Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

India Virtually Eliminates Tetanus as a Killer

nytimes.com

Post reply on HN
Print view View original

21–30 of 38 posts

Re: India Virtually Eliminates Tetanus as a Killer

#21

Post by merpnderp »

nostrebored wrote: post #7
merpnderp wrote: post #4

Earlier quoted context omitted.

In the US there have been recent papers discussing how roughly 10% of the medicare budget goes to people who live less than a year, with the implication that perhaps we shouldn't be spending so much on people with so little time. It is a well established fact by the CBO (Congressional Budget Office) that roughly 10% of the medicare budget is wasted on fraudulent claims (even though their rejection claim rate is rough…

Exactly. Fraud is terrible in both cases, and should be a known factor so that we can evaluate how to procede. For instance, aid to Sub-Saharan Africa constitutes roughly 70% of the budget of SSA countries. Illicit outflows of that aid money is increasing at a rate of 20% per year. I'm struggling to find the data about how much aid actually reaches the intended location, but it's significantly lower than one would ho…

I think you've laid out why corruption and fraud should always be a high priority to fight even when they are a low cost. Fraud is corrosive, and when left unchecked will expand. If a dentist can get away with 50 fake treatments at a nursing home one year, why would he shoot for 100 fake treatments the next, thus doubling his portion of the fraud.

Which is exactly what you've described in Africa. If a general can divert 20% of the aid to his offshore account one year, why would he shoot for 40% the next?

Re: India Virtually Eliminates Tetanus as a Killer

#22

Post by dragonwriter »

merpnderp wrote: post #20
DougWebb wrote: post #8

Earlier quoted context omitted.

Expanding on sophalces' point: Assuming the figures you quoted are correct, how much of the medicare budget is spent on fraud prevention? That includes: * time spent by Congress and Medicare deciding what is and what is not covered, * deciding who is and who is not covered, * what the rules and processes are for preventing and discovering fraud, * what the process is for handling fraud * the actual time needed to enf…

Medicare's budget is around ~$600 billion. It is highly unlikely that the CBO, FBI, DHS, and IRS spend $60 billion looking into potential medicare fraud given how many of those just named organizations could fit into a $60 billion budget (3 of the 4).

Strangely, you left out of that list of organization the main one that investigates Medicare fraud (and the one whose expenses in doing so are included in Medicare's budget), to wit, HHS, the agency that actually administers Medicare.

(Three of the Four agencies you mentioned don't even investigate Medicare fraud, except incidentally.)

Re: India Virtually Eliminates Tetanus as a Killer

#23

Post by rm_-rf_slash »

GFK_of_xmaspast wrote: post #13
rm_-rf_slash wrote: post #10

>India has reduced cases to less than one per 1,000 live births, which the W.H.O. considers “elimination as a public health problem." One in one thousand of over a billion is still a rather large number. Shouldn't the WHO use proportional statistics for populations over, say, 100 million?

"One billion" is not the live birth rate.

At the risk of being further downvoted: no shit.

Re: India Virtually Eliminates Tetanus as a Killer

#24

Post by univalent »

This is very cool. I remember as a kid every time I had a cut or scrape my parents would rack their brains for the date of the last 'booster shot'. I was also told cautionary tales of tetanus seizures (?) that could break major bones because of the stress of the convulsion.

Re: India Virtually Eliminates Tetanus as a Killer

#25

Post by jessaustin »

adventured wrote: post #18
GFK_of_xmaspast wrote: post #14

Earlier quoted context omitted.

People say the same thing about California.

No people don't say the same thing about California. In California it's a rare occurrence among the 38 million people that live there, caused by a tiny fraction of the population - almost exclusively a subset of the homeless. In India, it's ~45% of 1.2 billion people.

...almost exclusively a subset of the homeless.

And late-night alcohol drinkers! Maybe you've never done it, but lots of people, of both genders, have.

Re: India Virtually Eliminates Tetanus as a Killer

#26

Post by merpnderp »

dragonwriter wrote: post #22
merpnderp wrote: post #20

Earlier quoted context omitted.

Medicare's budget is around ~$600 billion. It is highly unlikely that the CBO, FBI, DHS, and IRS spend $60 billion looking into potential medicare fraud given how many of those just named organizations could fit into a $60 billion budget (3 of the 4).

