Please tell me the U.S. health care system is not BROKEN (ethical, illegal)

[ParkTwain]

Read this entire page from the National Health Care Anti-Fraud Association (NHCAA), which is "a unique, issue-based non-profit organization comprising private- and public-sector organizations and individuals responsible for the detection, investigation, prosecution, and prevention of fraud against private and public health insurance plans. Established in 2000, The NHCAA Institute for Health Care Fraud Prevention is a separately incorporated, tax-exempt educational foundation that provides education and training to private- and public-sector health care anti-fraud personnel."
About NHCAA mainpage (broken link)

"About Health Care Fraud"
About HCF (broken link)
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A Serious and Costly Reality For All Americans

Since the early 1990s, health care fraud – i.e., the deliberate submittal of false claims to private health insurance plans and/or tax-funded public health insurance programs such as Medicare and Medicaid – has been viewed as a serious and still-growing nationwide crime phenomenon, linked directly to the nation’s ever-growing annual health care outlay, which in calendar-year 2003 alone amounted to $1.7 trillion (the Office of the Actuary, Centers for Medicare & Medicaid Services). This represents a growth of 7.7 percent over the prior year.


That Some Health Insurance Claims Are Fraudulent is Beyond Dispute

It is an undisputed reality that some of the more than 4 billion health insurance benefit transactions processed in the United States every year are fraudulent. Although they constitute only a small fraction, those fraudulent claims carry a very high price tag.

Each year, for example, the Office of Inspector General of the U.S. Department of Health and Human Services conducts a formal audit of the Medicare program’s fee-for-service claim payment system.On February 21, 2002, the HHS-OIG reported its finding that of the $191.8 billion such claims paid in 2001, 6.3 percent – amounting to $12.1 billion – should not have been paid due to erroneous billing or payment, inadequate provider documentation of services to back up the claims and/or outright fraud.
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The Involvement of Organized Criminal Groups

So strong an invitation to some is the country’s ever-larger pool of health care money that in certain areas – Florida, for example – law enforcement agencies and health insurers have witnessed in recent years the migration of some criminals from illegal drug trafficking into the safer and far more lucrative business of perpetrating fraud schemes against Medicare, Medicaid and private health insurance companies.

In South Florida alone, government programs and private insurers have lost hundreds of millions of dollars in recent years to criminal rings – some of them based in Central and South America – that fabricate claims from non-existent clinics, using genuine patient-insurance and provider-billing information that the perpetrators have bought and/or stolen for that purpose. When the bogus claims are paid, the mailing address in most instances belongs to a freight forwarder that bundles up the mail and ships it off shore.
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Dishonest Health Care Providers Take the Greatest Toll

Individual patients can, and in some cases do, commit health care fraud—either on their own or in collusion with dishonest health care providers. By far the greatest damage, though, is attributable to fraud committed by dishonest health care providers. This is not because large numbers of physicians and other health care professionals are dishonest. On the contrary, the vast majority are honest and ethical, and they too are victimized both by the dishonest few within their professions and by the increasing number of professional criminal operations that pose as health care providers for purposes of committing fraud.
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In “institutional” cases, involving such perpetrators as hospital chains, national laboratory companies, transportation, pharmaceutical and medical equipment companies, the totals in various federal criminal and civil fraud cases of recent years have ranged from tens of millions to hundreds of millions of dollars. Several recent high-profile fraud cases involving hospital chains and pharmaceutical companies, for example, have resulted in criminal and/or civil settlements ranging from $600 million to $850 million.
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[Evlevo]

I think it is broken for everyone but the folks who end up getting a check (HMOs and Insurance).

There are too many things to list that should be improved, with the only drawback being a smaller bottom line for a few "middle men".

[AnthonyB]

Broken

Sad to think of all that money flowing out while millions can't go to a regular doctor and the insured spend precious time and money fighting for the services they pay for.