As the attached flyer shows, dermatologists are alerting patients that they will not be able to have same-day procedures for the most basic dermatological procedures.  Instead, under the proposed changes to Medicare, dermatology patients will have to schedule more visits, make more trips to the doctor, wait longer between procedures, and pay more since they are making more visits to the doctor.

These changes are now impacting how dermatologists are seeing patients.  Not in the future, but right now, right before the midterms are held in November.

The changes are part of the Centers for Medicare & Medicaid Services (CMS) proposed 2027 Medicare Physician Fee Schedule, which sees a projected 9% overall payment reduction for dermatology practice reimbursements. The proposed changes will mean a 50% payment cut for same-day evaluation and management (E/M) visits paired with a medically necessary procedure like a biopsy or cryotherapy.

In addition, dermatology practices will face changes in how overhead and practice expenses are calculated without direct physician input.

According to the American Academy of Dermatologists website, the proposed changes to Medicare by MAGA Republicans “could force local dermatology practices to limit Medicare capacity, potentially leading to longer wait times for appointments and risking delays in skin cancer diagnoses when early detection is critical.”

The American College of Mohs Surgery said on its website that Medicare reimbursements are falling while inflation is increasing. “Physicians are the only healthcare providers whose Medicare payments do not receive an annual statutory inflation update. While overhead costs, clinical staff wages, equipment, and general inflation continue to surge.”

The group said the proposed 9% decrease in reimbursements for 2027 “is entirely unsustainable,” even as similar cuts will be affecting other physician practices. In practice, these cuts will mean  a 50% cut to same-day evaluation and procedure care, accompanied by “volatile shifts in practice expense calculations that would result in cuts to dermatological care.”

The cuts to dermatology practices is especially crucial for people who are susceptible to skin cancers, especially in high-altitude states, such as Utah (~41 to 44 cases per 100,000); Minnesota (~37 cases per 100,000); Vermont; Idaho; and New Hampshire.

Skin cancer is the most common form of cancer in the United States, according to the Centers for Disease Control. One CDC study suggests that each year, about 6.1 million adults are treated for basal cell and squamous cell carcinomas at a cost of about $8.9 billion.  The National Cancer Institute found that in 2026, an estimated 112,000 people will contract skin melanoma, accounting for 5.3% of all cancers.  An estimated 8,510 people will die from skin cancer in 2026, accounting for 1.4% of all cancer deaths.

MAGA Republicans Lied About Avoiding Medicare Cuts

Despite years of promising not to cut benefits to Medicare and Medicaid, the reality is very different.

The Medicare Rights Center said the latest Republican tax bill “takes direct aim at Medicare, gutting eligibility and restricting access to benefits, while also cutting Medicaid in ways that would harm people who are dually eligible for both programs. For low-income older adults and people with disabilities, the health and economic ramifications of these cuts would be devastating.”

This also includes cutting Medicare benefits to people with lawful immigration status, many of whom have paid taxes in the US.

ABC News reported that Trump has repeatedly promised to protect Medicare, Medicaid, and Social Security, but the actions of MAGA Republicans say otherwise. In 2015, Trump said he would “Save Medicare, Medicaid and Social Security without cuts,” but when he was elected, he tried to dismantle it.

In an Oval Office interview on Jan. 31, 2025, Trump said: “We’re going to love and cherish Social Security, Medicare, Medicaid. We’re not going to do anything with that, other than if we can find some abuse or waste, we’ll do something, but the people won’t be affected. It will only be more effective and better.”

House Speaker Mike Johnson, a MAGA Republican, told reporters that “No, the president has made clear that Social Security and Medicare have to be preserved.”

Despite what the press says, political violence is as American as apple pie.

On Dec. 24, 2024, a sunny day with temperatures in the mid-50s, on a New York City street, Brian Thompson, the CEO of UnitedHealthcare, was shot and killed by an unidentified assailant. The shooting happened in broad daylight in front of the New York Hilton Midtown Hotel. Thompson was in New York to attend an investor’s meeting when he was killed.

