Every time we hear that medical insurance premiums are taking another hike, we either silently fume or share our negative comments with others. First of all, we can’t resist remarking that under Obamacare, we were all supposed to benefit. In reality, the only ones making out better are those who pay very low, or no, health insurance because of their income. The rest of us have been hit hard.

Those of us over 65 and on Medicare quickly learn that it offers only very basic coverage, so monthly insurance premiums are a must. To be fair, it’s not entirely the government’s fault that the money doesn’t stretch as far as they’d like. One of the main reasons is because the system is fraught with massive cheating to the tune of some $60 BILLION a year. The June AARP bulletin carries an investigative report by Joe Eaton which sheds light on a fine example of Medicare fraud, focusing on a Dallas crook who established an in-name-only medical group which filed false claims over a five-year period netting him $375 million. Unfortunately, he’s got a lot of company all across the country, with fictitious medical centers and physicians collecting millions for procedures that never happened. Far too many of them get away with it, going for years, sometimes indefinitely, without being caught. Even legitimate providers are sometimes guilty of “padding’’ their bills to Medicare.

The government is trying to track waste, abuse and fraud in the Medicare system, but it’s a monumental task with 4.5 million claims a day and a payout of $1 billion a day. Is it any wonder, then, that so many fraudulent claims slip through the cracks?  We’re pessimistic about their chances of locating providers that don’t really exist except on paper in such a massive system, but feel that investigation on a state by state level, even the county level, would reveal more incidences of fraud. For instance, Medicare fraud specialists would be much more likely to see red flags in the billing system if they were dealing with a much smaller area. You’re more likely to find that XYZ medical center in some small town doesn’t even exist if you have local folks to ask. The same goes for phony “doctors.’’  

Health care expert Malcolm Sparrow is credited with saying that fraud may account for up to 30 percent of Medicare payouts. Just think what that kind of saving could mean to the entire Medicare program. We hope illegal medical centers, doctors and fictitious charges are destined for exposure in the months to come so this valuable service to retirees can be on strong financial footing in the years to come.