Government and Health Care

The welfare queen myth

June 30, 2015
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David Graham recently wrote for The Atlantic in “The True Face of Medicare Fraud” (June 19, 2015) that the people most likely to bilk the system are doctors and medical providers, not “welfare queens.”

He pointed to a recent $712 million bust, the biggest in U.S. history, to show that medical professionals, not patients, are to blame for large-scale fraud.

The welfare queen myth needs to be re-examined. We are given a stereotypical view of Medicaid or Medicare recipients driving their new Cadillacs from provider to provider to reap some undeserved benefits. This, according to the stereotype, occurs most often is our large cities. However, there is a simple question that needs to be asked: “How many public dollars go into the patients’ pockets as opposed to how many dollars go into the providers’ pockets?” Or to put it more succinctly, “Who gets paid?”

Since payments go directly to the provider, not the patient, can a patient get rich from falsely claiming to have ailments in need of treatment? Or can providers get public monies by treating a person that others also claim to be treating? Similarly, how many treatments are really necessary?

Clearly, the recent enforcement actions by Medicaid and Medicare indicate that there are some providers who intentionally bilk the public system. Further, there are some who may unintentionally bilk the system by providing services to patients already being served by others.

Let’s put the welfare queen label into perspective. Perhaps the rightful target of derision should be those unscrupulous providers whose Cadillacs get partially paid for by public health care funds. Thankfully, they are in a minority in our communities.

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