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Post 15 Apr 2013, 8:56 am

bbauska wrote:Thank you, as that was my next point. As for the government worker...

If that person knowingly assists another person to get disability, then the worker is guilty of conspiracy to commit fraud. It takes knowingly assisting, not just having a program.

Do you think it is fraud and conspiracy?


If you're asking me, it sure is if both the doctor and "patient" know the patient isn't incapable of working.
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Post 15 Apr 2013, 9:03 am

I wasn't, but thank you for your opinion. I pretty much had you figured out. My question is for RickyP.

If it is fraud and/or conspiracy, should it be prosecuted?

BTW, and earlier post about PET scans... I would support that as evidence of depression if it is paid for by the claimant.
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Post 15 Apr 2013, 9:12 am

Since the implementation of the ACA over the next few years may make cases of fraud in order to receive medicare nonexistent ...its largely moot.

But what would you do with all of the people who managed to get themselves on medicare through this method? And what would become of them?
Without access to medical insurance they become part of the line up at emergency wards....
Does that make sense?

It strikes me that you are all worried about whether or not the law is broken without regard to whether or not the law really works to the benefit of society
Its some law that forces doctors to break it in order to ensure that their patients can receive the medical care they require...

You all sound like the sort that would convict a man for stealing bread to feed his family.
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Post 15 Apr 2013, 9:14 am

Nice sidestep, and accusation. Answer the question.
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Post 15 Apr 2013, 9:22 am

bbauska, I haven't side stepped anything. I've called this "fraud" all along. By the letter of the law the doctors and the applicants may be committing fraud.
I've said the law is an ass if the reason they are committing the fraud is in order to get medicare.
And according to the original source, it is a major reason for fraud.
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Post 15 Apr 2013, 10:08 am

rickyp wrote:Since the implementation of the ACA over the next few years may make cases of fraud in order to receive medicare nonexistent ...its largely moot.


What?

Maybe there's a logical connection . . . would you please spell it out for those of us who, thankfully, do not live in your head?

How will the ACA stop fraud? I need another laugh.

It strikes me that you are all worried about whether or not the law is broken without regard to whether or not the law really works to the benefit of society

Its some law that forces doctors to break it in order to ensure that their patients can receive the medical care they require...


Um, no. Actually doctors aren't "forced" to do anything. And, if their patients need to be on disability, there's no problem. They put them on it.

On the other hand, if they lie and say someone is disabled when they're not . . . how could that ever be justifiable?

You all sound like the sort that would convict a man for stealing bread to feed his family.


And, you sound like the sort who would see a man with a furnished apartment and a stocked refrigerator, and feel he's justified in stealing a loaf of bread if the government won't give it to him.

You keep trying to justify fraud. That's just a bizarre position. There are people in the country without healthcare. However, if they can't afford healthcare, they get free healthcare. In MA, we have MassHealth. In CA, it was Medical.

The people without healthcare insurance are those who don't want it but could afford it, illegal aliens, or those who don't prioritize it. Under the ACA, those numbers won't change much. Since "pre-existing conditions" will be covered, there is little benefit in paying for insurance before you need it.
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Post 15 Apr 2013, 10:25 am

Ricky, have you provided any evidence that people are on disability for the medical benefits? The rapid growth of disability in the last 10 years prior to ACA kicking in, while we have had a relatively consistent healh care policy suggests that this is not the case. Your argument is based on a premise and I don't think you've proven your premise.
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Post 15 Apr 2013, 10:49 am

How is Obamacare supposed to stop this?
Obamacare is NOT universal health care, it simply requires everyone to obtain insurance and "helps make it affordable" by taxing the crap out of those of us who can afford it (making it more expensive in the long run). Poor people without jobs are still not able to afford it and will continue to not get it, yes they will be "breaking the law" by not having insurance but then they "break the law" by getting disability they do not qualify for. If anything, I think the requirement to have health insurance would cause even more people to claim disability!
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Post 15 Apr 2013, 1:38 pm

Tom, if that's how you read it, it is not what I meant. If I believed the current system was fine, I would mot have suggested improvements. I agree that fraud is not a problem.

