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Women receiving public assistance, as a group, have a birth rate 3 times higher than women who don't receive public assistance. That, in itself has led to the additional problem of nearly half of all U.S. births being paid for by Medicaid. 70% of those kids will never rise out of poverty, even as adults.
How is supporting all those additional poor people (Medicaid, SNAP, public housing, etc., etc.) that are added to our population every year sustainable, or even possible at all?
Let me guess... your answer is "print more money to infinity."
We fund HC, not silk stockings. We will need more money in 10 years than we have today. Infinity is a straw man. Not needed. We remain productive, we grow, we will need more money. The world will need more of our money.
"Cathcart grinned. "He got the cash money the same way we
have gotten all cash money since Roosevelt put the gold back in
the ground-right off the printing presses. But he didn't have to
print much of it. The checks were issued at the Bank and the
merchant and a great many others had accounts at the Bank and
very little cash money changed hands. The bulk of it was mere
bookkeeping entries, made by the bank clerks. Holmes had
implemented what the bankers had known for centuries but
were barred by LaGuardia from doing-taking money out of an
inkwell. What's the matter, son? Still not satisfied?"
"Well, I don't know. Everything you have said seems okay,
but how about this? If you keep pouring money into a country
indefinitely, you are bound to get inflation, fixed prices or no
fixed prices."
"You don't pour it in. You add just enough to keep it running.
Each fiscal period the additional amount is the closest possible
approximation of the amount necessary to prevent a spread
between consumption and production, based on the value of the
nation's inventories."
"But why do you have to keep adding money all the time?"
"I said I would stay away from theory but I'll give you this
hint to chew over: the amount necessary to add each period is
theoretically equal to the amount of savings invested as capital in
the preceding period. And one more hint: Doesn't it take more
money to run the country's industry now than it did when
George Washington was President?"
Robert A. Heinlein 'For Us,The Living'.
Written in 1934, but not published until 2001.
I don't disagree with the above, and it proves my point. Private Health Insurance loves to insure healthy people. So whatever they do to keep people healthy is a WIN for them.
However, Medicare has to take care of ALL elderly and disabled people. There are no healthy people on the pool and healthy people make money for the plans. You have said at nauseam that the issue is UTILIZATION. Guess what? Healthy people do not use the plan that much.
Regarding Tricare: It is a health plan only available to retired military, but guess what. The soldiers did not pay into it when they were on active duty. This is simply a government health insurance plan that is WAY CHEAPER than the private plans and IT WORKS! Doctors accept the plan, no issues there, It is so good that over 65 retired military keep Tricare rather than using Medicare.
Wrong about Tricare (8 years Air Force).
Epsdt is the advancement of early treatment and diagnosis of KIDS! Employer group insurance provides outreach, education, ambulatory assistance, free dme equipment, especially for the really sick.
I won't speak for other payors and their programs, but providing on site care at worksites is not for 'healthy' ... It's to get those injured 'onsite' care as quickly as possible vs waiting for an ambulance, then transport, then.,. Etc...
Also, vaccinations onsite... That's preventative, trying to help people stay healthy (although I personally disagree with many vaccination programs).
Are their one off cases where administrative issues, usually incompetence, look like denials or access to care prevent or hinder payment of treatment? You bet. Are there literally thousands of people contacted daily by outreach nurses at payors, calling members leaving the ER, or an impatient stay, asking what assistance is needed, do they need home care or assistance with transport for follow up care, or delivery of prescriptions? Yep.
No company is going to be a saint, and their are always admin foul ups. But to place all blame on for profit companies, as is being indicated, and not even understanding many denials are from poorly trained billers by the provider (where seminars are given by payors to teach cci because it costs them to adjudicate the claim however many times its billed... And not saying all providers or anything like that. There's enough issues with provider payor relations for either side to point fingers), or providers using outdated technology (tge payor I worked for created, hell I created, free portals for providers/members to submit claims, get remits, etc.. As a self serve tool where they could bypass a third party, putting all transactional cost on the plan), etc...
Not to pick on you but you mentioned Apple before as wealth creators... For themselves! A closed source, completely proprietary set of devices solely created, and then using courts for protection (lightening cable vs every other tablet and phone using the micro-usb...)solely to maximize their profits!
It would seem that one should also have as much mistrust for Google, Facebook, etc... Why? How can companies like that offer everything for free? Just by the 'advertising' on the website? Hell no, they sell users privacy! Both to private data miners and the cia, Fbi, state and local. Yet nary a peep.
Insurance company does that, or provider, you got 4 layers of hipaa fines!
This is a good point. The well to do reproduce far less than the poor and that will have catastrophic consequences. But, the educated class thinks they are helping the planet by going childless.