After an intensive, multi-state search, police apprehended a suspect, Luigi Mangione, 26 years old.  On December 9, five days after the shooting, Mangione was charged with the fatal shooting of Brian Thompson, the chief executive of UnitedHealthcare.

Aside from being a capital crime, the murder of corporate CEOs is considered a political assassination, which automatically activates the highest law enforcement powers available to apprehend the perpetrators.

Unlike the shooting of an ordinary local shop owner who is not the head of a publicly traded company, the murder of one of the nation’s largest healthcare insurers has more business and corporate security ramifications than personal ones.  Corporate America’s tremendous contributions and support of federal and state governments cannot function without state protection.

It’s no wonder that the arrest of Mangione after an intense manhunt was only the start of the shockwaves it sent through corporate America, especially in the multi-billion-dollar medical insurance industry that involves daily decisions about the personal medical care its participants will receive.  Denying this care is always an emotional decision, and in some cases, it means life and death.

So, it is not surprising that after Thompson’s shooting, the news emerged that UnitedHealthcare had the worst participant denial rate in the health insurance industry.  Much of their profits were driven by the company rejecting 33% of all claims, twice the industry average of 16%.‌ (In 2023, AvMed and United HealthCare were the medical insurance companies with the highest denial rate for in-network claims in the United States, at 33% each.)

All of this was happening as UnitedHealth Group, the largest health insurer in the United States, insured over 50 million people.

Since affordable health care has been a sensitive national topic for decades, the current debate over the extension of subsidies under the Affordable Care Act has sparked tensions between Democrats and Republicans.  This intense debate was not lost on Mangione, a graduate of the Ivy League University of Pennsylvania in Philadelphia, where he majored in computer science and graduated in May 2020. He was also valedictorian of an all-boys preparatory school.

As an intelligent man, Mangione’s motive was clear: to focus attention on the inequitable healthcare system, its wasteful practices, its impact on individual patients, and the need to revamp the national healthcare system.

The shooting also raised the sensitive issue of why the murder of a corporate CEO is different from any other state-sanctioned murder of a political or corporate leader who engages in actions that harm the American people.

Is the murder of Thompson any different than the CIA-sponsored murder of Salvador Allende, the democratically elected president of Chile, in 1973?  Or, how about any of the other US and corporate-sponsored coups in South America, as seen in this chart. (As of Dec. 3, 2026, we can add Venezuela.) And these do not include the coups conducted in Africa and the Middle East.

Maybe the Thompson murder raised alarm bells because he embodied the pursuit of profits at all costs, even if some people were hurt.  After all, this is the same corporate practice that causes water, air, and chemical pollution that kills thousands of people, but is considered “externalities” by many economists, unless a class action lawsuit holds the corporation accountable.  Thompson was part of the “old boy network” that feels comfortable examining statistics in corporate boardrooms, insulated from the impact of its practices on plan participants.

The Murder Had a Definite Impact

The question is: How did this killing affect UnitedHealthcare and others in the healthcare industry?

Immediately after the shooting, the media reacted predictably. It lamented the killing and said political violence has no place in American society, and called for civil discussion and prayers.  But the press has no historical memory.  It forgets that every significant social-economic-cultural advancement in American history has been done by an organized movement comprised of advocates who inevitably confront corporate or state power to advance the cause.

There have been violent protests in the movements connected to civil rights, women’s voting rights, war protests, environmental protections, Native American, and Chicano organizing, labor organizing, abortion, and protests against unpopular elected leaders. Each of these movements has seen violence and created martyrs.  Violence is as American as apple Pie.

UnitedHealthcare is no exception.  The corporation’s own bereavement message online was mocked by 77,000 laughing response posts.  A Gallup poll in 2024 found that 51% of respondents had a somewhat negative attitude towards the healthcare industry, compared to 36% who had a somewhat favorable opinion.

So, it’s not surprising that after Thompson’s murder, corporations began spending “record amounts to keep their executives safe in response to rising threats,” according to a Reuters report.  Corporations also began removing photos of their top executives from company websites.

But aside from the obvious, how did this murder affect UnitedHealth’s operational policies?

