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  1.    #1  
    For all those that think the health care reform bill was just awful, please note the following.

    Authorities said busts carried out this week in Miami, New York City, Detroit, Houston and Baton Rouge, La., were the largest Medicare fraud takedown in history — part of a massive overhaul in the way federal officials are preventing and prosecuting the crimes.
    In all, 94 people — including several doctors and nurses — were charged Friday in scams totaling $251 million. Federal authorities, while touting the operation, cautioned the cases represent only a fraction of the estimated $60 billion to $90 billion in Medicare fraud absorbed by taxpayers each year.
    For the first time federal officials have the power to overhaul the system under Obama's Affordable Care Act, which gives them authority to stop paying a provider they suspect is fraudulent. Critics have complained the current process did nothing more than rubber-stamp payments to fraudulent providers.
    "That world is coming to an end," Health and Human Services Secretary Kathleen Sebelius told The Associated Press after speaking at a health care fraud prevention summit in Miami. "We've got new ways to go after folks that we've never had before

    The Associated Press: 94 charged in Medicare scams totaling $251M
  2. #2  
    Can't happen soon enough. For the record, I still think the general idea of govt run health care is.....not good. But certainly there will be some tangible benefits of the presidents legislation and this is one of them. I've never understood the excuse of "not having the man power" to crack down on medicare fraud. The money that could have been saved ($251 million in this case) could go a long way towards hiring some additional auditors to track down the crooks.
  3.    #3  
    I'm stunned. No comments from Groovy, Micael or Kam saying "thank you President Obama, for helping fight fraud in the private practice of medicine, and saving taxpayer money"? Amazingly quiet. Go figure.
  4. groovy's Avatar
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    #4  
    Quote Originally Posted by davidra View Post
    I'm stunned. No comments from Groovy, Micael or Kam saying "thank you President Obama, for helping fight fraud in the private practice of medicine, and saving taxpayer money"? Amazingly quiet. Go figure.
    Sorry davidra, I'm not in a position to respond immediately to every post. But I have to point out that the second paragraph seems to me to have little to do with the first. Fraud is fraud and it's no more illegal now than it was in 2007. In fact, I read that this is the third crackdown in a little more than 12 months. When did Healthcare reform get passed?

    I appreciate that they're cracking down on this type of fraud but why the mad rush right now? Sorry, I smell politics. Just like the politics behind the spate of immigration raids a couple years ago. We'll see how long this lasts.
  5.    #5  
    Quote Originally Posted by groovy View Post
    Sorry davidra, I'm not in a position to respond immediately to every post. But I have to point out that the second paragraph seems to me to have little to do with the first. Fraud is fraud and it's no more illegal now than it was in 2007. In fact, I read that this is the third crackdown in a little more than 12 months. When did Healthcare reform get passed?

    I appreciate that they're cracking down on this type of fraud but why the mad rush right now? Sorry, I smell politics. Just like the politics behind the spate of immigration raids a couple years ago. We'll see how long this lasts.
    Did you read the reference? Only the passage of the Health Care Reform bill has given them the ability to crack down. Specific provisions were written into it for that reason, and now they are implementing them. It is the health care reform bill that is enabling the crackdown now...not politics.
  6. groovy's Avatar
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    #6  
    Quote Originally Posted by davidra View Post
    Did you read the reference? Only the passage of the Health Care Reform bill has given them the ability to crack down. Specific provisions were written into it for that reason, and now they are implementing them. It is the health care reform bill that is enabling the crackdown now...not politics.
    So prosecuting those who file false claims wasn't possible before? Or it wasn't illegal to file false claims before? And how did they do it those other two times before Healthcare reformed passed?
  7.    #7  
    Quote Originally Posted by groovy View Post
    So prosecuting those who file false claims wasn't possible before? Or it wasn't illegal to file false claims before? And how did they do it those other two times before Healthcare reformed passed?

