Health care clunkers
Published Thursday, July 2, 2009
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Before we buy another government health care vehicle, let’s consider the ones already parked in the garage.
Medicare is so cumbersome and pays so little for a procedure that many private practice doctors won’t accept it. Obama plans to fix this by cutting reimbursements to providers by 30 percent. It is also administered so poorly that it’s rate of inflation is 34 percent higher than private health care.
Medicaid is perhaps the most abused system in the country. I saw this on a daily basis in an emergency room. Moms routinely brought three or four kids in to be seen because one had the sniffles. What the heck, it’s free! However, to my knowledge no complaint we made was ever investigated.
The Department of Veterans Affairs said it had recently exposed 10,000 patients to HIV and hepatitis because of improperly sterilized equipment. Even Congress complains about the care given to our vets. A client whose father was in a VA long-term care facility once doubled the length of a vacation to get him out of there and into a private facility because of the dearth of care.
Together, these programs represent tens of trillions of dollars in future, unfunded, expenses.
By the way, in a recent international survey of doctors, only those in one country said they experienced no shortage of health care facilities.
That country — are you sitting down? — the U.S.
So let’s consider the old clunkers before we buy the shiny new model.
Steve Bogard
Fairbanks
Community Discussion
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Unfunded is the key word.
Politicians look to medicaid and (more easily) to the VA for budget cuts. When you take a system that is handling more and more cases for less and less money with increasingly expensive proceedures, what do you expect?
And medicaid is not corrupt. The funding to investigate fraud has been cut, and fraud does happen, but it is the most efficient in terms of administrative overhead of any insurance plan in America.
Part of the idea is that if that lady has health insurance, maybe she can take her kids to the doc instead of using up ER resources. Maybe afford some medicine too. ER is not automatically medicaid care, most of it is people with nowhere else to go who just don't pay their bill.
And I dont think I have the energy for another of these letters. Healthcare is rationed in this nation by income, and I and many Americans want to stop being afraid of dying because we are poor. I don't expect much though, given the active and intense money-lobbying/bribing coming from the Medical Industry. I know if I get terribly sick, I will have to sneak into Canada and live as a bum... I won't get treated here.
so the US is the only country with no shortage of health facilities and doctors? So why does EVERY major study rank us almost dead last in industrialized nations for the health system taking care of the population as a whole?
Isanova just never seems to get it that if corrupt and stupid people are pouring money down a rat hole, and they attempt to "fix" it by enlarging the hole and pouring down even more money, the whole process has a lot more to do with money, greed, and stupidity than it has to do with health care.
mwmcintyre,
"So why does EVERY major study rank us almost dead last in industrialized nations for the health system..."
It sounds like a simple question but it's not. There are multiple reasons (and I'll probably forget some of them). First, there's the fact that many people are young and healthy and CHOOSE not to obtain health insurance when it is available to them. Second, is the fact that many people loose their jobs and are "temporarily" out of insurance when some medical emergency strikes (but that is a problem with the insurance industry and could be addressed with a change to laws regarding them).
I've dealt with "Managed Care" (which is what you'd get on a massive scale if Government "Single Payer" Health Care is implemented) and it's not about health care, it's about the money. The government CANNOT afford to pay for all the health care that's needed which is why we would instantly have to start with "rationing" and those who are beginning to get older? Forget it, we've outlived our usefulness; perhaps you are still young enough to be considered "useful" but I'm over 60 and approaching what some would call "useless" (even though I'm still almost 30 years from the age my mother died)...
Doug said: First, there's the fact that many people are young and healthy and CHOOSE not to obtain health insurance when it is available to them.
Buahaha... if you were making 24,000 a year and insurance costs you $800-$1200 or more a month, you would CHOOSE not to either.
mcwmcintyre -- can you post links to those studies?
Corrupt
intransitive verb
1a: to become tainted or rotten
1b: to become morally debased
2: to cause disintegration or ruin
I have heard and known a lot of people in this nation who's lives have disintegrated and fallen into ruin due to health insurance companies denying them treatment and after-the-fact cancellation of health-care when they got sick.
I am not for throwing money down holes, but I do think government can compete, bring the costs down and give people who cannot buy insurance... not for lack of money but because they have conditions which make it impossible. Heck if you want a true stimulus for this nation switch to a single-payer national system and assume control over all the insurance companies. When companies big and small in this country no longer have to spend an average $10,000 per employee on health-care... our economy will be like a spring chicken. More business = more taxes, so the govt spending will be offset somewhat.
Still, I prefer government competition in this case rather than wholesale nationalization.
Alaska has been audited by the Feds and it has over the years found that providers in this State have filed false claims that have cost the tax payers millions of dollars. That kid with the sniffles, how many other procedures were ordered that would be covered but were not needed. Just like other insurance programs, providers know when the golden goose has arrived and they milk it for all it is worth. Look how many medical test that the American public has been told are needed on a routine bases are now not needed. The system needs to be cleaned up. Remember for about 200,000 people a year on Medicaid in Alaska the bill runs well over a billion dollars a year.
