Where's the outrage over Bay State's health care giveaway?
by Barbara Anderson

The Salem News
Wednesday, April 6, 2011

So I was talking with the state inspector general last week about the people from 48 other states who are coming to Massachusetts to get free medical care. He put out a report on it last month that hasn't received the attention or outrage it deserves.

I've known IG Greg Sullivan since he was the state representative from Norwood, one of the last real Beacon Hill Democrats, serving during the era when conservative Dems were standing up to Gov. Michael Dukakis. They and the Republicans were resisting the second major Dukakis tax hike, which included a sales tax on services.

Legislators were told that this new tax would cover only the services used by "the rich" such as the fees charged by accountants, lawyers, and architects.

Rep. Sullivan did some quick research at the Department of Revenue and stood during debate to read the list of 594 services that would be taxed, which included your haircut and neighborhood kids mowing your lawn. After his hour-long performance, the overall tax bill passed by only a few votes; and the sales tax on services section was repealed the next year, after Bill Weld became governor, and before it took effect.

So I was pleased when Sullivan became head of the independent watchdog agency created in 1981 with a mission to "prevent and detect fraud, waste, and abuse in the expenditure of public funds." His latest report, titled "Ongoing Analysis of the Health Safety Net Trust Fund," is what my dad would have called "a doozy."

One of the viable arguments for passing what everyone now calls RomneyCare in 2006, was to address the problem of the "free care pool" that provided free medical care to Massachusetts residents (including illegal immigrants) who didn't have insurance. Since hospitals couldn't absorb these costs alone, eventually insurance companies and businesses that provided health insurance had to chip in. Those of us with insurance paid for this through higher premiums and longer waits in emergency rooms, which the uninsured used for general medical care.

RomneyCare was intended to relieve the pressure on emergency rooms by getting almost everyone to take some responsibility for their health care by buying basic insurance (which was supposed to be "affordable"), then creating the Health Safety Net (HSN) for the poor. It was made clear that only Massachusetts residents would be eligible for this care, and the state was supposed to have a validation system like the one used for Medicare, Medicaid and by health insurance companies for their own claims.

I called Sullivan to ask what went wrong. He told me that instead of building the new system on those existing models, state bureaucrats decided to create their own oversight system. It was harder than they thought, so after three years they gave up!

They gave up! There is no claim oversight system! There's just a place where bills go to be paid, no questions asked! No proof of residency is required, no Social Security number, no proof that the claimant is actually "poor."

Sullivan's office hired its own auditor. During the one year checked, ending June 30, 2010, $405 million was paid out in claims from hospitals and community health centers. Millions were paid in duplicate claims and medically unnecessary claims that a private insurance company would have caught.

Sullivan told me that the average insurance company rejects 10 percent of claims. HSN had some 20 percent of claims that were questionable and rejected none of them.

When the Office of the Inspector General (OIG) inspected, it found that people from every state but Arizona and some foreign countries have received free care here, at our expense (roughly $7 million worth).

The OIG, as required by statute, reported the lack of oversight to the Patrick administration, which had already acknowledged last fall that $35.7 million had been spent on emergency health care for 52,000 illegal immigrants in one year.

The governor says the report is exaggerated. I don't know how you exaggerate audit numbers. I think he means our concern about this outrage is misplaced, in his humble opinion.

Being interviewed last week by Howie Carr on WRKO, Sullivan noted a paid $4,000 claim for a bottle of Lipitor and a claim paid for someone born in 1880, just to give an idea of what can get through the non-existent HSN validation system. Bills were paid for men who had hysterectomies, women who had vasectomies, and people with headaches who had a foot X-ray.

After the Boston Herald covered the quietly-released report [here and here], Republican state senators called for better verification of applicants' eligibility and improved safeguards. During the recent supplemental budget debate, Sen. Bruce Tarr, R-Gloucester, filed three amendments to the state's 2011 supplemental budget to crack down on the flaws in the system. The amendments failed. The one roll call shows that besides Tarr, only the three other Senate Republicans and two Democrats, voted in favor.

All our North Shore Democratic senators voted to let out-of-staters keep getting free care while we residents struggle to pay our required health insurance premiums, and then pay more to cover the unaccountable free care pool with taxpayer subsidies. Remember this doozy in November 2012.

The comments made and opinions expressed in her columns are those of Barbara Anderson
and do not necessarily reflect those of Citizens for Limited Taxation.

Barbara Anderson is executive director of Citizens for Limited Taxation. Her column appears weekly in the Salem News and other Eagle Tribune newspapers; bi-weekly in the Tinytown Gazette.

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