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Affordable Care Act Exchanges Fail To Detect Counterfeit Documentation (atr.org)
Tulsa_Time writes with this excerpt of an account from the (unapologetically partisan) Americans for Tax Reform about a report released by the Government Accountability Office in which "application and enrollment controls on the federal exchange and two state exchanges (California and Kentucky)" were investigated by supplying false information; in each case, the investigators were able to obtain and activate health insurance through the exchanges. A slice:
Ten fictitious applicants were created to test whether verification steps including validating an applicant's Social Security number, verifying citizenship, and verifying household income were completed properly. In order to test these controls, GAO's test applications provided fraudulent documentation: "For each of the 10 undercover applications where we obtained qualified health-plan coverage, the respective marketplace directed that our applicants submit supplementary documentation we provided counterfeit follow-up documentation, such as fictitious Social Security cards with impossible Social Security numbers, for all 10 undercover applications."
I'm sure submitting false information on those forms is illegal. So, make sure all the people responsible go to jail.
The pro-ACA people don't care about screening out fake applicants. They think any person getting another government handout is a good thing, regardless of circumstance.
The anti-Obamacare people don't care about fixing the screening process either. They want to get rid of the government exchanges altogether.
No one wants the process fixed. So it won't be.
This is the typical charge for obtaining gov't assistance under many different false pretenses, but typically under-reporting income.
I, for one, would prefer to keep the trust but verify nature of the programs... the aim is not to catch fraudsters straight away, but to help folks when they need it. Sure, some will game the system, but likely not for an extended period before getting caught with the hand in the cookie jar.
Happiness in intelligent people is the rarest thing I know.
Ernest Hemingway
You want to arrest the GAO for fraud, for doing their actual job?
That's who wrote the report. Americans for Tax Reform just reported on it.
If they are running the checks it means they are using them as a "manual override" against their internal data(which may be flawed). These checks exist to redistribute wealth via price discrimination according to a "means" test. If a person can claim to make less money than they actually do: the idea of selling a commodity below market price falls apart and attempts at rationing quickly become unsuccessful.
If the auditors scammed them successfully, that is "smoke" to the fire of a process breakdown. Gasp! It isn't 100% effective. It's true.
Actually, I have suggested this exact plan. The US should tax Norway to buy stuff for US benefit recipients. Norway is rich. Why shouldn't we tax them?
Oh god, no! Those poors were able to buy healthcare!
Or, they were able to get free services that other people get to pay for.
Don't disappoint your bird dog. Go to the range.
Most of the insurance increase has been from people signing up for medicare.
I'm ok with that, but that doesn't mean it hasn't caused problems for other people.
"First they came for the slanderers and i said nothing."
While true, you ignore the fact that they started skyrocketing long before Obamacare was passed.
OTOH, if you mean that the insurance companies should be cut out of the healthcare system, I agree completely. I'm in favor of free coverage for everyone without all the god-damn middlemen that have tripled the price. (And I mean that as in "God damned the sheep and they died.". Those insurance parasites should just drop dead...or at least be rapidly put on unemployment.)
I think we've pushed this "anyone can grow up to be president" thing too far.
I, for one, would prefer to keep the trust but verify nature of the programs
I would if there was any "verify". There was not.
People claim the U.S. should emulate Europe, but it seems they go mysteriously silent when it comes to emulating the controls that Europe has to make healthier care voting work to prevent fraud. If a system has endemic fraud it will eventually fail.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
Just like the services YOU get from the government that other people help pay for. The biggest leeches and thieves in this country are those who want all the rights and benefits of being here, yet none of the responsibilities.
Fascism: An authoritarian and nationalistic right-wing system of government and social organization. See also: NAZI's
Single payer. Book it done.
Hi! I make Firefox Plug-ins. Check 'em out @ https://addons.mozilla.org/en-US/firefox/addon/youtube-mp3-podcaster/
Because they aren't in the US, Goldman Sachs is, and they pay less US taxes, take more currency out of circulation, and receive far greater benefits than Norway does from the US government. Let's tax the people who have all the money stashed away for their casino gambling financial industries. They should pay at least much as the rest of us. Or what, their "entitlements" (handouts in these cases) are okay? The ACA is a windfall for the industry far greater than the medical packages offered, yet as always, the 'uppity' poor are to blame. It would be far cheaper and simpler to just give everybody a damn card and make the bureaucrats do the paperwork.
