Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
You are confusing Medicare with *Medicaid* and SSDI
The first is an entitlement program; unless you (or spouse) have paid into and otherwise qualify you don't get benefits. Medicaid and SSDI are essentially welfare programs paid for out of general tax revenue and in the case of the former shared costs with states.
Medicare actually is one of the most efficient "health insurance" plans in the USA. Yes, there is fraud, waste and abuse but it does the job intended better and for less cost than private.
Where you would see any fight in expanding Medicare would likely come from physicians and hospitals who are already moaning over the low reimbursement rates for providing care to seniors. Ask them to expand that "loss" to younger patients and there likely will be all out war.
I don't have a problem with paying cash to the people that ACTUALLY take care of patients. However, private insurance provides ZERO health care. ALL they do is collect money by raising premiums to patients and reducing or denying services. This activity increases the profit margin.
I don't have a problem with paying cash to the people that ACTUALLY take care of patients. However, private insurance provides ZERO health care. ALL they do is collect money by raising premiums to patients and reducing or denying services. This activity increases the profit margin.
Denying claims and coverage, raising premiums, and lowering the payments to health care providers increases the profit margin of the private health insurance industry.
Wrong. Payors (the term) pay adjudication costs for receiving, adjudicating, and remitting the claim. Again, there is so much that the 'informed' have no knowledge of, even inside the industry... Correct coding, edi, 3 party, reinsurance, clearing houses...
Payors, one I worked for for many years, only make 'profits' off the administrative dollars (which I was a major part of). Basically, the less humans 'see' a claim, auto adjudication, the lower the cost administratively. How many doctors, lawyers, hospital cios I showed their billing practices cost them money...
In short, every claim is a 'life'. That's how payors view their members. Most view those claims as if it's their family members. Also, private payors don't set the billing and coding guidelines but have to utilize that set by the AMA (which doctors detest).
I can explain, from the time a life looks for care, to remittance, to the eft transfer to the provider... It will take about 200 pages and most will tune out by page 3 because it is easier to believe the tripe on TV or those who don't understand the business of healthcare (which includes many who work for 'insurance companies' and most in the provider community).
My wife and I are older than 65 and both of us have been on Medicare for a couple years now, we love it and I would like to see it open to everyone but everyone, and I do mean everyone, would simply have to pay the same amount for their Medicare Insurance as my wife and I pay.
The cost for each of us:
Part B Premium: $104.90
Medicare plan G: $135.00
Medicare Plan D: $ 29.00
Total Each: $268.90
Monthly Total for Both of Us: $537.80
So now you know Medicare is not free, we pay for it now and we paid for it by working 50 years and paying taxes.
If you are married with two children you should be able to purchase Medicare for what we pay for it: $268.90/month for each member of the family for a total monthly premium of $1,075.60.
Don't get me wrong, I am not complaining for the cost it is the best health insurance you can purchase because it nails your cost so there isn't any surprises.
With Plan G my total annual deductible is $147.00.
With Plan G I do not have any co-pays everything is 100% covered and after I meet my co-pay, which usually happens in March, my wallet never, ever leaves my pocket for the rest of the year. Doctor, hospital or whatever it is all covered after I meet my deductible.
Plan D covers pharmacy and it generally isn't that expensive. Unless you are taking some serious meds total pharmacy shouldn't run over $200/year /person.
But here is the catch, everyone pays! I am sick and tired of having worked my entire life, my first W-2 was 1966, and there are to many out there that feel entitled to something for free that I paid for my entire life.
Agreed: look at your utilization (your use). A ma plan may help reduce that based on your zip code, it may not. My parents live in Florida and for the last 10 years, that's been my side job (free of course): count your out of pocket (premium, deductive, and your 20% co insurance) and then measure that against your pool of local MAs... Specifically looking at the scripts and member responsibility.
Medicare is not "insurance." It is a "pay-as-you-go" plan.
Completely false. There are premiums to part B (part A Premium us automatically Taken from SS payments). The 'pay as you go' is the 20% co insurance for services rendered, parts a and b. Politicians say that but it is not factual.
Not sure I am following the logic of any perceived cost savings by allowing the "young and healthy" to be covered by Medicare. Medicare is financed through a 2.9% payroll tax, 1.45% split between employers and employees. So your average person works their entire adult life to age 65, pays in over than period, then is covered (not counting the many other additional out of pocket costs for supplements, etc.) Young, healthy persons being enrolled would not do anything to bring downs costs, in fact, it would have the opposite effect, and would dramatically escalate costs. You would have the young/healthy folks using a system they have not paid into over a 45 year period.
Not sure I am following the logic of any perceived cost savings by allowing the "young and healthy" to be covered by Medicare. Medicare is financed through a 2.9% payroll tax, 1.45% split between employers and employees. So your average person works their entire adult life to age 65, pays in over than period, then is covered (not counting the many other additional out of pocket costs for supplements, etc.) Young, healthy persons being enrolled would not do anything to bring downs costs, in fact, it would have the opposite effect, and would dramatically escalate costs. You would have the young/healthy folks using a system they have not paid into over a 45 year period.
The 'thought' people are trying to say is that, by allowing those under 65 to 'buy' into traditional Medicare, increasing the 'pool' but submitting less claims 'healthier population'... Then the influx of dollars will be greater then the outflow.
They aren't taking into account what you stated: Medicare is already funded by fica and all w2 and 1099's contribute. So a person 'buying' into Medicare is... They already technically do. Lol
I actually think Medicare could make money by insuring young healthy people. Why not?
Medicare reimbursement rates would bankrupt MANY hospitals and physician practices in the US. For my specialty, Medicare pays 1/4th to 1/5th of regular insurance. We are able to see medicare patients as the loss we have on them is offset by private insurance patients.
When one talks about physician and facility reimbursement, everyone forgets about OVERHEAD. If rates are cut dramatically, we still have fixed overhead costs (staff, lease, equipement, disposeables) that must be paid.
Bankrupting MANY practices in the US does little to alleviate the current physician shortage. How could "single payer" work? If physicians were put on salaries. However, then you have a situation like the VA, in which salaried physicians see about 1/4 the number of patients that private practice physicians see in one day.
That is the problem with socialism.......................................
Many people who have Medicare are disappointed in it. It is not great insurance. I know, I have it.
Curious. What would make it " great insurance"?
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