Strangely, you left out of that list of organization the main one that investigates Medicare fraud (and the one whose expenses in doing so are included in Medicare's budget), to wit, HHS, the agency that actually administers Medicare. (Three of the Four agencies you mentioned don't even investigate Medicare fraud, except incidentally.)

Those organizations do investigate medicare fraud with the HHS. And do you really believe that more than $60 billion is being spent investigating? That would make the auditing organization roughly 6 times as big as the IRS.

Given how big a deal the FBI made out of a medicare fraud case that garnered nation attention just a few weeks ago, I'd say very little is spent tracking down fraud.

Here's the biggest bust ever, and it amounts to catching around $100/million a year in fraud, a tiny fraction of the $60b total. http://www.hhs.gov/news/press/2015pres/06/20150618a.html

Re: India Virtually Eliminates Tetanus as a Killer

#27

Post by dragonwriter »

merpnderp wrote: post #26
dragonwriter wrote: post #22

Earlier quoted context omitted.

Strangely, you left out of that list of organization the main one that investigates Medicare fraud (and the one whose expenses in doing so are included in Medicare's budget), to wit, HHS, the agency that actually administers Medicare. (Three of the Four agencies you mentioned don't even investigate Medicare fraud, except incidentally.)

Those organizations do investigate medicare fraud with the HHS. And do you really believe that more than $60 billion is being spent investigating? That would make the auditing organization roughly 6 times as big as the IRS. Given how big a deal the FBI made out of a medicare fraud case that garnered nation attention just a few weeks ago, I'd say very little is spent tracking down fraud. Here's the biggest bust ever,…

> And do you really believe that more than $60 billion is being spent investigating?

I don't think it really matters, since you are the one who narrowed the original suggestion that the total cost of Medicare fraud -- which you've stated is $60 billion with a handwave at CBO without specific citation -- might be less than the total cost of resources expended in "fraud prevention" (not just investigation), including (explicitly, per the post upthread) the resources expended in all of the following activities:

* Congress and Medicare deciding what is and what is not covered

* deciding who is and who is not covered,

* what the rules and processes are for preventing and discovering fraud

* what the process is for handling fraud

* the actual time needed to enforce these rules and follow the processes

* time spent by care givers and patients complying with the rules

You reducing this to just investigation costs is, well, missing the point being made.

Re: India Virtually Eliminates Tetanus as a Killer

#28

Post by afarrell »

th0waway wrote: post #11
sophacles wrote: post #6

Earlier quoted context omitted.

Fraud should be a concern, however at some points, the attempts to eliminate it outweigh (in terms of cost and effort) the effect of its existence. At that point it becomes a morality issue rather than a practical one. For comparison, I wonder if the CBO was given full investigatory power into private insurance, would they discover a higher or lower fraud percentage? It would not surprise me if they were higher, and…

I would expect it to be the reverse: there is no incentive for government programs to root out fraud, if they fall short, they just raise taxes. For private companies - if they are being defrauded, it directly affects their bottom line, and the bottom line of their executives (who would be VERY interested to make sure bonuses increase). If we are talking about fraud within the company/government, I would expect the s…

The people in charge of trying to root out fraud don't have the power to raise taxes. They aren't congresscritters.

That doesn't imply that they aren't demoralized, ineffective, or hamstrung, but still.

Re: India Virtually Eliminates Tetanus as a Killer

#29

Post by trextrex »

rm_-rf_slash wrote: post #23
GFK_of_xmaspast wrote: post #13

Earlier quoted context omitted.

"One billion" is not the live birth rate.

At the risk of being further downvoted: no shit.

I'm not sure if you're implying that the population growth rate of India is very high, but if you are that's not true anymore. It's actually very close to replacement levels with parts of India where it's actually below replacement levels [1]

[1] http://qz.com/317518/finally-indias-population-growth-is-slo...

Re: India Virtually Eliminates Tetanus as a Killer

#30

Post by afarrell »

PhearTheCeal wrote: post #12

Now if only they could eliminate defecating in the streets. [1] In India, nearly half of the population - more than 590m people - relieve themselves in the open [1] http://www.bbc.com/news/health-33980904

This was also a problem among the colonial militia camped outside Boston in 1775. It was difficult to solve because people don't like being told where to shit by officers they elected a few weeks ago.
Post reply on HN