Food, fuel, transportation, housing, clothing, and any other necessity are regulated by cost and a persons ability to pay. If they all were free we would all have huge homes, drive all over the place in nice new vehicles, eat at all the best dining establishments, and wear the newest and best clothes. Why should health care be any different? At what point did health care become a right in this country?
This country doesn't need another entitlement program that we can't pay for.
mwmcintyre:
"so the US is the only country with no shortage of health facilities and doctors? So why does EVERY major study rank us almost dead last in industrialized nations for the health system taking care of the population as a whole?"
the problem must be with the population, or the ones doing the ranking. i'm voting for the problem is with the population. we aren't europe. government run health care will be an unmitigated total disaster in the usa and the attempt will cause massive suffering.
Some of us don't want to die just so health-insurance can be a money-making industry. I know I dont
Doug is right about one thing its all about money.profit,greed.
The answer take the profit, greed out of the picture....go for
single payer.
Go to school, get good grades, graduate, get a good job with health benifits and stay there.
On the other side, our political system, insurance system, and medical system is so corrupt. Your screwed even if you do what you should do.
health care is not a right or entitlement. if you do not have it you should not be treated at all. just go home and suffer for not having it. people have choices and if you choose to have a big house expensive toys and no health care when you get sick you will either get better or die. cold hard facts of life. but the problem now is if you are on welfare you get medical care, if you are certain race you get it. so make it even across the board either buy it or do not get anything.that means welfare moms are out of luck. now give me hell all liberals who want to spend my money.
mwmcintyre cannot provide a link to those studies, he was "generalizing" based off of a progressive, liberal mentality. He's been told we're last, so he believes it.
This is called being a lemming.
Isanova,
BALONEY! Health Insurance does not cost "between $800-$1200 or more a month" (not, that is, if the person is willing to go to work and find a job with health benefits)!
twain,
If I'm right about "money.profit.greedand the answer is to take the profit, greed out of the picture..." the answer is most certainly NOT to put the government in charge of the whole mess. The Government has been "in charge" of social security for decades and it's about to go bankrupt because the government considers it "the third rail of politics" and they're afraid to touch it...
polarmark, so you're admitting right out that if a study doesn't have results you agree with, you will ignore it or blame it on something else. Nice to know.
Doug: Choose? That's hilarious, when the cost of health insurance equals half or more of your paycheck, that's not a choice. And just saying get a better job is moronic, SOMEONE has to work those jobs, the economy will not support every single person getting a good job with benefits. On an individual basis, you have a point, looking at the whole picture, that just doesn't work.
1. The mother brought her children to the emgency room because one they would have to wait two months to get into the doctor's appointment book.
2. Then they have to pay a percentange even on medicade.
3. If they owe money to the TVC for any reason you are put on a service of pay only.
4. Yes the system is full of holes and errors and I do believe that any plan that is brought to the tables is only going to pissed the doctors off and no one will comply. What just because the President says so the whole country is going to jump yeah right.
Isanova
Last time I checked, Food, Fuel, Clothing and other essentials were also money making industries that are needed for you to continue to live as well. Want those for free too?
prospector: not good with posting links, check out the WHO site.
I do believe we have some excellent facilities and doctors in America, it's access that is a major problem and affordability. The insurance companies already hamper the system in all the ways the anti-govt crowd are saying the govt will do, but the govt doesn't have the same motivation(pure greed). People should have a right to basic health care the same way they should have a right to basic schooling and to be protected through police, fire department and the military. One of the jobs of government is to "Promote the general welfare"(taken straight from the beginning of the Constitution).
Shortage of health care facilities,.. health care costs??
Fairbanks has a shortage of facilities, because every time someone wants to open something, banner health AKA Fairbanks memorial hospital and now Tanana Valley Clinic, rallies up with it's lobbyists and keep the Certificate of needs program in full swing, blocking any kind of competition. They say we don't need more, yet they are continually expanding the size and services of their operation.
If there was more options, we'd have lower costs!
You want to blame the government for cutting medicaid?? try blaming the health care facilities for WAY overcharging for medical costs, which create the tremendous burden on the system.
Duh!
What we need, is more clinics like Interior health care, which is subsidized and charges patients on a sliding scale of what they can afford. That clinic is always booked up and understaffed. That ALONE, should cry out for the need of more affordable health care facilities and the need for some changes.
Before you cry foul and rant about health care interventions, and how we have enough facilities, throw away your health insurance, and try paying out of pocket like so many other Fairbanksans. Dread the time you might fall off a ladder, or trip over a hose breaking an arm, and wondering how long it will take you to pay that little accident off.. if you'll get enough services to make sure it will be fully functional again.. if you'll be able to work or get laid off.
So many things people with health insurance takes for granted, but hey! it's practically free right? It's a big circle of greed. But it all starts with the hospital and high health care costs.
The government should be involved. Just as they set minimum wages, they should set maximum health care costs. "you can only charge this much for: asprin, tylenol, xrays, initial visits, etc." People don't scream much when we're told the minimum you have to pay employees, why should anyone cry over them telling health care facilities that serve the public, and obtain ANY federal or state subsidies, how much they can charge?
chenasteamer...I did what you said to do which I thought would protect me in my old age...guess what - it doesn't work.
