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Spent on Medicare and Medicaid annually — with documented waste, fraud, and abuse

The federal government spends over $1.3 trillion per year on Medicare and Medicaid. The HHS Office of Inspector General estimates that improper payments — including fraud, waste, and abuse — account for tens of billions of dollars annually, with little accountability for whether patients actually benefit.

In healthcare fraud prosecuted by the DOJ since 1997 — the tip of the iceberg

Since 1997, the Department of Justice has recovered over $100 billion in healthcare fraud settlements and judgments under the False Claims Act. Experts estimate that prosecuted fraud represents a fraction of total fraudulent billing — most is never detected or reported.

Of all U.S. healthcare spending is estimated to be waste — not care

A landmark study in JAMA estimated that approximately 30% of all U.S. healthcare spending — roughly $760 billion to $935 billion per year — is waste: unnecessary services, excessive administrative costs, inflated prices, fraud, and missed prevention. The population being "served" sees none of it.

The markup on hospital services compared to Medicare rates — for the same procedure

Studies consistently show that hospitals charge uninsured and out-of-network patients 340% or more of what Medicare pays for identical procedures. The billing system is not designed to serve patients — it is designed to maximize revenue from federal programs and private insurers alike.

Americans report skipping needed medical care due to cost — despite billions in public funding

Gallup consistently finds that approximately 1 in 3 Americans report delaying or skipping needed medical care because of cost — even as the federal government pours over a trillion dollars annually into the healthcare system. The money flows to the workforce and the institutions. The patients go without.

Healthcare executives earning over $1 million annually at nonprofit hospitals receiving federal funds

An analysis of IRS Form 990 filings found that over 6,000 executives at nonprofit hospitals — institutions that receive billions in Medicare, Medicaid, and tax-exempt status — earn more than $1 million per year. Overtime abuse and executive compensation are subsidized by public funds while patients are denied care.

False Claims Act violations

Hospitals and insurers that bill Medicare or Medicaid for services not rendered, not medically necessary, or not delivered as billed are committing federal fraud under 31 U.S.C. § 3729. The False Claims Act imposes treble damages and civil penalties — yet enforcement reaches only a fraction of violators.

Anti-Kickback Statute

Federal law prohibits any person or entity from offering, paying, soliciting, or receiving anything of value to induce or reward referrals of items or services covered by federal healthcare programs. Pharmaceutical companies, device manufacturers, and hospital systems routinely violate this statute — and the penalties are rarely commensurate with the profits.

EMTALA — the right to emergency care

The Emergency Medical Treatment and Labor Act requires any hospital receiving Medicare funds to provide stabilizing emergency care regardless of ability to pay. Hospitals that divert, delay, or deny emergency care to uninsured or Medicaid patients are violating a federal statute — and a constitutional obligation to every person within their jurisdiction.

Equal Protection and the right to equal treatment

When federally funded hospitals and insurers systematically provide inferior care to Medicaid patients, patients of color, or low-income populations — while billing the federal government at full rates — they are not merely committing fraud. They are violating the Equal Protection Clause of the 14th Amendment and Section 1557 of the Affordable Care Act, which prohibits discrimination in any health program receiving federal financial assistance.