    The Affordable Care Act: New Tools to Fight Fraud, Strengthen Medicare and Protect Taxpayer Dollars

    The Affordable Care Act will improve and expand consumer protections, strengthen Medicare, and reduce health care costs. One important way it achieves these goals is by improving government-wide efforts to fight fraud and waste. The new law contains some critical new tools to improve and enhance the Administration’s efforts to prevent, detect and take strong enforcement action against fraud in Medicare, Medicaid and the Children’s Health Insurance Program as well as private insurance. The new law contains:
    Tough New Rules and Sentences for Criminals: The Affordable Care Act directs the Sentencing Commission to increase the Federal sentencing guidelines for health care fraud offenses by 20-50% for crimes that involve more than $1,000,000 in losses. The law makes obstructing a fraud investigation a crime and makes it easier for the government to recapture any funds acquired through fraudulent practices. And the law makes it easier for the Department of Justice (DOJ) to investigate potential fraud or wrongdoing at facilities like nursing homes.
    Enhanced Screening and Other Enrollment Requirements: The Affordable Care Act provides critical tools for fraud prevention, including new authorities for stepped-up oversight of providers and suppliers participating or enrolling in Medicare, Medicaid, and CHIP such as mandatory licensure checks. Based on the level of risk of fraud, waste and abuse, providers could be subject to fingerprinting, site visits and criminal background checks before they begin billing Medicare, Medicaid, or CHIP. The Act also allows the Secretary to prohibit new providers from joining the program where necessary to prevent or combat fraud, waste or abuse. The law also allows the Secretary to withhold payment to any Medicare or Medicaid providers if a credible allegation of fraud has been made and an investigation is pending.
    New Resources to Fight Fraud: The Affordable Care Act provides an additional $350 million over the next ten years to help fight fraud through the Health Care Fraud and Abuse Control Account (HCFAC) from FY 2011 through 2020. The Act also allows these funds to support the hiring of new officials and agents that can help prevent and identify fraud.
    Sharing Data to Fight Fraud: Building on the Obama Administration initiatives, the law requires the Secretary to expand the Centers for Medicare and Medicaid Services integrated data repository to include information from Medicaid, Veterans Administration, Department of Defense, Social Security Disability Insurance, and Indian Health Service, and enhances data matching agreements among Federal agencies. These agreements will make it easier for the Federal government to share data, identify criminals and prevent fraud. The DOJ and Office of the Inspector General (OIG) both receive clearer rights to access CMS claims and payment databases. The Secretary also now has authority to require States to report additional Medicaid data elements with respect to program integrity, program oversight and administration.
    New Tools to Prevent Fraud: The Affordable Care Act requires providers and suppliers to establish plans detailing how they will follow the rules and prevent fraud as a condition of enrollment in Medicare, Medicaid, or CHIP. Other prevention provisions focus on high fraud-risk providers and suppliers including Durable Medical Equipment (DME) suppliers, home health agencies, and Community Mental Health Centers (CMHCs). For example, CMHCs will now be required to serve at least 40 percent non-Medicare beneficiaries to crack down on centers that only bill Medicare and are not legitimate CMHCs.
    The bill also strengthens the government’s authority to require surety bonds as a condition of doing business with Medicare. To crack down on fraud in orders and referrals, providers and suppliers who order or refer certain items or services for Medicare beneficiaries will be required to enroll in Medicare and maintain documentation on orders and referrals.
    Expanded Overpayment Recovery Efforts: The Secretary is provided new authorities to identify and recover overpayments through the expansion of Recovery Audit Contractors (RACs) to Medicaid, Medicare Advantage and Part D (the Medicare drug benefit). Providers, suppliers, Medicare Advantage plans, and Part D plans must self-report and return Medicare and Medicaid overpayments within 60 days of identification.
    Enhanced Penalties to Deter Fraud and Abuse: The Affordable Care Act provides the OIG with the authority to impose stronger civil and monetary penalties on those found to have committed fraud. The Secretary also is provided new authority to prevent providers from participating in Medicare or Medicaid. For example, the Secretary may exclude providers and suppliers for providing false information on an application to enroll or participate in a Federal health care program. Individuals who order or prescribe an item or service while being excluded from a Federal health care program, make false statements on applications or contracts to participate in a Federal health care program and providers who identify a Medicare overpayment and do not return it are also subject to strict new fines and penalties under the new law. Finally, the law ensures that States may terminate a provider under Medicaid if a provider is terminated under Medicare or another State Medicaid program.
    Greater Oversight of Private Insurance Abuses: The new law also provides enhanced tools and authorities to address abuses of multiple employer welfare arrangements and protect employers and employees from insurance scams. It also gives new powers to the Secretary and Inspector General to investigate and audit the health insurance Exchanges. This, plus the new rules to ensure accountability in the insurance industry, will protect consumers and increase the affordability of health care.
    Implementation Progress to Date

    The Administration is already at work implementing provisions in the Act to help fight fraud. On April 30, 2010, HHS issued an Interim Final Rule with Comment that:
    • Requires inclusion of the National Provider Identifier on all applications and claims;
    • Requires physicians and eligible professionals who order or refer supplies, items, or services to be Medicare enrolled; and,
    • Requires physicians and suppliers to provide documentation of written orders for DME, home health or other items and services.
    • CMS also issued guidance notifying providers and suppliers of the new 12 month claims submission deadline under the new law.

