Every year as much as $60 billion in taxpayer money is stolen from Medicare, which pays for the health care of seniors and the disabled. This massive rip-off is done through various schemes, but largely by fraudulently billing for services or medical equipment they do not provide. “The legitimate Medicare recipient is hurt, the legitimate business that’s dispensing this and serving patients is hurt, every taxpayer is hurt, and we need to come down on this with both feet," U.S. Secretary of Health and Human Services (HHS) Michael Leavitt told the press in December 2007. But no serious crackdown has taken place, despite calls by legislators from both parties. “Medicare fraud is running rampant across Florida and across the country,” Senator Mel Martinez, Republican of Florida, told The Miami Herald in February 2008 “We need to send a message to those bilking billions from the system that we won't stand for it and the penalties are going to be severe.” A Democrat, Representative Pete Stark of California, said bluntly of HHS’s weakness in detecting fraud: “This agency is incompetent,” he told The New York Times in August. A spokesman for the Centers for Medicare and Medicaid Services at HHS put the blame on Congress: “Over the past four years, the administration has requested $579 million for the Health Care Fraud and Abuse Control Fund. Congress has not provided any of these resources.” He also noted that, despite the Centers’ insufficient resources, the agency has saved billions of dollars through their existing fraud review processes and pilot programs.

Follow-up:
HHS Secretary Leavitt has suggested increasing the amount of money spent on reviewing claims and identifying fraud, but despite sustained bipartisan criticism, the problem persists.

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Politicians of all stripes have repeatedly pledged to reduce the number of Americans lacking health insurance, but since 2000, the number of uninsured people under age 65 has increased from 39.6 million to 45 million. In his 2000 presidential campaign, George W. Bush told The Associated Press, “I believe every American should have access to quality, affordable health care by giving consumers better information about health care plans, providing more choices such as medical savings accounts, and changing tax laws to help more people, such as the uninsured and the self-employed, afford health insurance.” But political progress on this vexing — and expensive — issue has proven elusive, and the United States remains the only wealthy industrialized nation that does not guarantee universal health insurance coverage for its citizens. While deep disagreement remains over how best to improve the American health care system, there is widespread consensus that the system is broken. Both 2008 presidential nominees acknowledged the problem and offered major — if very different — plans to reform the system to reduce the numbers of uninsured. According to an October 2008 poll by the Kaiser Family Foundation, 62 percent of registered voters agreed “it is more important than ever to take on health care reform.” A few states — most prominently Massachusetts and California — have taken up the issue of health care for the uninsured on their own, with varying degrees of success. But the failure of the federal government to make progress on this issue not only leaves many Americans without health care, but also costs the nation an estimated $65 billion to $130 billion each year, according to The National Academies’ Institute of Medicine.

Follow-up:
Throughout his presidential campaign, Barack Obama promised to enact reform to make health insurance “affordable and accessible to all” Americans. But questions remain about how he will finance his plan, and now some analysts wonder whether the costs and urgency of the financial bailout will push health care reform to the backburner.

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