Dr. Paul Winfree - Medicaid Fraud

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On fifty five KRC, the talkstation Ato six here fifty five car CD talk station and a happy Thursday to you. Out of the r with Irbdadation Next.

Mer Jay Rattler.

But right now I'm really excited and please welcome to the fifty five KRC Morning Show. Doctor Paul Winfrey, President CEO of an organization called the Economic Policy Innovation Center. He served a top management policy roles in the White House, US Senate as well as think tanks, and during the first Trump administration, he served as the Deputy Assistant to the President for Domestic Policy and Deputy Director of Domestic

Thanks for having me. I appreciate it. Well.

When you read the news, you think the world is coming to an end. Oh my god, eight point six million people are going to be deprived of healthcare if these reforms go in that the Republicans are talking about. Let us start with it seems to me that many of the Democrats who are railing against requiring people who are able bodied in their prime work years to actually participate and work or do something for twenty hours a week,

That's exactly right.

I mean, if you break down the eight million person number or the eight million lost coverage number, one point four million of those folks are illegal immigrants. One and a half million of them are not eligible for Medicaid, but they've been retained on the program by regulations that are promulgated by the Biden administration. Another couple of million are people who don't even exist right now, but CBO says may exist in the future and maybe eligible for Medicaid.

So what they've done is they've undermined Medicaid's original intent. They put all these people on who weren't eligible for it originally. How is it that it expanded so much and people didn't say, well, well, whoa whoa, we're we're this is this has gone way on the scope of what was truly intended, yeah.

To get this.

When Obamacare was created in twenty ten, and then it expanded the Medicaid program to the healthy adults in twenty fourteen, they knew that states would be disinclined to expand Medicaid to the healthy population because it would have added to their state budgets, and so what they did is they set up a new financing structure that rewards states for

So the left has been advocating for universal health care. I mean it was supposed to Obamacare is supposed to do that. I know Hillary Clinton never to do it back when she was the first lady. But obviously it didn't go through then. But this sounds just like a nefarious backdoor mechanism to create that reality because more and more people are expanded put on Medicaid and are not in private insurance or or dealing with it on their own.

So the left has been talking for years about Medicare for all, right, Bernie Sanders has been talking about Medicare for all for years.

You've got bills to do this.

Democrats in the House, Aos, they also have bills to do this. The real trojan horse here is that it was never intended to be Medicare for all. It was intended to be Medicaid for all. And one of the big differences that seniors know between Medicare and Medicaid is that doctors get paid much less for seeing the vulnerable population in Medicaid than they do for Medicare or private health insurance.

Or even Medicaid for the healthy.

Adults because of the incentive structure to push medicine towards the healthy adults in the Medicaid program. What that means is that right now today there are about seven hundred and ten thousand disabled Americans on Medicaid wait lists to get things like home health care because the states have again been incentivized not to spend on that population because that's what the federal government has been telling them to do.

That's where we're going right now.

Eighty million Americans are on Medicaid, a program that was originally intended to be for the truly vulnerable.

And I know you've pointed out in your research, your in your writings on this that states exploit medical Medicaid with with what you referred to as loopholes, private provider taxes and state directed payments which you I think referred to as money laundering schemes.

How do these work?

And isn't this a reform that should be incorporated into what the Republicans are trying to do right now?

So the Medicaid provider taxes. If if the private sector were.

To do this, it would be illegal. People will go to jail.

Literally.

What happens is that the states tax medicaid providers, insurers, and hospitals in particular. They then re burse the same amount of money that they're taxing the hospitals and the insurance. So they pay the insurers and the hospitals to pay the tax. They then bill the federal government for the amount of that tax, and the federal government reimburses the state.

The states then split the.

Money that they get from the federal government with the providers, so they send it to the insurers and through higher capitation rates or higher premiums, and they send it to the hospitals through to higher payments.

But here's the really wild thing that's going on here again. Because states get.

Nine dollars from the federal government for every one dollar that they spend on the healthy population, they're incentivized to gain this in particular in the direction of the healthy population.

And so what we're seeing right.

