Reading a wide variety of blogs is one of my favorite pasttimes. I have my experience with Medicaid fraud to thank for this; my eyes were opened to how things are not as they seem. Prior to my deep dive into the real workings of Medicaid, I was a dyed in the wool believer that Medicaid was an essential service for the poor. 10 plus years as a provider at both Children's Medical Center and UT Southwestern had broken my heart to the plight of the poor and their deep need for quality dental care. (believe me friends, this is still the case - but not the point of this post.). As a Medicaid orthodontic provider, I was proud to be a part of a national effort to help the poor. And I had plenty of company. Many, many healthcare providers are deeply committed to helping the poor by participating in Medicaid. I was fortunate to see the system work really well for kids that needed care. Challenging cases and great results. It was cool.
To make a long story short, after 3 years of working with the state of Texas and a number of various groups on what to "do" about Medicaid fraud, I've come to the conclusion that Medicaid is no longer a government program for the poor but actually a RESOURCE creation effort.
A national resource is usually something of marketable value, like timber, fertile land, water etc. In our capitalistic system, private industries tap natural resources and create value by turning the resource into a commodity which is sold for a profit. A passive natural resource is turned into a money producing, job creating, economic driver. It is my belief that the Medicaid program has been misrepresented to the US citizens. Instead the Medicaid recipient being a drag on the economic health of the nation, the Medicaid recipient has been turned into the untapped natural resource. Fiat money has made this switch possible.
Consider the potential Medicaid recipient as an untapped natural resource. Once this person is awarded Medicaid status, Medicaid providers (hospital systems, doctors, durable medical goods services, and others) can now, by delivering goods and services, tap the Medicaid recipient as a money producing, job creating economic driver. Medicaid money fuels economic activity and job production in poor communities.
Stopping Medicaid fraud will simply not happen because there is NO real incentive to limit Medicaid expenditures. Medicaid recipients participate in our economy as PASS THROUGH economic participants. Follow me because this part is a little confusing. Instead of generating economic activity by spending a paycheck in the local economy, Medicaid recipients generate economic activity by being the source from which government money is spent into the local economy. Any effort to limit the Medicaid services provided ends up limiting the economic activity and job creation in the local economy. Medicaid recipients are actually RESOURCES from which profit is derived. Unfortunately, just like forests risk clear-cutting and mineral rich land risks strip mining, Medicaid recipients are at signficant risk of abuse at the hands of profit seekers. I have seen this happen over and over, to my deep sadness. For all my effort, I have very little success - the profits to be gained are just too great for a handful of people to stop.
So back to blog reading. It took a lot of reading to sort all of this out. I would like to thank Yves Smith at NakedCapitalism and Charles Hugh Smith at OfTwoMinds, along with many, many others. I encourage you to always seek the truth in all things, but particularly when things just don't make sense.