another reason for healthcare reform

badbabysitter

Vault Girl
Joined
Jul 6, 2002
Posts
19,179
we've never had this kind of defrauding up in Canuckistan for a very good reason...

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NEW YORK — A vast network of Armenian gangsters and their associates used phantom health care clinics and other means to try to cheat Medicare out of $163 million, the largest fraud by one criminal enterprise in the program's history, U.S. authorities said Wednesday.

Federal prosecutors in New York and elsewhere charged 73 people. Most of the defendants were captured during raids Wednesday morning in New York City and Los Angeles, but there also were arrests in New Mexico, Georgia and Ohio.

The scheme's scope and sophistication "puts the traditional Mafia to shame," U.S. Attorney Preet Bharara said at a Manhattan news conference. "They ran a veritable fraud franchise."

Unlike other cases involving crooked medical clinics bribing people to sign up for unneeded treatments, the operation was "completely notional," Janice Fedarcyk, head of the FBI's New York office, said in a statement. "The whole doctor-patient interaction was a mirage."

The operation was under the protection of an Armenian crime boss, known in the former Soviet Union as a "vor," prosecutors said. The reputed boss, Armen Kazarian, was in custody in Los Angeles.

Bharara said it was the first time a vor – "the rough equivalent of a traditional godfather" – had been charged in a U.S. racketeering case.

Kazarian, 46, of Glendale, Calif., and two alleged ringleaders – Davit Mirzoyan, 34, also of Glendale, and Robert Terdjanian, 35, of Brooklyn – were named in an indictment charging racketeering conspiracy, bank fraud, money laundering and identity theft.

The indictment accused Terdjanian and others of hatching other schemes involving stolen credit cards, untaxed cigarettes and counterfeit Viagra. It also alleges that during a meeting last year at a Brighton Beach restaurant, Terdjanian pulled a knife on someone who owed him money "and threatened to disembowel the individual if the debt was not paid."

A judge jailed Terdjanian without bail on Wednesday at a brief hearing. Afterward, his attorney said his client denies the charges.


Kazarian and Mirzoyan were scheduled to appear in court Wednesday in Los Angeles.

Authorities began the New York-based investigation after information on 2,900 Medicare patients in upstate New York – including Social Security numbers and dates of birth – were reported stolen.

The defendants in the New York case also had stolen the identities of doctors and set up 118 phantom clinics in 25 states, authorities said. The names were used to submit fake bills for care that was never given, they said.

Some of the phony paperwork was a giveaway: It showed eye doctors doing bladder tests; ear, nose and throat specialists performing pregnancy ultrasounds; obstetricians testing for skin allergies; and dermatologists billing for heart exams.

In the New York portion of the case, more $100 million in fraudulent bills were submitted and Medicare paid out at least $35 million, sometimes by wiring it to the clinics' banks accounts, investigators said.

Most of the defendants "were Armenian nationals or immigrants and many maintained substantial ties to Armenia" and criminals there, the indictment said. Couriers would often carry cash proceeds from the fraud back to Armenia, it added.

Prosecutors were seeking forfeiture of real estate in Las Vegas; Palm Springs, Calif.; and elsewhere, and of a 2007 Maserati and a 2006 Jaguar.
 
http://www.nationalpost.com/news/Prescription+fraud+Canada+health+care+system+falls+victim/3655958/story.html

"Ms. Soria had been victimized by a brazen scheme that insurance investigators and professional regulators say is becoming increasingly common in Canada's health-care system: the theft of medical professionals' identity to obtain insurance payments for services that are either never rendered, or carried out by unqualified personnel.

Experts say clinics, spas and private individuals are usurping the names and registration information of practitioners ranging from massage therapists to psychologists and doctors frequently, then filing bogus claims, often in cahoots with the named patients. They can make tens of thousands of dollars using one stolen identity, with relatively little chance of being caught and almost none of facing criminal prosecution."
 
http://www.nationalpost.com/news/Prescription+fraud+Canada+health+care+system+falls+victim/3655958/story.html

"Ms. Soria had been victimized by a brazen scheme that insurance investigators and professional regulators say is becoming increasingly common in Canada's health-care system: the theft of medical professionals' identity to obtain insurance payments for services that are either never rendered, or carried out by unqualified personnel.

Experts say clinics, spas and private individuals are usurping the names and registration information of practitioners ranging from massage therapists to psychologists and doctors frequently, then filing bogus claims, often in cahoots with the named patients. They can make tens of thousands of dollars using one stolen identity, with relatively little chance of being caught and almost none of facing criminal prosecution."

you're actually helping me with this one...in the past few years there has been a massive push by the Conservative party to privatize healthcare, and the more they do so,,,the more and more we've seen of cases just like this above case so clearly notes
please note that it wasnt the government's fumbling that let this happen.. but a growing private market that is allowed to get away with more and more medical fraud
 
http://www.canada.com/national/nationalpost/news/cnspolitics/story.html?id=f1768dfb-3c25-4213-9046-a7c5164c3e7a

"When Dino Kornokios visited relatives in Toronto two years ago, the Greek citizen had more on his mind, it seems, than a family reunion.

