The bureaucrats are going nuts

Tuesday, November 24, 2009

I had a strange epiphany recently about Medicare fraud and abuse and the great futile lengths CMS has gone to eradicate it.

For several years now, I’ve had an ongoing battle with the gray squirrels in my neighborhood, which goes by the name Oakhurst, and with good reason. It’s loaded with oak trees, which produce acorns, which, as you know, are a dietary staple for Sciurus carolinensis.

Here’s the thing about squirrels: No matter how many billions of acorns are available, they’ll never pass up a chance to raid a birdfeeder stocked with delicious oily sunflower seeds. More than once, I’ve filled our feeder in the morning and returned home in the evening to find it empty. We’ve got a lot of backyard birds, and I know from experience that a full birdfeeder will last my feathered friends a week. A couple of squirrels, however, will empty it in a day.

I’ve tried everything to keep that from happening but to no avail.

So this summer I bought a Marksman pump action .177-caliber pellet gun. Over a 10-day period in July, I shot and killed 10 squirrels, and for the next two months, the gray varmints avoided our yard like the plague.

Here’s where HME fraud and abuse comes in.

If CMS attempted to keep squirrels from a bird feeder, the situation would get very ugly. First, the bureaucrats would encase the feeder in a cage. They would then electrify the cage, and maybe even concoct a flaming wall. Each layer of defense would make the feeder more impenetrable—for the birds. The squirrels, being an ingenious bunch with plenty of time on their hands, would eventually find some way around all of these barriers.

In this little story, of course, the birds represent providers, the feeder is the Medicare trust fund and the squirrels are the crooks.

I’m not advocating that CMS shoot crooks that defraud Medicare out of $60 billion a year (at least not yet). But it’s apparent that adding layer upon layer of bureaucracy has done little to solve the fraud and abuse problem. This strategy— and competitive bidding is just one more sorry chapter—only makes it more difficult and expensive for legitimate providers to serve Medicare beneficiaries. The crooks, like squirrels, continue to go about their merry way.

I use a pellet gun to selectively eliminate unwanted pests. The birds I enjoy are never at risk. CMS should adopt a similar approach: Weed out fraud and abuse without unduly burdening legitimate HME providers. To do otherwise, it seems to me, is just plain nutty.