Health-care reform smoke dreams--what are they smoking?

President Obama says that, without reform, unnecessary Medicare and Medicaid expenditures resulting from fraud, waste, and inefficiency over the next 10 years will amount to $622 billion. That’s over $60 billion per year! Even in Washington, DC, that’s a lot of money—enough for an aggressive program to eliminate the causes. Yet none of the health-care reform bills under consideration in the Congress will begin to close those senseless rat-holes. Certainly they pay lip service to savings, with 50-odd new boards and Commissions, bonuses to hospitals for improving care, and increased penalties for fraud convictions. But a careful reading shows all of these measures to be hopes and dreams, characteristic of all of the failed attempts throughout history to reign in Federal expenditures and eliminate fraud and predatory raids on the Treasury. It is unreasonable to project substantial savings from such vague hopes, although the promoters of the bills include many billions of such savings in their financial scoring. Will you support a bill that combines enormous new expenditure levels with toothless, token provisions to eliminate Medicare and Medicaid fraud, waste, and inefficiency?