I wonder how long Medicare could survive on the money the private insurance market brings in.
ACA repeal bill
- Thread starter mseabolt
- Start date
We both know how well our government manages money. It wouldn't matter how much money was brought in because waste, lack of accountability, and partisan politics would ensure its bankruptcy. It's a decent utopian thought exercise though.
Heehee. Plenty that blog doesn't address when it comes to Medicare/Caid vs private insurance. If only it were an apples to apples comparison.
There's plenty Medicare can do and has done to decrease payments to providers because well, they are the government. Less isn't always better though, and razor thin margins can be troublesome in health systems because those margins are used for capital purchases to keep up with technology. In order to keep the doors open, many health systems rely on the robust payments from private insurance to offset losses on Medicare, Medicaid, and uninsured patients. Private insurance companies have to negotiate contracts with providers. CMS mandates you take what they pay or you get no payment at all, even if that payment doesn't cover cost.
http://www.modernhealthcare.com/article/20160507/MAGAZINE/305079963
So before it was government healthcare is bad because they would be wasteful, now confronted with facts it is bad because it is too stingy with hospitals?
Glad to see that private insurers are doing what they can to keep healthcare inflation in check.
Oh please. They are wasteful. Look no further than Medicaid, Medicare, and the VA. Not hard to spend 60 seconds on Google to find plenty of instances of waste. Comparing the "efficiency" of Medicare to private insurance companies is dumb and you know it's dumb. If private insurers could fix payments like CMS, they would in less time than it took me to type this sentence. Interesting to note that a net negative on government reimursement would lead to closure of hospitals if the private insurance industry couldn't be fleeced for the gap. Is a net negative part of the strategy of a single payer system? If not, since that is how Medicare and Medicaid currently operate, how would the net negative be addressed to prevent closures and prevent long waiting lists for care like that awesome Canadian single payer?
https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2016
Regarding healthcare cost inflation, which came first? Unfunded government mandates are just that, unfunded. A quick review of that subject shows plenty of blame to go around, including our awesome, cost effective, and fiscally responsible federal government.
I am sure you can find all kinds of anecdotes. I already found the data for you. Not only is the cost lower, the overhead is an order of magnitude lower.
Sucks to be the one defending private insurers then.
Interesting to note that many hospitals don't have a negative margin on Medicare (from your article above). That is how the free market works right? The efficient hospitals survive and get market share from the inefficient hospitals that close.
If Medicare and Medicaid increased their reimbursement rates 10% they would still be cheaper than private insurers.
Umm healthcare inflation came first. What unfunded government mandate are you even talking about?
As in just one? Lol! I see where this is going. Well, let's see, there's that tiny gubmint regulation called EMTALA for starters. There are plenty more, but you already know this. I hope you're just playing obtuse for the usual routine.
Anecdotal waste? For real? And I thought I was in for some actual discussion. I can't keep a straight face responding to this horseshit. But here, I'll throw you a bone I found as the first link in a simple Google search of "VA wasteful spending," but only because you actually made me laugh with your last post. And the first link doesn't do the VA full justice by what appears just on page 1 of the search results OF JUST THE VA.
From the anecdotes of the VA OIG
https://veterans.house.gov/va-conference-expenditures-under-investigation
What unfunded mandate? Anecdotal waste... hahahahahahaha. Seriously thanks for the laughs.
Here's one more on that awesome Canadian healthcare we should emulate.
https://www.google.com/amp/s/sec.th...adas-health-care/article25626630/?service=amp
https://www.google.com/amp/s/sec.th...adas-health-care/article25626630/?service=amp
I forgot to respond to this. It's too bad that hospitals that close are usually in rural areas and in low income/poor payer mix areas. But screw those people if their hospitals can't be efficient enough to overcome the government payments that don't even cover the cost of providing care, especially when they are overly reliant on the government because of the population they serve.
http://kff.org/report-section/a-loo...ccess-to-care-three-case-studies-issue-brief/
Hmmm. I wonder what else could explain differences in life expectancy besides expenditures on healthcare. Surely nothing at all right?
Man, I'm not sure why a guy like you with access to this pretty looking graph hasn't taken this bull by the horns and showed them scientists that the life expectancy disparity question is easily solved by this lone single graph.
https://www.ncbi.nlm.nih.gov/books/NBK62597/
Spoiler alert: they talk about heathcare expenditure.
Like killing a fly with an Abrams tank. I almost feel guilty.
Interesting. All of those countries stopped reporting healthcare expenditures? I learn new shit on this board everyday. According to this awesome graph, Switzerland was the last to report something in 2005. We know nothing from Japan from 1997 or so to present, and Chile has been MIA on this data since the mid 1980's. Definitely seems legit.
Edit: Now I see what they did. They only assigned dates to the US. Interesting. Strange way to present comparable data.
Like moving a pebble with a D10 dozer.
