By Kevin D. Williamson
Sunday, September 11, 2016
‘Waste, abuse, and fraud.” These are the words
politicians say when you ask them what it is they would cut to balance the
budget. If they’re really wonky, they might add “duplication.”
I have put the question to dozens of politicians over the
years, and have rarely received anything like an honest answer. That’s because
the honest answer is unpopular: We have to cut Social Security and Medicare
spending modestly and military spending significantly, and we’ll probably have
to raise some taxes, too, or at least forgo the tax cuts that politicians of
both parties habitually promise.
“Waste, abuse, and fraud,” W.A.F. I call it WAFfling.
We are not going to waffle the deficit away.
But we might waffle away a third of it.
The federal budget deficit in 2015 was $439 billion;
that’s down about two-thirds from where it was in 2010. For all those radio
ranters and cable-news mouthholes asking what electing Republicans ever has
accomplished, there’s your answer. (Oh, and the fact that Michigan is a
right-to-work state, that the First and Second Amendments survive, and, come to
think of it, a bit
more.) Change happens slowly (if only there were an Anglo-American
political philosophy dedicated to gradualism!), but it happens, and that’s how
it happens. There are no permanent victories in politics, however, and the
deficit is expected to creep up this year, and then to rise steeply in the
future if the major entitlements are left unreformed and allowed to become
supercharged drivers of deficit spending.
Which brings us to the criminal — and I do not use the
word figuratively — administration of Medicaid by the Obama administration.
In September, the Department of Health and Human Services
sent out a warning that improper payments under Medicaid have become so common
that they will account this year for almost 12 percent of total Medicaid
spending — just shy of $140 billion. (Total improper payments across federal
programs will come to about $139 billion this year, according to estimates that
have proved too generous in the past, and almost all of that is
Medicaid-driven.) That rate has doubled in only a few years, driven mostly by
the so-called Affordable Care Act’s liberalization of Medicaid-eligibility
rules.
I used to work the late shift at a Burger King across the
street from a cowboy bar, which ensured a festive atmosphere after last call,
and when the manager settled up the books at 4 a.m., he did not expect us to be
accurate down to the last penny. There might be a 1 percent or 2 percent
variation from mistakes in counting out change or the like. I once got called
into the manager’s office because my till was short some suspiciously round
number, like $20, and they were on the verge of either going through my pockets
or firing me when someone discovered where the mistake had been made.
Twenty bucks is an error. $140 billion is — pardon my
English-major math — about 7 billion times worse an error. And 12 percent in
improper payments isn’t an error rate — it’s a malfeasance rate.
But Burger King has standards. The Obama administration
does not.
Some perspective: We’re spending more than seven times as
much on improper, illegal federal payments as we do on NASA. We’re spending
nearly 20 times as much on improper, illegal federal payments as we do on the
National Science Foundation. We could build 13 Ford-class aircraft carriers
every year for what we are spending on improper and illegal payments driven by
Obamacare. We’re spending twice as much on improper and illegal payments as it
would cost to pay all the tuition costs of every American college student. (Not
that having Uncle Stupid do that is a good idea.) If improper and illegal
federal payments were an economy of their own, that economy would be bigger
than Hungary’s and and more than twice the size of Guatemala’s.
That’s a big waffle.
Question: Who is getting fired over this? Who is going to
jail? What, if anything is being done.
Answer: “ . . . ”
No, that’s okay, I’ll wait.
“ . . . ”
Really?
Really.
The Obama administration is not lifting a pinky to do
anything about this, even though analysts such as John Hood have — for years —
been arguing that it is necessary and possible to reform this mess. As the Wall Street Journal has reported, we
don’t even verify that doctors billing Medicaid for services rendered are
actually doctors. In many cases, we do not do much to verify that their
patients actually, you know, exist.
We’ve paid untold billions of dollars to “clinics”
that turn out to be little more — or nothing more — than post-office boxes and
prepaid cell phones.
And as bad as that 12 percent rate is, some policy
scholars believe that it is in fact probably worse.
As I have argued at some length, the real problem with
the welfare state is not the poor people receiving checks — it’s everybody in
the middle, the vast array of government employees, their union allies,
contractors, and third parties who earn six-, seven-, eight-, or nine-figure paydays
taking their cuts of money we think we’re spending on the poor. This is an
enormous criminal conspiracy against the American people and the public fisc.
And what’s the Obama administration been doing? Hiring
behavioral-science experts to get more people hooked on government programs.
Kurt Vonnegut couldn’t have thought this up.
Waste, abuse, and fraud? In Washington, that’s not a set
of problems — it’s a career path.
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