    The Affordable Care Act: New Tools to Fight Fraud, Strengthen Medicare and Protect Taxpayer Dollars



    Whistleblowers Remain Most Powerful Tool in Fighting Medicare Fraud
    While the debate rages on about the viability of healthcare reform, two things are certain: (1) Medicare and Medicaid have been and will continue to be fertile grounds for fraud; and (2) whistleblower suits are the most effective tools for ferreting out false claims and healthcare fraud.
    Since 2009, nearly $6 billion has been recovered in state and federal false claims act cases (including criminal penalties). Under the federal and False Claims Act, whistleblowers may file actions on behalf of the federal government to recoup Medicare false claims. Likewise, many states have false claims act that permit whistleblower suits for Medicaid false claims.
    With a few minor differences most state false claims acts operate like the federal False Claims Act, requiring that treble damages be paid for fraudulent billing and up to $11,000 per false bill be levied as a penalty. Actions brought by whistleblowers are known as qui tam lawsuits and by statute result in a whistleblower award of between 15-25% of any recovery based on credible, first-hand knowledge by the whistleblower. In cases where the whistleblower is permitted to proceed alone, he or she may receive up to 30% of the recovery based upon her efforts and involvement in the suit.
    While the Affordable Care Act provides many new criminal and civil penalties and new tools for fighting healthcare fraud, it is the whistleblower protection provisions that are likely to be the most used - and most litigated. As word of enhanced whistleblower protection spreads, more and more individuals with knowledge of healthcare fraud are likely to come forward. No matter what you think about healthcare reform, that's a good thing.
    Affordable Care Act - What Does it Mean For Medicare Fraud Whistleblowers?

    Thank you, President Obama.
  8. groovy's Avatar
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    #8  
    So, what they're saying is that whistleblower protections needed for the future because they've provided valuable information in the past. That says nothing about how this PPACA was in the least bit responsible for these recent crackdowns. I propose, considering the time it takes to set up a sting, get warrants, etc, that nothing in the PPACA had anything to do with this. That said, it may be responsible for these recent arrest being prosecuted more severely, but that remains to be seen.

    As I said, I appreciate the good start. Time will tell if it's a sign of things to come or politics as usual. One thing is for sure, Sebelius trying to link these arrests to the passage of healthcare reform is politics as usual.
  9.    #9  
    Quote Originally Posted by groovy View Post
    As I said, I appreciate the good start. Time will tell if it's a sign of things to come or politics as usual. One thing is for sure, Sebelius trying to link these arrests to the passage of healthcare reform is politics as usual.
    I disagree. Please note this.

    March 24, 2010
    Health Care Reform Legislation Seeks Funding for 13 New Health Care Fraud Stike Forces

    As reported previously here, a central feature of the Obama administration’s health care reform has been the HEAT (Health Care Fraud Prevention and Enforcement Action Team) initiative is the use of Strike Force teams. Strike Forces are multi-agency units of Federal and State law enforcement personnel designed to identify, investigate, and prosecute Medicare fraud. Strike Forces are supported by a CMS data analysis team and CMS program experts.
    Since May 2009, this Administration has expanded Strike Force cities from Miami and Los Angeles, when Strike Force teams were launched in Houston and Detroit in May 2009 and in Brooklyn, Baton Rouge, and Tampa in December 2009. (To read more, click: here).
    Building on the momentum started last May, U.S. Department of Health and Human Services Deputy Secretary William Corr and U.S. Department of Justice Acting Deputy Attorney General Gary Grindler, testified earlier this month before the United States House of Representatives Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Committee on Appropriations and stated that the entire $250 million increase in the President’s Budget advances the goals of the HEAT initiative.
    Strike Force defendants are also more likely to receive prison sentences and longer terms of imprisonment than more traditional criminal health care fraud defendants. Since the Strike Force’s inception, over 94% of all Strike Force defendants were convicted and sentenced to terms of imprisonment compared to 64% of all criminal health care fraud defendants. The average prison term for Strike Force defendants was 45 months, which was about 10% longer than the overall national average for federal health care fraud defendants over this same period.
    New Strike Force locations are chosen based on thorough analysis of Medicare claims data, which helps identify hot spots of unexplained high-billing levels in concentrated areas, and a review of the most effective allocation of investigative and prosecutorial resources. The cost associated with Strike Forces expansion resulting in 20 locations by end-of-year FY 2011 is an estimated $46 million.
    Health Care Fraud Blog :: Published by Miami and Fort Lauderdale, Florida, Healthcare Attorney & Medicaid, Medicare, and Insurance Fraud Defense Lawyer, Robert David Malove

