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Politics : Formerly About Advanced Micro Devices -- Ignore unavailable to you. Want to Upgrade?

To: Alighieri who wrote (536602)	12/15/2009 9:38:51 AM
From: i-node	Respond to of 1577917

industry experts tell us that fraud is pervasive industry wide but not easily quantifiable Industry experts also tell us that private insurance fraud is a fraction of what MC/MA fraud is. But you don't need an industry expert to tell you that. You need only deal with the various organizations. What is really interesting, however, is that both Medicare and Medicaid have insanely difficult enrollment processes. Yet, private insurance generally requires ZERO enrollment. At all. You have a claim, you send it to them. That's all that's required. With MC or MA they won't accept a claim for months after your enrollment is submitted. You'd think if enrollment could solve the problem, they'd have it nailed. But still, private insurance loses a fraction (well less than 10%) to fraud of what MC/MA loses.

To: Alighieri who wrote (536602)	12/15/2009 12:24:01 PM
From: Tenchusatsu	Respond to of 1577917

Al, you are just too biased to address these issues. First, the estimates on private insurance fraud by any source I can find do not even come close to approaching your exaggerated expressions, and second, according to you, Medicare is run like a clock and there is little to no fraud...your bias oozes out of your posts...industry experts tell us that fraud is pervasive industry wide but not easily quantifiable but you trump that with you superiors knowledge and so it becomes a waste of time posting to you...and when you are cornered you quickly turn to invective and insults...that's the reaction of liar caught in his trade. Tenchusatsu

To: Alighieri who wrote (536602)	12/15/2009 1:09:37 PM
From: i-node	Respond to of 1577917

You are just too biased to address these issues. You're mistaking my knowledge of the subject matter for bias. First, the estimates on Medicare fraud by any source I can find do not even come close to approaching your exaggerated expressions, and second, according to you, private insurance is run like a clock and there is little to no fraud... You aren't looking in the right places. The foremost authority on the subject is Malcolm Sparrow, who is a Professor of Public Management at Harvard's JFK School of Government. Here were his remarks before the Senate in May, 2009: "The units of measure for losses due to health care fraud and abuse in this country are hundreds of billions of dollars per year. We just don't know the first digit. It might be as low as one hundred billion. More likely two or three. Possibly four or five. But whatever that first digit is, it has eleven zeroes after it." Now, Sparrow was talking about ALL health care fraud -- but we know what the NHCAA estimates are for private insurance -- 3%. It is, frankly, ALMOST ALL MC/MA -- GOVERNMENT programs. To put it in context it was estimated that NY state Medicaid fraud may have run as high as 42% in 2005. As I was saying. You don't have a clue what you're talking about and people with as little knowledge of the subject as you apparently have really ought to just not try and discuss the subject.