Using bogus identification and residency documents, he obtained an Ontario medicare card and used it to procure $40,000 in health services at Canadian taxpayers' expense, police allege. Then he went back to Greece.

If Mr. Kornokios ever returns, he will face arrest on fraud charges laid last year. In the meantime, officers on the watch for such cases have plenty to keep them busy.

Mr. Kornokios is just one of 100 or so people -- including some Canadians -- investigated every year on suspicion they fraudulently sought treatment in Ontario's government-funded medical care system.

Similar health-card scams are reported across Canada, and are dwarfed by bigger, more elaborate frauds committed not just by patients, but often by those who treat them.

From doctors who bill for non-existent appointments to dentists who perform major restorative work on healthy teeth and organized rings that recruit every sort of health professional, economic crime saps billions of dollars a year, by some accounts, from the over-burdened health system."
 
http://network.nationalpost.com/np/.../2009/05/12/health-care-lies-about-canda.aspx


Another American blowhard
Just who is this jerk, Rick Scott of propaganda-mongering Conservatives for Patients’ Rights? He and his group are fabricating negatives about Canada’s health care system and I resent this. I am an American who has lived in Canada for more than 35 years. I can vouch that the system is more than adequate and is not run by civil servants but by doctors who are able to treat everyone, rich or poor.
Mr. Scott, and other conservatives (code for rich) are against universal health care without any justification whatsoever. Their criticisms are in accurate and should not be broadcast.
Where are the ethics in network broadcasting? I saw one of Scott’s ads on CNN recently and wondered why the same curation of content was not imposed on CNN advertising messages as is upheld editorially. If CNN is unwilling to vet content, then where is the FCC?


The real story
Here are the facts as to why Canada’s medical system, far from perfect, is dramatically better than America’s:
1. It is cheaper even though it takes care of the entire population, or 10% of GDP compared with 15% in the U.S.
2. Canada’s health care system which fully looks after 32 million people costs roughly what the private-sector health insurance companies make in profits in the United States looking after less than half the population for excessive premiums.
3. Canada’s health care system is cheaper still if the litigation costs of fighting over medical bills is eliminated as it is when the government is the sole-insurer. Estimates are that court costs and judgments add another 2 to 3% of GDP to the total medical tab.
4. Canada’s health care system enhances economic productivity. Workers diagnosed with illnesses can still change employers and be employable because they are not rejected by employers with health benefits due to pre-conditions.
5. Infant mortality is much lower in Canada and Europe than in the U.S.
6. Outcomes with major illnesses, such as cancer and heart disease, are better than in the United States.
7. Longevity is better in Canada and Europe than in the U.S.
8. No emergency is neglected in Canada.
9. Some elective procedures may take longer if compared to blue-ribbon U.S. health care but that’s no comparing apples with apples. More appropriately, the overall population’s care should be compared and there are tens of millions of Americans who are uninsured or uninsurable.
10. No one in Canada goes broke because of medical bills whereas ARP estimates half of personal bankruptcies are due to unpaid, high medical bills.
11. Canadians are able to choose their own physicians and to seek multiple opinions.
12. Canadian doctors and nurses are better trained than American counterparts and U.S. physicians must study for at least a year in order to qualify to practice in Canada.
13. Drugs made and invented in the United States are cheaper in Canada, Europe and Japan because our communal health care means volume discounts and savings passed along to society. Americans are overpaying.
14. Americans are being cheated by a patchwork quilt system where the highest risk people – veterans, the indigent and elderly – are insured by governments but the “gravy” or young, healthy people are handed over to private insurance companies.

Is Canada’s system perfect? No and nobody said it was. Networks should stop allowing propagandists to tell lies and any arguments about other countries’ practices should be ignored as totally irrelevant.
The United States is a rich and talented nation and it’s very upsetting to me, as an American, that it does not have the world’s best medical care for its citizens instead of one of the worst.
Americans deserve better.




Read more: http://network.nationalpost.com/np/...alth-care-lies-about-canda.aspx#ixzz12OVCcsEb
 
So you're admitting the first line of you OP was naively incorrect, by spouting a bunch of talking points containing a variety of half-truths?
 
and by pointing out a handful of individual cases that its inherently ineffective as opposed to a system that let a gang of criminals defraud people of hundreds of millions in your case?
 
and by pointing out a handful of individual cases that its inherently ineffective as opposed to a system that let a gang of criminals defraud people of hundreds of millions in your case?