    I do have some inside knowledge about this. Bill Corr, who is noted in this article, has been a close friend of mine for thirty years, and in fact worked with me in east Tennessee. In fact, I helped him get his first job in Washington. I can tell you that this recent investigation was definitely related to the expansion of fraud investigations begun by this adminstration, and assisted by the legalities provided by the reform bill. And as you point out, the prosecution will be much more vigorous. This administration had already cracked down on fraud before the bill, and even more will take place in the future.
  10. #10  
    Health care fraud in itself is largely a fraud. The system is essentially so broken an convoluted that practically ALL health care agencies are to one degree or another "guilty" of "fraud" due to a multitude of non nefarious reasons such as confusion/disagreement of charge definitions, charting requirements etc. Add to that the protected get rich quick aspect the government has (not new to obamacare) given to whistleblowing and it's becoming near to malpractice in the level at which it rapes the coffers of money meant to pay for patient care.
  11.    #11  
    Quote Originally Posted by babydaddy75 View Post
    Health care fraud in itself is largely a fraud. The system is essentially so broken an convoluted that practically ALL health care agencies are to one degree or another "guilty" of "fraud" due to a multitude of non nefarious reasons such as confusion/disagreement of charge definitions, charting requirements etc. Add to that the protected get rich quick aspect the government has (not new to obamacare) given to whistleblowing and it's becoming near to malpractice in the level at which it rapes the coffers of money meant to pay for patient care.
    The system is indeed badly broken and has been for years. The best solution is a single payor plan and universal coverage. Everyone's covered for everything. It's amazing how easy that makes things. Yes, there would be documentation requirements, but they could be simplified easily. There would still be fraud, but it would be easier to detect.
  12. #12  
    Agreed
  13. groovy's Avatar
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    #13  
    Quote Originally Posted by davidra View Post
    I do have some inside knowledge about this. Bill Corr, who is noted in this article, has been a close friend of mine for thirty years, and in fact worked with me in east Tennessee. In fact, I helped him get his first job in Washington. I can tell you that this recent investigation was definitely related to the expansion of fraud investigations begun by this adminstration, and assisted by the legalities provided by the reform bill. And as you point out, the prosecution will be much more vigorous. This administration had already cracked down on fraud before the bill, and even more will take place in the future.
    If that is indeed the case, it's something to be applauded. Cracking down on fraud is something to be applauded in any case. Like I said, we'll see how long it lasts. Hopefully, it will go a long way in cleaning up the system but it will still be somewhat of a drop in the bucket compared to the overall cost but. On the other hand, in paying for this behemoth every little bit will help.
  14. KAM1138
    KAM1138's Avatar
    #14  
    Quote Originally Posted by davidra View Post
    I'm stunned. No comments from Groovy, Micael or Kam saying "thank you President Obama, for helping fight fraud in the private practice of medicine, and saving taxpayer money"? Amazingly quiet. Go figure.
    As if I'm spending my time waiting for some claim of yours to come up. Just another example of your incredibly dishonest way that you go about behaving here. Really--a fine example of the slimey way that you operate--posting as if my not waiting here to comment on your claims is my being "amazingly quiet."

    Let's address the inherent lie in your claim. One need not pass many harmful things in order to have one helpful thing. If you were an honest person you'd acknowledge that I (and others) advocated addressing the fraud that exists, period. Actual Reform efforts that would allowed for more effective fighting of Fraud could have been passed a year before, your little pet nightmare bill, so please stop with the endless dishonesty.

