Clarke Posted February 25, 2013 Posted February 25, 2013 Oh bhai, what kind of ridiculous tangent are you on ? When was the last time Adobe was needed to save someone's life ? Or someone went bankrupt because of their Adobe purchases ? Significant % of all bankruptcies in America happen because of healthcare costs, and as the article shows, costs which have nothing to do with the value they provide. Healthcare cannot be compared to Apple. It is literally apples and oranges. +1 Healthcare in simple terms is life and death. You can't afford Photoshop or iPad, live with your old desktop with the open source software or whatever. You can't afford a heart surgery, the next question is can your family afford the funeral cost ?
Lurker Posted February 25, 2013 Posted February 25, 2013 Oh bhai, what kind of ridiculous tangent are you on ? When was the last time Adobe was needed to save someone's life ? Or someone went bankrupt because of their Adobe purchases ? Did you bother to check the context in which Adobe was raked in?? Or did you go ultra liberal as usual? If the conjecture is that Healthcare companies are making money left right and center, just who are these companies?? I have provided an example where the largest Healthcare provider, HCA, has less valuation than Adobe. Nevermind the fact that most likely HCA employs 100 times more workforce, attends to more human beings and save lives. Significant % of all bankruptcies in America happen because of healthcare costs, and as the article shows, costs which have nothing to do with the value they provide. What a surprise. Sorry to be cynical but everybody knows this, you really needed an article to shine the sun here? Healthcare cannot be compared to Apple. It is literally apples and oranges. Of course you can not. Because companies like Apple, or Oracle or MSFT or Google, are most likely up your alley. They should not compromise, because most likely YOU will have to compromise. It is easier to ask Pfizer, HCA and others to compromise because then it is they who are making sacrifice, not you :winky:
Crookbond Posted February 25, 2013 Posted February 25, 2013 Would overseas mediclaim policies from India work for you guys?
G_B_ Posted February 25, 2013 Posted February 25, 2013 damn uk's nhs may have its flaws but not even even private sector is that expensive.
anotherhawkeye Posted February 26, 2013 Posted February 26, 2013 ^They should have the travellers insurance at the very least. Too many desis take things for granted and prefer saving maybe a thousand dollars on health insurance for family' date=' sometimes themselves. Don't they effin get it, the alternative is probably bankruptcy/debt for a decade or two ?[/quote'] Read the fine print people. Travelers insurance is a scam. The friend I mentioned earlier had travelers insurance (was paying close to a $1000 per month), but still owed $200k to the hospital. 1. Travellers insurance deny 90% of claims as 'pre existing condition'. They will only pay for common cold, flu, etc. Have a kidney stone? They will say it was pre-existing. Have a emergency heart surgery? Pre-existing condition. Prostate problem? Pre-existing condition. See, they'll deny every expensive treatment. 2. If they decide to pay, they typically cap daily hospital allowance at $1500 to $2500 while the cost is usually several times that. So they may pay $10000 out of your bill of $150,000. Read the article in the OP again where they talk about people who had insurance. We are ****ed. :sad_smile::cry_smile:
Brainfade Posted March 5, 2013 Posted March 5, 2013 Would anyone care to look at it from the providers' point-of-view? Reading through the article made it clear - time and again - that hospitals/providers order a battery of unnecessary tests as a defensive measure against lawsuits, thus driving costs up. Another problem began many decades ago with HMOs and other insurance companies profiting based on increased regulation and bureaucracy. It's a constant tug-o-war between them and the providers. To comply with insurance regulations and push claims through, doctors/hospitals have had to hire more billing people. Insurance companies change codes on diagnoses. A doctor may perform the same procedure, but all of a sudden, the insurance refuses to pay for it. And the back-and-forth begins - memos get sent. committees meet., lawyers add billable hours. And you, the patient, ends up paying for all this bureaucracy by shelling out 10 times as much for Tylenol. And what did the Dems give us? A 2000+ page law (PPACA) with not a whiff of tort reform and nary a line in 2000+ pages to make it more cost-effective for providers to provide care. Instead we got this: Obamacare does some good work around the edges of the core problem. It restricts abusive hospital-bill collecting. It forces insurers to provide explanations of their policies in plain English. It requires a more rigorous appeal process conducted by independent entities when insurance coverage is denied. These are all positive changes, as is putting the insurance umbrella over tens of millions more Americans — a historic