The numbers are staggering to be sure, but the biggest problem is fraud. The government pays out millions every year in bogus claims. Fake companies buy names and socials, submit claims for three months then close shop and open under a new name and do it all over again. In the documentary I saw, the company did not even claim to offer any services or drugs, purely non-existant medical supplies like O2, potty chairs etc. All small ticket items that "it would cost too much to investigate". By the time someone on that list gets an explaination of benefits and calls to state that they did not receive the items, the company has moved on to a new name with a new list.