Medicare Fraud and Baby Boomers

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Willie Sutton was a prolific bank robber, who reportedly stole an estimated $2 million over a forty-year period. When ask why he robbed banks, he responded, “Because that’s where the money is.” Applying this criminal business plan to modern days, Willie Sutton most certainly would have targeted government health care programs.

With health care expenditures nearing 18% of the nation’s gross domestic product, the fraud bulls eye on health care expenditures is substantial. In fact, U.S. spending on health care hit $2.7 trillion in 2011, and some experts have estimated that over 10% is lost to fraud, waste and abuse.

However, the worst is likely yet to come, because health care expenditures—and, by extension, health care fraud—will skyrocket in the coming years, as the baby boomer generation ages into Medicare. Indeed, according to the Kaiser Family Foundation, currently 10,000 baby boomers turn 65 every single day, and the per capita health costs at that age and older are $9,744 a year, compared to $2,739 for those 25 to 44.

This mounting tsunami of health care fraud requires immediate action from a government that is increasingly gridlocked in partisan paralysis. However, until decisive action is taken to further sure up health care funds, whistleblowers remain on the frontlines, incentivized and encouraged by the False Claims Act qui tam provisions. In turn, with courageous citizens vigilantly guarding the public fisc, perhaps modern-day Will Suttons will seek targets other than our limited government health care dollars.