breakthrough. But none of it is a path to bending the health care cost curve. Indeed, while Obamacare’s promotion of statewide insurance exchanges may help distribute health-insurance policies to individuals now frozen out of the market, those exchanges could raise costs, not lower them. With hospitals consolidating by buying doctors’ practices and competing hospitals, their leverage over insurance companies is increasing. That’s a trend that will only be accelerated if there are more insurance companies with less market share competing in a new exchange market trying to negotiate with a dominant hospital and its doctors. Similarly, higher insurance premiums — much of them paid by taxpayers through Obamacare’s subsidies for those who can’t afford insurance but now must buy it — will certainly be the result of three of Obamacare’s best provisions: the prohibitions on exclusions for pre-existing conditions, the restrictions on co-pays for preventive care and the end of annual or lifetime payout caps. Put simply, with Obamacare we’ve changed the rules related to who pays for what, but we haven’t done much to change the prices we pay. And this Babugiri: The 159 new boards and commissions created in the PPACA bill. 1. Grant program for consumer assistance offices (Section 1002, p. 37) 2. Grant program for states to monitor premium increases (Section 1003, p. 42) 3. Committee to review administrative simplification standards (Section 1104, p. 71) 4. Demonstration program for state wellness programs (Section 1201, p. 93) 5. Grant program to establish state Exchanges (Section 1311(a), p. 130) 6. State American Health Benefit Exchanges (Section 1311(b), p. 131) 7. Exchange grants to establish consumer navigator programs (Section 1311(i), p. 150) 8. Grant program for state cooperatives (Section 1322, p. 169) 9. Advisory board for state cooperatives (Section 1322(b)(3), p. 173) 10. Private purchasing council for state cooperatives (Section 1322(d), p. 177) 11. State basic health plan programs (Section 1331, p. 201) 12. State-based reinsurance program (Section 1341, p. 226) 13. Program of risk corridors for individual and small group markets (Section 1342, p. 233) 14. Program to determine eligibility for Exchange participation (Section 1411, p. 267) 15. Program for advance determination of tax credit eligibility (Section 1412, p. 288) 16. Grant program to implement health IT enrollment standards (Section 1561, p. 370) 17. Federal Coordinated Health Care Office for dual eligible beneficiaries (Section 2602, p. 512) 18. Medicaid quality measurement program (Section 2701, p. 518) 19. Medicaid health home program for people with chronic conditions, and grants for planning same (Section 2703, p. 524) 20. Medicaid demonstration project to evaluate bundled payments (Section 2704, p. 532) 21. Medicaid demonstration project for global payment system (Section 2705, p. 536) 22. Medicaid demonstration project for accountable care organizations (Section 2706, p. 538) 23. Medicaid demonstration project for emergency psychiatric care (Section 2707, p. 540) 24. Grant program for delivery of services to individuals with postpartum depression (Section 2952(b), p. 591) 25. State allotments for grants to promote personal responsibility education programs (Section 2953, p. 596) 26. Medicare value-based purchasing program (Section 3001(a), p. 613) 27. Medicare value-based purchasing demonstration program for critical access hospitals (Section 3001(b), p. 637) 28. Medicare value-based purchasing program for skilled nursing facilities (Section 3006(a), p. 666) 29. Medicare value-based purchasing program for home health agencies (Section 3006(b), p. 668) 30. Interagency Working Group on Health Care Quality (Section 3012, p. 688) 31. Grant program to develop health care quality measures (Section 3013, p. 693) 32. Center for Medicare and Medicaid Innovation (Section 3021, p. 712) 33. Medicare shared savings program (Section 3022, p. 728) 34. Medicare pilot program on payment bundling (Section 3023, p. 739) 35. Independence at home medical practice demonstration program (Section 3024, p. 752) 36. Program for use of patient safety organizations to reduce hospital readmission rates (Section 3025(b), p. 775) 37. Community-based care transitions program (Section 3026, p. 776) 38. Demonstration project for payment of complex diagnostic laboratory tests (Section 3113, p. 800) 39. Medicare hospice concurrent care demonstration project (Section 3140, p. 850) 40. Independent Payment Advisory Board (Section 3403, p. 982) 41. Consumer Advisory Council for Independent Payment Advisory Board (Section 3403, p. 1027) 42. Grant program for technical assistance to providers implementing health quality practices (Section 3501, p. 1043) 43. Grant program to establish interdisciplinary health teams (Section 3502, p. 1048) 44. Grant program to implement medication therapy management (Section 3503, p. 1055) 45. Grant program to support emergency care pilot programs (Section 3504, p. 1061) 46. Grant program to promote universal access to trauma services (Section 3505(b), p. 1081) 47. Grant