Eliminating fraud is an issue members of both parties could have found agreement on long ago.
While we can disagree about the size and scope of government-run health care programs, no one wants to see taxpayer dollars gratuitously wasted. Yet, that is exactly what has been happening in health care for years.
I’m confident fraud constitutes at least $100 billion or about 13 percent of annual Medicare and Medicaid spending. As a practicing physician, my experience tells me that figure could be much higher. Harvard's Dr. Malcolm Sparrow, author of “License to Steal,” estimates that annual losses from fraud could easily be in the 20 percent or 30 percent range, even as high as 35 percent.
Others dispute that claim but the debate about numbers itself reveals a major part of the problem: the government that administers these programs has no idea how many billions are lost due to fraud.
The first reform should be for government to measure losses to fraud and report them accurately. Second, Congress should look to the credit card industry as a model of fraud containment. In that $2 trillion industry, fraud is one-tenth of one percent while fraud in Medicare and Medicaid at least 100 times higher.
Finally, we have to acknowledge that fraud exists, in part, because doctors and others want to game a system that has been distorted by government intrusion. Less government will equal less fraud. Policymakers won’t agree on that point but we can, and should, agree to take serious common sense steps to limit this enormously expensive problem.
U.S. Senator Tom Coburn, M.D. (R-OK), a practicing physician, is the author of the Patients' Choice Act (S. 1099) along with U.S. Senator Richard Burr (R-NC) and U.S. Representatives Paul Ryan (R-WI) and Devin Nunes (R-CA).