I will give you credit with your diligence. Hopefully you verify those who take an opposite position and learn more along the wAy.
Although I don't agree with many of the theories on this thread about government in HC helping in any way (due to years working with them), I'm also not trying to persuade or convince.
The more people know how systems work, the better off people are.
This is a good point. The well to do reproduce far less than the poor and that will have catastrophic consequences.
Yes, it will. It's inevitable and unavoidable if we continue our present course.
Quote:
But, the educated class thinks they are helping the planet by going childless.
There's more to it than that, though. Look at the behavior the government is incentivizing by providing more and better (larger Section 8 housing, etc.) freebies to the poor for having more and more kids.
Many here defend the 3-4% profit margin of the BIG three private insurance companies, but that amounts to billions and billions of dollars for just doing paperwork.
It's more than just doing paperwork.
They keep the system solvent.
"In the past 20 years, our overriding philosophy has been that the health system cannot spend more than its income.
Virtual budgets are also set up at the regional levels; these ensure that all participants in the system—including the health insurance funds and providers— know from the beginning of the year onward how much money can be spent." -- Franz Knieps German Minister of Health (2009)
Source: How Germany is reining in health care costs: An interview with Franz Knieps
With a pay-as-you-go system like you want, if you collect $250 Billion in taxes in one month, then that's all you can spend, unless you go into debt.
Yes, it will. It's inevitable and unavoidable if we continue our present course.
There's more to it than that, though. Look at the behavior the government is incentivizing by providing more and better (larger Section 8 housing, etc.) freebies to the poor for having more and more kids.
As... Well my current situation is its own and I receive no public help. However, those comments are, or come across as,, very negative and judgement all.
As... Well my current situation is its own and I receive no public help. However, those comments are, or come across as,, very negative and judgement all.
No judgment intended. It's just a matter of fact. To put it in abstract terms... giving more of something to someone who does more of something else creates an incentive to do more of that something else.
No judgment intended. It's just a matter of fact. To put it in abstract terms... giving more of something to someone who does more of something else creates an incentive to do more of that something else.
I know how intended. I personally don't take offense at anything. Not that I'm some zen master, just seen too much to be concerned of others opinions or personal beliefs.
But matter of fact statements, and I can do a bunch about some of the theories postulated on this and other threads, especially when correct, often don't lead to 'education', but instead resentment.
Ex: any economic theory that indicates digitizing money is fiscally responsible is incorrect in every instance tried.
Now everyone will weigh in with a bunch of bs, based of their politico-economic theory, probably with the retread links, much keynsian based... But tge old saying money doesn't grow on trees, except at the fed, is still correct. Lol. They may make it grow on trees but it is very fiscally irresponsible.
I don't disagree with the above, and it proves my point. Private Health Insurance loves to insure healthy people. So whatever they do to keep people healthy is a WIN for them.
However, Medicare has to take care of ALL elderly and disabled people. There are no healthy people on the pool and healthy people make money for the plans. You have said at nauseam that the issue is UTILIZATION. Guess what? Healthy people do not use the plan that much.
Regarding Tricare: It is a health plan only available to retired military, but guess what? The soldiers did not pay into it when they were on active duty. This is simply a government health insurance plan that is WAY CHEAPER than the private plans and IT WORKS! Doctors accept the plan, no issues there, It is so good that over 65 retired military keep Tricare rather than using Medicare.
1. I employ four nurses, two nurse practioners, two receptionists and a biller coder
2 I have $1 million in overhead per year
3. If I only had medicare patients, I would generate $400K per year and would lose $600K per year with ZERO income.
4. Medicare "managed care" takes regular medicare and makes it worse by restricting payment and access
5. Drug companies and equipment makers could not survive if reimbursed for medicare rates (contacted)
Quote:
Originally Posted by Julian658
As a practice manager you blow the horn for private health quite well.
Your numbers make no SENSE.
How do those numbers not make sense?
Overhead includes employee salaries, employer contributions to FICA, rent, utilities, taxes, accountants, etc.,
Average salary of an RN (I think Hawk is in TX, if not - using TX anyway) is $60K.
$60K x 4= $240,000K
Average salary of a Nurse Practitioner is $107K.
$107K x 2 = $214,000K.
Average salary of a receptionist is around $30K.
$30K x 2 = $60,000K.
Biller/coder?
$34K
Employee salary overhead alone is $548K per year.
Now add in employer payroll tax contributions....and possible employer contributions to employee 401K/retirement plans, the employer side contributions to employee HC plans.
Don't forget you still have to pay for malpractice insurance, supplies, make any leased equipment payments, cleaning company bills, office rent, utilities, phone bills, cable bills, magazine subscription bills (never saw a doc's office without em), and taxes.
These "things" add up.
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