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Do you think it's possible you might be confusing Medicare with Medicaid? Of course this can all vary of region. In my neck of the woods, everyone accepts medicare patients. Thisis not the case with Medicaid.
There is also a trend towards concierge services for both insured and Medicare patients. Those who are willing and able to pay more, get more time and attention. I have no clue of their outcomes are better than anyone else's.
No, I'm not confusing Medicare and Medicade. In fact, I know of no doctors who presently takes Medicade patients because Medicade pays little or nothing,....mostly nothing.
This is not hearsay,..it's factual in our community, and since there is no county hospital or hospital district, there is no ER to service patients without insurance. Having family in the medical field, it is a clear fact that those people over 70 years of age will have one hell of a time getting medical help. They have already been told by hospitals that Obamacare will limit the types of services to Medicare age people, and will concentrate on the illnesses affecting younger patients. Hospitals say that there will be no peer reviews under Obamacare, and that people not qualified to make medical judgments will be tasked with making decisions regarding treatment of older patients.
Reading that article lead me to a couple of conclusions:
1. I should bring my own supplies to the hospital so I don't get over charged: pen, bandaids, alcohol pads, gowns etc.
2. MEdicare/Medicaid does seem to be a lot more efficient around processing paperwork
3. In my region, the hospitals with mostly medicare/medicaid/uninsured patients are not profiting. They may have chargemasters but I imagine the collection rate is 10% of the chargemaster price considering the patients don't have the means to pay.
4. There is way too much marketing BS in the product selection
I think things could be vastly improved in a few ways.
1. Medicare/Caid couple pay the hospitals a bit more. To keep up with inflation and encourage doctors to accept new patients under these plans
2. If no one wants to let Medi*** negotiate drug prices/durable goods/etc, it would be great if they could implement some sort of rebate program, where if the hospital uses an item on medicare's approved list, they get an instant bonus payout or something, to incentivize using the cheaper and more effective solution. **funded by the equipement or drug maker. Like spiffs in technology and other consumer products
3. We need caps on markups in the charge master. Alcohol pads should not cost $70.
If we are comparing Medicare payments, they use the same fee schedules.
If you are comparing private insurance under age 65 or those that are not
disabled, it's a different story based on how high percentage co-pay or
deductible they have.
But this is a thread on comparing Medicare, is it not?
This is the eye opening article in this issue of Time magazine. A long article but astounding!
So naive.
We could lower health care costs even more by mandating that doctors work for minimum wage or even better, make them work for free. There is nothing creative or good about government price controls.
The Time article is about as non-partisan as it gets.
The health care industry spent $5.36 billion lobbying Congress between 1998-2012. That's three Presidents and different house majorities. In contrast, defense interests spent a paltry $1.53 billion in the same timeframe.
Health care cost is more than three times as large.
Medicare is the only entity that has kept the costs down. Note the difference in medical costs of private pay, insurance pay, and Medicare pay. Medicare pays the true cost of medical care. Insurance and especially private pay are charged at least 10x the true cost.
You say Medicare pays the true cost of medical care. Okay. It uses government power to keep the costs it pays below that which the private sector pays. But where's the explanation of how they are holding costs down for anyone who isn't on medicare? Or is your contention that since medicare pays less that everyone should be on medicare?
I am afraid that you don't know what you are talking about.
If we had 100% of our patients on medicare, as you propose, our practice would go bankrupt and have to close. I would offer that most practices would have to do the same.
We break even or lose a little on every medicare patient we see. Private insurance keeps us afloat.
Every year, there is a proposed 30% reduction in reimbursement to physicians. Every year, that is postponed. If those cuts go through, most of us will drop medicare altogether. The old folks are nice, but we cannot bankrupt our practices.
Want to cut costs?
1. malpractice reform. We over order tests to avoid litigation. Medical imaging and prescription costs are the true drivers of increased healthcare costs.
2. mandate generic only meds for medicare/medicaid patients. They worked fine ten years ago- they still work fine.
3. allow physicians to halt care when predicted mortality is > 95% in patients on medicare. Most of medicare spending is on patients in their last three months of life and is wasted.
4. make deductibles higher for everything except emergent/urgent treatments. People will think about the true cost of procedures/visits as well as the cost of the drugs they are prescribed.
5. allow open insurance markets so that patients can shop for cheaper plans. Cheaper plans, however, usually mean higher co-pays and denied coverage for many things.
6. eliminate the "fee for service" system of medicine. I really don't know how you could do this, as I don't know what entities could "employ" physicians. However, I would offer that there would be far fewer cardiac caths, GI scopes, ect......
I'm sure glad you're not my doctor. Did you go into medicine just to make money?
I'm sure glad you're not my doctor. Did you go into medicine just to make money?
Do you think doctors should work for free?
Doctors undergo extensive training. Maybe you would prefer a less trained person tending to your medical needs.
Few doctors go into medicine "just to make money", but I don't see any other profession that offers their services for free, or any professional degreed persons who do not wish to capitalize on their training. Why should doctors not be expected to make money like every other person who works for a living?
Dollars to donuts you don't work for nothing. Wonder why you thinks others should?
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