While UnitedHealthcare has not announced any specific operational or policy changes, the company is clearly re-examining its policies. At a Reuters NEXT conference in New York, in December 2024,  Amazon Pharmacy chief medical officer Vin Gupta acknowledged the systemic issues fueling public anger. “Our health system needs to be better (…) There’s a lot of things that should cause a lot of outrage,” he said.

At the same event, Pfizer’s chief sustainability officer, Caroline Roan, echoed Gupta’s sentiments, as she said: “There is clearly a larger dialogue that needs to happen, and we’re going to be taking our time to try to understand exactly what happened and understand that feedback, and see where we can play a positive role.”

The murder also ignited a tremendous public response about the distrust of the federal government and the dominance of healthcare insurance companies when it comes to dictating federal health insurance policies.

In the video below, Vanguard Communication’s CEO Ron Harman King discusses the possibility of revamping the healthcare system as a result of the murder.

As Mangione recognized, healthcare reform will not happen as long as the Trump administration and its pro-monopoly Justice Department are in power.  Second, Democrats are powerless, and in some cases spineless, to confront the healthcare industry.

So, while the corporate media downplays the importance of the Thompson murder, corporate America has been shaken and is reacting in private to this attempt to challenge its undisputed power.

Internet financial fraud has been increasing for two decades, and the latest statistics from the FBI show it is continuing to derail the lives of more people and causing more financial hardships.

Worse, prosecution levels for internet financial frauds are dropping dramatically.

In 2021, the FBI’s Internet Crime Complaint Report (released on March 22, 2022), listed 847,376 complaints of suspected internet crime. This was a 7 percent increase from 2020, and the crimes resulted in losses of over $6.9 billion.

This translates into an average of 2,000 complaints per day, according to the FBI Internet Crime Complaint Center. The victims include average people, as well as celebrities, such as Sylvester Stallone, Wesley Snipes, Al Pacino, Neil Simon, Martin Scorsese, David Blaine and Uma Thurman, Sting, Alais Morinsetts, Robert De Niro, Anne Hathaway, Sidney Poitier, Dane Cook, Liv Tyler, and Kiefer Sutherland.

But estimates about internet fraud are conservative because most people do not report it. “While it’s true that Internet-based financial fraud is on the rise, getting concrete information about how many people are being convicted of these crimes or even how much money is being stolen is next to impossible,” according to Linda Chavez and the Founder and CEO of Seniors Life Insurance Finder, in Los Angeles.

While the trend in internet fraud covers the gamut from phishing scams, ransomware, non-payment-non-delivery scams, and personal data breaches affecting businesses, individuals, and public facilities, including infrastructure and hospitals, the prosecution and conviction rates are not easy to discover.

Fraud is now an accepted practice among certain politicians and their supporters, such as Trump supporter Steve Bannon, who do it because hey know their chances of being caught are small. The ramifications of the historic 2008 housing fraud scandal disrupted the housiong market, caused a severe recession, and tainted the credibility of the Democratic Party, and its Attorney General Eric Holder.

While frauds are common among banks, such as BNY Mellon, Chase, Bank of America, it is an inherent part of the US medical insurance industry. For instance, Medicare fraud costs taxpayers an estimated $800 billion a year, according to the Bloomberg News. This includes false claims, overcharges, networks doctors and hospitals over-inflating bills and billing for services that were never delivered.

Worse, it seems few people in law enforcement and other regulatory agencies make those conviction and prosecution statistics readily available.

Why Internet Financial Fraud Prosecutions Are Dropping

What are the reasons for this?

First, the Justice Department “has never made internet fraud a real priority, in part because these kinds of cases are not particularly attractive to prosecutors,” attorney and former Federal prosecutor Ankush Khardori wrote in a March 2021 article.

Second, the losses from individual victims “tend to be relatively small and widely dispersed.”

Third, a lot of internet fraud emanates from outside the US, and “it can be hard and bureaucratically cumbersome to obtain evidence from foreign governments, particularly from countries where these scams comprise a large, de facto industry that employs many people.” Prosecuting fraudsters operating outside the US is a time-consuming process, and even if large frauds occur and perpetrators are identified, extraditing them is costly.

