Disguised Health Care Costs: The $1.5 Trillion Fraud
If House Democrats hold a vote on their health-care overhaul this weekend, they might as well vote to abolish the Congressional Budget Office too.
It would be no more audacious (and much more honest) than the way they have gamed the CBO’s rules to hide $1.5 trillion of the cost of their legislation — which has to be the biggest fiscal obfuscation in the history of American politics.
C/P Politico
Pakistan: More Aid, More Waste, More Fraud?
Pakistan long has tottered on the edge of being a failed state: created amidst a bloody partition from India, suffered under ineffective democratic rule and disastrous military rule, destabilized through military suppression of East Pakistan (now Bangladesh) by dominant West Pakistan, dismembered in a losing war with India, misgoverned by a corrupt and wastrel government, linked to the most extremist Afghan factions during the Soviet occupation, allied with the later Taliban regime, and now destabilized by the war in Afghanistan. Along the way the regime built nuclear weapons, turned a blind eye to A.Q. Khan’s proliferation market, suppressed democracy, tolerated religious persecution, elected Asif Ali “Mr. Ten Percent” Zardari as president, and wasted billions of dollars in foreign (and especially American) aid.
Still the aid continues to flow. But even the Obama administration has some concerns about ensuring that history does not repeat itself. Reports the New York Times:
As the United States prepares to triple its aid package to Pakistan — to a proposed $1.5 billion over the next year — Obama administration officials are debating how much of the assistance should go directly to a government that has been widely accused of corruption, American and Pakistani officials say. A procession of Obama administration economic experts have visited Islamabad, the capital, in recent weeks to try to ensure both that the money will not be wasted by the government and that it will be more effective in winning the good will of a public increasingly hostile to the United States, according to officials involved with the project.
…The overhaul of American assistance, led by the State Department, comes amid increased urgency about an economic crisis that is intensifying social unrest in Pakistan, and about the willingness of the government there to sustain its fight against a raging insurgency in the northwest. It follows an assessment within the Obama administration that the amount of nonmilitary aid to the country in the past few years was inadequate and favored American contractors rather than Pakistani recipients, according to several of the American officials involved.
Rather than pouring more good money after bad, the U.S. should lift tariff barriers on Pakistani goods. What the Pakistani people need is not more misnamed “foreign aid” funneled through corrupt and inefficient bureaucracies, but jobs. Trade, not aid, will help create real, productive work, rather than political patronage positions.
Majority of Americans Say Afghan War Not Worth Fighting
According to a recent Washington Post-ABC Poll, the majority of Americans say the war in Afghanistan is not worth fighting.
Usually, I don’t take kindly to polling data; they are ephemeral snapshots of public opinion that fluctuate with the prevailing political winds. But I will say (as I’ve said before) that Central Asia holds little intrinsic strategic value to the United States. In that respect, I can understand why Americans are growing skeptical of continuing what’s become an “aimless absurdity.”
America’s flagging support for the war comes as millions of Afghans head to the polls to elect their next president. Hamid Karzai, the incumbent, is the front-runner, but if he is unable to secure more than 50% of the vote there will be a run-off scheduled for early October. Given the pervasive levels of corruption within his own government, if Karzai ends up winning, America and the international community might be perceived as propping up an illegitimate government; however, if Karzai loses, it might further alienate the country’s largest minority group, the Pashtuns, among whom Karzai, and the Taliban, pull most of their support.
This morning, New York Times reporter Carlotta Gall writes from Kabul, “initial reports from witnesses suggested that the turnout was uneven, with higher participation in the relatively peaceful north than in the troubled south.”
Before the elections, Taliban militants, mainly concentrated in the southern and eastern provinces but now spreading to the north, threatened to cut off fingers marked with purple ink used to indicate when someone casts a vote. Ms. Gall writes: “In the southern city of Kandahar, witnesses said, insurgents hanged two people because their fingers were marked with indelible ink used to denote that they had voted.” Wow! Maybe the elections will be a watershed moment in Afghanistan’s history: the democracy experiment comes as a death sentence.
On a lighter note, there are already allegations of voter fraud. An inspection of the rolls revealed the name of an unlikely voter, “Britney Jamilia Spears,” one of a number of phantom voters.
Many people would agree that the atmosphere surrounding Afghanistan’s presidential elections is analogous to the country as a whole: dysfunctional. Candidates are forging alliances with warlords; tribal elders are being offered jobs, territory, and forgiveness of past sins to secure their allegiance; and Britney Spears is a registered Afghan voter. It’s about time that America narrow its objectives and start bringing the military mission to a close.
Fun With DHS Press Releases!