“He’s not deformed, he’s just drunk!”
The pro-ACA people don't care about screening out fake applicants. They think any person getting another government handout is a good thing, regardless of circumstance.
It's interesting that you describe health care as a "handout", and bolster the metaphor with "regardless of circumstances".
There are perhaps three dozen examples of government-funded health care in the world that we can look to as examples. The US health care ranks worse than all of the top 10 countries.
Framing it as "it's a government handout" implies the subtext "(that you do not deserve)", and is a bit of a misnomer. Our system is horribly broken, we pay 6x as much as other countries and for that price get substandard care.
In short, many *many* people suffer needlessly because our health care system isn't a government handout.
So... I don't see a problem here. We do in fact deserve better health care. We're the US, we *were* the best.
Would you care to explain why a government handout is bad, in this specific instance?
(And before someone asks "well, how do you propose we fix it?", let me just say that we could find a system we like and copy it wholesale. For example, the Canadian system is better than the US system overall, and we could simply copy their procedures and implement them. If we did that, 80% of the money we now spend on health care would be available to stimulate the economy.)
Quality/accuracy auditing takes money. There's usually a brake-even point where the savings from catching problems is less than the cost of auditing as more auditors are added. We'd need more info to know where the break-even point is.
I suspect it may not be a real problem as long as they check credentials when an expensive procedure or treatment is done, such as surgery or an expensive medication.
Before such, as long as the "fakes" pay their insurance fees, they are not a (significant) cost drain to the system.
In short, fraud happening on the enrollment end may not be a practical problem.
Table-ized A.I.
How about if in the course of applying, the fake person also describes a lifestyle that qualifies them for completely subsidized care that other people get to go to work every day to buy for them? This is no different than any other of benefit fraud
Well, it is different, an insurance is just paper (contract), when you obtain the contract to benefit a person that doesn't exist, you've acted in bad faith and obtained a contract that is invalid by nature.
:)
So your chances of successfully upholding the contract is slim. That said, yesm the fake people could probably get some care, before the private insurance company starts looking at the details... This is another problem with private insurance, if there is a problem with contract the insurance company will declare it invalid (but they won't do so before you file a claim, ie. only when do it when you the insurance).
But yes, this is great
Note. insurance contracts in the US are in my experience, super sketchy have through my employer and had to fight very hard to get any kind of actual paper... and I'm still not satisfied that I have sufficiently strong contract to sue my insurance provider should it come to that, and certainly not if my employer decided not to look out for my interest (which I don't have contract saying they will). So legally speaking I'm is a poor standing (despite working for tech company, and having an good PPO plan).
Pretty sure Reps had nothing to do with the ACA, but go ahead and spin anyway..... like a top.
Everything above is my opinion....YMMV
Yes, shame on the ones that dared to provide help for fellow human beings.
While we speak about lost money, how much did we pour into banks?
Because they aren't in the US.
We should tax Norway specifically because they aren't in the US. If we tax Norway, the US gets all the benefit and no one in the US pays anything for it. It's all benefit and no cost.
While true, you ignore the fact that they started skyrocketing long before Obamacare was passed.
Healthcare costs have been rising world-wide. Obamacare marked a decrease in the rise for the USA.
And I agree with you on the middlemen. They're adding approximately 30% to the cost of our healthcare by themselves. Minimum.
I don't read AC A human right
Of course. If you have contradictory first hand experience, then it's a lie. I personally know low paid working stiffs who were not helped by Obamacare.
Plans are still expensive.
Even worthless plans are expensive.
Deductibles are still high.
Plans without high deductibles are astronomical.
Costs continue to rise for everyone getting to the point where you need to be "wealthy" to afford a plan at all anymore.
A Pirate and a Puritan look the same on a balance sheet.
No. Obamacare DOUBLED the rate of increase for plans. My state had respectable individual plans that could not be canceled. Except Obamacare caused them to be canceled. Now the decent replacement plans look like they're going to be canceled and nothing will be left but total crap.
A Pirate and a Puritan look the same on a balance sheet.
Yes the "trust but verify nature of the programs" should have been done.
It could have all been fixed with a 100 point check like system https://en.wikipedia.org/wiki/...
Bring in any mix of a birth certificate, passport like paperwork to show citizenship, refugee docs, licence or permit, local government docs, utility bill, rent agreement.
