- Private health insurance companies are evil, vicious, rapacious creatures (but not people) whose policies, claim-handling procedures, and premium costs murder hundreds of millions of people annually while generating profits sufficient to pay for their Perrier-filled toilets.
- Everyone must be forced to buy health insurance from the aforementioned companies.
There are other explanations like the Fluke (aka "Black Hole of Georgetown") Theorem, but all of this adds up to one simple argument patiently repeated by Obama and his Ministry of Propaganda over and over again to us bitter clingers: it was necessary for the government to step in and take regulatory control worthy of Eva Peron over a fifth of the US economy.
Because, after all, we know how incredibly well the government manages what it already controls.
While Federal law permits Medicare payments for services rendered to an alien who is lawfully present in the United States, Medicare benefits are not allowable for aliens who are not lawfully present. If a Medicare claim was processed after the Centers for Medicare & Medicaid Services' (CMS) data systems indicated that a Medicare beneficiary was unlawfully present in the United States, CMS was able to prevent the payment. However, when CMS's systems did not indicate the unlawful presence status until after a claim had been processed, CMS was not able to detect and recoup the improper payment. Because CMS did not always receive the unlawful presence information promptly, Medicare payments totaling $91.6 million were made to health care providers (providers) for services to approximately 2,600 unlawfully present beneficiaries during calendar years 2009 through 2011. CMS did not have policies and procedures that would have enabled it to detect such improper payments after the payments were made. Consequently, CMS did not notify its payment processing contractors (Medicare contractors) to recoup any such payments.Have no fear, bleeding-hearts; they didn't leave other people with sketchy claims out.
Prisons, not the Centers for Medicare & Medicaid Services, pay for health care of incarcerated people who are otherwise eligible for Medicare (incarcerated beneficiaries). If a Medicare claim was processed after CMS's data systems indicated the incarceration status, CMS was able to prevent the payment. However, when CMS's systems did not indicate the incarceration status until after the claim had been processed, CMS was not able to detect and recoup the improper payment. Because CMS did not always receive incarceration information promptly, Medicare payments totaling $33.6 million were made to health care providers (providers) for services to approximately 11,600 incarcerated beneficiaries during calendar years 2009 through 2011. CMS did not have policies and procedures that would have enabled it to detect such improper payments after the payments were made. Consequently, CMS did not notify its payment processing contractors (Medicare contractors) to recoup any such payments.According to the American Enterprise Institute, the average American worker retiring in 2009 paid $64,971 in Medicare payroll taxes over their lifetime - which means that, in the matter of two years, Medicare's vaunted administrative efficiency managed to vaporize the sum total of dollars extracted from every single paycheck received over the entire 44-year working life of 1,927 individuals who presumably were legal citizens who mowed their lawns, gave at the office, and kept their noses clean.
Whoever said crime does not pay clearly had no experience with government bureaucrats.
Now for those evil, vicious, rapacious (but not a person) private insurance companies, this cost would come, to use a complicated financial term, "out of their own hides" as unrecoverable operational loss. There would be a massive audit, severe imposition of harsh internal controls, a likely drubbing in the stock market, and a definite dip in the company's fortunes.
But since Medicare is the thing nearest and dearest to Obama's heart - a government-mandated monopoly that has essentially banned its competition - it need not bother with any of that; it just starts charging everyone else more.
Now, again, if one of those evil, vicious, rapacious (but not a person) private insurance companies made the revelation that everyone else's premium costs were going up because the company was giving politically-connected groups benefits to which they were not entitled and, as a bonus, that they were too lazy to do anything about it, there would be executive heads flying, nineteen Piers Morgan prime-time screaming specials, and Al Sharpton/Jesse Jackson/Toure/(insert your own race-baiter here) yelling something about money-crazed Jewish crackers out to hurt black people.
In Washington, they call it "a good solid B-plus".
So keep that in mind, seniors, working people, children, and babies waiting in Mormon celestial temples for a start date of about two centuries from now: the message from Obama and The Bureaucrats is that, if you think there's value in working for a living and paying your taxes, you are chumps.