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Everyone in the country seems to have their panties in a wad
By Peary Perry (bio)

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Everyone in the country seems to have their panties in a wad over the current healthcare issue. It’s hard to go an hour of the day without someone speaking out for or against it. What you hear is pretty well determined by where you happen to be standing at any given time. Move ten feet in any direction and you are fairly certain to hear an opposing viewpoint.

Now, I follow the news about as close as anyone in this country. I believe it’s just part of getting older. I remember my grandfather sitting in front of a radio every night listening to the news of the day. He read the paper in the morning and listened to the same news each night. I do almost the same thing.

While I will not take up your time trying to change your mind about whatever position you happen to have that is contrary to mine, it should suffice to say that I think you are wrong. I’ll let it go at that.

What I do want to do is throw out some comments I feel are mostly common sense and which all of us need to think about as we go along in trying to solve this very complex and thorny problem.

The President came out the other day and told us that he intends to pay for the healthcare plan by eliminating fraud and waste in the Medicare and Medicaid system. This has got me puzzled. First off I think we have had these two programs for a number of years and hardly a week goes by that we don’t read about some doctor or medical company somewhere in the country being charged with crimes relating to medical fraud. So, I guess my problem is simply this…if the system has been in existence for over forty years and we haven’t cleaned up the fraud and waste by now, how can we expect it to improve in the coming years? Why hasn’t the government eliminated the fraud and waste long before now, instead of just now looking at it and determining that it’s a problem that could be solved and thus freeing up enough revenue to provide healthcare to millions of people in this country? Seems to me they should have done this years ago.

You may recall that I had a total knee replacement just over three months ago. I am covered by Medicare and have no complaints about the doctors or the hospital. What does yank my chain is the fact that after I got home, some person showed up at my door with a walker and a potty chair. I explained that I did not need either one, but they left them anyway. I used the walker for about a week, but never had need for the potty chair and called the company to tell them we wanted them picked up. They refused and said they were mine and there was nothing they could do about it. How many times does this occur over the face of this county each and every day?

When my mother died several years ago, I found that a company had been getting paid for a wheelchair and home health care visits for over a year after she went into the nursing home. She never had a wheelchair of her own and the home health care people certainly did not visit her in the nursing home. I wrote to Medicare and reported this. I received a form letter back, no phone number, no contact information, no file or case number on a piece of paper that had been copied so many times it was hard to read. Obviously they don’t seem to appreciate this type of information.

In my former life I owned an investigative company that worked on insurance fraud cases. I was at a conference one day and overheard two insurance executives discussing the so-called ‘cut-off’ point which as I recall was around $7500. I asked them if this was the upper limit for them to start a fraud investigation. They advised that this was the lower limit. Any claim below $7500 was accepted and nothing would cause them to be suspicious unless it was over this figure. I told them that they could lose a lot of money with people filing claims under $7500 and they told me they were aware of it, but that was their policy. Stupid policy in my opinion.

I suppose the bottom line for this week is that if the system is broke now and hasn’t been fixed in over forty years at either the government or insurance company levels, how is making the system bigger going to help us? Shouldn’t we take some time out, cure the problems we have already incurred and then see if we can afford to move forward?

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Posted by Peary Perry on September 23rd, 2009
Permanent link: Everyone in the country seems to have their panties in a wad
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