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Depends your initial costs of IT, EMR etc. It will take a few years to break even. My GI colleagues are just breaking even after installing their EMR in 2011.
Yes. I was over generalizing. I haven't kept up with my primary care colleagues as much. But specialist do get much less on the Medicare reimbursement than with private.
Agreed, most Hospitals in their current structure would get squeezed out quickly without Medicare. That's because they they've taken 30-40 plus years to structure their business around providing services that take in Medicare.
The hospitals (mainly a lot of physician owned in places like Texas) and ASCs do extemely well without Medicare. It's because they were designed without Medicare in mind. They are run a lot differently than your "non profit" community hospitals.
But it all comes down to payer mix. We all know this. Hospitals with more than 50% Medicare payer mix combined another 15-20% Medicaid and not sustainable for long term without government assistance. We all know which ones they are.
Medicare is 'Gov't assistance'. Our hospital makes good money as a result. Medicaid is about a wash even with ACA expansion.
Doctor owned hospitals typically don't do senior general hospital care which is the bulk of expensive HC in the world. When you limit your hospital to specialties, and avoid Medicare on top of that, you are about guaranteed major profits through patient selection as your risks are so low. Younger healthier and less complicated private coverage patients are the cream. Great for the doc owners, bad for local hospitals that lose this cream.
Our hospital is about your description above and makes good money year after year, as it is well run. I profit share with them, and 15-20% return on my investment year after year should tell you something.
With primary care and the new Medicare bonus codes, for every Medicare patient there is a $166-$111 bump in low overhead revenue per year. With no patient copay. Plus post-hospital follow up bonuses if they are admitted. So a typical primary care practice with 500 Medicare patients, there is some good and easy to obtain added revenue there if you've paid attention and done your IT homework.
In my opinion the ACA was designed to do two things. First it was designed to limit the number of health insurance companies through restrictions, second it was designed to fail in order to later implement single payer. It will succeed unfortunately.
We learned from Medicare part D, that too much information is a large negative for the patients. So in general fewer HC carriers can be a plus. But of course up to a point. If people have only 1 or 2 options that's not good. In AZ we have many more options year 2 compared to 1.
ACA is an abortion. It is way too complicated, and that is a large part of the problem. But it is nonsense to think that it was designed to fail. It is too complicated, as the more liberals didn't get their way with UHC or even the public option. The public option pathway still being my own choice. As a doc and as a patient.
The U.S. doesn't have the tax system to pay for it. European countries have regressive tax systems to pay for universal health care, etc. The U.S. middle class and below refuse to pay the amount of taxes it would take to pay for UHC. So, it won't happen. There's not a broad enough tax base to pay for it.
And yet... we don't see "the masses suffering" for paying regressive taxes in any of those European countries.
This is the first time I've ever seen a good argument as to why health care would be difficult to implement in the USA so I wanted to salute that
If I understand well, it's true that, in France at least, probably the rest of Europe too but not sure for all, we (as workers or business owners) pay "in advance" (ie taken from our paycheck, immediately from the source) so it makes it easier to round up the money. But I can understand how the same system would be difficult to adapt in your country.
BUT, here also, there is roughly 50% tax payers and 50% non tax payers (because they earn too little or because they are out of work/retired/children/disabled/etc).
I also wonder how paying for military and huge banks bailing out is ok but health should be an individual's responsability only.
What I mean is OF COURSE getting proper health care is a human's right or should be and I hope it becomes one worldwide one day (although I'll be dead when that happens, no, I'm not thinking only of the Occident).
I actually feel a bit sad that a country who considers itself a leader would be the last in the West to understand that (the rest of us have had the system for +60 years) and still debate it and i'm probably not the only one.
Have we gone this far as to not accept that? What good is there living in the "developped world" if we conduct ourselves like savages wouldn't ? Amass more and more money? For nothing? Money is only useful for what it buys and brings and the true fortunes are education, health, curiosity and willingness to be wrong and learn again. Those shouldn't be on the "free market" line because they ARE necessities to our continuation as human beings, they have a much bigger value than their cost.
The primary objection to Universal Health Care is those that could afford their own private health care do not want to pay for the health care of the people that cannot. To the first group adequate health care is a privilege that must be defended at whatever cost to the unprivileged.
It is a simple variation of the "I've got mine and to hell with you" syndrome.
The primary objection to Universal Health Care is those that could afford their own private health care do not want to pay for the health care of the people that cannot. To the first group adequate health care is a privilege that must be defended at whatever cost to the unprivileged.
It is a simple variation of the "I've got mine and to hell with you" syndrome.
False. It's about not advocating theft. People should voluntarily organize and help people who need it.
I oppose the idea of the federal government being the healthcare insurance provider. When you control the healthcare options/insurance, you have unlimited access to patient records. Also, universal healthcare isn't free. Everyone pays one way or another. This is important when you realize that when our federal government takes control of something, the operating cost and inefficiency of operation goes up fast. I fully support offering assistance to those who've fallen on hard times and can no longer afford their own insurance. What I don't want is to support those who choose to not support themselves.
I oppose the idea of the federal government being the healthcare insurance provider. When you control the healthcare options/insurance, you have unlimited access to patient records. Also, universal healthcare isn't free. Everyone pays one way or another. This is important when you realize that when our federal government takes control of something, the operating cost and inefficiency of operation goes up fast. I fully support offering assistance to those who've fallen on hard times and can no longer afford their own insurance. What I don't want is to support those who choose to not support themselves.
I will take out a quote from your post but still quote the whole because I'm certainly taking it out of context and I apologize for that.
Quote:
Originally Posted by victimofGM
Also, universal healthcare isn't free. Everyone pays one way or another. .
Certainly. It's actually an ideological question so I stand corrected by myself that it is indeed a very "USA" issue.
But maybe, just maybe, it also adds something to society? Like solidarity? Like seeing a stranger as a part of the world you live in instead of dog-eat-dog society? You pay for him, he pays for you and we are all part of a social system that will help us, should we fall under bad times? Wouldn't that be a great addition to society instead of seeing a stranger as a potential thief?
Of course, some people will profit from the system. OF COURSE. But don't forget most people are decent people. I am you without your life experience, you are me without my life experience, etc.
The person some here mock or acccuse could also be them one day.
I truly hope not as I wouldn't wish harm on anyone, but if any "accident of life" happens to any of them, I also hope they'll have the honesty to admit they were wrong about "politics that allow people to not suport themselves".
****Cheate**** happens.
Most people are decent people, keep that in mind :-)
If you oppose health care reform (the inferior Obamacare, or much preferred single-payer model), please list your reasons for doing so.
I oppose universal health care as a right for every American citizen because:
1.
2.
3.
Good luck.
Haved seen government-run healthcare, as well as lived it.
US Army. The VA. Public hospitals.
No thank you.
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As I've already proven, UHC countries use regressive taxes to pay for it.