When I turned 65 and became eligible for Medicare, everything changed. When I tried to make an apppointment with what I thought was my doctor, I was told that since I hadn't been in for 4 years, I was considered a new patient. I could fill out the new patient paperwork but would be refused because of being on Medicare. I called every medical facility and doctor in Fairbanks that's listed in the phone book, and was told the same thing by all of them. One receptionist suggested I go to the Emergency Room. I said, that's not appropriate, this is not really an emergency, just a painful on-going problem. Out of desperation, I went to the Emergency Room. When I explained that I had tried to see a doctor over my problem, the Admitting Emergency Room Nurse said not to worry, and that many seniors were coming to the ER as they can't get a regular doctor to see them. I also have health insurance through my former employer, but Medicare is now considered my primary insurance. In this visit, my private insurance sent paperwork that the total bill was $206.80, my private health insurance paid $42.13, my primary insurance (Medicare) paid $10.53, and I would be responsible to pay $9.76. However, paperwork from Medicare shows the total bill of $236.00, Medicare approved $85.21, the approved amount was being applied toward my deductible, nothing was being paid to the hospital, and I may be billed for $85.21.
I wasn't even aware there was a deductible with Medicare. I am waiting to see if Fairbanks Memorial Hospital will send me a bill. This whole thing is confusing and I am still trying to find out what's going on with Medicare.
I realize that I am lucky to have good health and this bill is no big deal. However, I'm concerned about possible future larger health problems and bills, and I also resent being forced to go to the Emergency Room for problems that could be solved with a simple doctor visit.
I am hoping that President Obama is able to do something major to fix the present health care system we have in the United States. I feel that we do have excellent health care - it's just getting to the source to use it and being able to afford it. We need to nationalize health care, get rid of the health insurance companies, and have the government set reasonable prices for medical procedures. Everyone could pay a reasonable rate to the government, and those that are low income and can't pay would still have free health care similar to Medicaid.
The Republicans have made such a mess out of everything, including health care, that I will never again vote for anything Republican including candidates or policies. The Democrats have also made some bad decisions, but I'm going with them from now on!
jwcehc: When a significant portion of the population doesn't have access to those things, solutions should examined for that as well, right now there are many options for food and clothing. Food banks and thrift stores come to mind. We do also have food stamps for the poor, and housing programs. No one is saying that people shouldn't work and take responsibility for themselves but many people can't or don't know how, and we, as a society, should help them because it makes our society a better place to live, reduces crime because we have less desperate people willing to commit crimes, helps people stay productive members of society because if they stumble, it allows them to get up and back in the game much faster and easier than if there were no safety net. If health care were readily available to all then many people would continue to be productive citizens who, under the current system, fall through the cracks. Providing for the basics of a decent life improves the quality of life for everybody. Will some people take advantage of this? Absolutely, but that doesn't mean we should throw the baby out with the bathwater.
Ponderous, check the WHO, last time they ranked the world health systems, we were 37th, not exactly impressive and not generalizing.
http://commonwealthfund.org/Content/Publ...
There you go Ponderous, another one for you.
If it wasn't for the good ole USA having such a powerfull military we would be totally screwed. And thats because this country has so, so many problems.
USA has been in the back row nose bleed section as far as health for many, many years. The current WHO statistics are of no surprise at all. Our infrastructure is a shambels also. People in this country are more concerned about sports statisitics than they are about whats going on around them.
jawhip-
Your logic escapes me. You turn 65, go to Medicare, and are disappointed and disillusioned by this government program (foisted upon us by Democrats, by the way), both in it's coverage and institutional bureacracy, and now your solution is more government run health care. Why would a much bigger, much more bureacratic government program offer anything but bigger problems? And your anger is directed not at the party responsible for the program, but at the Republicans. If you grab a hot iron skillet off a burner, and burn your hand, do you have a compulsion to stick your hand on the stove itself, while cursing at the refrigerator?
---
Isanova-
You say "unfunded" like it's only a matter of the federal government deciding to pay for the program. The unfunded liability for Medicare is $40 trillion. "Unfunded" in this case means that there is no money, anywhere, to pay for Medicare. There is no blood in that turnip.
I reviewed your link, ... did you notice that the majority of grants coming from your commonwealth organization are going to advocacy groups for healthcare reform? All well in good if these were non-partisan organizations, ... unfortunately, this is political, such as their grant-giving, such as your link.
There are two sides of the issue, one who believes healthcare is fine the way it is, and the other doesn't. I happen to believe healthcare is good the way it is, not perfect, but a damn site better than the other countries that our administration is trying to model.
Unimpressed.
jwcehc,
Last time I checked Food, Housing and Gas were not at such exorbitant prices that they are out of the common person's ability to purchase them. Well they are in the villages, but at least they can move somewhere else to be able to afford them without leaving the country.
