MORE MEDICAID CORRUPTION

Kayode Y. Abrams had nearly a dozen traffic citations and a criminal record when the District's Medicaid agency hired his company to drive the city's neediest to medical appointments. And when Abrams' company wasn't transporting Medicaid patients, the 33-year-old businessman had a side job: He was an organizer in a Northern Virginia crack-cocaine ring, according to court records.

Despite his criminal record, Abrams won certification as a Medicaid provider in the District. It was no fluke. Gaining entry into the lucrative but little-known industry has required little more than a driver's license, an inspected van, auto insurance and valid rates on file. Neither the D.C. Department of Health, which oversees Medicaid, nor the Washington Metropolitan Area Transit Commission, which licenses motor carriers, has conducted background checks of company officials in recent years.

City officials recently have pledged to reform the troubled program, but the lack of oversight raises questions about the overall management of the city's more than $1 billion Medicaid program. Last year, the District spent $22.3 million for nonemergency transportation of Medicaid patients -- slightly more than what the city paid for patients to see individual doctors, according to city records. "There's more paid for transportation trips than doctor visits, and anybody can tell you that smells," says D.C. Council member David A. Catania, at-large independent.

Kayo LLC, founded in 2002, was one of about 200 Medicaid transporters operating in the city before it collapsed in the wake of Abrams' arrest and 10-year prison sentence last year. Even with its owner in prison, Kayo LLC remains on a directory of Medicaid providers posted by the Department of Health on its Web site. Medicaid, which provides health insurance for the poor, is funded by the federal government and the states, which also manage their programs.

Much more here




Australia: Long wait for a little girl in pain

A 10-Year-old girl with chronic tonsilitis has been told she has to wait more than a year for surgery to relieve her constant pain. Bindy Fuller, of Warren in central western NSW, is in pain and requires constant medication. Her mother, Karon Fuller, said today that when she heard the NSW government claim there were only 50 people waiting longer than a year for surgery, she was hopeful her daughter would not have to wait long for her tonsils to be removed.

But after contacting Dubbo Base Hospital in May, Mrs Fuller said she had since been told Bindy would have to wait until November 2007.

Opposition health spokeswoman Jillian Skinner said the operation would only take 30 minutes. "Here's a little girl who has suffered tonsilitis all her life and has now been told she has to wait to November 2007 to have treatment," Ms Skinner said. "I can only imagine how difficult it is for a mum, hearing a premier boasting about few people waiting for surgery, to be told that you now have to wait longer than ever."

A spokesman for NSW Health Minister John Hatzistergos said it was unlikely Bindy would have to wait until November next year for surgery. He said she had been assessed as a category three patient and would therefore be scheduled for surgery within 12 months. This meant she was not due to receive surgery until May 2007 and it was unlikely the hospital would contact her before January.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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