The healthcare industry has been under fire for years for various reasons. Medications are too expensive, doctor's visits cost an astronomical amount, and people have seen numerous stories of fraud and corruption within the system. Well, that has never ended, even as the times change.
The New York Times recently did some analysis of Medicare records and raised some big concerns over massive fraud taking place with private insurance companies. It is not some chump change fraud either. We are talking fraud in the multiple billions of dollars.
Christopher Weaver, a reporter for the New York Times, says they uncovered over $50 billion in fraud, mostly done through falsely diagnosing diseases.
"They did this by scrubbing patients' charts, then sending nurses to houses to collect diagnoses, even when no doctor was treating the patient for those conditions," he says.
During a span from 2018 to 2021, private insurers mostly with the Medicare Advantage program, made millions of questionable diagnoses, which added billions in extra costs for them to take to the bank.
Many of those included deadly illnesses for which patients then received zero care. As mentioned, it also included many diseases that patients did not even have.
Some safeguards and changes have come, but there are still too many questions that need answers. One of them is a big one.
"The question is why are insurers allowed to add diagnoses like this...because in many instances, it is just basically like a blank check," he says.
One example from the Times showed more than 66,000 of these cases under the Medicare Advantage umbrella.
During a stretch from 2019 to 2021, some patients were diagnoses with diabetic cataracts even though they had already gotten surgery. That led to the government paying insurers more than $700 million in that time.
It is yet another mark on the American healthcare system, and unless someone makes a drastic change, insurance companies will keep robbing us and fattening their own wallets.