Share on Google Plus Share on Twitter 1 Share on Facebook 2 Share on LinkedIn Share on PInterest Share on Fark! Share on Reddit Share on StumbleUpon Tell A Friend (3 Shares)  
Printer Friendly Page Save As Favorite View Favorites (# of views)   9 comments

Exclusive to OpEdNews:
OpEdNews Op Eds

Romney says corporations are people, so why aren't HMO hoodlums going to jail?

By   Follow Me on Twitter     Message Summer Harrison     Permalink
      (Page 1 of 2 pages)
Related Topic(s): ; ; ; ; ; ; ; ; ; ; (more...) ; ; ; ; , Add Tags  (less...) Add to My Group(s)

Must Read 3   Valuable 2   Well Said 1  
View Ratings | Rate It Headlined to H4 8/13/11

Author 39691
Become a Fan
  (2 fans)
- Advertisement -

The victims of Medicaid fraud can seldom speak up for themselves by Summer Harrison

If corporations are people, as Mitt Romney told a group today, then why aren't the companies caught defrauding Medicaid and Medicare in jail?

Romney's full statement, quoted in the Huffington Post, is:

"Corporations are people, my friend... of course they are. Everything corporations earn ultimately goes to the people. Where do you think it goes? Whose pockets? Whose pockets? People's pockets. Human beings my friend."
"Everything ultimately goes to the people."  That sure isn't the case
with the big HMOs caught defrauding the taxpayers of billions of
dollars intended to provide medical services to children.

I've asked before:  if you were an employer and caught an employee stealing from you, would you hire that person again?  And if you did and they did it again, would you hire them back a second time...a third time....?

Why is this any different from the Administration continuing to award federal subsidies to corporations already caught stealing from the government?

PR for the health insurance industry has done a great job fogging the mirror on Medicaid and Medicare.  They have framed the entire debate in terms of the skyrocketing cost of medical care, the undeserving nature of recipients, and how the public budgets for these programs should be cut.

The problem is reality conflicts rather substantially with this PR "spin."
- Advertisement -

First, let's get the idea that Medicaid is for the poor or unemployed out of the way.  Two-thirds of the national budget goes to keeping children and adults with disabilities, along with the elderly, out of institutions.  Our country actually has a wonderful set of laws and regulations designed to keep families together, by providing medically necessary services in the individual's home.  When the Medicaid budget starts getting cut, it's this two-thirds that is affected the most, and carries the highest human toll in misery and death.

Second, we need to remember that just because expenses are reported by insurance companies to federal authorities, doesn't mean those figures are accurate.  The whistleblower case against Wellcare unsealed last summer reported expenses inflated by up to 299%.  In Florida, investigators discovered Unitedhealth had billed the state for more than $2 million of speech therapy for children with disabilities that never took place. 

Ironically, the insurance companies use these same inflated costs to justify premium increases in their state Medicaid contracts.  In fact, the companies have to show they are losing money on the state contracts to get the rate increase.  But if they were losing money in all the states that have awarded increases, how are they continuing to report record profits?

In its first quarter 2011 filing with the SEC, Wellcare said that "Hawaii program rate increases ... we believe have improved the stability of the program."  With the company's operating profit jumping from 13.1% to 19.3% just in the past nine months, how much of the raise is being applied towards costs is in serious question.

Meanwhile, when PR flacks and industry reps talk about cutting provider rates, they forget to mention that doing so just increases the corporate HMO's profit margin.  The HMO is not a "provider" in this lingo; it has replaced the state accounting and quality control bureaucracies with its own employees.  The providers are the nursing agencies, pharmacies, hospitals, medical supply companies, day care centers for people with disabilities and other small businesses that provide direct services to the people needing them.
- Advertisement -

The biggest myth of all is that the issue that needs to be addressed is how to cut budgets.  In essence, we are being asked to make decisions about cutting budgets without knowing how those budgets are spent.  It might seem logical to equate Medicaid budgets with how much is spent on medical care, but that leaves out the twenty-to-fifty percent profit the HMO is scooping off the top of every payment they get from the government.  Right now that totals somewhere between $2 billion and $5 billion a month, depending on how much fraud is going on.

As quietly as the government has been auctioning off Medicaid and Medicare to for-profit HMOs, the White House has taken steps to let these corporations know that federal regulators won't be watching too closely how these funds are actually spent.

On April 26, the Administration backed an agreement between Wellcare, nine states and the federal government, settling all the Medicaid fraud cases against them for $137 million.  In return, the government agreed not to consider Wellcare a criminal and not to hold this non-criminal past against them in any future contract negotiations. 

Next Page  1  |  2


- Advertisement -

Must Read 3   Valuable 2   Well Said 1  
View Ratings | Rate It

Take action -- click here to contact your local newspaper or congress people:
Stop auctioning Medicaid and Medicare off to for-profit HMOs

Click here to see the most recent messages sent to congressional reps and local newspapers
I'm the mom of a 12 year old with multiple severe disabilities. Since April 2009 I've been blogging about the medical civil rights of children as well as adults with disabilities. As state budgets reacted to the larger economic picture, the (more...)

Share on Google Plus Submit to Twitter Add this Page to Facebook! Share on LinkedIn Pin It! Add this Page to Fark! Submit to Reddit Submit to Stumble Upon

Go To Commenting

The views expressed in this article are the sole responsibility of the author and do not necessarily reflect those of this website or its editors.

Follow Me on Twitter

Contact AuthorContact Author Contact EditorContact Editor Author PageView Authors' Articles
- Advertisement -

Most Popular Articles by this Author:     (View All Most Popular Articles by this Author)

Son-of-a-glitch: The bi-partisan selling of Medicaid

Supreme Court case could decimate the social contract to keep families together

Obama's $1 trillion subsidy to big business insurers

Romney says corporations are people, so why aren't HMO hoodlums going to jail?

Wall Street HMOs use government funds, fraud, to pad profits, outgrow S&P 500 by 25%