Monday, July 21, 1997

Medicare’s staggering
errors and fraud

ADVOCATES of a universal health-care system ought to look at what's happening with Medicare. Federal investigators have found that the government overpaid hospitals, doctors and other health-care providers last year by $23 billion -- 14 percent of the money spent in the program.

It has long been suspected that Medicare bills are riddled with errors and the program is rife with fraud. But this is the first comprehensive audit of the program, the first major attempt to verify those suspicions and quantify the result.

What the investigators found was a mess. June Gibbs Brown, inspector general of the Department of Health and Human Services, said the books of the Medicare agency and its contractors were in such disarray that they could not be properly audited. Brown said there was no way to tell how much of the overpayment resulted from fraud.

The $23 billion figure is a very rough estimate. Brown told lawmakers that the improper payments could have gone as high as $28 billion or as low as $17 billion. Even the low figure, however, would be unacceptable.

Equally as serious was the finding that the government had no reliable way to prevent or detect improper payments. There is no reliable estimate of what the government might be owed on unpaid claims for services already provided, because the government and its contractors kept inadequate records.

If the government is going to adopt some sort of comprehensive health-care plan for the entire population, the problems incurred in Medicare could grow enormously. As it is, the waste is prodigious. Medicare is threatened with bankruptcy unless steps are taken to rein in costs. But eliminating overpayments, whether through errors or fraud, could go a long way to keeping the program solvent.

Hong Kong's triads

THERE has been concern that the turnover of Hong Kong to China will result in a loss of human rights, particularly freedom of speech. There is also reason for concern that Hong Kong's criminal societies, the triads, will be allowed to operate unrestrained.

It may be impossible to hold the triads in check. Hong Kong's new governor, Tung Chee-hwa, isn't likely to try if it means fighting the gangsters' friends in China. Tung owes his fortune to a bailout by Beijing when his family's shipping company was about to go under.

The result could be that the rule of law, vital to Hong Kong's success as a center of commerce, could be threatened. Even Hawaii could be affected -- by increased drug smuggling and money laundering by the triads.

Same-name marriage

PROPONENTS of same-gender marriage may take heart in a recent Supreme Court ruling -- in South Korea. Negating a law that had been on the books since the 1300s, that country's high court struck down a ban on marriage between people with the same last name. Why the big deal? Well, when about 20 percent of South Koreans or 10 million people share the surname Kim, an outdated law stood in the way of many happy couples achieving nuptial bliss.

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John M. Flanagan, Editor & Publisher

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