.
Darned if I can think of a way (outside the government box) to legislate preventing more of some of the people from shooting their lawnmowers. I hafta say the analogy doesn't work for me, Friend. Guess it's best I am not in a position to do the thinking (outside the box).
And big numbers ($7billion) in fraud - well I'm suspicious of how calculated and the agenda of who reports.
Best I can do is, when I know my services will be billed to Medicare or Medicaid, is to bill them honestly. Best I can do for now.
Did you know HHS Secretary Leavitt has a blog? Like him or not (like the person who appointed him) the system is set up to give him the power to run the social services lawnmower. Perhaps he can be persuaded to respond to Mr. Wilson's report of the facts - ?
Barbara-
What I mean by shooting the lawnmower is doing things like offering cheap cheap wheelchairs to people instead of dealing with the fraud. Cutting costs by ruining what Medicare was set up to offer.
I find it rather tragic that people depending on the program face changes that will hurt services/equipment rather than Medicare looking at the widespread fraud. It's like having debates while people are going to be sitting in wheelchairs that don't fit or meet their needs and ignoring the real issues.
United Spinals position on this (if you click on Medicare I have posts on that) is in alignment with most of my views on this subject.
Your explanation helps a lot, Ruth. I agree with you that the trend in regulation on DME is bad for PWD needing specialized equipment. I suspect that people who benefit from continuing the status quo of furthering the trend (more regulation vs real solution) use fraud to meet their own agendas.
At a recent meeting with the administrators of the home health agency I contract with....explanation for more documentation requirements based on more auditing - done by attorneys contracted to recoup so-called fraud money. The explanation (the person the administator quoted) made it look like the government was making a 'good investment' by paying someone to investigate fraud in the Medicaid system.
Prescription and payment for specialized DME, specifically wheelchairs for children is in the same negative trend. I'm familiar with a lot of what goes on behind the scene - not visible to parents and patients.
Where should my outside-the-box ideas go - where can they be effectively tried? Complex, no simple solutions. I know, I'm not very encouraging. I'm a better problem-solver in a specific situation, with specific persons and known facts.
Please continue to voice the problems of DME acquisition in the public-funded programs. Barbara
Great post, wonderful analogy. Thank you for helping to put context around the Medicare fraud issue.
Michael Reinemer
American Association for Homecare (AAHomecare) michaelr@aahomecare.org.
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