program to develop and promote shared decision-making aids (Section 3506, p. 1088) 48. Grant program to support implementation of shared decision-making (Section 3506, p. 1091) 49. Grant program to integrate quality improvement in clinical education (Section 3508, p. 1095) 50. Health and Human Services Coordinating Committee on Women's Health (Section 3509(a), p. 1098) 51. Centers for Disease Control Office of Women's Health (Section 3509(b), p. 1102) 52. Agency for Healthcare Research and Quality Office of Women's Health (Section 3509(e), p. 1105) 53. Health Resources and Services Administration Office of Women's Health (Section 3509(f), p. 1106) 54. Food and Drug Administration Office of Women's Health (Section 3509(g), p. 1109) 55. National Prevention, Health Promotion, and Public Health Council (Section 4001, p. 1114) 56. Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (Section 4001(f), p. 1117) 57. Prevention and Public Health Fund (Section 4002, p. 1121) 58. Community Preventive Services Task Force (Section 4003(b), p. 1126) 59. Grant program to support school-based health centers (Section 4101, p. 1135) 60. Grant program to promote research-based dental caries disease management (Section 4102, p. 1147) 61. Grant program for States to prevent chronic disease in Medicaid beneficiaries (Section 4108, p. 1174) 62. Community transformation grants (Section 4201, p. 1182) 63. Grant program to provide public health interventions (Section 4202, p. 1188) 64. Demonstration program of grants to improve child immunization rates (Section 4204(b), p. 1200) 65. Pilot program for risk-factor assessments provided through community health centers (Section 4206, p. 1215) 66. Grant program to increase epidemiology and laboratory capacity (Section 4304, p. 1233) 67. Interagency Pain Research Coordinating Committee (Section 4305, p. 1238) 68. National Health Care Workforce Commission (Section 5101, p. 1256) 69. Grant program to plan health care workforce development activities (Section 5102©, p. 1275) 70. Grant program to implement health care workforce development activities (Section 5102(d), p. 1279) 71. Pediatric specialty loan repayment program (Section 5203, p. 1295) 72. Public Health Workforce Loan Repayment Program (Section 5204, p. 1300) 73. Allied Health Loan Forgiveness Program (Section 5205, p. 1305) 74. Grant program to provide mid-career training for health professionals (Section 5206, p. 1307) 75. Grant program to fund nurse-managed health clinics (Section 5208, p. 1310) 76. Grant program to support primary care training programs (Section 5301, p. 1315) 77. Grant program to fund training for direct care workers (Section 5302, p. 1322) 78. Grant program to develop dental training programs (Section 5303, p. 1325) 79. Demonstration program to increase access to dental health care in underserved communities (Section 5304, p. 1331) 80. Grant program to promote geriatric education centers (Section 5305, p. 1334) 81. Grant program to promote health professionals entering geriatrics (Section 5305, p. 1339) 82. Grant program to promote training in mental and behavioral health (Section 5306, p. 1344) 83. Grant program to promote nurse retention programs (Section 5309, p. 1354) 84. Student loan forgiveness for nursing school faculty (Section 5311(b), p. 1360) 85. Grant program to promote positive health behaviors and outcomes (Section 5313, p. 1364) 86. Public Health Sciences Track for medical students (Section 5315, p. 1372) 87. Primary Care Extension Program to educate providers (Section 5405, p. 1404) 88. Grant program for demonstration projects to address health workforce shortage needs (Section 5507, p. 1442) 89. Grant program for demonstration projects to develop training programs for home health aides (Section 5507, p. 1447) 90. Grant program to establish new primary care residency programs (Section 5508(a), p. 1458) 91. Program of payments to teaching health centers that sponsor medical residency training (Section 5508©, p. 1462) 92. Graduate nurse education demonstration program (Section 5509, p. 1472) 93. Grant program to establish demonstration projects for community- based mental health settings (Section 5604, p. 1486) 94. Commission on Key National Indicators (Section 5605, p. 1489) 95. Quality assurance and performance improvement program for skilled nursing facilities (Section 6102, p. 1554) 96. Special focus facility program for skilled nursing facilities (Section 6103(a)(3), p. 1561) 97. Special focus facility program for nursing facilities (Section 6103(b)(3), p. 1568) 98. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 6112, p. 1589) 99. Demonstration projects for nursing facilities involved in the culture change movement (Section 6114, p. 1597) 100. Patient-Centered Outcomes Research Institute (Section 6301, p. 1619) 101. Standing methodology committee for Patient-Centered Outcomes Research Institute (Section 6301, p. 1629) 102. Board of Governors for Patient-Centered Outcomes Research Institute (Section 6301, p. 1638) 103. Patient-Centered Outcomes Research Trust Fund (Section 6301(e), p. 1656) 104. Elder Justice Coordinating Council (Section 6703, p. 1773) 105. Advisory Board on Elder Abuse, Neglect, and Exploitation (Section 6703, p. 1776) 106. Grant program to create elder abuse forensic centers (Section 6703, p. 1783) 107. Grant program to promote continuing education for long-term care staffers (Section 6703, p. 1787) 108. Grant program to improve management practices and training (Section 6703, p. 1788) 109. Grant program to subsidize costs of electronic health records (Section 6703, p. 1791) 110. Grant program to promote adult protective services (Section 6703, p. 1796) 111. Grant program to conduct elder abuse detection and prevention (Section 6703, p. 1798) 112. Grant program to support long-term care ombudsmen (Section 6703, p. 1800) 113. National Training Institute for long-term care surveyors (Section 6703, p. 1806) 114. Grant program to fund State surveys of long-term care residences (Section 6703, p. 1809) 115. CLASS Independence Fund (Section 8002, p. 1926) 116. CLASS Independence Fund Board of Trustees (Section 8002, p. 1927) 117. CLASS Independence Advisory Council (Section 8002, p. 1931) 118. Personal Care Attendants Workforce Advisory Panel (Section 8002©, p. 1938) 119. Multi-state health plans offered by Office of Personnel Management (Section 10104(p), p. 2086) 120. Advisory board for multi-state health plans (Section 10104(p), p. 2094) 121. Pregnancy Assistance Fund (Section 10212, p. 2164) 122. Value-based purchasing program for ambulatory surgical centers (Section 10301, p. 2176) 123. Demonstration project for payment adjustments to home health services (Section 10315, p. 2200) 124. Pilot program for care of individuals in environmental emergency declaration areas (Section 10323, p. 2223) 125. Grant program to screen at-risk individuals for environmental health conditions (Section 10323(b), p. 2231) 126. Pilot programs to implement value-based purchasing (Section 10326, p. 2242) 127. Grant program to support community-based collaborative care networks (Section 10333, p. 2265) 128. Centers for Disease Control Office of Minority Health (Section 10334, p. 2272) 129. Health Resources and Services Administration Office of Minority Health (Section 10334, p. 2272) 130. Substance Abuse and Mental Health Services Administration Office of Minority Health (Section 10334, p. 2272) 131. Agency for Healthcare Research and Quality Office of Minority Health (Section 10334, p. 2272) 132. Food and Drug Administration Office of Minority Health (Section 10334, p. 2272) 133. Centers for Medicare and Medicaid Services Office of Minority Health (Section 10334, p. 2272) 134. Grant program to promote small business wellness programs (Section 10408, p. 2285) 135. Cures Acceleration Network (Section 10409, p. 2289) 136. Cures Acceleration Network Review Board (Section 10409, p. 2291) 137. Grant program for Cures Acceleration Network (Section 10409, p. 2297) 138. Grant program to promote centers of excellence for depression (Section 10410, p. 2304) 139. Advisory committee for young women's breast health awareness education campaign (Section 10413, p. 2322) 140. Grant program to provide assistance to provide information to young women with breast cancer (Section 10413, p. 2326) 141. Interagency Access to Health Care in Alaska Task Force (Section 10501, p. 2329) 142. Grant program to train nurse practitioners as primary care providers (Section 10501(e), p. 2332) 143. Grant program for community-based diabetes prevention (Section 10501(g), p. 2337) 144. Grant program for providers who treat a high percentage of medically underserved populations (Section 10501(k), p. 2343) 145. Grant program to recruit students to practice in underserved communities (Section 10501(l), p. 2344) 146. Community Health Center Fund (Section 10503, p. 2355) 147. Demonstration project to provide access to health care for the uninsured at reduced fees (Section 10504, p. 2357) 148. Demonstration program to explore alternatives to tort litigation (Section 10607, p. 2369) 149. Indian Health demonstration program for chronic shortages of health professionals (S. 1790, Section 112, p. 24)* 150. Office of Indian Men's Health (S. 1790, Section 136, p. 71)* 151. Indian Country modular component facilities demonstration program (S. 1790, Section 146, p. 108)* 152. Indian mobile health stations demonstration program (S. 1790, Section 147, p. 111)* 153. Office of Direct Service Tribes (S. 1790, Section 172, p. 151)* 154. Indian Health Service mental health technician training program (S. 1790, Section 181, p. 173)* 155. Indian Health Service program for treatment of child sexual abuse victims (S. 1790, Section 181, p. 192)* 156. Indian Health Service program for treatment of domestic violence and sexual abuse (S. 1790, Section 181, p. 194)* 157. Indian youth telemental health demonstration project (S. 1790, Section 181, p. 204)* 158. Indian youth life skills demonstration project (S. 1790, Section 181, p. 220)* 159. Indian Health Service Director of HIV/AIDS Prevention and Treatment (S. 1790, Section 199B, p. 258)*