    If this does have good results, I'd be happy to congratulate President Obama for whatever part he had in that. Only an ***** would lack the ability to discern that one must not hate all parts of a bill to oppose it. That kind of blunt, dishonest evaluation might be something that people like you depend on, but I'm not handicapped by that failing.

    Further--you're touting this as some sort of example of great government action, forgetting that this fraud is due to sloppy work on behalf of the government previously. You're acting as if BEFORE this, it was legal to defraud the government (taxpayer) of money. Utter nonsense. Oh, yes, thank you government for eliminating SOME of the waste that you allow, burning our tax money. Oh, thank you Mr. Obama for harming me LESS than you did before.

    Speaking of Fraud however...here's an article that puts to rest a number of lies that the Obama administration engaged in regards to this so-called "reform" bill.

    http://www.nytimes.com/2010/07/18/he...alth.html?_r=1

    You see--its the same old playbook move, by a government that believes it has no limits. Sell the public on a lie (that this isn't a tax) and then go to court saying that it is. This is of course right out of the FDR playbook.

    Now, of course, this argument is a crock of nonsense--which demonstrates that this administration will argue anything they need to get what they want, but it reveals the inherent fraud that was perpetrated in passing this "reform" bill.

    For people interested in liberty and a proper limited role of government (which our Constitution demands), this is literally arguing that there are no limits.

    Again, with this "reasoning" which is nothing more than an demand for unfettered power, what exactly CAN'T the government do? According to the Criminals forwarding this notion, the government literally can tell you what you must purchase with your own money.

    I don't care what your political bend is--if this sort of reasoning, which is a thinly veiled "We do what we want", doesn't concern you, then you're a serf at best.

    KAM
  15. KAM1138
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    #15  
    Quote Originally Posted by davidra View Post
    I'm stunned. No comments from Groovy, Micael or Kam saying "thank you President Obama, for helping fight fraud in the private practice of medicine, and saving taxpayer money"? Amazingly quiet. Go figure.
    Let me also point out the hypocrisy that comes with this given that you've pooh-poohed, fraud as a significant problem in terms of scope. So, while you didn't oppose that, you argued against it being of paramount importance, but now turn around and tout it, as if it should justify the entire law.

    EDIT: The comments I was thinking of were likely in reference to Tort Reform, not fraud.

    KAM
    Last edited by KAM1138; 07/19/2010 at 09:10 AM. Reason: Correction
  16.    #16  
    Quote Originally Posted by KAM1138 View Post
    Let me also point out the hypocrisy that comes with this given that you've pooh-poohed, fraud as a significant problem in terms of scope. So, while you didn't oppose that, you argued against it being of paramount importance, but now turn around and tout it, as if it should justify the entire law.

    Typical, irrational, inconsistent "reasoning" I've come to expect.

    KAM
    Sorry. You are, as usual, totally wrong. Please show me one instance where I said fraud was not a significant problem. Sometimes your lack of perspective clouds the truth. No, sorry. Almost always your lack of perspective clouds the truth.

    And this is a fine example. Instead of commenting on whether or not you think the President of the United States has been effective in getting a law passed that will dramatically reduce fraud, your comment is incorrectly directed at me. Not that I actually expected you to address the point of the thread. That would be too painful for you.
  17. KAM1138
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    #17  
    Quote Originally Posted by davidra View Post
    Sorry. You are, as usual, totally wrong. Please show me one instance where I said fraud was not a significant problem. Sometimes your lack of perspective clouds the truth. No, sorry. Almost always your lack of perspective clouds the truth.
    EDIT: I had mistaken comments about Tort Reform (and the costs) with fraud.

    Quote Originally Posted by davidra View Post
    And this is a fine example. Instead of commenting on whether or not you think the President of the United States has been effective in getting a law passed that will dramatically reduce fraud, your comment is incorrectly directed at me. Not that I actually expected you to address the point of the thread. That would be too painful for you.
    I guess you missed where I said: If this does have good results, I'd be happy to congratulate President Obama for whatever part he had in that.

    KAM
    Last edited by KAM1138; 07/19/2010 at 09:11 AM.
  18.    #18  
    Quote Originally Posted by KAM1138 View Post
    You've stated many times that it just wasn't a major factor--it wouldn't add up to that much. That was your typical response to anyone who focused on fraud.



    I guess you missed where I said: If this does have good results, I'd be happy to congratulate President Obama for whatever part he had in that.

