It is one of the principal reasons the health care industry spends more money lobbying Congress than any other industry.
07.03.2026 15:48 โ ๐ 1 ๐ 0 ๐ฌ 0 ๐ 0@mfcannon.bsky.social
โAn influential health care wonk at the libertarian Cato Instituteโ โ Washington Post. โA pleasant discoveryโ โ Capitalism magazine. Washingtonianโs โMost Influential Peopleโ in DC 2021-present.
It is one of the principal reasons the health care industry spends more money lobbying Congress than any other industry.
07.03.2026 15:48 โ ๐ 1 ๐ 0 ๐ฌ 0 ๐ 0
Health care industry lobbyists defang every effort to make Medicare more efficient.
www.cato.org/policy-...
In 1996, scientist Carl Sagan lamented Congress abolishing the Office of Technology Assessment in 1995: youtu.be/ROx2iCGE4dY
That event occurred because health care industry lobbyists did not want Congress studying how wasteful the supposedly efficient Medicare program is.
Consider: AL, KS, SD & WY would get more Medicaid money from the federal government under the OBBBA. All four are smaller states with two GOP senators.
05.03.2026 19:55 โ ๐ 1 ๐ 1 ๐ฌ 0 ๐ 0This raises the question of whether drafters deliberately structured OBBBA provisions to โbuyโ enough votes to ensure passage, and found the support of senators form those sparsely populated states carried the lowest fiscal price.
05.03.2026 19:55 โ ๐ 1 ๐ 0 ๐ฌ 1 ๐ 0
The study could spur further profitable research, including into correlations between OBBBA state fiscal impacts and statesโ political makeup.
Example: Wyoming and South Dakota would see net increases in federal Medicaid funds.
A new @RANDCorporation study provides important perspectives on how various provisions of the OBBBA will affect Medicaid overall and individual states.
The correlation isnโt perfect, but it projects many Democratic states will lose money and many GOP states will save money.
www.washingtonpost.c...
01.03.2026 15:41 โ ๐ 0 ๐ 0 ๐ฌ 0 ๐ 0
โWe have to avoid overlearning the lessons of the past.โ
- JD Vance
The CBO said the Obamacare-exempt plans often covered more expenses (lower deductibles and cost-sharing) and more providers (broader networks) than Obamacare plans.
All while making health insurance affordable without government subsidies.
Itโs not the case that everyone is a fraudster.
Itโs not only the far right that harbors those antisocial thoughts.
I encourage everyone to remember that, while fraud against government programs is bad, other things that government does are far worse: open.substack.com/pub/mfcannon...
We should see what they find and take it from there.
But the biggest question at the moment is, why werenโt these data publicly available from the start? Why did it take 60 years?
(Answer: the fraud lobby.)
As for why private-sector individuals are digging into the data, no doubt many are good civic-minded folk who are trying to do their part for God and country.
Others may have more political motives (e.g., they want to make a point about immigration).
Between the political constraints and their inadequate funding (itself a result of political constraints), they might not even try.
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0So even if the bureaucrats were looking at the new Medicaid data and saw home-health hot spots in Brooklyn and elsewhere, they might not get very far if they pressed the matter.
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0"...Democrat of New York, and other politicians.โ Medicare officials, no doubt expressing a sentiment shared by members of Congress, admit they avoid aggressive anti-fraud measures that might reduce access to treatment for seniors.โ
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0"When the federal government began poking around a Buffalo school district that billed Medicaid for speech therapy for 4,434 kids, the New York Times reported, โthe Justice Department suspended its civil inquiry after complaints from Senator Charles E. Schumer...
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0
People think Iโm kidding when I say there is a fraud lobby, but there are absolutely powerful interest groups that lobby to preserve the ease with which people get money from these programs:
โPoliticians routinely subvert anti-fraud measures to protect their constituents.
Congress has made it so easy for people to bill Medicare and Medicaid, and uses so few antifraud measures, that those programs are effectively giant ATMs. Anyone who punches in the right numbers can make off with bags of cash.
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0Oh, and the health care industry spends six times more than the defense industry on congressional lobbying.
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0In government health programs, itโs far worse. Health the largest category of federal spending, the programs are vastly more complex (harder to police), and recipients have even less patience for antifraud measures. Health care can be a matter of life and death, after all.
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0So, to the extent the government tries to use them in Social Security/EITC/WIC/etc., we complain to our members of Congress. We complain, and Congress dials back the anti-fraud measures, until the complaints and the antifraud measures reach an equilibrium.
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0When itโs the governmentโs money, weโre not willing to put up with those inconveniences because subsidy recipients and taxpayers receive effectively zero personal benefit from assisting with or tolerating those antifraud measures. The savings do not redound to us.
25.02.2026 17:28 โ ๐ 0 ๐ 0 ๐ฌ 1 ๐ 0If you didnโt tolerate those things, if you switched to a credit card company that didnโt employ such measures, youโd have to pay more (likely, via a higher interest rate).
25.02.2026 17:27 โ ๐ 1 ๐ 0 ๐ฌ 1 ๐ 0Ditto when they block the occasional unusual purchase. You tolerate it because itโs not much of an inconvenience, and it saves you money.
25.02.2026 17:27 โ ๐ 1 ๐ 0 ๐ฌ 1 ๐ 0We โvoteโ on those approaches, taking their costs and benefits into account when we choose where to shop, where to bank, etc. Your credit card company requires you to input your zip code at the gas pump because doing so prevents a substantial number of frauds.
25.02.2026 17:27 โ ๐ 1 ๐ 0 ๐ฌ 1 ๐ 0
Hereโs how I just explained the problem of fraud in government programs.
Humans bring fraud. Itโs everywhere.
People who provide us goods and services take various steps to protect themselves and us from fraud.
As bad as Medicare and Medicaid fraud are, far worse are the countless ways government violates our health care rights and places health care out of reach of vulnerable patients.
mfcannon.substack.co... #CatoSOTU
"Covid-related frauds...exceeded $280B...Obamacare enrollment fraud is pervasive, likely costing taxpayers $27B...[CMS] made $87B in 'improper payments' to fraudsters and people who provided insufficient documentation in 2024."
www.cato.org/comment... #CatoSOTU