Now play out in quite literally real time is that there's a pollution between state governments and the hospitals and the insurers to figure out ways in which they can increase premiums and prices for the healthy adult population to take advantage of these money laundering schemes. And what that's doing is it's quite literally redirecting the way that medicine is delivered so that the vulnerable folks don't want to

And personally, I mean, just as a as a.

Tax paying American, I think that that's wrong, and I don't want to see my own my own tax dollars go for things like that.

That structure is just.

I'm just mine. My mind is boggled by this, doctor Winfrey. And then that's the way it exists, creating zero incentive whatsoever for states to want to reign in or or ride heard over the medicaid dollars that are being spent. I mean, there's zero incentive there.

Their zero incentive. And we've seen, I mean, your listeners know exactly.

The states that have abused this the.

Most without me even saying the names, California and New York. But California and New York have used these money long during scams to funnel more and more money back to the back back to the state governments from the Feil government. They've then used the profits from these money laundering scams to provide health insurance medicaid for illegal immigrants, but also to pay for things that have absolutely nothing to do with healthcare to fund budget shortfalls in their own states.

Some of those loopholes.

But really I think that they can go even even further than what than what they're doing well.

And you know, it's sort of like I wish the American public who could listen to this particular interview now or at least have the understanding that doctor Winfrey here has, because then they would easily reject these screams and wailing and gnashing of teeth about all these eight million people are going to lose their medical benefits because as you describe it, of course clearly they shouldn't have them anyway.

I think would rile people up and will be anger.

That's exactly right.

The Congressional Budget Office just last week put out a letter that said that if you reduced the f MAP, or the amount of the federal contribution for the healthy population, down to the rate that the philogarment paced for the vulnerable population, it will save about seventy one billion dollars a year. At the same time, only about two million

I can only imagine the lobbying frenzy that's going on right now in DC given this as a topic of conversation with reconciliation.

It's absolutely incredible.

Let me give you another just a quick fact here that really surprised me when I discovered.

It a couple of months ago, and.

That is is that the highest compensated healthcare insurance CEO in the country is a Medicaid managed care provider. He covers Medicaid recipients. Eighty eight percent of his beneficiaries are on Medicaid, the rest are on the other twelve percent are either on Obamacare subsidized plans or Medicare advantage plan. They cover about five point two million people in America. This is the highest compensated health insurance CEO in the country.

Welfare to people, right.

I think that that's wrong and also one.

In which one hundred percent of your revenue is connected to the federal government. Right, Like we should, you know, we should have a better profit motive for people who could make money by actually improving people's lives and making them healthier.

Amen to that sounds like a lot of the problems we're have with non governmental organizations just generally speaking. I mean, they exist to create jobs for the people that work within the organizations and taking federal taxpayer dollars and really I think going out into the world and literally accomplishing nothing except perhaps letting the money loop back a little bit to line the pockets and politicians in DC.

BINGO. I mean, that's exactly right.

And you know, one of the things actually, you know, that we've been talking to some of the members of COMMRESCE about is that there's pretty good data on how when you expand Medicaid and other welfare programs, democratic turnout in democratic counties goes up. And the reason for that is because the healthcare industrial and welfare industrial complex uses these NGOs that are that are that are far left in many cases, like planned parenthood and others to help

Put into boot harvest and uh. And so you know, by by expanding.

The welfare state, not only are we creating a culture of dependency, but we're also creating a culture that feeds one party, one political party over the other.

And that's intentional.

They that's they they know that that's what they're doing.

We are you didn't you didn't come looking for an argument today, doctor Paul Winfrey. Unbelievable, so so revealing and so nefarious. If I can boil down this entire concept of what's gone on, what's what's unfolded over the years with Medicaid, EPIC, ep I CE, epic for America dot org. Really valuable website you've got going there and the work that you're doing there is just is so important.

Doctor.

Thank you so much for spending time with my listeners and enlightening them and me on the how bad this is out there. And let's keep our fingers crossed and we do get some reform paths, because this is a this is a sinking ship round. This is just one part of the of the budget and clearly we have outspent ourselves to a degree that I think it's an existential threat to our existence as a country.

Thank you very much for having me.

I really appreciate it. It's been my pleasure, sir. Thank you.

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