The bottom line is that internet fraud is a huge problem no one wants to address.  “Experts agree that the reason for this lack of transparency is that nobody wants to talk about it. Large insurance companies work with the banks to keep quiet about exactly how much money they lose to fraud every year because they don’t want their customers—or potential customers—to know things like whether or not they will be reimbursed if their accounts are hacked,” Chavez of Seniors Life Insurance Finder, said.

“This problem has gotten so out of hand that some banks don’t even bother reporting losses due to fraud anymore. According to some sources, large banks can lose as much as $500 million per year overall from various types of scams, but only report about 10 percent of those losses because they are embarrassed by how bad things have become,” Chavez continued.

Law Enforcement Tolerates White-Collar Fraud

Internet fraud prosecutions, as well as other white-collar criminal prosecutions, declined during the Trump administration. A report from the Justice Department and Syracuse University found that the average annual number of white-collar defendants decreased 26 percent to 30 percent during Trump’s first three years in office from the average under President Barack Obama.

The prosecution record in the current Biden administration, and the US Justice Department of Merrick Garland, is also off to a slow start, according to Khardori. Some of the reasons for this include poor coordination between the dozen or so federal and private agencies that collect internet fraud complaint data in the US.

This is not a new problem. Writing in a 2017 report from the Stanford University Financial Fraud Research Center, Marguerite DeLiema, said “The two main sources of official crime statistics in the United States both largely ignore fraud victimization. The primary source of agency data, the Uniform Crime Report (conducted by the FBI), currently does not include fraud in its list of closely watched crimes.”

DeLiema, who is now an Assistant Research Professor at the University of Minnesota, School of Social Work, wrote in a recent email that the COVID pandemic has caused an increase in crime rates, including fraud and scams. “While anti-money laundering rules apply to many companies that process payments, including fraudulent ones, these laws are not always enforced.”

This was certainly the case with an internet fraud that victimized a Beverly Hills PR firm owned by Devon Blaine and his client. The fraud involved a hacked email address, a Zelle scam, and identity theft. But, when the owner contacted the Beverly Hills police department to report the theft, they wrote a report but did not take any action because the owner was not the direct victim of the theft.

“No one at the police department wanted the email header code that would have pointed to the hacker’s email provider and address,” Blaine wrote in an e-mail. “How can there be a conviction if law enforcement does not pursue the crime? Certainly, no insurance company has covered these losses.”

Where are the Courts and Law Enforcement?

Another major problem stems from tepid enforcement directives that don’t prioritize fraud prosecutions. Some critics have blamed this failure to prosecute internet-related fraud crimes, directly on the leadership of Attorney General Merrick Garland.

At the local and state level, law enforcement people lack the resources and time to pursue fraudsters that are often outside of their jurisdiction and more technologically  sophisticated.  “There are few convictions for Internet fraud because it is easy to commit and hard to track down the perpetrators,” according to Adnan Jiwani, Digital Marketing Team Lead, at PureVPN, in Hong Kong.

“The criminals can be anywhere in the world, and they often use sophisticated methods to cover their tracks. Even when they are caught, it can be difficult to prove that they committed the crime,” Jiwani said. “Prosecutors may not have the resources or expertise to go up against well-funded cybercrime networks. And many people don’t report online scams because they are embarrassed or think that nothing will happen. As a result, Internet fraud remains one of the most rampant crimes in the world.”

Other reasons for the low conviction rate are that more people are doing it using more sophisticated schemes. This includes “sustained fraud schemes” that capitalize on data breaches, which “make it easier for fraudsters to access personal identification information (PII),” according to Nick Hodge, of the Daily Profit Cycle newsletter.

Using information from a data breach, Hodge said fraudsters will combine actual and bogus data to build new, synthetic identities. “Then, they open fake bank accounts and credit cards. These criminals just cease paying after they’ve acquired great credit scores.”

In a fraud takeover scheme, fraudsters can take control of an account and make fraudulent online purchases using stolen passwords and credentials obtained through data breaches and social engineering. “A modest transaction like buying groceries with a debit card can lead to a major one like borrowing money from someone else’s bank account,” Hodge said.