If a simple CT scan didn't cost 3 times my yearly salary, or a car wreck ER visit put someone $300,000 in debt, this might be a different discussion. This is why I support government competition as opposed to say, total federal control. Putting it in private hands has led to making money at the cost of people's lives, and we put the burden of paying that on businesses which are sinking in this country. We wouldn't likely have had as much outsourcing of wholesale industries if the cost of health-care was not so high. Bringing it down with competition will not only save lives, but significantly boost our economy in ways a stimulus bill or tax break could never do.
TheBigDipper,
Yes I realize that, but wouldn't you also agree that ALL of what our government is doing and has been doing for decades is unfunded? From the USDA to the war in Iraq, we are paying people in borrowed money. It would take 10-20 years of literally everyone government employs working for free to pay off our debt. If you want to gripe about financial soundness, why aren't you rallying to cut the military's budget (39-40% of our spending IIRC), dramatically raise taxes and pass a law stating the budget cannot be in the red? Don't want to get behind a 16% jump in everyone's income taxes?
TheBigDipper...So, what are your ideas on a solution? Instead of trying to psychoanalyze my reasoning (you're way off base, by the way), tell us if you have any ideas of your own on how we can fix the health care problems in our country. I'm certainly willing to listen to anything that has merit. I'm not really worried about myself - I figure my days are numbered, and, if I'm lucky, I'll drop dead without being forced to have medical care. It's the young people in our country that I'm concerned about, including my children, grandchildren, and great grandchildren.
Isanova-
National defense is mandated by the Constitution. The other stuff has been made up and added on. Many of them, as benevolent as they seem, are neither mandated nor affordable. Sorry, but we don't live on Big Rock Candy Mountain. Or communist utopia, in your case.
---
jawhip-
There is a solution for people still of working age. That is what McCain was proposing, with a few tweaks, which was tax credits for individual health insurance. Let people pick their own insurance and their own doctors, without government interference. If they are unemployed, or working poor, they would get stipends from the government, much as they do now for people under the taxable rate with Earned Income Credits. This way there is no new bureacracy, no new government red tape, and no new buckets of money for corrupt politicians or medical providers to steal from, as the politicians have with every other pot of money they have ever gotten their thieving hands on.
As for Medicare for the elderly, I don't have specific answers. A top to bottom reform is obviously in order. It is broken as is, and if we continue with it, or expand it, all we will do is run the bill up even more. And as with SS, it wont be there for the next generation.
I apologize if you think I was trying to psychoanalyze you. I was trying to interpret your comments. Where did I get it wrong?
Great letter! Thanks!
So, throw money at the insurance companies? Where is that mandated in our constitution?
Do you realize that insurance is regulated on a state-by-state basis? Opening up sale nationwide would create chaos in the insurance oversight world. It would be impossible to lodge a complaint when the oversight board is in Rhode Island, and the whole system would collapse. I'd like to ask where you think people with Diabetes, a history of cancer and other illnesses should go when no insurance companies will touch them? What are you going to do about businesses that turn you away after the fact when you get sick because they don't want to pay for your care?
In one breath you talk about our nation being fiscally unsound, and in the next you want to use tax cuts to pay for private insurance (which for most people is more expensive than their taxes) Its not an answer at all.
Yes government is by and large not the best at running things, but they are not wholly incompetent. Medicaid is more efficient than private insurance companies, at least in terms of paperwork/bureaucracy/administration. Private Industries may not be out for corruption, but they are out for squeezing every dollar they can be it from government, business or your pocket. They don't care if you die or get sick, if they can save/make a buck its all good.
Isanova: "Private Industries may not be out for corruption, but they are out for squeezing every dollar they can, be it from government, business , or your pocket. They don't care if you die or get sick, if they can save/make a buck its all good."
If you replace "Private Industries" with "The Federal Government" in that statement it would be identical in every other way, and still true.
So why would it be better?
The so called health care reform is just another scheme to buy votes with taxpayer money. The financial sector, the auto sector, the energy sector and now the health care sector are all being nationalized.
Every one of these sectors has suffered from distortions in the market caused by federal programs and policies. And the solution is for the federal agencies to simply own and run all meaningful aspects of the economy.
We have an example of single payor run health care called Norton Sound in Nome. You are much better off going to a vetrinary. At this time people can opt out, and go to Anchorage or Seattle to see a real doctor, what is being proposed under the guise of "reform" will take any options away.
We are moving from a Republic with approx. 50% free people supporting themselves and the freeloaders, to 99% groveling for government provided benefits and a 1% elitist ruling class.
Isanova-
I see your point. Unlike those evil capitalist insurance companies, the government cares about us. The government loves us. The government is good. Capitalists are evil. We all love Big Brother. Big Brother loves us.
Isovana
"Yes government is by and large not the best at running things, but they are not wholly incompetent."
Name one thing that the government runs that is not incompetent?
The military would be the best example of something that works but is a money pit. Blackwater could run it better and more efficient, there is a reason the green zone was protected by them.
Social Security- A joke from the beginning
Medicare- a huge joke, most people dont know is that Medicare sets a price that can be charged for any given service. I work with an Ambulance company we have a transport that is say $1000 well medicare says that it will only pay $250 for that transport and we have to accept the write down. They fix costs so we move them on to the insured. Medicare is costing the private insured people more money.
