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It will take 100% of doctors accepting Medicare-for-All rates and that won't happen.
Yet Germany rations healthcare.
And then there's the matter of future unfunded liabilities for Germany (and all EU States). The need to increase taxes to continue funding Social Welfare programs is very real.
We can't.
1. Mediacare for all would bankrupt many, many practices.
2. medicare has marked regional differences in payment
3. those states which are the lowest cost and most efficient are reimbursed the lowest
4. medicare has markedly different relative rates of payment to specialists vs primary care
5. many specialists would be unable to practice with "medicare for all"
6. overhead costs are fixed (but do rise with inflation) and still need to paid, regardless of reimbursement
It would bring more money in the system, as people still have to pay premiums with Medicare. Young people use less care, but would theoretically still be paying in the system.
It would bring more money in the system, as people still have to pay premiums with Medicare. Young people use less care, but would theoretically still be paying in the system.
It will take 100% of doctors accepting Medicare-for-All rates and that won't happen.
Yet Germany rations healthcare.
And then there's the matter of future unfunded liabilities for Germany (and all EU States). The need to increase taxes to continue funding Social Welfare programs is very real.
It goes without saying that in an universal system, all doctors will be required to accept whatever the government pays them. If they don't, they're out of a job, plain and simple. They really need to pass a law immediately forcing doctors to accept Medicare / Medicaid patients, with strict enforcement.
And I don't want to ever hear the words "unfunded liabilities" again - this is the government's way of extorting higher taxes now for "projected liabilities" deep into the future - when a lot of us won't even be alive. What they're really doing is raising taxes so they can pay for their pet projects, just like they did in the '80's when they doubled the self-employment tax and raised the payroll tax (and it was quite significant, too - I can't believe the so-called "conservatives" at the time fell for such a scam.)
Figure out what things costs *now* and adjust the revenue stream to pay for it *now.* Next year, do the same thing. I, for one, will not be suckered into paying more tax which is supposed to take care of these ephemeral "unfunded liabilities" and have them squander it on jets that can't even fly. If I pay more tax, that money had better come back to me.
Trump is on Meet the Press this morning talking about Healthcare Insurance.
The basis is requiring states to allow the sale of healthcare insurance across state lines and having hundreds of companies compete in the Individual Plan Market. Sounds great, eh. The devil is in the details.
He does not seem to realize that the ACA gives the states the right to decide what beyond " Essential Services" to mandate. No two states mandate the same thing. Some states don't mandate outpatient surgery. Some states do funky stuff networks vs out of network. Some states allow adult children to stay on their parent's plan beyond age 26. The biggest difference is medications covered or not.
Cost of healthcare is dependent upon Utilization and healthcare provider competitiveness, or lack thereof, of the very local healthcare market. People who live in areas of fewer claims pay less than those who live in areas with a higher claim rate. Those who live in highly competitive healthcare markets pay less than those who live in areas with less competitive healthcare markets.
Then there's the whole in - network deal. Insurers establish network contracts with healthcare providers.
Lastly, every state has unique regulations for insurance.
Trump also made clear, once again, that the government ( not clear if he was talking state or federal) will take care of those who cannot afford insurance.
Wake me up when 50 states agree to federal standards, substantially beyond the ACA and how this will make healthcare insurance more affordable for everyone.
I am not advocating short life spans... When those numbers were set up, 65 was reasonable. Now, well if it's changed, those +- 15 or so years of me (42) get screwed... But regardless, we all are in a way.
I would like to opt out of ss and FICA, voluntarily give up most to date contributions, and I'll still contribute .5% and not be allowed to collect ss or Medicare if I get to keep the rest of that tax money
65 for SS may be a bit early. But IMO 65 remains reasonable for HC, as that is about when the typical S hits the fan for so many people in the USA.
If it were up to me I'd have eliminated payroll taxes in 2009, and still provide SS/Medicare via more new money creation.
Too rich? I started with nothing. I earned my way to where I am. No one handed me anything. What do I get for all the planning, initiative, motivation, hard work, responsibility, sacrifice, delayed gratification, and subsequently the achievement that has resulted from all of that? Disproportionate punishment from the government for doing so.
That actually dilutes the value of the dollar, making the poor even more poor than they already are.
I much prefer the way Scandinavian countries do it: the highest marginal income tax rate is applied to the middle class (so there's much less drastic of a penalty, comparatively, for earning an above average income), and EVERYONE pays a 20-25% VAT tax on top of that.
Since 2008 I have supported middle class preference as far as tax and benefits.
The poor we take of, the rich are on their own and obviously continue to succeed.
Less middle class tax, more benefits = means more new money creation.
Last time I checked, younger, presumably healthier people, are charged substantially less than older people in the individual plan market. Younger people also have the ability to buy Catastrophic Plans in the individual plan market.
Despite being healthier as a mass, younger people are more likely to experience :
A maternity event , 40% of which are paid for by Medicaid because the bio parents cannot afford to pay for it
Acquire STDs
Drive with only state minimum liability insurance and become involved in serious traffic accidents
Drive while under the influence
Become victims of violence ( Anyone think gangbangers who get shot or otherwise attacked have healthcare insurance? )
Just a question since you indicated you are quite removed from the admin side of your practice. Double check with who does the accounting and see if the Medicaid fee schedule covers the overhead.
It does. But if I just did Medicaid my earnings would not be enough incentive for me to keep the office open.
Why must a GP see 30 patients a day? Because the pay per patient is extremely low and there is overhead. And the patients at large think that the docs are millionaires and overlook the scam of the private health insurance industry.
A well run general medical office practice can be profitable enough, especially if over heads can be kept low through expense sharing.
I could barely manage solo, but with 10 docs sharing expenses in a low COL area, I make enough money seeing 100 patients a week.
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What they're really doing is raising taxes so they can pay for their pet projects, just like they did in the '80's when they doubled the self-employment tax and raised the payroll tax (and it was quite significant, too - I can't believe the so-called "conservatives" at the time fell for such a scam.)