Finally, if fraudsters are caught, they often face more lenient penalties than others who are convicted of other types of fraud, attorney Ty Gibson of Gibson Hill LLC, Houston, Texas, said.

“A lot of insurances now cover internet fraud, also known as computer fraud, so I think that the ones to blame are the authority and legal teams in charge of catching and punishing this specific type of crime, as better methods need to be developed in order to put a stop to it.”

A new financial analysis finds that Medicare for All, a bill (S 1804) introduced by Sen. Bernie Sanders in 2017, is not only financially viable, but that it could provide health care for all Americans and reduce health care spending by $2.93 trillion over the current system.

The report, entitled an Economic Analysis of Medicare for All, by Robert Pollin, James Heintz, Peter Arno, Jeannette Wicks-Lim, and Michael Ash of the Political Economic Research Institute (PERI) at the University of Massachusetts, Amherst, found that the current health care system is overly expensive compared to other developed nations, delivers lower quality care and prevents about 9% of the population from receiving health care because they cannot afford it.

“As of 2017, the U.S. was spending about $3.24 trillion on personal health care—about 17% of total U.S. GDP.  Meanwhile, 9% of U.S. residents have no insurance and 26% are underinsured—they are unable to access needed care because of prohibitively high costs. Other high-income countries spend an average of about 40% less per person and produce better health outcomes. Medicare for All could reduce total health care spending in the U.S. by nearly 10%, to $2.93 trillion, while creating stable access to good care for all U.S. residents,” the report said.

In short, the study found that Medicare for All could cover everyone in the U.S. with no copays and cut overall health spending by almost one-fifth. This would be accomplished at a savings of about $2 trillion less than what Americans are spending today.

The 200-page report, which was reviewed by 12 academics, economists, doctors and public health policy experts before it was released, covers Universal Health Care and Health Outcomes; Demand Increases and Costs of Universal Health Care; Cost Saving Potential under Medicare for All; Financing Medicare for All; Budgetary Impacts on Businesses and Families; The Transition into Medicare for All; and the Macroeconomic Impacts of Medicare for All.

As presented in the original Sander’s bill, Medicare for All would provide U.S. residents with “decent health care as a basic right. “The analysis said this would be accomplished by “establishing a health insurance system that covers all residents in a manner comparable to the coverage now provided for residents 65 years old and older under the existing Medicare program. All health care consumers will also have the right to receive care from the providers of their choice.”

Medicare for All Would Save Money

The analysis also found that overall U.S. health care costs could fall by “about 19% relative to the existing system.” The biggest sources of cost saving will be in the areas of administration (9% savings in total system costs); pharmaceuticals (6% savings in system costs); and establishing “uniform Medicare rates” for hospitals, physicians, and clinics. This would generate a 3% savings in system costs.  In the first years of the Medicare for All program, money would be saved by reducing fraud and waste.

Funding Medicare for All

Paying for Medicare for All would come from four primary sources, the analysis said:

• Business health care premiums would be cut by 8% relative to existing spending per worker. This would generate $623 billion in revenue.
• A sales tax of 3.75% on non-necessities. There would be exemptions for food and beverages consumed at home; housing and utilities; education and non-profits. Net worth tax of 0.38 percent would produce and estimated $193 billion in revenue.
• A net worth tax of 0.38%, with an exemption on the first $1 million in net worth. This tax would apply to only the wealthiest 12% of U.S. households and would produce $196 billion in revenue.
• Taxing long-term capital gains as ordinary income. This would produce $69 billion in revenues.

Who Objects to Medicare for All? Easy. Just Follow the Money

In a January 2019 interview, Robert Pollin, a co-author of the study, said hospitals and doctors would benefit under a Medicare for All program.  “The doctors and hospitals are going to come out fine. We spend a lot of time showing that, yes, we’re going to lower their rates by about 7%. On the other hand, they are going to also save on their administrative time. …So if we cut their rates by 7% on average, but their administrative time goes down by 8%, that means they have 8% more time to see patients and bill for their time with patients. On balance, they’re going to come out okay,” Pollin said.

He also expected stiff opposition from private health care insurance and the pharmaceutical companies. This is because what “we’re talking about basically the euthanasia of private health insurance. They will oppose Medicare for all massively. The only way to deal with that problem is to fight against the opposition,” Pollin said.

