Medicare shows Government not fit to run healthcare?

Kelly - posted on 01/26/2010 ( 8 moms have responded )

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http://online.wsj.com/article/SB10001424...

Since Obama previously held up the Mayo Clinics as an example of what we could expect under the proposed healthcare reform, (efficiency and lower costs according to the article) does this show the government is not capable of making healthcare reform work with the proposed bill?

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Sara - posted on 01/27/2010

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Medicare may regulate costs, but so does every other insurance company. The problem is that insurance companies are only willing to pay a certain percentage of the actual cost (so that they can inflate their profit margins), so hospitals and other providers inflate the costs so that they have a chance covering their costs. So prices are astronomical on both sides of the equation due to this tug-of-war between insurance and providers. This is probably why the Mayo clinic does not want to accept Medicare anymore, they can't afford to. This is why every provider can pick and chose which healthcare plans they will accept...it's all a profit driven system. IMO, regulation on both sides will help to bring down costs.

I just want to say that another reason the costs are so inflated is because of people who have no health insurance and their lack of ability to pay for services. That money is written off by doctor's practices and hospitals every year, but we do pay for that through our costs. So, it has to be addressed that people who lack health insurance in this country are a BIG problem.

And how is Obama trying to force a UHC system? They can't even get a damn public option included in the bill, much less pass a UHC bill? Maybe I'm just not understanding you, Kelley? If you look at countries that do have UHC (Canada, UK, Australia, etc) they actually have less costs, and the standard of care is not sub-par. I'm all for UHC, but it will never happen in the US, because people equate it with socialism, which is apparently, intrisically evil.

The one thing I do think that we have missed the boat on is Tort reform. I think if we want to solve the healthcare crisis in this country, you have to address malpractice and the astronomical costs of malpractice insurance for physicians.

~Jennifer - posted on 01/26/2010

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I'll agree with you on the 'medical device suppliers'.....

I just got a bill in the mail from the company that we rented Peter's wheelchair from after his surgery.
After the insurance paid their share my 'balance due' is $393.58.

He had the chair for 16 days.
Just over 30 bucks a DAY to rent a wheelchair?
It's disgusting.

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Kelley - posted on 01/27/2010

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Tort reform!!!
That's the word I was looking for last night! Yes I think this was big missing point.

Thank Sara

Kelly - posted on 01/27/2010

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I do, but I also think that once something is passed, it will be virtually impossible to take it back or reduce it if it shows to be the wrong thing in the future. The shady way Congress is trying to get their agenda accomplished shows that they know this. I don't think they are being responsible, and I definately don't think they have the best interests of the American people as a whole. Basically what I am saying, is that the idea of "healthcare crisis" is inflated. The current system overall needs work, but it is not completely broken as some would like us all to believe. Why not be a little more conservative on the front end, take our time and craft a solution that will be viable? It would be a lot harder, but not impossible. At the end of the day, more people would have access to affordable healthcare, and the country wouldn't be further bankrupted to provide it.

Sara - posted on 01/27/2010

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I agree it is a complicated issue, and you make some great and valid points. I don't think any bill could ever cover all of the issues needed to improve healthcare in this country, but don't you think we need to start somewhere?

Kelly - posted on 01/27/2010

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Sara, that is one point that I have brought up in the past that others kind of dismissed at the time. (tort reform) I agree with you that it would make a big difference. The cost issue is definately a sticky situation. Providers charge inflated prices to insurance companies and private individuals to try and mitigate loss from the set price that medicare pays, the non-payment from those who can't pay, etc. I am not sure that it is standard policy of insurance companies to refuse to cover the actual cost of services. They ARE fighting paying inflated costs, as they should. Why should they pay for those who don't pay a premium? Of course the insurance companies need to make some profit, but overall their profit margins are relatively low.

http://www.usnews.com/money/blogs/flowch...

Overall, the situation is much more complicated than just passing the current bill. While we can't just refuse service to undocumented immigrants, they are a huge drain on our system. Here is an example I found on fairus.org:

"The costs of medical care for immigrants are staggering. The estimated cost of unreimbursed medical care in 2004 in California was about $1.4 billion per year. In Texas, the estimated cost was about $.85 billion, and in Arizona the comparable estimate was $.4 billion per year.