suraj Posted March 6, 2013 Posted March 6, 2013 Dont worry' date=' I have the perfect insurance plan for you - [url']http://tinyurl.com/ahgcykf :dontmentionit: :hysterical::hysterical::hysterical::hysterical:
Ram Posted March 6, 2013 Author Posted March 6, 2013 And what did the Dems give us? A 2000+ page law (PPACA) with not a whiff of tort reform and nary a line in 2000+ pages to make it more cost-effective for providers to provide care. Instead we got this: The effect of Tort reform on costs of health-care is incredibly over-blown. Doctors prescribe a battery of utterly useless tests completely disconnected from the patients problem not only because they are afraid they may get sued because of an incorrect diagnosis, but mainly because it gives them an opportunity to fleece money from the patients. You keep going back to the regulations as a source (or solution) to America's healthcare woes. The American health-care Industry does not have a regulation problem. It has a GREED problem. And no amount of regulation (or the lack of it) can tackle that. A startling parallel can be drawn b/w Wall Street and the Health-care Industry on how personal greed has led many peoples' lives to ruins. Of course, it is also true that the presence of enticing sources of income like Medicare (and other govt. sponsored programs) is definitely a great incentive for health-care institutions to over-charge their customers. But then again, if it was not Medicare, it would be something else.
Brainfade Posted March 6, 2013 Posted March 6, 2013 The effect of Tort reform on costs of health-care is incredibly over-blown. Doctors prescribe a battery of utterly useless tests completely disconnected from the patients problem not only because they are afraid they may get sued because of an incorrect diagnosis, but mainly because it gives them an opportunity to fleece money from the patients. You keep going back to the regulations as a source (or solution) to America's healthcare woes. The American health-care Industry does not have a regulation problem. It has a GREED problem. And no amount of regulation (or the lack of it) can tackle that. A startling parallel can be drawn b/w Wall Street and the Health-care Industry on how personal greed has led many peoples' lives to ruins. Of course, it is also true that the presence of enticing sources of income like Medicare (and other govt. sponsored programs) is definitely a great incentive for health-care institutions to over-charge their customers. But then again, if it was not Medicare, it would be something else. You are right on some points, but way off on others. First, let me point out the wrong. Medicare reimbursements - you are wrong that Medicare reimbursements are an incentive. If anything, they can be so low that doctors (especially specialists in independent private practices) have stopped seeing Medicare patients. My oncologist friend in FL loses money on each Medicare patient he sees, and has to make it up by charging the others more. If not, he cannot pay the army of employees he needs to keep to make sure the paperwork is up to date. More ridiculous is the inordinate amount of time that Medicare insurers take to reimburse him. Even more ridiculous is that Medicare will not let him treat poor patients out of his goodwill at rates that are lower than their rates. The hassle was too much, and he quit treating Medicare patients. It is going to get worse with PPACA, as it cuts reimbursements even further. And don't even get started on Medicaid. Second, you did not address the cost of cumbersome, regulatory paperwork that is imposed on providers by both the the government and insurance companies - the overhead, if you will. Now, the right. You are right that greed exists, even in healthcare. Even laziness, at times. It is not universal, but it is there. You are right that I was ignorant in overblowing the contribution of med mal (and thus the practice of defensive medicine) on healthcare costs (I had read it was ~ 24%, but recent studies seem to indicate it is ~ 10%. Some say even as low as 1%). But all of these studies clearly conclude that, while tort reform is not the only solution, it HAS to be the first one to be tackled to bring costs down. It is clear that PPACA skirted that issue completely and focused on imposing even more regulation and bureaucracy. BTW, did you see the parts of the TIME magazine article that I bold-faced where they showed insurance costs going further up due to PPACA policies? Here is a fascinating New Yorker article about costs. See how some many private, non-profit hospitals like The Mayo Clinic, Duke Hospitals, and others practice accountable medicine. It can be done - (a) it just needs some good people with a good conscience and (2) getting the government out of the way. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all It is very long, so I just copied a very short excerpt. No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not. You must pay attention to insurance rejections and government-reimbursement rules. You must think about having enough money for the secretary and the nurse and the rent and the malpractice insurance. Beyond the basics, however, many physicians are remarkably oblivious to the financial implications of their decisions. They see their patients. They make their recommendations. They send out the bills. And, as long as the numbers come out all right at the end of each month, they put the money out of their minds. Others think of the money as a means of improving what they do. They think about how to use the insurance money to maybe install electronic health records with colleagues, or provide easier phone and e-mail access, or offer expanded hours. They hire an extra nurse to monitor diabetic patients more closely, and to make sure that patients donÃÕ miss their mammograms and pap smears and colonoscopies. Then there are the physicians who see their practice primarily as a revenue stream. They instruct their secretary to have patients who call with follow-up questions schedule an appointment, because insurers donÃÕ pay for phone calls, only office visits. They consider providing Botox injections for cash. They take a Doppler ultrasound course, buy a machine, and start doing their patients scans themselves, so that the insurance payments go to them rather than to the hospital. They figure out ways to increase their high-margin work and decrease their low-margin work. This is a business, after all. In every community, youÃÃl find a mixture of these views among physicians, but one or another tends to predominate. I truly hope that you and others here are seeing all sides of this. And speaking of fleecing, I hope you are also able to see everything that is wrong about PPACA. It is easy for the President to stand on the pulpit and say "We are going to guarantee that everyone will have insurance." It is easy for Pelosi to say "We will read it after it is passed." It is difficult to articulate the intricacies to the general public - things like its failure to address healthcare costs, the heavy tax increases to cover implementation costs, premiums going up, less reimbursements for physicians, employers dropping coverage en masse, employers cutting employee hours to part-time so as to avoid providing coverage, government having to spend even more to cover these folks - all in the name of hypothetical universal coverage. Buying into the Obama rhetoric was the easy part. The devil is in the details.
Ram Posted March 7, 2013 Author Posted March 7, 2013 You are right on some points' date=' but way off on others. First, let me point out the wrong. Medicare reimbursements - you are wrong that Medicare reimbursements are an incentive. [b']If anything, they can be so low that doctors (especially specialists in independent private practices) have stopped seeing Medicare patients. My oncologist friend in FL loses money on each Medicare patient he sees, and has to make it up by charging the others more. If not, he cannot pay the army of employees he needs to keep to make sure the paperwork is up to date. More ridiculous is the inordinate amount of time that Medicare insurers take to reimburse him. Even more ridiculous is that Medicare will not let him treat poor patients out of his goodwill at rates that are lower than their rates. The hassle was too much, and he quit treating Medicare patients. I dont buy that completely. The Unite States govt. hands out $800 bn every year in medicare reimbursements. Think about that figure for a second.. $800 bn! The entire income of the govt. of India (a country of 1.2 billion people) for the year of 2012 was around $215 bn. What that actually means is that the United States govt. spends 4 times as much on the health-care of its senior citizens than what the Indian govt. receives as income. To me, that is staggering. Clearly, all of this wealth is going into the pockets of the health-care providers across the United States. Still, they complain about losing money on health-care patients. I would like to think the correct term in this context would be 'We make lesser money on health-care patients' (as I am sure you know, by law, service providers are required to charge medicare patients lesser than the the 'market price'). It maybe true that there maybe instances of individual specialists who may find it not profitable to service medicare patients, but the by and large truth remains the fact that a majority of the Industry is profiting massively from it. All the whining and complaining is because they want even more. Plus, if a specialists can make twice as much money seeing a patient with insurance than he or she can make seeing a medicare patient, of course they will go for the former. After all, they have limited consultation time during the day. It is going to get worse with PPACA, as it cuts reimbursements even further. And don't even get started on Medicaid. And I would to think you should appreciate it. The problem right now is not that medicare reimbursements are too low. The govt simply pays out too much, for too little care. Fraud is rampant. Bogus claims are abundant. The solution is not to increase medicare payments, but to make it more stringent. Second, you did not address the cost of