U.S. health care system encourages cheating

Politicians are now fighting about health care reform. Many of them are defending the status quo and propose that there should be no changes, even though a report by the World Health Organization in 2000 ranked the United States in 37th place in health care after countries like Belgium, Chile, and Morocco. Many Americans do not have health insurance because they cannot afford it. Many middle-income families choose to be without health insurance even when coverage is offered by their employers because of the cost. In 2005, approximately 47 million Americans, or 16 percent of the population, did not have health insurance.
The medical establishment and the pharmaceutical industry benefit from the current system and consistently pressure congress to avoid changes. People who work for employers that offer medical Flexible Spending Arrangements (FSA) also benefit by cheating the system.
A medical Flexible Spending Arrangement allows you to set aside part of your yearly salary for health expenses. The limit is usually from two to five thousand dollars. This money is not taxed, but if you don’t spend the money within the tax year that you allocated it, you lose it. People who have large medical expenses generally use all that they allocate. People with normal health expenses who use the money for prescriptions, medical deductibles, and over-the-counter drugs may risk to lose a lot of money unless they cheat. But cheating is easy. Toward the end of the year, when people know that they are not going to need the FSA money, they go to one or more drugstores to buy items that can be returned unopened. They buy crutches, blood pressure monitors, glucose meters, and any other items that qualify under the FSA plan. They then send copies of the receipts to the FSA administrator to get a check for their “medical expenses”. Once they have the FSA check, the original receipts and the unopened items are brought back to the stores to get complete refunds. In essence, these people receive tax-free income corresponding to the cost of the fake medical expenses.
Medicare Health Insurance is also subject to a lot of fraud. It is not unusual for people with impaired cognitive abilities or a poor knowledge of English to sign multiple blank forms for goods and services which a dishonest provider will use to obtain money from the government. Medicare patients may notice unusual charges made on their behalf, but they usually do not complain because they get what they need from the provider at no cost. Let us say that a patient needs some specialized walker or equipment for mobility, but Medicare will only cover a portion of the cost. The shrewd (and dishonest) provider will tell the Medicare patient to sign two forms to get the item free. One of the forms will be used by the provider to cover part of the cost. The other form will be filled out with some fictitious claim that will cover the rest of the cost, plus a nice bonus for the provider. It is a win-win situation. Right?
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The old adage that “necessity is the mother of invention” is so true. When we are frustrated, or our current approach to a problem does not produce satisfactory results, we often try something else, and in the process we may discover something new.