If a person has problems finding or updating the paperwork, help them get some of the above sorted out. The REAL ID Act https://en.wikipedia.org/wiki/... will be the next big change for many.
Domestic spying is now "Benign Information Gathering"
Why would anyone here want to go into too much detail? If you make it easy to identify yourself then you're just putting a target on your back for every kook and troll on the planet.
The average slashbot should be smarter than that.
A Pirate and a Puritan look the same on a balance sheet.
"Those poors" are not debt ridden suburbanite conspicuous consumers. They know the value of money and don't squander it. They PAY CASH for services rendered and they don't even suffer for it.
Some of "those poors" are more solvent than you are.
A Pirate and a Puritan look the same on a balance sheet.
"undocumented freeloaders" just pay cash.
They actually work, so they have it to spend.
You are confusing "undocumented freeloaders" for our urban poor that are too proud to take certain kinds of jobs.
A Pirate and a Puritan look the same on a balance sheet.
Since when has extremist paranoid weird ass conspiracy shit like this graced the front page of Slashdot? What the hell? Anybody check anything about this out before deciding to Slashdot it?
Or just really? We've gotta have this here? Come on.
Obamacare was already law prior to Mitt running for President...
Browsing at +1 - no ACs, I ignore their posts. So refreshing!
The one prior to Obama's first election. Seriously. The ACA is a Heritage Foundation healthcare reform plan, which was *trumpeted* by Republicans as being the perfect way to fix our broken healthcare system right up until the moment that Obama endorsed it, and actually started pushing to get the thing turned into a law. The moment that happened, Republicans turned against the plan, and, despite being responsible for more than 100 of the successful amendments to the original bill, voted against it in a futile attempt to *not* let Obama do something they'd been claiming they wanted (but not actually attempting) since Reagan was campaigning for office.
'Romneycare', as it was called in Massachusetts, was a state-level implementation of the same plan and is widely considered a very *good* system, which made it all the more ironic (and idiotic) when he argued against implementing that plan nationwide by claiming that it was harmful.
I'm in favor of free coverage for everyone without all the god-damn middlemen that have tripled the price.
So free coverage - who pays the doctors, the nurses, the janitors, keeps the lights on and equipment serviced, etc.?
Browsing at +1 - no ACs, I ignore their posts. So refreshing!
Just like the services YOU get from the government that other people help pay for.
Which ones are those? I pay far more federal, state, and local taxes than most people, and then sales taxes on the things I buy. Have the country pays NO income taxes. I'm in the half that does. Do the math. Things like NASA, defense, etc., are paid for out of discretionary funds, entirely paid for by income taxes or by borrowed money on which taxes have to pay interest. How are the people who pay no income taxes helping me to pay for those things, again? Please be specific.
Don't disappoint your bird dog. Go to the range.
Do you know how many ex-goldman Sachs employees have worked for the Obama administration? Have you ever looked?
You don't need to do hardly any up front auditing and you collect premiums. Make a single claim or claims over a trivial amount and then you do get audited - likely after someone has made payments under these fake accounts. The insurance company then just keeps all the money and cancels the contract.
Hell they do this now to honest people - they are experts at setting up a one sided contract and simply not paying for the i meat of reasons when the payout time comes.
Medicaid. If you're too poor, you're not even allowed to use the exchange.
Replacing insurance companies with the federal government does not cut out the middleman, you idiot.
? What planet do you live on? Inflation is 1.5% not 40%..
A lot of those 'respectable' individual plans weren't actually respectable if you got sick. I remember reading about a plan Walmart was offering. $5k deductible, $5k maximum payout, $100/month.
I don't read AC A human right
They are not "ex". The position is waiting for their return, just like Holder. This is normal. I always recommend voting out the crooks, but all I get are excuses and blame passing. It's not the politician's fault for winning.
“He’s not deformed, he’s just drunk!”
I'm not that far up on the statistics, though I know they're demographic adjusted. It doesn't help that the cost disparity holds up even or especially when you look at it on a procedure basis - Procedure A in the USA will cost 3-10x as much as procedure A elsewhere. An MRI, for example, is something like 1/30th of the price in Japan.
You're still paying even if you're borrowing to pay.
I don't read AC A human right
You're the idiot. You buried the point right in your post even. "Middleman" isn't "Middlemen". Yes, you're still going to have middle management, you're just going to have a lot less of it. IE the equivalent of one dude instead of a dozen.