IRS- need i say more
Dept of Homeland Sec.- great organization they are.
Isanova , I agree with most of your position on the subject . Now as far as figuring a fix , did you ever try to reason something with a pen full of starving hogs ??? Many here , would fit in that category .
Obama will fix everything
It would help if our doctors and legislators were not on the take with the Insurance and Pharmaceutical Companies.
Please tell me they aren't.
Health care in this country is kind of like Chrysler. The private sector has already made a completely messed up morass out of it. And now the government is going to take over and "fix" things.
Oh boy.
Steve Bogard,
Do you work for Dick Randolph's State Farm Insurance Agency?
If so, should we know that in advance?
I am amazed. There are people who think health care ought not to be a profitable business. What on earth would cause a person to go to medical school, the intership, and then the work schedule to be a doctor at all if there weren't a nice benefit from it all? If you came ot me and said I want you to fix my truck but you need to do it on my pay scale and get paid on my schedule I would thank him for coming by and show him where the door was. Broke truck or not.
Kind of funny though, you can argue it either way. We are ranked number 37 in the world, but other country's like Sweden, switzerland, canada, Austria, Belgium, Germany and New Zealand all have universal Health Care and LOOK!! They rnk above us, does that not say anything?
OOOPPPSSS... I lied, scratch New Zealand, they have cool great whites off their shores though.
cossack, the business as a whole should not be driven by profit, individuals being fairly compensated for their service and profitting that way is not a bad thing.
Ponderous, you ignored the WHO ranking completely. 37th, not impressed and definitively not better than all those other countries. Not surprising that the Republicans who depend on lies are convinced that everyone else uses them. Explain to me the ulterior motivations of champions of health care reform, Oh, that's right, to help people. The champions of "keep it the way it is"? The corporations raking in the millions of dollars while refusing treatment to millions of americans who are covered under them.
No one says the medical profession should not make a reasonable wage
for their services. They do in canada. However they should not be allowed to charge 20,000 dollars to take out a gall bladder, a
straightforward operation with no complications. Or 2,100 dollars
for the emergency room doctor that just looked at a dislocated wrist
didnt even lay his hands on it, just said send him up to the bone
doctor. When approached later to try and lower the bill and told I have no insurance because Im between jobs, the doctor insisted he
wanted his full pound of flesh. That happened right here at FMH.
So lets not talk about a profitable business, lets talk about
heartless overcharging, greed and a only concerned for their bottom
line. I dont want to hear about the medical profession that goes
into that field because they love people. Yes some do, but for
everyone of those theres 10 who want to wring the last drop of
blood out of the turnip.
This is me . When I was a young fellow , I heard about unions . I found that most had bargained for good wages on the check . It felt good on payday when you went to the bank with the paycheck . Then not too long after that , the union heads started to talk about pensions and health care . To the best of my memory , we negotiated so that 8 or 10 cents an hour was contributed from our hourly wage into a fund , which paid for our pension , and another fund for the health and welfare coverage . Me and my family always knew that we would not be turned away at the doctors office . For the most part the coverage payed 80% for an office visit , and payed more as the bill got larger . My pension was always fully funded , and was always worth what ever the contribution would earn . I had a wife that also worked , and between our plans the family was always covered . So when I was young I always worked on a union job . If it was not union I did not consider it . There were some lean times between jobs . When I went to work the first thing I would do was pay past bills , and then save enough to tide me over to the next job . After that the luxuries would come . Now I have a pension and am covered by medicare . Who knows what will happen tomorrow , I might be dead , or the world might come to an end , as some believe is going to happen sometime . The bottom line of all of this is that everybody payed for my coverage in one way or the other through time . But the first thing I had to demand it , and then seek support in obtaining it , by belonging to a union , and refusing to sell my labor short . I had to work hard , and be sure that the company did not regret that they had hired me . There is so much wealth out there , and it depends on how it is divided up , and who gets what part of it . A person will be given very small portion unless they demand their fair share . If people want affordable health care , they will have to demand it , and see that medical industry receives a fair payment , and nothing more . Some doctors may have to be starved out , and people die , while a proper level is reached .
Remeber if it run by our goverment it will be expensive!!
mwmcintyre -
The current is system is bad and can be improved. However, the suggested solution of government health care would make the system worse than it is now. So those of us who oppose the worse solution are not advocating that the system should not change we are simply advocating that we not make it worse.
Since the only 'solution' on the table right now is the Obama plan our options are limited to a bad system or a worse system and your argument is that the motive of those advocating the worse system are pure and altruistic makes it the better plan? You're wrong. The motives are irrespective, the result is what I am concerned about and the result of this 'solution' will put our nations health care system in a far worse status than it is in now or has ever been.
"the suggested solution of government health care would make the system worse than it is now. " I see. So we're more incompetent than the 36 countries that rank ahead of us? Why do you hate America?
