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Keep in mind, I've worked in the industry for a long time. Private, state, federal level. From claims to contracting, regulation to transactions, benefit configuration, finance, trend, and data analysis.
Whenever I hear the term, my first question does one mean single payer or coverage for all.
Maybe I can be convinced but how do those that advocate it systematically see it set up? Who administers it? Provider rates? Who sets coverage guidelines?
I could post a long list but either we'll get there or not. I just want to hear how it well 'work'.
Thanks
It will work as well as all other government run agencies, and that is poorly.
We have government run health care in the form of the VA, and it is terrible. Why someone thinks that is a good idea is beyond me
Va is an animal in and of itself. But I'm going to be fair with responders because healthcare delivery is an extremely complex beast that takes into account so much more than:
Members
Employers
Traditional Medicare
Medicare advantage
50 different medicaids
Mco's
Aco's
Private plans including Hmo, ppo, npos, aso
This doesn't include all the various parts of those, nor the coding, regulation, transactions, tpa's, coo's, etc...
It will work as well as all other government run agencies, and that is poorly.
We have government run health care in the form of the VA, and it is terrible. Why someone thinks that is a good idea is beyond me
Says the person who is enjoying the internet and the computer, both inventions a result of government research and funding. Its also intersting that veterans heavily support the VA according to polls, and the seniors heavily support Medicare, social security and other programs that improve the lives of tens of millions of Americans.
The current health care system in America is by far the most expensive in the world, a whooping 18% of GDP, compared to the more cost effective 9-12% in other countries (America is the only country with a privatized system which doesnt guarantee health care to its people).
Is the OP afraid of losing his job if we move towards a national health care system? Any big change means employment disruptions of course, but they will get help in order to find more productive work. And the private health insurance system is a HUGE layer of extra cost and inefficiency that other countries dont have.
Says the person who is enjoying the internet and the computer, both inventions a result of government research and funding. Its also intersting that veterans heavily support the VA according to polls, and the seniors heavily support Medicare, social security and other programs that improve the lives of tens of millions of Americans.
The current health care system in America is by far the most expensive in the world, a whooping 18% of GDP, compared to the more cost effective 9-12% in other countries (America is the only country with a privatized system which doesnt guarantee health care to its people).
Will you please share how it will work? I understand the industry very well but have no clue how uhc is being envisioned by proponents. I'm trying to learn how advocates see it being administered.
Is the OP afraid of losing his job if we move towards a national health care system? Any big change means employment disruptions of course, but they will get help in order to find more productive work. And the private health insurance system is a HUGE layer of extra cost and inefficiency that other countries dont have.
I'm a w2 contractor now. I'm not worried about that. I work for myself and get contracts on a broad range, mostly p&p and federal regulation adherence.
I just want to know how it works.
Ex: who sets the premium? Is their employer contribution that is a mandatory set rate? Where does that premium rate get sent to? Who maintains the IT?
I have what would be termed "single payer" insurance. I (and my employer) make a payment every month whether services are used or not, and then I make fairly low co-pays for services. The insurance has its own medical offices and hospitals and there's no outside services. Here's what I've found:
1. They make more money by not providing services. Requests for appointments are routinely challenged, telephone appointments with a physician's assistant are the new "doctor's appointments." Routine tests that used to be commonplace (urinalysis for a UTI, for example) are no longer "needed."
2. They magically have a perfect success rating. Other hospitals receive their ratings on errors, etc. from the insurance companies that pay the bills. Since they own everything, they provide their own statistics. According to the last statewide survey, they pretty much make no errors at all.
3. Their main concern is the stats--average patient BMI (reported to government under ACA), vaccination rates, instead of diagnosing problems. "I don't know" is now a perfectly acceptable diagnosis.
I hope the country doesn't move towards single payer as a solution. Those "layers"--doctor, insurance company, etc.--serves as a checks and balance system that I no longer have and sorely miss.
I have what would be termed "single payer" insurance. I (and my employer) make a payment every month whether services are used or not, and then I make fairly low co-pays for services. The insurance has its own medical offices and hospitals and there's no outside services. Here's what I've found:
1. They make more money by not providing services. Requests for appointments are routinely challenged, telephone appointments with a physician's assistant are the new "doctor's appointments." Routine tests that used to be commonplace (urinalysis for a UTI, for example) are no longer "needed."
2. They magically have a perfect success rating. Other hospitals receive their ratings on errors, etc. from the insurance companies that pay the bills. Since they own everything, they provide their own statistics. According to the last statewide survey, they pretty much make no errors at all.
3. Their main concern is the stats--average patient BMI (reported to government under ACA), vaccination rates, instead of diagnosing problems. "I don't know" is now a perfectly acceptable diagnosis.
I hope the country doesn't move towards single payer as a solution. Those "layers"--doctor, insurance company, etc.--serves as a checks and balance system that I no longer have and sorely miss.
Maybe I can be convinced but how do those that advocate it systematically see it set up? Who administers it? Provider rates? Who sets coverage guidelines?
I could post a long list but either we'll get there or not. I just want to hear how it well 'work'.
Thanks
You are still stuck in an insurance company mindset. Using Ontario as an example: single payer means that health care providers bill the government. There are no insurance companies setting "provider rate'"or coverage guidelines. Patients come in, swipe their health care card, and the doctors bill a "singe payer" - the government. No need for 1/2 the office dedicated to billing. The government sets rates for different procedures and services - with no coverage limits, deductibles or co-pays. Taxpayers fund the program and everyone, working or not, is covered.
Insurance companies still exist but mainly manage employer health plans that provide extras over covered care - private rooms, drug coverage, dental insurance, fertility treatments, ...
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