I was saying that if (in the worst case of the estimate from one of DF's links), about a third of claimants of particular types are not genuine, then at least (and quite possibly more) are genuine.

However, if the rules change to target the frauds, (which I think is what you and DF want, although it's still unclear to me if you want to exclude 'subjective' conditions or the way to diagnose and verify them) it would be of concern if that also hit genuine claimants.

Which is why, DF, I do not provide evidence - I am talking about a potential issue, an unintended consequence perhaps, not claimimg that the current system excludes genuine disabled people.
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Post 15 Apr 2013, 2:51 pm

danivon wrote:Which is why, DF, I do not provide evidence - I am talking about a potential issue, an unintended consequence perhaps, not claimimg that the current system excludes genuine disabled people.


That's nice.

I wonder, since you operate in the world of finance, if you would find a potential 33% fraud rate acceptable in areas other than Disability. For example, if only 33% of identities were stolen, would that be okay? If only 33% of checking accounts were emptied by conniving hackers, would that be okay?

I find you to be very generous with other people's money.

Now, I'll stipulate that it may not be as high as 33%. But, what level of fraud is acceptable?
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Post 15 Apr 2013, 2:58 pm

Ricky, have you provided any evidence that people are on disability for the medical benefits?

Fates article infers this ....

quote]But disability has also become a de facto welfare program for people without a lot of education or job skills. But it wasn't supposed to serve this purpose; it's not a retraining program designed to get people back onto their feet. Once people go onto disability, they almost never go back to work. Fewer than 1 percent of those who were on the federal program for disabled workers at the beginning of 2011 have returned to the workforce since then, one economist told me.

People who leave the workforce and go on disability qualify for Medicare, the government health care program that also covers the elderly. They also get disability payments from the government of about $13,000 a year. This isn't great. But if your alternative is a minimum wage job that will pay you at most $15,000 a year, and probably does not include health insurance, disability may be a better option[/quote]

ray
The rapid growth of disability in the last 10 years prior to ACA kicking in, while we have had a relatively consistent healh care policy suggests that this is not the case
.

Please explain. Because the source Fate posted documents the increasing numbers of older manual labourers who are qualifying for disability... becsaue they are losing their jobs and they have few if any prospects. (Not the reference to Dr. Timberlake in the article)

Over and over again, I'd listen to someone's story of how back pain meant they could no longer work, or how a shoulder injury had put them out of a job. Then I would ask: What about a job where you don't have to lift things, or a job where you don't have to use your shoulder, or a job where you can sit down? They would look at me as if I were asking, "How come you didn't consider becoming an astronaut?"


The fact that the health care policy was the same is the reason why, when older people lose their jobs from whence they likely get health benefits ..... they need Medicare. Getting health benefits through employment is a crappy system that punishes unemployed people particularly.
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Post 15 Apr 2013, 3:14 pm

rickyp wrote:
Ricky, have you provided any evidence that people are on disability for the medical benefits?

Fates article infers this ....


You inferred it; you claim the article implies it. However, the article cannot infer it. Impossible.

They also get disability payments from the government of about $13,000 a year.


I've already shown that is a bogus stat, why are you repeating it?

This isn't great. But if your alternative is a minimum wage job that will pay you at most $15,000 a year, and probably does not include health insurance, disability may be a better option


You really don't read and interact with what others say.

One is either disabled or not. Being disabled is not an "option."

ray
The rapid growth of disability in the last 10 years prior to ACA kicking in, while we have had a relatively consistent healh care policy suggests that this is not the case
.

Please explain. Because the source Fate posted documents the increasing numbers of older manual labourers who are qualifying for disability... becsaue they are losing their jobs and they have few if any prospects. (Not the reference to Dr. Timberlake in the article)


No, we have documented the opposite. That Dr. is anecdotal--not a trend.

The fact that the health care policy was the same is the reason why, when older people lose their jobs from whence they likely get health benefits ..... they need Medicare. Getting health benefits through employment is a crappy system that punishes unemployed people particularly.


If they don't make money, the qualify for Medicare.

Why don't you address any substantive argument, and keep dragging this ALL back to nationalized medicine?

