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Puckrein: Meaningful Change in Medicare Requires Tackling Fraud First

The Joint Committee on Deficit Reduction has been tasked with a budgetary conundrum of Brobdingnagian proportions — reaching consensus on at least $1.2 trillion in federal spending cuts by year’s end, or subjecting millions of Americans to automatic across-the-board cuts to essential health and social service programs.

Despite the frenzied environment and strong appetite to cut, slash and hack away spending to remedy the federal deficit, doing so conjures up that time worn, but apt, analogy of rearranging the deck chairs on the Titanic.

Cutting will do nothing to address the real problem. Focusing on cutting, rather than on addressing the fundamental challenges in the system will only make things worse. Real, effective and lasting solutions must take into consideration the rapidly diversifying and increasing U.S. population, focusing on price and quality, differentiating between cost and price, and doing all of these things within an intellectual environment that assigns the highest values to stimulating innovation and to investing in the health of American workers and their families.

Before Medicare was established in 1965, only half of Americans aged 65 and older had health care coverage. One-third lived below the poverty level. Almost 50 years later, the United States has had tremendous success in developing a program that enables our grandparents, neighbors and fellow Americans who served our country for years to access care they need.

A decade ago, when an estimated 40 million Americans were receiving Medicare benefits, we knew that in order to prepare for the influx of Baby Boomers we had to find significant changes and improvements. Unfortunately, those reforms have been slow to take hold and we find ourselves in a dire situation.

Elected and appointed officials across the nation must come to terms with the basic truth — that they cannot ensure the health and welfare of American workers and their families by undermining the foundation upon which that health is built. Before irreparable harm is done to Americans who depend on these essential programs, it’s time to take a step back and, once and for all, implement meaningful change.

One surefire way is to first target the specific areas in Medicare and Medicaid that are being permeated by waste, fraud and abuse.

Estimates from the Government Accountability Office indicate that as much as 10 percent of Medicare and Medicaid dollars are lost to fraud and abuse annually — tens of billions of dollars.

The government has begun taking steps to stop fraud and recover these much needed funds, however only a fraction of those dollars is expected to ever be recovered.

The truth of the matter is, it can be done and on a much larger scale. With new, advanced technologies to identify fraud and better processes for legitimizing payments before they are made instead of after, we can recoup billions of taxpayer dollars currently being wasted each year.

The National Minority Quality Forum has become part of a broad coalition to encourage lawmakers to do what they should have done many years ago: Fight fraud first. We believe, as do the American people, that no dollar should be taken from American seniors while money continues to be lost to waste, fraud and abuse.

Together with other like-minded organizations representing millions of Americans, we’re calling on the super committee to do what’s right and adopt program integrity reform that will ensure the health of Medicare and Medicaid for future generations.

Gary A. Puckrein is president and chief executive officer of the National Minority Quality Forum.

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