Ethics Whisperer

Tuesday, February 16, 2010

Compliance Tea Party - Hold the Sweatener

HealthCARE reform is dead. Even the administration no longer uses the term. Did you notice the unexplained shift from healthCARE reform to health PLAN reform? The public does not want government run healthcare. The Obama administration thought it could pull off what the Clinton administration couldn't. Wrong.

Why switch to PLANS? Well, who ever met an insurance plan that they could love? So let’s demonize the plans now. That’s the ticket. Health plan compliance professionals take note: You get busy once your industry is put on the 10 Most Wanted list. Ask your friends in pharma.

This is tragic, as there are things that need to get done in healthcare. We have to do something about those in the 55 to 65 age group who can not afford health insurance – often $25K a year and up - should they retire or lose their jobs. We have to quit driving drug prices up by forcing the pharmaceutical industry to massively subsidize European and Canadian healthcare. We have to simplify the rules of existing government sponsored programs such as Medicare and Medicaid so the funds in these program actually go to healthcare. And could we have some fraud enforcement in government programs targeting uninsured kids?

Defeat is not readily accepted here in DC. So expect to see additional evidence that you are a bunch of fraud committing, patient abusing, white collar criminals. I was amazed to learn that a bunch of compliance officers paid real money to have the government read them month old press releases saying what naughty boys and girls they were at the Intergalactic, Hear-It-To-Believe-It Fraud Hoe Down - or whatever it was called.

Those of us in compliance will not rest until fraud is reduced to as close to ZERO as is humanly possible. But we will never achieve that goal unless we are given some credit for what has been accomplished to date in fraud fighting – and we have accomplished quite a lot. I think I individually contribute to global warming when I hear that we have accomplished nothing and that the government needs an even bigger stick just to keep us in line. My message on this is that the compliance community and the government should be on the same page on this one. Could we please just get along?

copyright Mark Pastin

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