If we were arguing about the DH, you'd make it about the glories of socialized medicine.

You probably think the Korean crisis could be solved if only Un had better access to affordable healthcare.

Oh, and repeating the same tired arguments, failing to note any of the other facts that have been posted that refute your arguments, and bolding them didn't bolster them.
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Post 15 Apr 2013, 3:18 pm

fate
However, if they can't afford healthcare, they get free healthcare


Thee is no such thing as free health care. Tax payers are paying for it. Following is the convoluted bureaucratic way that hospitals are compensated for "charity".
Its bizarre. It means that the poor people without health insurance, hold off going for treatment....then when they do land in the emergency ward the most expensive place to treat a patient.
The people that doctors like Timberlake are putting on disability are at least, when they get Medicare, getting their health care in a more cost effective manner.

The costs of treating the uninsured must often be absorbed by providers as charity care, passed on to the insured via cost shifting and higher health insurance premiums, or paid by taxpayers through higher taxes.[75] However, hospitals and other providers are reimbursed for the cost of providing uncompensated care via a federal matching fund program. Each state enacts legislation governing the reimbursement of funds to providers. In Missouri, for example, providers assessments totaling $800 million are matched — $2 for each assessed $1 — to create a pool of approximately $2 billion. By federal law these funds are transferred to the Missouri Hospital Association for disbursement to hospitals for the costs incurred providing uncompensated care including Disproportionate Share Payments (to hospitals with high quantities of uninsured patients), Medicaid shortfalls, Medicaid managed care payments to insurance companies and other costs incurred by hospitals.[76] In New Hampshire, by statute, reimbursable uncompensated care costs shall include: charity care costs, any portion of Medicaid patient care costs that are unreimbursed by Medicaid payments, and any portion of bad debt costs that the commissioner determines would meet the criteria under 42 U.S.C. section 1396r-4(g) governing hospital-specific limits on disproportionate share hospital payments under Title XIX of the Social Security Act.[77
]

http://en.wikipedia.org/wiki/Health_car ... ted_States

Fate, you don';t seem to have a problem with this waste....or maybe you are fooling yourself when you say "they get free healthcare".
The point I've been trying to make to you is that if Timberlake puts someone on Disability, they cost less in the health care system then if the get their "free healthcare" through emergency wards...
If the health care was indeed Universal, as the ACA is but an incremental move towards, he wouldn't have to put them on disability.... And perhaps, because they wouldn't be risking their health insurance, they'd work at something...
Taking Medicare ourt of the equation would make Disability far less attractive and therefore far fewer people would apply.
Keep Medicare in the equation and the concern from a Dr. like Timberlake for his patients medical insecurity .... drives the disability diangnoses...
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Post 15 Apr 2013, 3:45 pm

rickyp wrote:fate
However, if they can't afford healthcare, they get free healthcare


Thee is no such thing as free health care. Tax payers are paying for it.


Thanks for proving one thing: you are an utterly unserious person.

Let's see . . . "If they can't afford it . . . " that implies there is cost involved.

"Get" that means they receive something from someone else. I'm well aware that the government is not some disembodied, 3rd person entity. The government is "us."

I'm the one who understands there's no such thing as a free lunch. Nevertheless, it's "free" to the recipient!

You are really displaying something--and it's not gray matter.

Fate, you don';t seem to have a problem with this waste....or maybe you are fooling yourself when you say "they get free healthcare".


Let's see . . . is there another alternative?

Ah, why yes--you're being a simpleton. Problem solved.

The point I've been trying to make to you is that if Timberlake puts someone on Disability, they cost less in the health care system then if the get their "free healthcare" through emergency wards...


Not so. Because they're also leaching Disability payments that they are not technically qualified for.
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Post 15 Apr 2013, 11:50 pm

DF no, a 33% fraud rate is not acceptable. What is? In principle no fraud is acceptable, but in reality you cannot guarantee to eliminate it, just do what you can to limit it and detect it. When it is below 1% it often becomes more costly to chase than to write off. And they do build fraud losses into business plans.

Still, I'm not convinced the fraud rate in disability is 33%. Just that you do have some evidence it could be up to that amount in certain categories.