Pollin is correct. A study by the Center for Responsive Politics, as reported in Open Secrets, found that congressional Democrats, who would be most likely to support this proposal, voted in direct response to how much money they received from the health care and  pharmaceutical lobbies. This study found that Democrats who were not co-sponsors of the Medicare For All bill were paid 146% more money from health insurance companies between 2011 and 2016 and 60% more from the big pharma lobby.

Not surprisingly, Senate Minority Leader Chuck Schumer (D-NY) was paid the most by health insurance companies and ranks third in donations from pharmaceutical companies between 2011 and 2016. Schumer did not support the bill.

House Minority Whip Steny Hoyer (D-Md) took the most donations from health insurance companies and second most from pharma in his caucus between 2015 and 2016 and does not support single-payer, OpenSecrets said.

“Perhaps next to Wall Street, the pharmaceutical industry is the most powerful political force in this country. They have spent more than $4 billion on lobbying and campaign contributions over the past 20 years. The time has come to say enough is enough. The American people are begging us to take real action to end the greed of the pharmaceutical industry. Americans should not be paying the highest prices in the world for prescription drugs,” according to Senator Bernie Sander (Ind-Vt.)

Limited Media Coverage of the Report

PERI’s financial analysis of Medicare For All addresses one of the biggest drains on the nation’s finances. The U.S. spends 18% of GDP, $3.3 trillion, on health care, while Germany, France, UK, are paying between 9% to 11% of GDP for health care and have better health outcomes than the U.S. Yet, while this report shows this health program is financially viable, it has not been picked up by major media outlets. Why not?

One reason may be that PERI comes from a distinctly moral perspective with a mandate to engage in “research and policy addresses the impacts of globalization, unemployment, financial market instability, central bank policy, living wages and decent work, the economics of peace, development, and the environment.” In short, PERI may be academically based, but it has a politically progressive bent.

These are not values shared by the corporate media, so it is not surprising they would choose to cover this research. Still, the analysis provides more evidence that Medicare for All (S1804), proposed by Sen. Bernie Sanders, was not a socialist financial pipe dream, but has a solid financial foundation based in real politics.

Progressive financial policies are being used in various degrees by developed nations worldwide and especially in nations that have accessible health care for their citizens, lower infant mortality rates, a retirement safety net for their citizens and better income equality than the U.S.

This Progressive Agenda is not a threat.  See if you disagree with the ideas below.

The Progressive Economic Agenda Courtesy of Senator Sanders

1. Stop corporations from using offshore tax havens to avoid U.S. taxes. Each and every year, the United States loses an estimated $100 billion in tax revenues due to offshore tax abuses by the wealthy and large corporations. The situation has become so absurd that one five-story office building in the Cayman Islands is now the “home” to more than 18,000 corporations.

The wealthy and large corporations should not be allowed to avoid paying taxes by setting up tax shelters in Panama, the Cayman                       Islands, Bermuda, the Bahamas or other tax haven countries. The first bill that Sanders introduced in the Senate (the Corporate Tax                  Dodging Prevention Act) would raise more than $580 billion over the next decade by eliminating the most egregious corporate offshore            tax haven abuses.

