Ordinary people are trying to make the rent, and fraudsters are ripping off Medicare, Medicaid and private insurance
The healthcare con is always on.
The loot, frankly, is astonishing. There's a Ferrari 296 GTS, apparently costing just shy of $600,000. A Rolls-Royce Phantom and a Bentley Continental (no prices mentioned). An $850,000 custom-made necklace from Bulgari. A luxury box at an NFL stadium. Endless cars, expensive watches, real estate. At least one yacht. And hundreds of millions of dollars in cash and investments.
All from ripping off Medicare, Medicaid and private insurance. Which means, ultimately, ripping off the rest of us - as taxpayers and payers of health-insurance premiums.
Meanwhile, ordinary people are trying to make the rent and are worried about affordability.
The chutzpah is shameless. These people are laughing at us.
All these ill-gotten gains were announced today as the Justice Department revealed the results of its latest nationwide healthcare-fraud bust, in which it charged 455 people with scamming the healthcare system and alleged up to $6.5 billion in fraud.
It's hardly surprising that the healthcare system attracts fraudsters like honey attracts bees. The U.S. spends more than $5 trillion a year on healthcare, far more than any other country. We spend about twice as much per person as any other country, including the rich ones. This massive gap really took off starting in the late 1980s (around the time the law was changed to allow pharmaceutical companies to advertise directly to consumers). The relative rate of increase has actually slowed since around 2009. But U.S. healthcare spending, at 17% of annual gross domestic product, is gigantic.
We've seen plenty of news in the last couple of months related to alleged fraud against Medicare and Medicaid, including the "takedown" of Medicaid fraudsters in Minnesota and six trial convictions announced in May.
But in all cases, readers should check the fine print. Many of these busts are outrageous. But the amount of money actually saved is generally far less than you read about. And it's a pittance compared with the total cost of healthcare, including the budgets of Medicare and Medicaid, and so it is not going to have any material effect on the federal budget. And contrary to what the Trump administration may tell you, it is nothing new.
The amounts that scam artists actually pocket from Medicare, Medicaid, Tricare or private insurance is generally a lot less than the amount you see in the headlines. The headline figure typically refers to the total amount that those involved in the fraud tried to bill the insurers. In some cases, they collected less than a third of that amount.
Last month, in the high-profile Medicaid case, the Justice Department announced it had arrested 15 people in relation to a $90 million fraud scheme. But it turns out this was a $90 million intended fraud. The actual amount pocketed by the scam artists was far less.
Recently the Justice Department boasted about securing convictions involving $1.1 billion in fraud. But nearly all of that money related to one case, and once again, the amount the fraudsters actually received was less than half that.
Furthermore, these fraud figures are not annual numbers. They are cumulative amounts stolen, usually over several years and sometimes over many.
Meanwhile, Medicare and Medicaid together spend more than $2 trillion a year. And the federal budget deficit this year is expected to be $1.9 trillion. These fraud busts will not make a material difference. You cannot bail out the Titanic with a soup ladle.
And despite the recent flurry of news and headlines, there is nothing new about these busts. The current administration is trying to link these cases to the new "fraud task force" announced in April and headed by Vice President J.D. Vance, but the fine print reveals the truth. Many of these cases date back years. The investigations were often begun during the Biden administration or even during the first Trump administration. You can see this in the court filings.
The White House didn't respond to requests for comment.
"Prior to the charges announced as part of today's nationwide Takedown and since its inception in March 2007," the Justice Department admits, "the National Fraud Division's healthcare Strike Force program ... has charged more than 6,200 defendants who collectively billed federal healthcare programs and private insurers more than $45 billion."
So, sadly, no: Today's news does not mean we are on our way to balancing the budget by rooting out "waste, fraud and abuse." The news, on the contrary, helps prove that we can't.
-Brett Arends
This content was created by MarketWatch, which is operated by Dow Jones & Co. MarketWatch is published independently from Dow Jones Newswires and The Wall Street Journal.
(END) Dow Jones Newswires
June 25, 2026 10:00 ET (14:00 GMT)
Copyright (c) 2026 Dow Jones & Company, Inc.
Comments