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I'll help you even further. Interesting breakdown of healthcare expenditures. With irresponsible healthcare use by Medicaid patients and the expectations of a fix it now healthcare consumer, it's really not difficult to see why the US spends more. We lead the world in pharmaceutical and diagnostic imaging consumption. It is intetesting how much public expenditure exists on healthcare in the US despite not having universal health coverage.
http://www.commonwealthfund.org/pub.../oct/us-health-care-from-a-global-perspective
But we should probably just stick to per capita money spent because that lone figure tells all of the story. You're a genius bro.
Nope. Nice thought though. I actually thought at one time that might be something of substance, but gun deaths are a drop in the bucket even for Chicago.
Read through the NIH link. It's a nice summary but the entirety is available to read. Like not a bashing you suggestion. If you are really interested, it provides some nice insight that will challenge even the most set mind. More complex than any series of graphs can show. They even talk about a leveling off of rate of life expectancy increases in Denmark and Norway and discuss how increased expenditure by both countries made a positive impact, but still have a difficult time determining what caused it to level off.
Buddy, the problem is that once you were smoked out in the climate change deal, it's just hard to to take you real serious. I never know if you're being honest or just saying whatever argument you can think of, like Kellyanne.
In all seriousness, one of the difficulties in comparing life expectancy is that we are measuring the effects of a myriad of things that happened in the past today. Diets, lifestyles (drinking, smoking, exercise etc), healthcare, etc all play a role. It's very difficult to isolate causes, and it's even more difficult when you consider that there is no uniform medical coding or disease reporting among most countries. The crosswalking that has to be done makes comparison very difficult.
I'm in favor of universal payer, just not using any current model we have (VA, Medicare, Medicaid) as a starting point. And as soon as politics become involved, which it will, it'll be screwed.
I have great ideas in my opinion. If it is going to be done right, it has to be developed by non-partisan bodies that have expertise in delivery on the healthcare side, the reimbursement side, and the consumer side as well. Gruber can't be involved. And to be funded properly, private insurance in all forms, including employer based insurance and that of government employees (I'm looking at you Congress) goes away completely, with that money and people going to the larger risk pool. We're all in. Medicare and Medicaid bite the dust and get folded in.
Besides tax based funding, citizens will bear some cost responsibility on a realistic sliding income scale, including the "poor" folks who currently abuse the shit out of Medicaid with nothing to dissuade them from doing it. To avoid rationing and unnecessary costs, healthcare consumers must become responsible healthcare consumers. If it hurts their wallet, it hurts their wallet. Lesson learned.
With all of that excess cash floating around, the government can provide an incentive program for healthy living, providing rebates etc. Bonuses for being conscious of health so to speak.
Government employees aren't eligible for bonuses for proper administration of the program. That shit only encourages fraud and abuse on the payer side which results in poorer care and wasted dollars on the consumer side. The whole shit show should have oversight from a minimum of 3 independent non-partisan committees who represent the consumer, the physicians, and the larger healthcare system. Audits will be frequent, accurate, and thorough. Any misdeeds or waste of funds (like millions on conferences and art) will be punished like it's a criminal act like it should be, including restitution and jail time.
And my great ideas are buried on page 6 of this thread. Geez.
Get over yourself. You smoked yourself out of any serious discussion with your "science is settled" and "funding bias doesn't exist in climate research" bits. That pales in comparison to your awesome gun control stuff though.
But yes, being serious. And so is my universal healthcare post above. Besides, I didn't write the linked paper. Just an attempt to educate you past the "we spend more and we suck because of it" ignorance.
One more thing for universal healthcare, the legal system regarding malpractice needs reform, a lot of reform. Comparisons of our system to those of other countries we compare costs with are embarrassing. Even more embarrassing is the amount of money that goes to representation and not the patient.
http://m.amednews.com/apps/pbcs.dll/article?aid=/20100503/profession/305039938&template=mobile_art
http://m.amednews.com/apps/pbcs.dll/article?aid=/20100503/profession/305039938&template=mobile_art
Some good ideas buried on page 6; sadly, any of you thoughts will come to fruition on, or about:
Very true. That's why I prefaced it with the disclaimer about politics. The shit stains in the capitol would ruin wet dreams if they had access to your brain.
Maybe there's some legs to that Dr/contract structure.
I still think Uncle Sam should just mandate some type of catastrophic policy for cost to everyone -- it'd be cheap and be hugely popular.
I still think Uncle Sam should just mandate some type of catastrophic policy for cost to everyone -- it'd be cheap and be hugely popular.
Not sure on the mandate portion, as you would probably guess. But I agree that this concept could be picking up some steam.
Thanks again for taking the time to post that.
big fan of this
wyoming spending 20k a year on healthcare for his family before obama turns a tap is not insurance in any way shape or form and makes me sick to think about.
