Boston Review: Great Exploitations

Exacerbating states’ natural inclination toward grift, private companies have taken power at all stages of the welfare system and have done so with an eye on states’ and their own bottom lines. States almost universally contract with private corporations to administer their welfare programs. Welfare providers, such as hospitals, also hire private companies to help them maximize payment claims. States then hire additional private companies to help them reduce their payouts to providers and increase their claims from the federal government. The federal government hires the same or similar companies to audit Medicaid and other industries and to review state actions. These companies lobby heavily at the state and national levels for their own interests and with little public scrutiny brought to bear on how they conduct their business. Hatcher details how often conflicts of interest and pay-to-play arrangements influence the votes of state politicians, for example. At each step, the companies profit off a system designed to provide a safety net for our most vulnerable citizens. They are, quite literally, stealing from the poor. And although it has the authority to do so, the federal government rarely pursues prosecution against revenue maximization schemes.