One of the frequent costs to U.S. taxpayers is delivery of babies to illegal alien mothers. A California study put the number of these anchor baby deliveries in the state in 1994 at 74,987, at a cost of $215 million. At that time, those births constituted 36 percent of all Medi-Cal births, and they have grown now to substantially more than half or the annual Medi-Cal budget. In 2003, 70 percent of the 2,300 babies born in San Joaquin General Hospital’s maternity ward were anchor babies. Medical in 2003 had 760,000 illegal alien beneficiaries, up from 2002, when there were 470,000."

These numbers have done nothing but rise since this data was collected. I am curious, any of the Canadian mothers have info on what it costs your country to provide healthcare to illegals? Do Canadian hospitals even provide services? I am not up to snuff on Canada law......

Bottom line, it is a complicated issue, that does need fixing. However, the proposed reform is not an acceptable solution. The US is unique just as Canada, the UK, etc. are, and what works in those countries simply wouldn't work here. I think even Congress and the Obama Administration realize that since the proposed bill does not emulate the healthcare model from any of those countries.

Kelley - posted on 01/26/2010

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Regulation, will not solve cost defficit, so with that thought at some point these costs that are going to be there wether you regulate, it is still going to cause a lack or gap. If there are cost of $5,000 for a surgery and hospital stay...just because these services and or facilities are regulated to collecting $2,500, It's not going to make care better and in the end something will give and it won't be just magically filled in or wrote off. I'm not saying that so many charges are insanely inflated, for example when my insurance co. told the hospital they charged 400x's (they really did this) the cost of a cat-scan above hosptials and they wouldn't pay. So the cost was obviously passed on to me (@ 400x's inflated) A whole lot of this inflated cost is passed on from illeagal immagrants...of which they will never recover these cost so it got passed on to the One's who actually DO have ins. This bill has not done anything to solve this problem it remains a walkin and free service for those who aren't even paying taxes, and not to mention just the non-paying public, which if they wanted to seek payment through tax return being withheld well... at least with a citizen there are some possible measure of responsiblity. But No this proposed (UHC) or the curent TAX-care health reform. You the taxpayer will pay and illegals get to get Free health services!!!

As far as it working in Canada, they do have health care provisions, but they actually do have insurance option. They are allowed to cover extras that they may feel ar elacking in current provisions, and ultimately and ideally isn't that the goal. To see our citizen be able to be treated medically and be responsible in their share? Obama's not after a system that would and could create a public that is responsible He is trying to force a single payer system, no options, Just government provision or regulations.







Medicare does regulate cost and sets what they will pay a provider and I think that the article showed that more and more facilities will eventually deny services for lack of cost coverage. regulation isn't the answer either. Responsibility and insurance options will regulate fair cost standards, but I personally believe that a systen that has developed inflated expenses, because Gov. would just PAY it in the past, and now they are deying procedures/services, it has left us wih inflated cost and non-payers lumped into this, and something else that's not been talked about a whole lot is the fact that physicians quite typicaly will spend aboout 60% of their cost just in malpractice insurance. This has gone beyond craziness and we're all suffering the consequinces, but a single payer system is nothing more that a universal meidcare... and you see how the government 'provision'(medicare) is being severly scaled back. Why? because the regulated price isn't covering the real costs of service, supply, personal/staff, skill physicians etc.. for all included.



Here's a clip about where a single (Gov.) payer system has ultimately driven a foreign health care system:







If the Government is going to regulate anything

-Government 'regulate' mandatory human health care's - preventative & general coverages that must be offered and then let these companies battle it out for our business. Either offered privately, corporately or govn. option.



Keep the Public free in choice and 1st. available

Let the Gov. be an option 4 those who prefer it or non-payers

Sara - posted on 01/26/2010

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Well, I think something that is being addressed by the current bill and a reason why Medicare has had so many problems is the controlling of costs. If you want to get spending under control, then you have to regulate. To answer your question, I do think government run healthcare can work. It works in the UK and it works in Canada. What’s needed in the US is to reign in the drug companies, the medical device suppliers and other entities who see the government picking up the tab as a perfect excuse to ramp the prices up to stupid levels.

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