They had it right at first, Medicare, when it was initiated in 1965, was intended to help pay hospitalization costs. In this regard it has served well. As Medicare expanded, however, it became a federal program dictating health care and reimbursement. With continued insinuation into the health care process the Medicare rules and regulations have become more stringent, onerous, and confusing. Much like the managed care industry Medicare has taken the “fat” out of the health care system and is now strangling what is left with a continuum of unproductive actions. When health care decisions were removed from from patient control the greatest asset of the system was eliminated. The inequities of coverage, the high administrative costs and the poorly defined regulations beg abuse. Responding to Medicare coding and billing requirements is a time-consuming and demeaning experience for all health care professionals. Clearly the government has set up, and continues to expand, an unnecessary adversarial system. Today’s physician can not possibly be in compliance with all the extensive and demanding Medicare documentation requirements. Now there is a political push to extend the Medicare program to cover drugs.
Real Medicare fraud can not be condoned but it is hardly surprising that, given the circumstances, that it is increasing. Health care attorneys report that the most common causes of disciplinary action by the government involve the difficulties in interpreting anti-fraud regulations and inaccurate billing. It has been also observed that trying to keep up with the law can be an almost overwhelming task. With the single exception of violent crime the federal government now considers health care fraud to be the nation’s primary criminal problem. This attitude is reinforced by the Oval Office which is now calling for Congress to provide more funding to create teams of “fraud fighters” across the country to better combat increasing Medicare fraud, abuse and waste.
Won’t someone in government realize that they have “met the enemy and it is them?.” Why not have Medicare return to its origins and help patient’s to pay the costs of care that they have, as informed consumers, selected? If the health insurance is returned to informed consumers the United States government will have produced over 250 million unpaid watchdogs overnight. This will then release legions of “fraud fighters” to engage in more important tasks for society.