OK here you go. I am on of these evil, greedy, etc. doctors here in fine old Fairbanks. Guess what, we all the know the system is horrible but we are working with what we have. Does something need to improve, you bet. But I am not sure what it is. I do know that dealing with Medicare, Tricare, etc. is not the answer. Not only is the paperwork horrendous and slow, if you make a spelling mistake or something along that line, not only do you not get paid, you open yourself up for a full audit where trust me, they will find something, no matter how minor, and hook a $ sign to the mistake as a penalty. They will then multiply that to the number of Medicare patients you have seen for the last X number of years to get your total $$ fine. Yes the payment from the government is about 15 cents on the dollar, but the constant threat of audit is what stops many from accepting this program. Medicaid is equally as bad.
I am not looking for sympathy because I know I make a great living. However, the thought of being told what I can charge or make for the remainder of my working life scares the heck out of me. When is the last time you got any dental work or legal work done? No limits on this are set. How about looking for a new truck? Maybe limits will ultimately be the answer, but be ready for a severe shortage of doctors when this occurs. There are many of us that are older but continue to work because we love what we do. Cut our earnings to the bone and most of us will just walk away. Combine this with fewer people willing to put their lives on hold and go $300,000-$400,000 in debt to be on a capitated system. You will then know what a physician shortage means. Many of you will relish in this thought. Class envy and anger is an ever present and normal emotion and that is fine. Just understand what is possibly in store for us all.
Lastly, healthcare is available to us all, just not affordable for many. If you break your leg, you are not turned away contrary to what many have written on previous submissions. You will be treated and fixed. Unfortunately many are then faced with a very high bill. Nowhere near the claimed $300,000 for an ER visit (that is just ludicrous and untrue) but for a major surgery and recovery, it can start to close in on this. I write off more than $150,000 a year for people who cannot pay as do many of my colleagues. I am OK with doing this because I know many are trying. I must admit it is difficult to feel realy sorry for someone who hurts themselves on their $12,000 snowmachine but then won't pay their bill, but those are the breaks. I hope a better system is found, but I don't think one that is all controlling is what our country is about.
puppydog
You are factually incorrect about medicaid
Adult medicaid has a co pay of $3 per visit. A patient CAN NOT be charged additionally and you agree to accept whatever medicaid pays. Often it is 20%-30% of what private insurance deems reasonable and customary.
Denali Kid Care has absoutely no co pay. The patient pays nothing no matter how much they use it or how much the charges are.
As for TVC, they can not legally require a person with medicaid to pay for service as you suggest.
dirtprof: "I see. So we're more incompetent than the 36 countries that rank ahead of us? Why do you hate America?"
Maybe he just doesn't share your vision of government control as a positive. Even though there are a lot of us that dosen't share the ultra progressive beliefs that you like to share from time to time. We still haven't asked you why you hate America? Have we?
another BRILLIANT letter from a public-can.
his notion, gid rid of medicare, medicaid and vetrens health coverage.
BRILLIANT!!!
you public-cans, you guys and gals, all run on that platform!!! (please please please do so.)
I like Senate's proposal to fine people $1000 for not having health insurance.
And everybody will be healthier (eating beans and rice).
Fbksak
$300,000 after a bad car injury is entirely possible if it involves major surgery and an extended stay in the hospital... but it was just a number thrown out there. $150K alone is more than five years worth of pay. Granted many docs do write off a lot, and I believe doctors like teachers are largely motivated by a desire to do good. I don't agree that pricecaps should be placed... prices SHOULD be determined by the free market (yes, and I am a commie).
Problem is that we live in a rather warped market, due in part to government but also due to our social structure. When someone comes in with a broken leg the hospital cannot refuse treatment... heck under the Hippocratic oath any doctor cannot, but when you have a service that must be provided and gets paid for sporadically, that is the biggest gum-up of all.
Imagine if you will that the Grociers charged $20 for a pound of rice. Hallibut steaks were $150 a piece. Corn Flakes, $40. Then imagine that some people (the rich) check out and pay for it, all is well. Some people check out and pay a discount price (the lucky), and some people say "I'm sorry I'm too poor, but you can't deny me food" and walk out with their groceries. Eventually, prices will raise so high that the ones who do pay make up for the ones who dont, only this leads to more and more who cannot pay, so prices continually rise.
That is our healthcare system in a nutshell. Sure some luxury items like chemotherapy and bone-marrow transplants are exempt and must be paid for, but a lot of treatment cannot be refused. People are taking the corn flakes (hospital visit) instead of the safeway brand (family doctor) because heck, they ain't paying for it! Might as well be seen now instead of going thru the hassle.
This is an economy people, and healthcare is out of control. We need to do something to bring prices back within the realm of reality first, and (us lefties believe) provide the opportunity for sick people to have an option besides death (just like we do foodstamps). You can argue in favor of no governmental control and just let the poor die (the Scrooge approach) or some form of governmental program that provides access (the Jimmy Carter approach). Neither are perfect, but personally I don't think America is such a greedy nation as to let the poor die on the streets.
err sorry, meant to say the LBJ approach on that last one*
Bryan: I don't think I ever opined that the US would fail where others have succeeded, which is what p3t did.
I tend to like free markets and dislike government intervention in economies. That's why I only reluctantly began supporting a single payer system when a Harvard study a few years ago showed that our system is so inefficient that we taxpayers already are paying the same as European countries do for universal health care, except we don't get the benefits. Moreover, a universal health care system would enable entrepreneurship among people who otherwise would be reluctant to risk his/her family's health insurance by leaving a job with benefits.
