Columnist incorrect about aid programs

In her Jan. 9 column, Veronique de Rugy discusses the fraud revealed in several programs funded by federal grants to the State of Minnesota. The fraud primarily involved large numbers of children for which assistance was not provided but for which billing was submitted and paid over an extended period. De Rugy concludes that “If we want less fraud, we need less government.”

Ordinarily, the federal government is the primary source of resources allocated to states by formula based on the frequency of the programs’ targeted population in the area. The states in turn distribute the funds through agreements with public, nonprofit, and sometimes commercial concerns. There is an old expression characterizing such occurrence: “The more tiers, the more tears.”

The fraud revealed in Minnesota seems to have occurred entirely at the lowest level by operators of what now appear to have been bogus organizations. If instead, the state itself had operated these programs the risk of insider fraud presumably would have been greatly reduced. Thus, Ms. de Rugy’s conclusion that government should not be dealing with these programs is incorrect.

Medicare fraud is not at the federal level. It is mostly committed by people claiming services who are not eligible or otherwise do not qualify for the services or by service providers claiming reimbursement for services never delivered. These cases are kept in check to the extent that the FBI and other enforcement agencies are sufficiently staffed and managed. Presumably, if we had Medicare-for-all, there would be no eligibility issues, although service providers submitting claims for services not delivered would still be a hazard.

Ms. de Rugy would certainly agree that if better procurement practices are to be realized for these kinds of services, then putting the money on the stump and watching what happens, as appears to have been the case in Minnesota, will not win the day.

Jim Kinney

Vernon Hills