tomw, any retail private enterprise –with similar trtansaction profile –would start ringing the alarm bells and bringing in the investigators at ‘slippage’ of two cents on the dollar. Medicare has about twenty-five cents slippage on the dollar. most would expect a government op to be able to run at no more than 200% or 300% the slip of a private. but TEN times? What is the problem –at one tenth the slippage, the cost of fraud controls would pay itself. At TEN times, the cost of controls would save about the GDP of France. It just don’t make no danmn sense. A gov’t so staffed and (dis)incentivized can’t possibly ever come anywhere near handling and defraying what it already has gathered in –and it wants another 20% or 40% of the GDP?