Lance Armstrong is this week’s VILLAIN LIAR. Here, Lance Armstrong provides great lessons for health insurance policy and our role in it. In the over-coverage of lying and liars in connection with Lance Armstrong’s admission, remarkably not a single report I saw focused on the proven lies (fact checkers abound) spouted by candidates during the election season. We accept those lies. So, thanks in advance to Lance Armstrong for providing an opportunity for me to encourage the media and politicians and us to learn from him.
Lance Armstrong taught us that media sheep work to publicize lies. Media’s exchange of information and re-use and re-packaging of the same information led to years of media support for Lance Armstrong. Much like the CUT ENTITLEMENTS mantra, the media assumed that Lance Armstrong was legit and this assumption shared as “truth” slanted all other reports about Armstrong.
We accepted the premise, Lance Armstrong doesn’t dope, as truth and his entire media career was overshadowed by that lie. Similarly, today, the continued assumption that CUTTING ENTITLEMENTS is the only way to discuss and consider changes to Medicare and Medicaid is untrue and is slanting all reporting based on the acceptance of that lie.
Media bias limits our ability to discern truth. The stripping of medals, the money that exchanged hands, the lawsuits, all of it was based in what Armstrong describes as, “I view this situation as one big lie that I repeated a lot of times.” The cascading lies, the erroneous award of prizes and money and fame based on lies all stemmed from the single lie that we assumed was true, that Lance Armstrong didn’t dope. Similarly, the one lie told over and over again that we MUST cut entitlements, has had and continues to have the cascading effects of cannibalizing people’s ability to afford and be eligible for healthcare.
Lance Armstrong was not the winner of the Tour De France, his lie made him the apparent winner and prevented other cyclists from achieving that status based on his lie. Few pay attention to “OTHER” great cyclists once the “BEST” has been identified. By identifying individuals, the PUBLIC as the “number one,” the most costly cause of current threats to solvency of government insurance programs, we IGNORE other possibilities more genuinely responsible for the decimation of our public and private insurance options.
Once you’ve identified the number one position, resources are directed at that number one position. If that identification is wrong, everything that follows is wrong as well. For Lance Armstrong this meant lucrative profits, fame and other perks that were not bestowed on other cyclists. For the public, identified as the number one problem with managing the costs of healthcare costs for insurance programs it means individuals become the source of the solution, meaning CUT ENTITLEMENTS, which EVERY news source and politician puts forth as inevitable.
Lance Armstrong has shown that a lie is a distraction. Based on his lie, Lance Armstrong deprived others from the attention and fame they might have deserved as well as diverting attention from the bigger issue of doping in his sport.
The continued distraction and attention paid to cutting benefits and getting more money out of individuals in order to “save” health insurance, distracts us from identifying and addressing real areas for savings. (Cutting benefits, increasing costs to insureds has NOT worked which indicates we are at least partially treating the wrong problem, not just that we need to make MORE cuts.) It’s like treating someone for diabetes who has heart disease, you can give more and more diabetes medication but ultimately the condition will not improve.
Government studies and statistics take time. One of the chief problems with Lance Armstrong’s case is that though allegations have been made from as recently as 2004, the United States Anti-Doping Agency evidence was issued in October 2012. In healthcare, there have been reports of the costs of fraud, all done analyzing data from prior times, all coming up with billions of dollars in fraud, abuse and waste but instead we focus on the immediate “savings” that can be achieved from cutting entitlements, it’s fast and easy.
Moving forward, it’s past time to focus media and government attention on an assumption of truth rather than myth, lie and distraction. This means a focus on the Three Stooges of healthcare, FRAUD, ABUSE and WASTE instead of the relentless perpetuation of the CUTTING ENTITLEMENTS lie.
Health insurance fraud, that occurs in both public and private insurance accounting for estimates of tens of BILLIONS of dollars a year at LEAST.
When it comes to fraud, individuals are only an infinitesimal part of the problem. The most common “patient” fraud doesn’t involve patients at all but instead the unauthorized use of their insurance numbers.
While some governmental and institutional steps are gradually taken to pursue fraud, there are few benchmarks, few demands, and few consequences for the lukewarm commitment by public and private insurers to stamp out health insurance fraud. Little is said by the recycled and restated mythology by media as they drum into our heads the lie, that CUTTING ENTITLEMENTS is a MUST having never devoted time, energy and resources to targeting health insurance fraud in the same way.
We occasionally hear some shameless self-promotion. For instance, HHS, in February of 2012 proudly announced that “Health Care Fraud Prevention and Enforcement Efforts Result in Record-Breaking Recoveries Totaling Nearly $4.1 Billion,” as reported in the annual report of the HCFAC, the Health Care Fraud and Abuse Control Program, based on conservative guesses about the annual expenditures on fraud that’s about 6 percent recovery of monies paid out fraudulently (not including the reduction in recovery for expenses of prosecution).
Fraud prosecution progress is attributed to Affordable Care’s provision for toughening penalties and for actions such as expanded sharing of records among law enforcement as contributors to the improved outcome. However, there’s also a description of the $350 million extra in taxpayer money that’s being added to current budgets to pursue these activities.
Absent serious attention paid to trimming down Federal expenses with simultaneous attention and accountability to waste and abuse within the ranks of government personnel and organizations those fractional recoveries, (fractional based on estimates of actual costs of fraud) will likely be devoured by bureaucratic expansion and expenditure.
Similarly, private insurers have made lukewarm efforts, including setting up all sorts of departments and divisions designed to prevent and recover from fraud but they too are not required to achieve results. Imagine the progress that would be made if EVERY attempt to raise insurance premiums required that additional fraud recoveries of a certain amount must be made before charging another nickel to insureds.
And finally, there’s the issue of whether LIES pay. For Lance Armstrong, yeah, they did, as they do for healthcare providers and institutions and government.
CUTTING ENTITLEMENTS isn’t painful for the government, it’s your money. No job reductions in the Federal government, and they’ve still got great insurance that taxpayer dollars go for. No problem for media talking heads telling everyone to suck it up, because they’ve got money and insurance coverage. No problem for healthcare providers, even when they’re caught, the negotiated settlements usually represent a fraction of the estimated costs. And in terms of jail time, Lance Armstrong likely won’t face any, as is the case with the enormous institutional personnel who participated in fraud.
In January, in Raleigh, NC, WRAL.com reports on 1/17/13 that “Judge Questions WakeMed fraud pleas agreement,” you can search for that article. WakeMed, a hospital, agreed to pay $8 million for fraud but potential criminal prosecution was deferred for two years as long as WakeMed follows agreements it made to fix certain practices which included billing Medicare for patient overnight stays when patients were sent home. No criminal prosecutions, no jail time.
Of course, sometimes there are criminal penalties including jail time for smaller fraud perpetrators. (You can see other prosecutions that are occurring on the oig.hhs.gov page which is the Office of Inspector General, Department of Health and Human Services, Criminal and Civil enforcement actions.)
It’s time for media, the public and government to consider retracting the lie that CUTTING ENTITLEMENTS is either the only or best way to preserve government insurance programs. Our disappointment in Lance Armstrong is because we expected him to tell the truth, and we should do the same of our news media and politicians. This is what Lance Armstrong has taught us this week.