Let’s fisk a DHS press release! It’s the “Statement by DHS Press Secretary Sara Kuban on Markup of the Pass ID Bill by the Senate Homeland Security and Government Affairs Committee.” Here goes:
On the same day that Secretary Napolitano highlighted the Department’s efforts to combat terrorism and keep our country safe during a speech in New York City,
This part is true: Secretary Napolitano was in New York speaking about terrorism.
Congress took a major step forward on the PASS ID secure identification legislation.
There was a markup of PASS ID in the Homeland Security and Governmental Affairs Committee. It’s a step — not sure how major.
PASS ID is critical national security legislation
People who have studied identity-based security know that knowing people’s identities doesn’t secure against serious threats, so this is exaggeration.
that will break a long-standing stalemate with state governments
Thirteen states have barred themselves by law from implementing REAL ID, the national ID law. DHS hopes that changing the name and offering them money will change their minds.
that has prevented the implementation of a critical 9/11 recommendation to establish national standards for driver’s licenses.
The 9/11 Commission devoted three-quarters of a page to identity security — out of 400+ substantive pages. That’s more of a throwaway recommendation or afterthought. False identification wasn’t a modus operandi in the 9/11 attacks, and the 9/11 Commission didn’t explain how identity would defeat future attacks. (Also, using “critical” twice in the same sentence is a stylistic no-no.)
As the 9/11 Commission report noted, fraudulent identification documents are dangerous weapons for terrorists,
No, it said “travel documents are as important as weapons.” It was talking about passports and visas, not drivers’ licenses. Oh — and it was exaggerating.
but progress has stalled towards securing identification documents under the top-down, proscriptive approach of the REAL ID Act
True, rather than following top-down prescription, states have set their own policies to increase driver’s license security. It’s not necessarily needed, but if they want to they can, and they don’t need federal conscription of their DMVs to do it.
– an approach that has led thirteen states to enact legislation prohibiting compliance with the Act.
“. . . which is why we’re trying to get it passed again with a different name!”
Rather than a continuing stalemate with the states,
Non-compliant states stared Secretary Chertoff down when he threatened to disrupt their residents’ air travel, and they can do the same to Secretary Napolitano.
PASS ID provides crucial security gains now by establishing common security standards for driver’s licenses
Weak security gains, possibly in five years. In computer science — to which identification and credentialing is akin — monoculture is regarded as a source of vulnerability.
and a path forward for ensuring that states can electronically verify source documents, including birth certificates.
We’re on the way to that cradle-to-grave biometric tracking system that will give government so much power over every single citizen and resident.
See? That was fun!
Assessing the Claim that CDT Opposes a National ID
It was good of Ari Schwartz to respond last week to my recent post querying whether the Center for Democracy and Technology outright opposes a national ID or simply “does not support” one.
Ari says CDT does oppose a national ID, and I believe that he honestly believes that. But it’s worth taking a look at whether the group’s actions are consistent with opposition to a national ID. I believe CDT’s actions — most recently its support of the PASS ID Act — support the creation of a national ID.
(The title of his post and some of his commentary suggest I have engaged in rhetorical excess and mischaracterized his views. Please do judge for yourself whether I’m being shrill or unfair, which is not my intention.)
First I want to address an unusual claim of Ari’s — that we already have a national ID system. If that is true, his support for PASS ID is more sensible because it is an opportunity to inject federal privacy protections into the existing system (putting aside whether it is a federal responsibility to manage a state system or systems).
Bernie Madoff and Government Fraud
In an op-ed Chris Edwards and I wrote for National Review Online yesterday, we shed light on the $100 billion or more in government subsidies pilfered by recipients through fraud and abuse:
Every year, criminals and cheats pilfer over $100 billion — that’s $40 billion more than Bernie Madoff scammed off his investors — in federal benefits to which they are not legally entitled. Medicare, Medicaid, food stamps, refundable tax credits, and many other programs are targets for looting.
Chris and I focused on fraud and abuse perpetrated by the recipients of taxpayer largesse, and Bernie Madoff made for a good comparison. But as the great economist and Cato adjunct scholar Robert Higgs also pointed out yesterday, “Bernie Madoff Was Only a Petty Crook Compared with Uncle Sam.” Typically, Higgs doesn’t mince words when it comes to comparisons between private and public Ponzi schemes:
Madoff, in contrast to the government, carried out his fraud in a civilized way: he merely misrepresented what he was doing, purporting to invest his clients’ money and to obtain a high rate of return on these investments. People dealt with him voluntarily. Those who suspected something was fishy did not do business with him, and some people went so far as to give substantial information to the SEC to show that Madoff’s business had to be fraudulent (which information the SEC ignored for years on end, of course).