    KAM
    I apologize. I missed your first post, and only saw the second. However, I have never said that fraud was minimal. You may be confusing that with my comments about tort reform, which has been demonstrated to not decrease costs. Anyone from Florida, the hotbed of Medicare fraud, would know that Medicare fraud is horrendous, and essentially takes health care away from those that need it. Why would I not support any measures to stop it? Since I favor a system that expands Medicare coverage to all, and have stated that in the past, doing away with fraud is essential for that to be successful and decrease costs. Given that Medicare recipients are very happy with the quality of their coverage, protecting Medicare from idiots that want to privatize it is high on my list of priorities, and stopping fraud is one way of doing that.
  19. KAM1138
    KAM1138's Avatar
    #19  
    Quote Originally Posted by davidra View Post
    I apologize. I missed your first post, and only saw the second. However, I have never said that fraud was minimal. You may be confusing that with my comments about tort reform, which has been demonstrated to not decrease costs. Anyone from Florida, the hotbed of Medicare fraud, would know that Medicare fraud is horrendous, and essentially takes health care away from those that need it. Why would I not support any measures to stop it? Since I favor a system that expands Medicare coverage to all, and have stated that in the past, doing away with fraud is essential for that to be successful and decrease costs. Given that Medicare recipients are very happy with the quality of their coverage, protecting Medicare from idiots that want to privatize it is high on my list of priorities, and stopping fraud is one way of doing that.
    Fair enough--I might have been thinking of your comments on Tort Reform, rather than fraud. If so, that is my mistake, and I retract my statement in regards to that. In fact--I'll even edit that post to note the mistake.

    I should note however, that even in my mistake, I didn't state that you opposed Fraud (or Tort Reform).

    KAM
    Last edited by KAM1138; 07/19/2010 at 09:15 AM.
  20.    #20  
    Quote Originally Posted by KAM1138 View Post
    As if I'm spending my time waiting for some claim of yours to come up. Just another example of your incredibly dishonest way that you go about behaving here. Really--a fine example of the slimey way that you operate--posting as if my not waiting here to comment on your claims is my being "amazingly quiet."

    Let's address the inherent lie in your claim. One need not pass many harmful things in order to have one helpful thing. If you were an honest person you'd acknowledge that I (and others) advocated addressing the fraud that exists, period. Actual Reform efforts that would allowed for more effective fighting of Fraud could have been passed a year before, your little pet nightmare bill, so please stop with the endless dishonesty.

    If this does have good results, I'd be happy to congratulate President Obama for whatever part he had in that. Only an ***** would lack the ability to discern that one must not hate all parts of a bill to oppose it. That kind of blunt, dishonest evaluation might be something that people like you depend on, but I'm not handicapped by that failing.

    Further--you're touting this as some sort of example of great government action, forgetting that this fraud is due to sloppy work on behalf of the government previously. You're acting as if BEFORE this, it was legal to defraud the government (taxpayer) of money. Utter nonsense. Oh, yes, thank you government for eliminating SOME of the waste that you allow, burning our tax money. Oh, thank you Mr. Obama for harming me LESS than you did before.

    Speaking of Fraud however...here's an article that puts to rest a number of lies that the Obama administration engaged in regards to this so-called "reform" bill.

    http://www.nytimes.com/2010/07/18/he...alth.html?_r=1

    You see--its the same old playbook move, by a government that believes it has no limits. Sell the public on a lie (that this isn't a tax) and then go to court saying that it is. This is of course right out of the FDR playbook.

    Now, of course, this argument is a crock of nonsense--which demonstrates that this administration will argue anything they need to get what they want, but it reveals the inherent fraud that was perpetrated in passing this "reform" bill.



    KAM
    Having apologized for missing the one comment that actually addressed the thread, however, the rest of the post is your usually puffery and nonsense. I'm sure that in your head of heads you really think that the republicans would have passed anything that the President of the United States wanted passed, even to control fraud. That's your fantasy world.
    As for me, I'm fine with them calling it whatever they want. I would prefer if they are going to call it a tax, then we should just go to universal coverage and increase taxes as needed to pay for it, but one does what one has to do to get the necessary end product, which in this case is health care for all who need it. I have not ever apologized for justifying any means to this end. It supplants politics as far as I"m concerned, so I'm good with whatever it takes to reach that goal. You feel free to consider that an invasion of your liberties. Believe me, I could care less. There are things more important than theoretical arguments. This is one.
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