formerexpat
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Post by formerexpat on Jun 8, 2011 21:56:23 GMT -5
Would this suffice: aging.senate.gov/crs/medicaid7.pdfPage 5: a) private outlays - $1,135.2bn b) public outlays - $970.3bn c) total outlays - $2,105.5bn B / C = 46.1% Assuming the inflation of public spending still is higher than private [no reason to believe not], this is closer to 50% now. This also does not take into account that it is widely reported that up to 20% or more of Medicare costs are subsidized by the private system since Medicare reimbursement does not cover the actual cost [i.e. the $7 Tylenol pill effect]. I use 50% conservatively since it's impossible to know the true effect of the private subsidization of Medicare costs by the private industry.
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Post by lakhota on Jun 8, 2011 22:06:26 GMT -5
How are Medicare costs "subsidized" by the private system? Don't you mean "subsidized" by Medicare recipients who pay out-of-pocket or use supplemental Medicare insurance to cover what Medicare doesn't pay?
If not, please explain...
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formerexpat
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Post by formerexpat on Jun 8, 2011 22:26:09 GMT -5
No. Medicare/caid sets repayment prices for various procedures, appointments, etc with doctors. Doctors are forced to take these amounts as payment for services [if they accept Medicare patients]. Sometimes, these amounts do not cover the true cost of service. While the Medicare/caid patient may have some out of pocket costs, these sometimes do not make the doctor/hospital whole on cost.
As an offset, insurance companies to make up the difference in their payment for services.
Take my recent example. We have one of the best insurance policies in the country...between my company and me, we pay $20k a year for it. We just had a baby. No complications luckily, easy in, easy out, saw the doctor a minimal amount of time - total cost over $14k.
Somewhere in that bill - which was actually what my insurance company paid to the hospital, was the embedded cost of a Medicaid patient, was a patient that didn't pay but got service, etc, etc. Costs that need to be covered. Profits for the hospital, which I have no problem with - profit motive = more efficient & better hospitals.
Granted, the health insurance industry has some tax subsidies, but that's nothing more than a back door admission that the government is stiffing them on the front end.
There is plenty wrong with the system and a few no brainer changes we could make but I'm against single payer systems. They've been a failure in every country that has kind size to it. <30m people - you might have a good system. between 30 - 60m and you'll start seeing cracks in the system. >60m people - a total clusterf***...kind of like Medicare/caid now.
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Post by lakhota on Jun 8, 2011 23:05:00 GMT -5
"Embedded cost of a Medicaid patient"? Now that is rich. How about the embedded costs for emergency room treatment for people who don't have insurance and/or never pay their medical bills? Some don't even have addresses. Who eats those costs? [i.e. the $7 Tylenol pill effect] Demystifying, and Maybe Decreasing, the Emergency Room BillNOBODY PAYS RETAIL The majority of hospitals are required by law to treat any person who walks into an emergency room whether that person has insurance or not. To make up for those who cannot or will not pay, a hospital sets its so-called gross charges very high. At the same time, hospitals negotiate contracts with managed care and commercial insurance carriers that specify prices much lower than the gross charges. Medicare and Medicaid dictate lower rates for medical services to hospitals. In virtually every instance, “we get paid a lot less than we bill,” said Michelle Leone, senior vice president for revenue cycle operations at Continuum Health Partners in New York City. You may receive a statement that shows your E.R. visit totaled $3,000, for example, but your insurer may agree to pay just $500, which the hospital will accept. Depending on your plan, you owe either a portion of that $500 — say, 20 percent, after a deductible — or a co-payment. People without insurance end up with bills that are much higher than those for covered patients, because the uninsured are charged the hospital’s gross rates. More: www.nytimes.com/2010/08/07/health/07patients.html?_r=1formerexpat, you have been very disingenuous in this matter. You knew better. Shame on you.
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cme1201
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Post by cme1201 on Jun 9, 2011 6:45:40 GMT -5
This is not true, people who do not know how to negotiate pay higher. I have not had insurance for several years, I have yet to pay anything that resembles what the hospital charges.
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floridayankee
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Post by floridayankee on Jun 9, 2011 7:46:09 GMT -5
This is not true, people who do not know how to negotiate pay higher. I have not had insurance for several years, I have yet to pay anything that resembles what the hospital charges. Some would be quite surprised the number of different retail items DW and I negotiated price breaks on. Haggling never works at big box retailers so get off the beaten path and your options increase significantly.
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NoMoreLunacy
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Post by NoMoreLunacy on Jun 9, 2011 12:39:20 GMT -5
Social Security should not be privatized. It should be abolished. 401ks and IRAs should be abolished as well. Why should people get tax subsidies for saving for their own selves? People should save for retirement, and the tax subsidies plus the money that goes towards Social Security should be given back in the form of tax cuts.
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zipity
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Post by zipity on Jun 9, 2011 15:47:02 GMT -5
Doctors are forced to take these amounts as payment for services [if they accept Medicare patients]. Sometimes, these amounts do not cover the true cost of service.So when the government cuts the revenue stream for doctors forcing them to operate at a loss, that's bad. BUT... When the government cuts it's own revenue stream by cutting taxes forcing huge deficits, that's good. Got it.
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formerexpat
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Post by formerexpat on Jun 9, 2011 21:35:28 GMT -5
It's clear you don't understand the discussion at hand, so let the adults speak and leave the room.
Some of this happens too. But the two events aren't mutually exclusive. They can both happen and be issues in the current system.
We're never going to get to a point where we agree about the fundamental issue. I believe that I've seen enough evidence that government has fu**ed up everything its touched enough for me to believe I want it to touch as little as possible when it comes to my life.
That includes healthcare & retirement; two very important components of the livelihood of a person in the US. They've proven to mismanage these programs significantly, and mostly to the benefit of their political gain - not the overall long term interest of the citizens.
I like ravinglunatics recommendation but too many people are way too reliant on our government for that to happen.
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Post by lakhota on Jun 9, 2011 21:38:00 GMT -5
You had marginal credibility before, but now you have none with me.
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formerexpat
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Post by formerexpat on Jun 9, 2011 21:45:56 GMT -5
My thoughts exactly. At least we agree on something.
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AgeOfEnlightenmentSCP
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Post by AgeOfEnlightenmentSCP on Jun 10, 2011 8:13:08 GMT -5
This is not true, people who do not know how to negotiate pay higher. I have not had insurance for several years, I have yet to pay anything that resembles what the hospital charges. You just explained in the simplest possible terms why Medicare dollars should start following the PATIENTS rather than being paid directly to providers. But the fact is that people are lazy. They don't want to deal with paying the bills. And of course our seniors are completely helpless and could never handle it. They'd be taken advantage of. They're savvy enough to vote and select our leaders, but let them handle a hospital bill? Never!
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