I've read accounts of foreign medical providers. They just don't have the billing nonsense that we worry about all the time. They don't have to fight with a dozen insurance companies, just the one, generally speaking.
I don't read AC A human right
Here we go again with the country comparisons. With countries only a fraction of the population of the United States. For instance, Canada (per google, 2013): 35.16m. US (per google, 2013): 316.5m. It's a problem of scale. I'm not saying it can't be done, just saying that "they did it for their tiny amount of people" is not good enough.
I worked for seven years in the medical insurance business (so glad to have left the field!) and the ignorance seen in many high-rated posts here is astounding.
1. GAO report, so no fraud
2. Even if someone wanted to fraudulently create an applicant, I don't see the problem, as long as they don't submit a claim. What's wrong w/ additional premium? (I will ignore the geeky underwriters, as I understand their position, but haven't seen any relevant objections so far about messing up the statistics.)
3. You cannot begin to appreciate the stupidity of pretty much everyone in the insurance business - so the inability to do very basic SSN validity checking comes as no surprise at all.
I left the year ACA came into effect, so got to experience the fun as we tried to implement insurance plans that Congress had not defined. See, ACA went into effect 2014, but we (that is, insurance companies) didn't have black letter law or even Federally-defined policies established (on many different fronts) until way past Jan 2014. How can you determine policies if underwriters don't know what the rules are???
Biut what continues to be under-reported is what a complete disaster/fail the back-office procedures are. Are we finally able to determine if someone is eligible? When I left, there was no way to tell if an applicant was qualfied for subsidies under the various arcane income rules.
If I were dictator, I'd immediately force hospitals and pharmaceutical companies to fall under the anti trust laws that everyone else has to follow. The high-deductible plans were created under the assumption that consumers would be motivited to shop around for the cheapest deal. But, it is impossible to get an actual quote for a procedure. If you require hospitals to produce a rate sheet that applies to all, and permitted people to import drugs from anywhere in the world, a massive amount of money could be saved.
But this cuts into rx profits, and we can't have that.
Unless you are wealthy the plans are subsidized so it is affordable. Saying it isn't is a Republican lie.
Bullsh*t, Bullsh*t, Bullsh*t, Bullsh*t, Bullsh*t, Bullsh*t, Bullsh*t, Bullsh*t!!!!!!!! A thousand times Bullsh*t. I lost my job, had ZERO INCOME. I still had to pay FULL PRICE for my coverage. Redid my application, NO CHANGE. NOT EVEN TAX CREDIT. I'm sure SOME people are getting subsidized, but it isn't people like me who have paid into the system for 30 years.
If you are not allowed to question your government then the government has answered your question.
My health insurance rates have nearly doubled since the implementation of Obama care.
I guess it's "affordable" when you're on the government dole and US taxpayer is footing the bill.
KEEP OBAMA IN PRESIDENT!!!
Mine quadrupled and I got less coverage.
If you are not allowed to question your government then the government has answered your question.
When my wife attempted to sign up for coverage they repeatedly asked for the same documentation and when they received it, they said that they couldn't find her in the system, so it does weed out legitimate people, just apparently not people with fake documentation.
If you are not allowed to question your government then the government has answered your question.
But all of those people presumably contribute. The GDP of the US is 17 trillion. The GDP of Canada is 1.8 trillion. The ratio is about the same. Seems like a valid comparison to me.
Put another way, the population of Europe is larger than the United States. All the countries within it have some variant of government subsidized/mandated/provided health care. That seems to work fine.
But not when he was governor of Massachusetts. The ACA is basically a clone of the system enacted there that was a major accomplishment of the Romney administration. That, in turn, was a copy of an idea from the Heritage Foundation in the early 1990s meant as the conservative alternative to the (failed) Clinton plan.
Income taxes aren't the only taxes, you know.
But at the Federal level, that's what pays for the non-entitlement spending. I don't receive any entitlements, and probably never will. So I'm still not sure who it is that I'm supposed to be thanking for helping me, here, as the GP says they are.
Don't disappoint your bird dog. Go to the range.
I hear that a lot but can never find where any vote in congress happened where republicans actually voted for it.
