Infographic: Strengthening Medicare

Fighting Medicare fraud has long been a top priority for President Obama. Today, we are releasing a new infographic that describes how the Affordable Care Act -- the new health care law -- is helping the Obama Administration crack down on Medicare fraud and make Medicare stronger. The new infographic shows how the law increases penalties for criminals who commit fraud and provides new enforcement tools to stop fraud and save taxpayers money.

We are committed to using these new tools to fight Medicare and other health care fraud, and we are getting results: The Administration’s anti-fraud efforts recovered $4.1 billion in taxpayer dollars last year, the second year recoveries hit this record-breaking level. Total recoveries over the last three years were $10.7 billion. Prosecutions are way up, too: the number of individuals charged with fraud increased from 797 in fiscal year 2008 to 1,430 in fiscal year 2011 -- a more than 75 percent increase.

Just last week, the Department of Health and Human Services and the Department of Justice announced "a nationwide takedown by Medicare Fraud Strike Force operations in seven cities has resulted in charges against 107 individuals, including doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $452 million in false billing." And on Monday, the Departments announced that, as a part of their Health Care Fraud Prevention and Enforcement Action Team initiative, they had resolved an investigation into a pharmaceutical company’s unlawful promotion of a prescription drug. The Justice Department reported that, "the resolution – the second largest payment by a drug company -- includes a criminal fine and forfeiture totaling $700 million and civil settlements with the federal government and the states totaling $800 million."

The infographic also shows how the Affordable Care Act is making Medicare stronger and providing new benefits. For example:

    32.5 million people with Medicare received at least one free preventive service thanks to the health care law.

    People with Medicare who hit the prescription drug donut hole have already saved $3.4 billion on their prescription drugs.

    By 2021, the average person with Medicare will save nearly $4,200 thanks to the new health care law.

You can learn more about these efforts and our work to implement the Affordable Care Act by visiting whitehouse.gov/healthreform.

RPC Fast Facts: Anatomy of a CLASS Act "Ponzi Scheme"

Socialist Health Care, part 1

By Zach Foster

There has been an incredibly amount of outcry and mutual enmity bordering on hatred between opposing political schools of thought when it comes to the Health Care Reform Act passed last year by Congress under the guidance of President Obama.  Those opposed to it, affectionately naming it “ObamaCare,” cite the socialist tendencies of this legislation as their basis for opposing it.  It is true that the law is socialist in its nature, though not everyone understands why.  The fact of the matter is that socialism and the health care industry are not mutually inclusive and have conflicting interests.

Let us explore the present differences between the public and private sector, as well as some key terminology.  There is a difference between socialism and state welfarism—acts by the state to provide for the needs of the poor.  Socialism is the complete regulation of industry and property by the state (or whatever governing body exists in the laughably utopian and purely theoretical socialist utopia).  If the federal government had created a public health insurance option that is simply another brand of health insurance, owned and operated by the Department of Health and Human Services, meant to be in healthy competition with the various private sector insurance brands, it would most likely be patronized and utilized by the poor, i.e., citizens who cannot afford private sector insurance.  That is an example of state welfarism.  When used in moderation, state welfarism isn’t a bad thing.  After all, there is nothing wrong with a government that makes provisions for the well being of its citizens in case of individual emergencies.  Where the system goes wrong is when the large and inattentive government bureaucracy in state welfare permits (fails to detect) individual citizens who learn to prolong their dire circumstances and live off of government handouts.  This is nothing but a drain on government funds and an unhealthy incentive for people to stop being productive (a phenomenon which has happened on a large scale under socialist republics).

Most citizens who go on unemployment or food stamps or apply for low-cost housing only do so in the short term, because they are honorable people who truly want to get back to work and provide their family with a high quality life, and this is alright.  However, when the federal government intervenes often in industries and in the lives of citizens, it is not only socialist (because of the heavy regulation), it is also a revocation of personal liberty.  When the federal government passed laws dramatically controlling the entire health insurance industry, it was performing socialistically.  While the author does freely admit that there were many problems with various health care industries, such as setting unreasonably low ceilings for coverage, turning people away, listing every ailment under the sun as a non-covered “preexisting condition,” etc., it was not the federal government’s role to step in and make expensive demands on the industry whose implementation was to begin alarmingly soon.  This will surely drive up prices for the insured citizens, who will now have to pay more.  See the author’s article on the 9/11 Zadroga Bill for an explanation of how corporate prices rise.

Rather than take socialistic measures, the federal government (if its high-ranking self-appointed messiahs felt they truly needed to get involved) should have taken steps to insure greater competition and quality control in the industry. 

Next: The effects of capitalism vs. socialism on health care; Cuba is NOT the model!

White House White Board: Health Reform & Rate Review

By Stephanie Cutter

For the past decade, Americans have seen double-digit health insurance premium increases.  From 2000 to 2010, premiums rose 114 percent and nothing suggests that the quality of insurance coverage improved.  In many cases, insurance companies had free reign and weren’t held accountable when they attempted to raise rates on consumers. Only 26 states and the District of Columbia can reject premium increases that are excessive or unjustified, and many of these states lack the resources to use this authority to protect consumers.

That’s beginning to change.  Here’s how:

First, the Affordable Care Act gives states $250 million to enhance their rate review procedures so they can better protect consumers and stop unreasonable premium hikes from taking effect. 46 states and the District of Columbia have already received a share of these resources and they’re using the new funds to make more information about premiums available to the public and get the authority they need to oversee the insurance marketplace and protect consumers.

Second, the Affordable Care Act brings new transparency to the health insurance market by requiring insurance companies to publicly justify any unreasonable premium increases.  Under the new rules, if an insurance company proposes to raise rates by 10% or more, they must publicly disclose on their own, as well as HHS’ website the justification for the increase. The appropriate state insurance commissioner or, if a State does not have an effective rate review process, HHS, will then review the insurance company’s justification to determine whether or not the increase is justified.  In some states like, Washington and Maine, all new insurance premium rates, regardless of whether they are below 10% need to be approved by the state insurance commissioner’s office ahead of time, and will continue to be reviewed moving forward.

Shining a bright light on health insurance premium increases and conducting aggressive rate review will help control costs for American families. And we know rate review works. States like Washington and Maine have strong review laws that have been effective at protecting their residents from out-of-control premium increases.  And just recently, Connecticut regulators recently rejected a proposed 20 percent rate increase that would have impacted 48,000 consumers after their review found that such an increase was unjustified and excessive.

Health and Human Services Secretary Kathleen Sebelius has recorded a new White House White Board video to explain just how this new rule works, and how rate review helps states review and crack down on unjustified premium hikes and protect consumers.  You can see the video at http://www.whitehouse.gov/blog/2010/12/21/white-house-white-board-health-reform-rate-review?utm_source=122210&utm_medium=intro&utm_campaign=daily.