From a 2005 Report
Especially relevant to our current times is: #5. Medicare Overspending
Especially relevant to our current times is: #5. Medicare Overspending
The first place to trim runaway federal spending is in waste, fraud, and abuse.
Lack of information is not the problem. Today, government waste investigations and recommendations can be found in hundreds of reports, such as:
~Studies published by the U.S. Government Accountability Office (GAO),[1]
~The Congressional Budget Office’s Budget Options book,
~Inspector general reports of each agency,
~Government Performance and Results Act reports of each agency,
~The White House’s Program Assessment Rating Tool (PART) program reviews, and
~The Senate Governmental Affairs Committee’s 2001 Government at the Brink reports.
Excerpts:
1. The Missing $25 Billion
Buried in the Department of the Treasury’s 2003 Financial Report of the United States Government is a short section titled “Unreconciled Transactions Affecting the Change in Net Position,†which explains that these unreconciled transactions totaled $24.5 billion in 2003.[2]
The unreconciled transactions are funds for which auditors cannot account: The government knows that $25 billion was spent by someone, somewhere, on something, but auditors do not know who spent it, where it was spent, or on what it was spent.
2. Unused Flight Tickets Totaling $100 Million
A recent audit revealed that between 1997 and 2003, the Defense Department purchased and then left unused approximately 270,000 commercial airline tickets at a total cost of $100 million. Even worse, the Pentagon never bothered to get a refund for these fully refundable tickets. The GAO blamed a system that relied on department personnel to notify the travel office when purchased tickets went unused.
3. Embezzled Funds at the Department of Agriculture
Federal employee credit card programs were designed to save money. Rather than weaving through a lengthy procurement process to acquire basic supplies, federal employees could purchase job-related products with credit cards that would be paid by their agency. What began as a smart way to streamline government has since been corrupted by some federal employees who have abused the public trust.
A recent audit revealed that employees of the Department of Agriculture (USDA) diverted millions of dollars to personal purchases through their government-issued credit cards. Sampling 300 employees’ purchases over six months, investigators estimated that 15 percent abused their government credit cards at a cost of $5.8 million. Taxpayer-funded purchases included Ozzy Osbourne concert tickets, tattoos, lingerie, bartender school tuition, car payments, and cash advances.
4. Credit Card Abuse at the Department of Defense
The Defense Department has uncovered its own credit card scandal. Over one recent 18-month period, Air Force and Navy personnel used governÂment-funded credit cards to charge at least $102,400 for admission to entertainment events, $48,250 for gambling, $69,300 for cruises, and $73,950 for exotic dance clubs and prostitutes.
5. Medicare Overspending
Medicare wastes more money than any other federal program, yet its strong public support leaves lawmakers hesitant to address program efficiencies, which cost taxpayers and Medicare recipients billions of dollars annually.
For example, Medicare pays as much as eight times what other federal agencies pay for the same drugs and medical supplies.[6] The Department of Health and Human Services (HHS) recently compared the prices paid by Medicare and the Department of Veterans Affairs (VA) health care program for 16 types of medical equipment and supplies, which account for one-quarter of Medicare’s equipment and supplies purchases. The evidence showed that Medicare paid an average of more than double what the VA paid for the same items. The largest difference was for saline solution, with Medicare paying $8.26 per liter compared to the $1.02 paid by the VA.[7] (See Table 1.)
6. Funding Fictitious Colleges and Students
In 2002, the Department of Education received an application to certify the student loan participation of the Y’Hica Institute in London, England. After approving the certification, the department received and approved student loan applications from three Y’Hica students and disbursed $55,000.
The Education Department administrators overlooked one problem: Neither the Y’Hica Institute nor the three students who received the $55,000 existed. The fictitious college and students were created (on paper) by congressional investigators to test the Department of Education’s verification procedures. All of the documents were faked, right down to naming one of the fictional loan student applicants “Susan M. Collins,†after the Senator requesting the investigation.
7. Manipulating Data to Encourage Spending
The Army Corps of Engineers spends $5 billion annually constructing dams and other water projects. Yet, in a massive conflict of interest, it is also charged with evaluating the science and economics of each proposed water project. The Corps’ “strategic vision†calls on managers to increase their budgets as rapidly as possible, which requires approving as many proposed projects as possible.[14] Consequently, the Corps has repeatedly been accused of deliberately manipulating its economic studies to justify unworthy projects.
Investigations by the GAO, The Washington Post, and several private organizations have found that Corps studies routinely contain dozens of basic arithmetic errors, computer errors, and ridiculous economic assumptions that artificially inflate the benefits of water projects by as much as 300 percent.
8. State Abuse of Medicaid Funding Formulas
Significant waste, fraud, and abuse pervade Medicaid, which provides health services to 44 million low-income Americans. While states run their own Medicaid programs, the federal government reimburses an average of 57 percent of each state’s costs.
9. Earned Income Tax Credit Overpayments
The earned income tax credit (EITC) provides $31 billion in refundable tax credits to 19 million low-income families. The IRS estimates that $8.5 billion to $9.9 billion of this amount—nearly one-third—is wasted in overpayments.
The complexity of the EITC law leads to many of these mistakes. Calculating the credits is more complex than calculating regular income taxes. While the credit amount depends on the number of children in a household, the tax code does not clearly define how a child qualifies for the credit. In addition, fraud and underreporting of income are common, and the IRS lacks the resources to verify the qualifications of all EITC claimants.
10. Redundancy Piled on Redundancy
Government’s layering of new programs on top of old ones inherently creates duplication. Having several agencies perform similar duties is wasteful and confuses program beneficiaries who must navigate each program’s distinct rules and requirements.
Some overlap is inevitable because some agencies are defined by whom they serve (e.g., veterans, Native Americans, urbanites, and rural families), while others are defined by what they provide (e.g., housing, education, health care, and economic development). When these agencies’ constituencies overlap, each relevant agency will often have its own program. With 342 separate economic development programs, the federal government needs to make consolidation a priority.
Consolidating duplicative programs will save money and improve government service. In addition to those programs that should be eliminated completely, Congress should consolidate the following sets of programs:
342 economic development programs;
130 programs serving the disabled;
130 programs serving at-risk youth;
90 early childhood development programs;
75 programs funding international education, cultural, and training exchange activities;
72 federal programs dedicated to assuring safe water;
50 homeless assistance programs;
45 federal agencies conducting federal criminal investigations;
40 separate employment and training programs;
28 rural development programs;
27 teen pregnancy programs;
26 small, extraneous K–12 school grant programs;
23 agencies providing aid to the former Soviet republics;
19 programs fighting substance abuse;
17 rural water and waste-water programs in eight agencies;
17 trade agencies monitoring 400 international trade agreements;
12 food safety agencies;
11 principal statistics agencies; and
Four overlapping land management agencies.