The reality is a lot different than the picture you attempt to paint. Outside of some republicans in very liberal states, very few supported it and the support it seems to have recieved was the lesser of two evils type. There are plenty of conservative states which republicans controlled all branches of government which refused to adopt similar laws or the law you claim they championed. It has never been brought to the floor of the house or Senate any recieved any significant amount of republican votes. During the primary, Romney got slammed hard for Romney care by republicans and democrats both. In fact, even the democrats had severe issues with the PPACA and it only passed by legislative maneuvering and bribes to democratic senators when the democrats controlled both houses of congress and the administration.
You really should look into what you are repeating before blindly repeating it. Perhaps doing a little sanity check on your reality would be wise to. It certainly doesn't match the pictures you painted which is likely why you find yourself "informing" people so often. The reason they didn't know is because it is made up or presented fictitiousaly.
Every government agency has to do something now and then to justify its existence. The Government Accounting Office ( www.gao.gov/ ) did a useful thing here. They have often done worthwhile work in scrutinizing other government agencies for waste, negligence, corruption and incompetence. Without having an agency to scrutinize the GAO it's difficult to know if we are getting bang for the buck.
But I think some people here are thinking of government agencies in general, like the ones reported on here and the regulators that supervise everything. Yes, lots of them stink--and here's the reason:
Most regulators including the tax authority, the banking regulators, insurance regulators, food inspection authorities, energy regulators etc ... most regulators are corrupt and actually serve and protect the industry that they 'regulate' in return for certain benefits. When they do need to justify their existence, their wrath is pointed at some little guy, some outsider, someone who can't afford a team of powerful attorneys. This is so common around the globe that it is assumed by many people. How many bankers suffered jail or any personal inconvenience because of the corruption that devastated the world for nearly a decade?
So yes, most regulators produce nothing but theater while big crimes go unnoticed. Big farming corporations get government handouts originally intended for small family farms. Big oil companies get billions in tax benefits and more. Proposed bank reforms fade quietly along with the public memory. Meanwhile pot smokers, welfare cheats and homeless people are persecuted and prosecuted while the fat cats get fatter ... But the GAO really has done some good work.
...omphaloskepsis often...
Here's a clue: "Government" doesn't pay anyone. Government takes money from some and gives it to others. Government doesn't pay - taxpayers pay. How is this different than having taxpayers directly pay for insurance and medical costs in the first place - other than the Government skimming a healthy chunk off the top for its jobs program?
Browsing at +1 - no ACs, I ignore their posts. So refreshing!
Maybe what works for a city or State doesn't necessarily work for the nation? Like a national minimum wage - what is a "living wage" that is fair and equitable across the entire country?
Browsing at +1 - no ACs, I ignore their posts. So refreshing!
do you REALLY want me to present you with a list of amendments supplied by Republicans, that became part of the law, starting with the requirement that al members of Congress and their staff give up their federal health insurance plans and use the exchanges?
The guy who said the election was rigged won the presidency with the second-most votes.
do you REALLY want me to present you with a list of amendments supplied by Republicans, that became part of the law, starting with the requirement that al members of Congress and their staff give up their federal health insurance plans and use the exchanges?
or will you simply concede that you're full of crap and don't know what the fuck you're talking about?
The guy who said the election was rigged won the presidency with the second-most votes.
What matters is that another poster is scolding those of us who pay the lion's share of the country's taxes for not being thankful for the help we're getting from other people ... when that "help" doesn't actually exist. It's worth talking about, because people who make those kinds of remarks are clearly not understanding who actually pays for what.
Don't disappoint your bird dog. Go to the range.
The Federal Government is a middleman, as there is only one. Federal employees are middlemen. You're still an idiot.
I'm downgrading you to 'moron', because you can abstract them as organizations. The federal government is a middleman. Insurance companies X,Y,Z, each with their own sets of middlemen employees, are still 'middlemen'. You have to go deeper to get to 'middlemen' with the feds as a 'single payer'.
When they've done studies, single payer systems over in Europe tend to have drastically lower paperwork costs associated with billing.
BTW, I tend to mirror insults. Don't call me names, I don't call you names.
I don't read AC A human right
Of course they do. They also have lower patient satisfaction and quality of care.
Do you happen to have a citation on that?
Also, would you consider a 1% or so better satisfaction rate worth paying twice as much?
For that matter, do you have a citation on the quality of care? Like I mentioned, Europeans tend to live longer, and there's not actually any indication that that quality of care is higher - we get more care, but our error rate is also higher, so you have extra 'churn' which means that it's not actually more effective.
I don't read AC A human right