cumbersome, regulatory paperwork that is imposed on providers by both the the government and insurance companies - the overhead, if you will. I have spent a massive proportion of my professional life in financial institutions, working on compliance/regulatory related projects. So I know what you are talking about. Even though the additional time/effort required to fulfill the new regulations can be tiresome, I would like to think that at no stage do they become debilitating. Now, the right. You are right that greed exists, even in healthcare. Even laziness, at times. It is not universal, but it is there. You are right that I was ignorant in overblowing the contribution of med mal (and thus the practice of defensive medicine) on healthcare costs (I had read it was ~ 24%, but recent studies seem to indicate it is ~ 10%. Some say even as low as 1%). But all of these studies clearly conclude that, while tort reform is not the only solution, it HAS to be the first one to be tackled to bring costs down. It is clear that PPACA skirted that issue completely and focused on imposing even more regulation and bureaucracy. Lets just say for discussion sake medical mal-practice accounts for 5% of all health-care costs. If the number is so low, then why do feel that health-care reform has to 'START' with that? Lets just cut to the chase, shall we? The GoP has been pushing for tort-reform as this silver bullet that ails all of health-care because their corporate sponsors and financiers from the health-care industry have been steadily pushing for this. Why? So that they can get sued less and by corrollary, keep more of their profits. I am not a fan of frivolous law-suits, but I am all for consumer protection and empowerment against big corporate that can hire powerful lawyers. BTW, did you see the parts of the TIME magazine article that I bold-faced where they showed insurance costs going further up due to PPACA policies? Rather than focusing on individual aspects of a legislation, we should focus on its net effect. At the end of the day, over a period of 10, 15, 20 years, does Obamacare successfully halt the rapid escalation of health-care costs or not. That is the question we should be asking of each other. Here is a fascinating New Yorker article about costs. See how some many private, non-profit hospitals like The Mayo Clinic, Duke Hospitals, and others practice accountable medicine. It can be done - (a) it just needs some good people with a good conscience and (2) getting the government out of the way. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all It is very long, so I just copied a very short excerpt. I read your excerpt. Call me a hopeless cynic, but a majority of health-care professionals in the United States fall in category 3. And I dont blame them for that. I would do the exact same thing If I were in that position. I truly hope that you and others here are seeing all sides of this. And speaking of fleecing, I hope you are also able to see everything that is wrong about PPACA. It is easy for the President to stand on the pulpit and say "We are going to guarantee that everyone will have insurance." It is easy for Pelosi to say "We will read it after it is passed." It is difficult to articulate the intricacies to the general public - things like its failure to address healthcare costs, the heavy tax increases to cover implementation costs, premiums going up, less reimbursements for physicians, employers dropping coverage en masse, employers cutting employee hours to part-time so as to avoid providing coverage, government having to spend even more to cover these folks - all in the name of hypothetical universal coverage. Buying into the Obama rhetoric was the easy part. The devil is in the details. Again, I would like to go back to the basic premise of your point - That regulation has the ability to make (or break) the business model of health-care providers. I think that is a fallacy. If that is the case, govts all over the world can simply regulate (or in other cases, de-regulate) towards prosperity and wealth. People (and businesses) will do what is good for their bottom-lines. Regulation, however stringent it is, does not even begin to scratch the surface. If employers are dropping health-care coverage for their employees, the more pertinent question to ask is not whether regulation is too cumbersome or not, but whether these organizations truly care about the welfare of the people who are at the core of their profitability? Again I repeat - American Industry does not a (over) regulation problem. It has a greed problem.
Brainfade Posted May 8, 2013 Posted May 8, 2013 I dont buy that completely. The Unite States govt. hands out $800 bn every year in medicare reimbursements. Think about that figure for a second.. $800 bn! I thought about it: 47+ million elderly people (think heart surgeries, Alzheimers, Diabetes, Osteoporosis, and a dozen types of cancer ... ) enrolled in Medicare. If my math is right, ($ 800*10^9 per year) / (47*10^6 enrolees) = $17,000 per enrolee per year.
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