Re-read the last line of post #4.

Comparing the Canadian and US health insurance systems is bit disingenuous.

There are more people on Medicare in the US than there are people in all of Canada.

There are more people living below the poverty threshold in the US than there are people in all of Canada.

To some of your other claims, here's someone who tries to compare objectively, if that's possible:

http://healthcare-economist.com/2007/10/02/health-care-system-grudge-match-canada-vs-us/
 
I'm missing the point here. The Armenians were nailed for defrauding the government out of $163 million, and somehow Obamacare is going to put a stop to it?
 
I'm missing the point here. The Armenians were nailed for defrauding the government out of $163 million, and somehow Obamacare is going to put a stop to it?

The claim is this never happens in Canada...see, the first line of the OP.

Don't lose too much sleep over the problem that this actually happens all the time in Canada, on a smaller scale with slightly different techniques.

That's not one of the talking points.
 
The claim is this never happens in Canada...see, the first line of the OP.

Don't lose too much sleep over the problem that this actually happens all the time in Canada, on a smaller scale with slightly different techniques.

That's not one of the talking points.

Would a talking point include the odds of a private insurance company getting bilked out of $163 million?
 
I really don't understand how a government system is going to stop people who are defrauding a government system.
 
I really don't understand how a government system is going to stop people who are defrauding a government system.

I've figured it out. Because Medicare funding is being slashed thanks to ObamaCare, there will be less for the government to be defrauded out of.
 
ObamaCare is Going to Fix It?

In the U.s. Medicare fraud was estimated at $60 billion in 2009 and has been in that area for several years. Damn they haven't been able to fix what we had and some 2400 page law that includes taxes on those who sell gold is not going to fix the fraud.

My dear young woman bigger government just means more opportunity for fraud.

As for Canada's system just a couple of bits of information.

More than half of Canadian adults (56 percent) sought routine or ongoing care in 2005 – of these, one in six said they had trouble getting routine care.

Fourteen percent of Canadians - approximately five million people - are still without a family doctor. Within this group, more than two million (41 percent) have tried to find a family doctor and were not successful

The Canadian Medical Association has openly expressed concerns regarding patient wait times and the strain of the system on providers.

Approximately 875,000 Canadians are on waiting lists for medical treatment

Despite a surge in spending during 2006 that represented a 5.8 percent increase from 2005 expenditures, wait times for patients in Canada are at an all time high.

# On average, Canadians have to wait:

* Four weeks for access to CT scans or ultrasounds;

* 17.8 weeks from general practitioners’ referrals to treatment by a specialist;

* More than eight weeks for MRIs; and

* Four or more months for surgeries deemed “elective,” such as hip replacements.

9# Nearly three-quarters of the patients waiting to see a specialist reported that they experienced worry, anxiety and stress, as did 60 percent of patients waiting for non-emergency surgery and diagnostic tests.

10# More than one-half of the people waiting for non-emergency surgery and diagnostic tests reported suffering pain because of the delay.

Canada is facing a brain drain as one in nine doctors who trained in Canada has left to practice medicine in the United States.

Three things I remember from the news over the last few years about Canada's health care system.

1. In Canada a man's Dr. thought he may have a brain tumor. The wait for an MRI was several weeks. He came to the U.S. and got the MRI and the U,S. Dr. removed the tumor and the man was recovering at home before he was due for his MRI at home.

2. A Member of Parliament came to the U,S. for cancer surgery because no Dr. in Canada could perform the procedure.

3. The woman in Canada who was going to deliver quads and she had to come to the U.S. because there was no Neonatal ICU available anywhere at home. BTW she came to North Dakota. North Dakota for Christs sake.

My own experience. My wife had both knees that needed to be replaced due to osteoarthritis. The referral to see the surgeon took about 4 days. Once she saw him he ordered MRI and within a week she had the imaging done.. Then told her she needed replacements. He was ready to do the surgery a week later.

Due some prior scheduling reasons she put it off a month. Her right knee was done in mid Jan. this year. Six weeks into her recovery she and I decided not to put off the 2nd. surgery. 2 1/2 weeks later she had her other knee replaced.

I just turned around and asked her how her new knees were compared to 10 years ago. Her answer. "Magnitudes better"

You might note the very short waiting times both for a referral to see a specialist and to get the diagnostic imaging, and the surgery done. My total out of pocket expenses was less then $500.

Just in case you think I'm a rich old white guy. I am old, I am white, and my income was only 50% above the is Poverty level for my family size.

I am more then willing and happy to live in the U.S. with the best health care system in the world.

Mike C.
 
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