Conceptualizing, Estimating and Reforming Fraud, Waste and Abuse in Health Care Spending

Abstract

The elimination of "waste, fraud, and abuse" from American medicine is not a quick or easy solution to the challenge of rising medical care costs. Although there are clearly some savings available, particularly in the area of administration, they likely amount to far less than many policymakers hope. Many ofthe policy options available for reducing excesses face significant political hurdles or involve value judgments about non-quantifiable issues involving quality of care. Other alternatives seem as likely to bar necessary medical care as to eliminate abuses. In some instances, particularly those involving consumerfraud, a crackdown may merely shift costs without saving any money. Finally, a number of the suggestions for trimming waste and abuse involve ethical and moral judgments that Americans have yet to acknowledge and, in any event, may not wish to sign over to the government or any other third party.