An interesting dichotomy popped up at Wednesday’s Senate Finance Committee hearing on Strengthening Medicare and Medicaid.  Testifying before the Committee, Dr. Donald Berwick, Administrator for the Centers for Medicare and Medicaid Services (CMS), made an impassioned plea to promote and encourage preventative medicine for a number of healthcare problems such as diabetes and cancer, arguing that getting at the problems early would save thousands of lives and millions of dollars.  However when asked about Medicare fraud, prevention was nowhere to be found, ironically recommending after-the-fact enforcement.  With thinking like this, it’s almost certain the Medicare will be gurney-bound for the morgue by 2025.

Prevention in healthcare makes sense.   There’s a greater chance of survival when cancer is discovered at stage one rather than stage four, not to mention a greater variety of treatment options. When chronic conditions such as diabetes are found early, patients can more easily manage them, mitigating costly – not to mention deadly – complications.  So, if preventative medicine cuts costs and saves lives, it would only make sense to write the same prescription to protect the Medicare program itself, right?  Guess not.

When asked about the rampant fraud in the Medicare system, Dr. Berwick referred to the new tools in the Affordable Care Act.  But rather than applying the same logic of prevention, Dr. Berwick testified about adding additional law enforcement to find the criminals after the fraud has been committed.  There seems to be a fundamental disconnect between how this law – which Dr. Berwick is charged with implementing – deals with the health of patients and how it deals with the ‘health’ of the Medicare program, which is in a very real danger of flat-lining.

Medicare loses $60 billion due to fraud every year, a figure many experts and law makers believe to be conservative. If Dr. Berwick and CMS applied the same principles of preventive medicine to the financial solvency of the Medicare, it could save American tax payers literally billions of dollars in fraudulent claims every year. For instance, by using a secure Medicare identity document with strong multi-factor authentication, we can prevent a huge percentage of Medicare fraud, stopping it before it starts. Just as it is easier to cure stage one cancer rather than stage four, it is easier to not pay fraudsters than attempt to track them down and retrieve the money after they’ve scammed the system.

The Medicare Trust Fund is on the verge of bankruptcy because the system is plagued with fraud, all of which can be easily prevented. A secure Medicare ID card with strong multi-factor authentication is preventative medicine at its best, and just what the doctor should’ve ordered.

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