2. Establish a Robin Hood tax on Wall Street speculators. Both the economic crisis and the deficit crisis are a direct result of the greed and recklessness on Wall Street. Creating a speculation fee of just 0.03% on the sale of credit default swaps, derivatives, options, futures, and large amounts of stock would reduce gambling on Wall Street, encourage the financial sector to invest in the job-creating productive economy, and reduce the deficit by $352 billion over 10 years, according to the Joint Committee on Taxation.
3. End tax breaks and subsidies for big oil, gas and coal companies. If we ended tax breaks and subsidies for big oil, gas, and coal companies, we could reduce the deficit by more than $113 billion over the next ten years. The five largest oil companies in the United States have made over $1 trillion in profits over the past decade. ExxonMobil is now the most profitable corporation in the world. Large, profitable fossil fuel companies do not need a tax break.
4. Establish a Progressive Estate Tax. If we established a progressive estate tax on inherited wealth of more than $3.5 million, we could raise more than $300 billion over 10 years. Sanders introduced the Responsible Estate Tax Act that would reduce the deficit in a fair way while ensuring that 99.7% of Americans would never pay a penny in estate taxes.
5. Tax capital gains and dividends the same as work. Taxing capital gains and dividends the same way that we tax work would raise more than $500 billion over the next decade. Warren Buffett has often said that he pays a lower effective tax rate than his secretary. The reason for this is that the wealthy obtain most of their income from capital gains and dividends, which is taxed at a much lower rate than work. Right now, the top marginal income tax for working is 39.6%, but the top tax rate on corporate dividends and capital gains is only 23.9%.
6. Repeal all of the 2001 and 2003 Bush tax breaks for the top two percent. In January, Congress finally repealed the Bush tax breaks for the top one percent—households making more than $450,000 a year. But the Bush tax breaks have been continued for the top two percent—households with incomes between $250,000 and $450,000 a year. Repealing the Bush tax breaks for all of the top two percent would reduce the deficit by about $400 billion over the next decade. After President Clinton increased taxes on the top two percent, the economy added over 22 million jobs. After President Bush reduced taxes for the rich, the economy lost over 600,000 private sector jobs.
7. Eliminate the cap on taxable income that goes into the Social Security Trust Fund. If we are serious about making sure that Social Security can pay all of the benefits owed to every eligible American for the next 50 to 75 years, we don’t do that by cutting benefits, we do that by scrapping the cap on taxable income so that a millionaire and a billionaire pay the same percentage of their income into Social Security as someone making $40,000 or $50,000 a year.

Right now, someone who earns $113,700 a year pays the same amount of money in Social Security taxes as a billionaire. This makes no             sense. Applying the Social Security payroll tax on income above $250,000 would ensure that Social Security remains solvent for the                  next 50 years. This plan would only impact the wealthiest 1.3% of wage earners; 98.7% of wage earners in the United States would not                see their taxes go up by one dime.

8. Establish a currency manipulation fee on China and other countries. As almost everyone knows, China is manipulating its currency, giving it an unfair trade advantage over the United States and destroying decent paying manufacturing jobs in the process. If we imposed a currency manipulation fee on China and other currency manipulators, the Economic Policy Institute has estimated that we could raise $500 billion over 10 years and create one million jobs in the process.
9. Reduce unnecessary and wasteful spending at the Pentagon, which now consumes over half of our discretionary budget. Much of the huge spending at the Pentagon is devoted to spending money on Cold War weapons programs to fight a Soviet Union that no longer exists. Lawrence Korb, an Assistant Secretary of Defense under Ronald Reagan, has estimated that we could achieve significant savings of around $100 billion a year at the Pentagon while still ensuring that the United States has the strongest and most powerful military in the world.
10. Require Medicare to negotiate for lower prescription drug prices with the pharmaceutical industry. Requiring Medicare to negotiate drug prices, similarly to what the VA currently does, would save more than $240 billion over 10 years.

If you are a RIA or financial services firm that wants to find like-minded clients, consider posting a notice on this site that lists your pro-investor business case. The listing information is available on the front page of this site. This information  can be accessed by clicking on the Business Listings and Submit Listing tabs.

In the millions of hours of TV commentaries and thousands of words addressing all aspects of the upcoming Republican tax bill, few have discussed the costs of fraud, what it costs American taxpayers, and how it depletes the federal budget.

Indeed, there are Republicans who want “to starve the beast” and cut off almost all funding for entitlement programs, excluding the military budget. Still, members of both parties have conveniently failed to address the prevalent practice of fraud and how it contributes to the national deficit while bolstering the growing practice of ignoring tax and ethical obligations.

Billions of dollars in fraud are regularly occurring in two major areas: Medicare-Medicaid and plain-old tax evasion. Both are established practices and part of major, complex systems, but the frauds are reaching astronomical proportions.