Isanova said:
"And I dont think I have the energy for another of these letters. Healthcare is rationed in this nation by income, and I and many Americans want to stop being afraid of dying because we are poor. I don't expect much though, given the active and intense money-lobbying/bribing coming from the Medical Industry. I know if I get terribly sick, I will have to sneak into Canada and live as a bum... I won't get treated here."
Perhaps you could find some Canadian to marry you. I read sometime ago about Americans being able to find Canadians who would out of the goodness of their heart do this to help those in the states in dire need. It is worth a shot to try some googling for a forum, etc. that could be helpful. Should anything develop, I would try and fly under the radar by doing what what ever was necessary to protect your privacy since any of these ISP's up here will cough up your personal data attached to your IP address in a heartbeat even without a court order.
And to fbksak, as one (you) who has benefited tremendously from the status quo of the American Health Care model, I appreciate your objective remarks. You are unique in that you didn't lie in your post like most who support the present system do. In fact, I also noticed you didn't offer a solution to the existing mess either. I suspect the reason you didn't is because you recognize there isn't one unless costs are controlled by fiat and that would require giving up some privilege that you now enjoy and that is tough to accept. Incidentally, this is not a put-down but a normal human reaction. We're all that way, no one wants to give up anything, we all want the other guy to.
dog
dirtprof -
1-36 other countries do not have a 10 Trillion dollar debt, 3 already poorly performing health programs (which are fine examples of what to expect from our government in terms of health care).
2- Please explain how my desire to have this country succeed (by desiring a successfull health care program vs a failing one) is hateful of America. Is it because I do not hail to Obama's plan?
Simplistic as I am sure this will sound, one of the biggest reasons for the high cost of healthcare is our lifestyle as a society. I include myself in this, so don't hasten to get mad. Face it, there are layers to the problems: poor eating habits lead to heart disease and diabetes, leading to physician's office visits, prescriptions, surgeries, etc, etc. Lack of exercise and a sedentary lifestyle can lead to overweight, which can cause the above problems as well as lowered immunity. The stress of our society has millions of Americans on one or more antidepressants. Take these problems to work with you and chances are you'll hurt your back, get carpal tunnel syndrome, and a host of other problems. Add to that pollution, hormones in our chicken, mercury in our fish, etc, etc, and we come up with diseases unheard of back in the nineteen century and before...the problem with the healthcare industry is far from simple, and the solutions are also going to be far from simple. Especially with the "graying of America"...the baby boomers, myself included, are getting older, and there is going to be a higher percentage of senior citizens than ever before...yet we are not living STRONGER, only longer, adding more strain on drain on the system. The problem has layers, and the solution also will have to have layers, and the proposed solutions, so far, seem too simplistic.
http://www.newyorker.com/reporting/2009/...
The above link is to an article that first appeared in the Newyorker in the June 1st, 2009. issue. Dog provided it in a previous post titled " Socialized care " in the DNM. I think it needs to be reposted. It is very informative.
mwmcintyre,
Oh, the ulterior motivation of health care reformers is to help people? Tell me, Mike, ... exactly which people, cause they certainly aren't helping me or any person I know who is already paying for their own healthcare. They are championing and paying for those who do not work, those who do not want to work, yet feel they deserve equal health care, as if it was a right.
Listen, go back to directing your fictional dramas, ...your analysis has no bearing on reality.
Fbksak....In rereading my earlier post I want to say there are many, many doctors who have their hearts in the right place and do lots
of free work to poor and I respect those doctors. I was only pointing
out there are many who dont have this kind of empathy. No offense
meant to you. I realize what you are saying about reimbursment from
medicare and the insurance companies. I do get statements from
medicare and blue cross on what they pay on my health services and
its a terrible situation. Over all the payments are about 25% of
charge amount.
I see several problems. Medicade and medicare has contunually been
underfunded by a congress that a large portion fought those programs
since their beginning and try to kill the programs by not funding
them to the point where they could be fully effective, hence the
squeezing of the doctors and hospitals.
The insurance companies are a different situation. Its total greed
with them. By denying certain proceedures, and cheerypicking who
they will cover and paying the providers a small portion of their
charges they guarantee great profits for themselves.
In honesty I have to also say in looking at the charges the providers
bill for is excessive. I realize probaly the reason this is done is
because you know your only going to get 25% of billed amount.
I have talked to many doctors about this situation and most are
as concerned as you seem to be. Those who take a serious look at
the single payer system like canada are beginning to realize the
benefits for them in this system.
No debt for schooling , its covered within the system. Fees to be
charged negotiated by provider organizations and government, all charge the same for same treatment. No free work, you get paid for
every service you provide. You dont have to shake them down at the door to see if they can pay. The ones who will see a great difference
would br those ones in specialties who overcharge for their services.
I hope you dont respond with how long they go to school. I dont
accept that as a reason to ravage us. I appreciate your pesponding
with your post. We need the dialog. My best to you.
