You certainly have presented a disturbing case. It's truly a shame, but given the large number of people in the Country, I guess there are bound to be those that manipulate the System. Many times the issues are investigated but yet certain "facts", not known publicly, can actually make the Entitlements legit. However, if you have the particulars of Abuse, I strongly suggest that you contact any SS office and they can begin the process of investigating. So-called "Fraud rings" have been persecuted successfully, and if not successful, at least you know that someone tried the enforcement route. And depending on certain/limited circumstances, a Reward may be payable vis a pporcess called QUI TAM

As to the Funding sources, Yes, it comes from your one Checkbook, one way or another, but it is very important to keep track of the "pots" from a number of perspectives. Remember that FICA tax is based on a different system that the Federal tax. Also, Medicaid (as opposed to Medicare--totally Federal and from FICA) is a Federally supported porgram that often has state funded enhancements. Medicaid is administered by the State, using a system of reimbursement from the Federal General Fund coffers. So it's important that abuse be tracked accordingly as the impact could be both Federal (for everyone) and State related (specific state residents).

For those of you that can re-call the early 1980s, the then Administration pushed through a series of Social Security Reform, one such was the rasiing of the Full Retiremeng age beyond 65 which most people recall from that Adminstration. Another was reform of the Soc Sec Disabilty Insurance Program. Enforcement resulted in outcries, and then slowly, quietly less vigorous appraoches were discussed. After a dip in DI paymnets, it rose again. Welfare Reform under the two term 1990's Administration, also made inroads to try to limit "generations of Receipents" as the terminolgy, if memory serves me, was TANF (TEMPORARY Assistance to Needy Families); States were to work at getting people into jobs and off the rolls within 5 years or face a reduction of Federal support. So both parties have tried to tackle this recently, but given the overall reduction of Federal staffing since the 80s/early 90s, it is really important for inidviduals who uncover Fraud/suspected Fraud to notify some responsible Agency. ( For those who wonder what is the federal administrative costs: they're low, especially compared to Private Insuarnce Companies: Medicare is about 2%; and an earlier Poster indicated Soc Sec is about 3%----anything under 10% in the Private Sector would be considered very efficient)

A knotty problem indeed.