According to the April 2014 March Medicare Payment Advisory Commission (from the Committee on Ways and Means Subcommittee on Health, No. HL–11), the Medicare program paid approximately $574 billion annually to over 1.5 million doctors, hospitals and medical suppliers. Citing a Government Accounting Office report, an estimated $44 billion annually is lost to fraud. The fraud stems from all levels of the medical system, including doctors and hospital administrators, home aid nurses, and medical supply vendors.

On the tax evasion front, this is being made more accessible because the IRS has lost 17,000 employees since the end of fiscal 2010, according to IRS Commissioner John Koskinen.  In 2016 alone, the IRS workforce decreased by 2,000 to 3,000 workers, according to a report in The Hill.

Speaking before a Senate Finance Committee last year, Treasury Secretary Jack Lew said that the IRS needs more funds for enforcement to seek out and prosecute tax fraud.

In 2016, the IRS estimated that tax evasion cost the federal government on average $458 billion per year between 2008 through 2010.

How much does tax fraud cost? In 2016, the IRS estimated that tax evasion cost the federal government an average of $458 billion per year between 2008 and 2010. The IRS calls this a “tax gap” and notes that the I.R.S. expects to recover about $52 billion of that lost revenue, resulting in a net tax gap of $406 billion annually. But with the decreased IRS workforce, that tax gap should increase, which will cost taxpayers more in lost federal revenues.

Medical Fraud on the Rise

On the Medicare and Medicaid fronts, fraud task forces have been busy, but they admit the scope of the problem is difficult to estimate.  In July 2017, the Justice Department charged more than 400 people nationwide in a major crackdown on healthcare fraud, saying it cost the federal government $1.3 billion in false Medicare and Medicaid billings. Those arrested include over 100 doctors, nurses, and other medical professionals.

In just one small example, one Washington Post expose found that since 1999, Medicare spent $8.2 billion to procure power wheelchairs and motorized scooters for 2.7 million people. As of 2014, the government said it cannot estimate how much money was paid to fraudsters. There are many other ways to conduct Medicare fraud. One site lists 28 possible ways to do it involving providers and members, Medicare pharmacy benefits, brokers and agents, and wheelchair providers.

These are just recent examples, but the problem is decades old. One reason is that Medicare is the fourth largest federal expenditure after defense, Social Security, and payments on the national debt. In a 1994 U.S. Senate Special Committee on Ageing hearing, experts said fraud cost 10% of the total Medicare and national healthcare budget, which in 1994 cost $10 billion to $20 billion annually. States with high elderly populations, such as Florida, especially South Florida, are the primary sites for fraud.

In that 1995 hearing*, the senators cited three reasons for the widespread fraud:

1. The methods used to commit Medicare fraud and abuse are difficult to detect. Some methods include billing for services or supplies that are not provided, providing medically unnecessary services, and altering billing codes to obtain higher payments.
2. The resources allocated to combat fraud are inadequate. For example, the Regional Inspector General’s Office in Atlanta inspects all Department of Health and Human Services (HHS) programs in eight Southeastern States. There are 300 different programs under the jurisdiction of HHS. Thirty-three agents and staff are assigned to cover these eight States, with ten agents and two support staff assigned to Florida, with only four agents in the Miami area.
3. There is a lack of coordination between federal agencies and the programs they oversee.

Is this fraud situation any better today? When the Justice Department made its arrests in 2017, it did so based on drug distribution, but this left the larger areas of providing unnecessary, expensive, and dangerous medical procedures and altering billing codes.

While the government has a program for citizens to call in Medicare fraud, the best way to prevent fraud is to enable, protect, and reward nurses who see fraud conducted daily.  However, doctors, medical, and hospital cultures relegate nurses to second-class status.  Worse, they are often the ones who have to administer unnecessary, painful, and dangerous procedures to unsuspecting patients.

If nurses could report fraud without the threat of losing their jobs and being blackballed in the medical industry, they could stop the fraud and the unnecessary pain delivered to patients. Without those protections, medical fraud will continue.

To report Medicare fraud or abuse, call the Medicare fraud tip line at 1-800-HHS-TIPS (1-800-447-8477).

*Hearing before the Special Committee on Ageing, United States Senate, 103^rd Congress, Second Session, Miami, Florida, April 11, 1994, Serial No. 103-17.