My wife is a Certified Coder, and has been for a number of years. But she started off on the side of the insurance ccmpanies so she would know how they work from the inside out. She did that until she just could not look herself in the mirror in the mornings.
Now she works for an air ambulance company, and since the incredible down turn in the economy it's gotten harder and harder to get money out of insurance companies. The good thing is that she does know the laws, and she loves to beat insurance companies over the head with them all the time where they are trying to screw people who have honest claims.
Believe it or don't one of the hardest things that she has to try and convince someone who works back east that someone has to have an air ambulance because they only want to pay for them to be transported by road. The concept that there are no roads is something that they just can not comprehend.
But what it really gets down to all the time is insurance companies trying to do anything and everything that they can to not pay a claim. What they love to do is work with an individual who has no idea what all the gibberish that they are saying means. So a lot of people go ahead and pay out of their pockets because they think that they have to. A number of times I've seen my wife help people out when an insurance company is wrong and knows that they are wrong. But it works so often for them that it's more than worth it.
So you are a member of the "Let's let people die because they're poor" crowd. Lovely sentiment. Speaking of fictional, this concept that all who cannot afford health care do not work or are irresponsible. There are many people in this country who work two or three jobs totaling 60 or more hours per week who cannot afford health insurance or health care. And what about those who, because of health conditions, literally cannot work through no fault of their own. Of course they are championing those who do not have access to health care, those are the ones who need champions, but apparently doing something good is only worthwhile if it benefits you personally, nice to know what kind of a person you truly are Ponderous.
Yes, I do believe that decent basic health care services should be a right, just like basic schooling, it provides an environment of equal opportunity and helps prevent denial of opportunities based on circumstances beyond individuals control.
This is makeing me ill.Really it is.Some one in the white house wants to fix something that has left millions to die.And you whine and complain about it.
I sick and tired of being over charged at the office and at the hospital.I sick and tired of docs who refuse madi what ever program.It might not pay what they want it to but it pays.I'm Tired of this only the rich or those who can pay the high amounts getting the best care.I'm tired of those docs who do take the program using the kids in it as an experament.
My youngest was put through a ton of test with her first doc.All of it because we where doing wieght checks every day.She was tested for issues in her tummy.She was given meds that make adults sick to find out nothing was wrong.I had people at the hospital asking why is this test being done.And i was going along with all of it for one little reason the doc said i'll turn you in to CPS.I finally drew the line when she demand to do a cardio ultra sound.The one used when you suffer a heart attack and is dangerous for a grown person.I found a new doc after that one but she lied when she said it was out side of the body.I don't know how many people where scammed into this kind of testing I did turn in said doc to the hospital and to medicare.
I sick to death of all this whining about how it's going to cost more or if you over a certain age you'll die.And most of all I'm sick and tired of fear the big medical problums that may or may not happen.
I watched my mom go through hell with cancer.I was sitting right there when the man who would be doing the radation and chemo thearpy ask what insurence she had.And it made no since.Why ask that because if you didn't have blue cross they'd let you die?Or was it simply trying to figure out how much to charge for it?All I do know is right then and there it felt like that whole fear of being to old pop'ed up in the room.Why?Easy my moms 50 years old has worked her butt off all of these years and one man shook her world upside down with one question.
I am also sick of the fact that the number one reason for people going bankrupt in this nation is health care costs.So yes docs will take a cut on profit.yes it will take time to iron it out.But with perventive care at a more affordable rate and people doing that same check up.Health issues will go down.
...life, liberty and the pursuit of happiness.
oh yeah, and free health care, child care, nice car, big house, a job that pays more than i am worth...
mwm-when do people become responsible for themselves? Why is it always up to the government to provide?
P3T
While I understand you feelings there.I'm not saying free health care.I'm saying affordable health care.Where we all can go and see a doctor and not have it like it is now where we fear getting sick because of cost.
it's not always up to the government to provide, P3T, but a government is there to protect and support the people and an essential job of that in order to create a more productive society is to help ensure a basic standard of living, not a luxurious one, but one where all basic needs are met such as food, shelter and healthcare. How we achieve those is up for debate, hopefully in such a way that those who are able will be able to provide for themselves. It only makes sense to create a centralized system for certain basic services. Bus lines or subways in major cities, for example help everybody whether you take advantage of them or not. When you ensure a decent standard of living for more people, you improve the quality of life for EVERYBODY. Crime goes down because there is less need for crime is a big example.
Some people have put forth the argument that the government run program(whatever it may be) would be just as greeedy as the private insurance companies. Here is why it would not: The private companies have many people whose income is based on how much money the company makes, thus the reason(well-documented) that the insurance companies go out of their way to deny claims, many times even in cases where they should be paying and they know it, but they also know most people won't fight their decision. In a government based program, the people running it will be salaried and have no personal financial incentive to deny care, in fact their mandate will be to provide care as much as possible. There has been no reason given by the conservatives as to WHY a government run program would try to get between you and your doctor, just the tired refrain of "Government is Evil" and "government doesn't work". Unfortunately it's a self-fulfilling prophecy, they don't believe in it, so they actively sabotage it, so they can then say they were right.
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