This report originally appeared in the March 2010 issue of DOTmed Business News

As mentioned in this space last month, various reports have estimated total fraud in Medicare and Medicaid to range from $54 to $120 billion a year...totals that exceed what GPOs, collectively, can claim to save each year. The waste and fraud take many forms, largely as improper payments by government including everything from simple errors to falling prey to fraudulent peddlers and providers of every stripe.

Perhaps President Obama read this column last month, since he has now trained his cannons on this monstrous problem, although he has fallen short of calling on GPOs for help. Instead, with more than a dozen anti-fraud ideas in his latest health care proposals, he intends to employ high-tech bounty hunters to scour suspicious activities and to monitor billings.

In many respects, this new focus is political, an attempt to harness Congressional support for fiscal responsibility, something both parties would applaud. Overlooked in the discussion, of course, is the glaring admission of incompetence in the existing government programs just as the Administration pushes for more government involvement. But government love is blind and the government has a history of loving incompetence.

But regardless, why has Obama not enlisted the likes of the GPO world in the fight against waste and fraud? Having granted a license to collect administrative fees via Safe Harbor legislation, the government seems justified in a "call to arms" in the battle to contain costs and attack abuse. And not just to reduce the pricing of simple supplies, but in the name of justice to be vigilant for any untoward mischief, whether by supplier, GPO, or provider. But justice in the byzantine, third-party, bureaucratic world of American health care is neither swift nor sure.

Perhaps President Obama thinks "GPO" stands for Government Printing Office and likely knows little about the health care supply chain world. And ironically, if he did investigate GPOs, he might be surprised how much effort they put into revenue cycle management with the goal of maximizing reimbursement for providers. I don't think this president is motivated, at this moment, to increase government outlays to hospitals.

But with Obama's recent embrace of bounty hunters, it may not be much of a stretch for him to deputize personnel from GPOs and hospitals as well as doctors and suppliers to add eyes and ears, all in close range, to the mission. Calls to the White House have not been returned.

OF COURSE, PHILOSOPHICALLY...

Our health care system bleeds profusely, with more and more calls for "fixes," merely Band-Aids for a monstrous wound. As Cornell's Roger Battistella writes in his book Health Care Turning Point, health care in America is "one of the most backward sectors of the economy." He goes upstream to identify the real problem, not just the symptoms, and that, as argued in this space before, is the simple fact that anything free is abused. He writes, "Because most consumers of health care are largely insulated from directly paying for the services they use, health care is generally perceived as an unlimited free good....Wants and needs become insatiable when care is believed to be free."

And his point is that consumers of health care are not as vigilant as they are with other purchases. Think of the millions of eyes and ears, those "invisible hands" unemployed in the health care market . . .such a waste.

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