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Old 04-08-2019, 10:44 AM
 
8,692 posts, read 3,787,828 times
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Quote:
Originally Posted by CaliRestoration View Post
The best way to "augment" the middle class is to stop taxing them to death to support entitlement programs (some in support of non-citizens).

Is it any coincidence that the middle class is devastated in places like California, and New York? I don't think it is.

As for medicare, I'll do you one better. We need more price transparency in the health care industry. The lack of transparency is what is keeping prices so high. Health care providers should be forced to compete in an open market like any other good or service.
I would cut middle class taxes and use new money where ever we can for welfare. Much welfare by the way goes to the middle class.

Medicare knows what medical things cost. They pay just above this. Transparency sounds fine, but as in Medicare the reimbursements are preset. Medicare could care less what some provider or entity wants to charge.

Easy, simple and non-emergent medical encounters are inherently cheap and can be price shopped. But those are not our large and overall HC cost drivers. Those big things like serious emergencies, surgeries, hospitalizations and complicated and chronic care are the biggies. And with much of these it is just too hard or well near impossible to price shop. Too much uncertainly and too many medically related unknowns.
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Old 04-08-2019, 12:54 PM
 
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Quote:
Originally Posted by Hoonose View Post
I would cut middle class taxes and use new money where ever we can for welfare. Much welfare by the way goes to the middle class.
That doesn't make any sense. Why would they need the welfare if they're keeping the money in the first place? Stop taking their money away so they can spend, save, or invest it. The government is horrible at allocating resources so why give them YOUR money to give back to you? So stop giving them that job.

Quote:
Medicare knows what medical things cost. They pay just above this. Transparency sounds fine, but as in Medicare the reimbursements are preset. Medicare could care less what some provider or entity wants to charge. Those big things like serious emergencies, surgeries, hospitalizations and complicated and chronic care are the biggies. And with much of these it is just too hard or well near impossible to price shop. Too much uncertainly and too many medically related unknowns.
Disagree. Medicare is absolutely rife with fraud and waste.
https://www.modernhealthcare.com/gov...are-fraud-case

The reason is because of lack of transparency. For true price transparency you need the data to be public so it can be examined and shopped.

You can price and line item ANYTHING. Saying "it's just too hard" is a cop out and excuse. There is literally no service in the country that cannot be priced out.
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Old 04-08-2019, 03:51 PM
 
8,692 posts, read 3,787,828 times
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Quote:
Originally Posted by CaliRestoration View Post
That doesn't make any sense. Why would they need the welfare if they're keeping the money in the first place? Stop taking their money away so they can spend, save, or invest it. The government is horrible at allocating resources so why give them YOUR money to give back to you? So stop giving them that job.
Whom do you mean by 'they' needing welfare? Who is keeping what money?

Quote:
Originally Posted by CaliRestoration View Post
Disagree. Medicare is absolutely rife with fraud and waste.
Sure there is some fraud, as with any large operation public or private. A few percent is not going to change our HC reform course. Fraud should and will always be pursued, but Medicare fraud is not our major HC cost driver.

Waste is harder to quantify. No doubt there is some serious waste in Medicare. But the big numbers are more from medical stupidity and laziness. I see it every day. Docs and other HC providers and entities ordering tests and doing what-not and such without first researching what has already been done and why. Not doing a simple, cheap and easy history or exam of the patients first on their own. This is where the big money lies. Docs control much if not most of their patients medically related spending. And that amount of money is typically on the order of 10X the docs income. So take hundreds of thousands of weak docs, and we get massive waste.
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Old 04-08-2019, 05:03 PM
 
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Quote:
Originally Posted by Hoonose View Post
Who is keeping what money?

I think that's pretty self evident.

Quote:
Sure there is some fraud, as with any large operation public or private. A few percent is not going to change our HC reform course. Fraud should and will always be pursued, but Medicare fraud is not our major HC cost driver.
Fraud and waste are the worst parts of Medicare. Absolutely. This isn't even argued by proponents of Medicare or Health Care for All.
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Old 04-08-2019, 05:18 PM
 
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Quote:
Originally Posted by CaliRestoration View Post
I think that's pretty self evident.



Fraud and waste are the worst parts of Medicare. Absolutely. This isn't even argued by proponents of Medicare or Health Care for All.
Sorry I couldn't follow your 'they'.

What percent of Medicare spending is waste? and fraud?
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Old Today, 10:57 AM
 
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Quote:
Originally Posted by Hoonose View Post
Sorry I couldn't follow your 'they'.
Not my problem.

Quote:
What percent of Medicare spending is waste? and fraud?
"Low estimates" are in the tens of billions.
https://publicintegrity.org/health/f...ons-last-year/

I suspect the costs of fraud and waste could be much higher.
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Old Today, 12:03 PM
 
8,692 posts, read 3,787,828 times
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Quote:
Originally Posted by CaliRestoration View Post
Not my problem.



"Low estimates" are in the tens of billions.
https://publicintegrity.org/health/f...ons-last-year/

I suspect the costs of fraud and waste could be much higher.
Most 'fraud' in Medicare is gray zone billing. Upcoding for instance without good documentation. Adding on non-related diagnoses. It is always in the providers best financial interest to sugar coat and get the most out of reimbursements. Versus actual planned felonious and out right criminal fraud. Most of us docs and facilities get audited from time to time, and half the time they find some 'fraud'.

Waste is a very big deal as I noted already. Far more in money than criminal fraud IMO. It could be on the order of 10% of all Medicare, maybe even as high as one third. I see it every day. I see it every day I'm here at my wife's bedside during her hospitalization. And medical errors.
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