The leaders of the U.S. government have carried out their Social Security fraud—essentially a Ponzi scheme, in substance exactly the same as Madoff’s scheme—since 1935. . . . The U.S. government, however, does not bother to claim any prowess in investing the money it forces people to surrender to its scheme. It admits that the ‘client’s’ return is now close to zero (varying a bit according to the client’s age and other factors). Nor does it carry out its admitted Ponzi scheme in a civilized way. Not only is participation in the scheme involuntary, but the government threatens violence against anyone who fails to participate as it commands him. Thus, the government operates its Ponzi scheme in a markedly more thuggish manner than Bernie would ever have dreamed of. He might have been a crook, but he was not a thug.
Health Care Priorities
As Washington debates a big increase in federal health care spending, I came across these two articles on what a splendid job the government is doing managing its current health programs.
Harvard professor Malcolm Sparrow recently testified that roughly $100 billion or more of Medicare and Medicaid dollars go down the drain each year due to fraud. It’s easy to rip these programs off because of their vast size and electronic claims processing. Medicare processes more than 1 billion of claims each year.
This Washington Post article last year described one particular example of the fraud. A high-school drop-out managed to bilk Medicare out of $105 million by submitting a 140,000 false claims from her laptop computer.
So we’ve got $100 billion or so of taxpayer’s hard-earned money being stolen each year from our current public health care plans. You would think that with today’s giant budget deficit that the highest priority of policymakers would be to reform these programs to reduce the unbelievable and disgusting amounts of graft. But no, many in Congress and President Obama have decided that current government health care works so well that they want to expand it.
President Obama wants to create a new “public health option” to “keep insurance companies honest.” Hey Mr. President, you should do something about the $100 billion of dishonesty in current public health plans, instead of hitting up taxpayers to fund an even more bloated health care budget.
How Does It Feel to Be at the Table Now?
On Monday, the Obama administration held a well-publicized love-fest with lobbyists for the health care industry. It turns out that rather than a “game-changer,” the event was a fraud. And the industry got burned.
At the time, President Obama called it a “a watershed event in the long and elusive quest for health care reform“:
Over the next 10 years — from 2010 to 2019 — [these industry lobbyists] are pledging to cut the rate of growth of national health care spending by 1.5 percentage points each year — an amount that’s equal to over $2 trillion.
By an amazing coincidence, $2 trillion is just enough to pay for Obama’s proposed government takeover of the health care sector.
Yet The New York Times reports that isn’t the magnitude of spending reductions the lobbyists thought they were supporting:
Hospitals and insurance companies said Thursday that President Obama had substantially overstated their promise earlier this week to reduce the growth of health spending… [C]onfusion swirled in Washington as the companies’ trade associations raced to tamp down angst among members around the country.
Health care leaders who attended the meeting…say they agreed to slow health spending in a more gradual way and did not pledge specific year-by-year cuts…
My initial reaction to Monday’s fairly transparent media stunt was: “I smell a rat. Lobbyists never advocate less revenue for their members. Ever.” The lobbyists are proving me right, albeit slowly. (Take your time, guys. I don’t mind.)
Waste, Fraud, and Stimulus
At Capitol News Connection, brought to you each morning by your tax dollars, they reported this morning:
With more than a trillion tax dollars tied up in the Troubled Asset Relief Program and stimulus spending, Congress is trying to figure out how to account for every penny.
Uh-huh. Congress is always on top of our federal dollars.
Coincidentally, just hours after the CNC report, the Government Accountability Office released a report warning about the lack of oversight procedures in the kitchen-sink stimulus bill. And a few days earlier the inspector general for the TARP program reported that Treasury has no real details on how TARP funds are being spent. In fact, IG Neil Barofsky told Congress that there were 20 criminal investigations into possible TARP fraud already underway.
Two months ago Barofsky and the comptroller general had warned of the likelihood of waste in huge new government programs:
Neil Barofsky, the special inspector general for the $700 billion Troubled Asset Relief Program, told a House subcommittee that the government’s experiences in the reconstruction of Iraq, hurricane-relief programs and the 1990s savings-and-loan bailout suggest the rescue program could be ripe for fraud…
Gene Dodaro, acting comptroller general of the U.S., told the subcommittee that a reliance on contractors and a lack of written policies could “increase the risk of wasted government dollars without adequate oversight of contractor performance.”
Evo Morales’ Biometric Identity System
It was with interest and concern that I read about the new election law recently signed by Bolivian President Evo Morales. The AP reports that it “sets stricter standards for voter authentication, introducing a $30 million system of biometric identification, based on voters’ fingerprints.”
It is important to secure voting systems against fraud, but be careful how you do it. Identity systems are powerful administrative tools which historically haven’t mixed well with authoritarian governments.
A biometric voter identification system was apparently a demand of Morales’ right-wing opposition. Don’t be surprised if he uses it to consolidate power or do far worse than that to his political rivals.
Some advocates have dabbled in supporting a national ID in the United States for election administration, but that would be error. I wrote about the many risks of uniform identity systems in my book Identity Crisis: How Identification is Overused and Misunderstood.
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