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We do have, with our regressive tax system, unlimited government borrowing, militaristic spending and other policies, a socialist economy designed to provide for the corporations and thier executives and owners.
We have a wonderful system of socialism for the rich and a brutal market for the rest. This is justified by the thought that the rich are 'winners' and deserve everything while the rest of us are 'loosers' and deserve nothing.
I have stated my solution (the publishable solution anyway) for this situation and it does frighten some of the 'winners'.
Three years is fairly long term. And, the physicans practice is stronger than ever.
What can I say -
If you think three years is long term.. hey more power to you.
It isn't a long term strategy. Its a means by which to drive up the value of their practice in the short run to eventually sell the practice for the highest price at a later date. That hinges completely on the buyer being totally uninformed which 5 years ago might have been the case. I can tell you.. it isn't the case now. There is not a single hospital that has been successful in not accepting Medicare. Not one.. and they would LOVE to not accept Medicare becasue it means they wouldn't have to have a costly ER. There may be some physician groups that can walk the tightrope but they too will more than likely collapse.
If you think three years is long term.. hey more power to you.
It isn't a long term strategy. Its a means by which to drive up the value of their practice in the short run to eventually sell the practice for the highest price at a later date. That hinges completely on the buyer being totally uninformed which 5 years ago might have been the case. I can tell you.. it isn't the case now. There is not a single hospital that has been successful in not accepting Medicare. Not one.. and they would LOVE to not accept Medicare becasue it means they wouldn't have to have a costly ER. There may be some physician groups that can walk the tightrope but they too will more than likely collapse.
I have another suggestion for fixing the health care system. Get the private insurance companies with their excessive executive salaries and profits, entirely out of the system. Provide for universal health care payments with a progressive tax on all income from all sources. Administer the new system with a few clerks and a large computer. Over all costs are lowered and health care providers are paid more and most users pay much less.
I didn't say you were talking about hospitals. I was simply providing another example. Which is why I said..
"There may be some physician groups that can walk the tightrope but they too will more than likely collapse."
Maybe since they are FPs they might make it because they don't have a large number of high dollar services.
I can tell you this.. whatever hospital they are sending patients to for inpatient care.. doesn't like those physicians.. at all.
Once again - I'm not talking about a hospital
I can tell you that both of the family practice physicans have very flourishing practices. Each of the practices has 3 physicans in each practice - and again, they do not accept Medicare.
The practices were able to grow substantially after cancelling Medicare.
As an aside: Some of their patients, who are on Medicare, have remained patients - and pay the office visit out of pocket.
One way to fix healthcare is to outsource it (which is already happening).
If you could fly to Mexico, have a procedure performed (lasik to ortho to cardio) by a JHACO approved facility, have a week stay in a hotel for recovery and get the same level of care for half the cost of having the same procedure done in some community hospital in states..
why wouldn't you?
get ready for it.. its just simmering now.. no real movement as of yet.. but it will happen on a grander schale in the years to come. Insurance companies will fawn over it..
I have previously posted ideas that I submitted to members of congress - and which after said submission I was asked, by Members of Congress, to serve on a citizens advisory group - to help develop suggestions for changes, to be submitted to Congress, by January 2009.
Some of the suggestions I have proffered are:
1) Allow health insurance to be sold across state lines
I don't understand how this would make a significnt difference, but if you know otherwise then that's great.
2) Remove pre-existing conditions as an exclusion - allow insurance companies to charge a surcharge of a maximum of 10% of the premium for these conditions.
Agree with the first part whole heartedly- don't agree with an additional premium.
3) Allow membership groups to form their own pool of potential insureds - much like a business can now do - currently these professional organizations, often made up of 100's of 1000's of members can't pool. This would create tremendous competition for business by the insurance companies - thereby lowering premiums
Again, if you think this would actually work, then fine.
4) Means testing: If someone is below a certain income level, and depending upon family size, a grant would be given to that person to allow that person to purchase private health insurance from the carrier of their choice. Government would not be involved in the delivery system thereby reducing the need to increase the size of government agencies.
Good.
5) Tort reform - put a cap on punitive damage awards in malpratice cases - this would reduce malpractice insurance premiums.
YES - I agree this could be enormously important in bringing down premiums in the long term.
6) Allow for 100% deductibility of all health insurance premiums and health related expenses including co-pays
Absolutely. This would also be an enormous help. I think someone else mentioned this too. It would certainly make it a little more palatable for the middle classes. Not sure if it would help the poor much, but better than nothing for sure.
I don't believe your answers cover everything by a long shot, but would be a definite improvement over what exists now. See we can reach common ground if we try! I definitely think that it is sensible to look for some 'American' solutions to the uniquely American problems. I am not sure that the USA is ready for a European style UHC YET - although I do believe that should be the ultimate goal. Right now any steps in the right direction are better than none, and your steps seem sensible to me.
I can tell you that both of the family practice physicans have very flourishing practices. Each of the practices has 3 physicans in each practice - and again, they do not accept Medicare.
The practices were able to grow substantially after cancelling Medicare.
As an aside: Some of their patients, who are on Medicare, have remained patients - and pay the office visit out of pocket.
Are you blind? Seriously? I just explained why I mentioned hospitals. It was simply to provide another example. I then went back and stated that "There may be some physician groups that can walk the tightrope but they too will more than likely collapse." so you wouldn't think I was just talking about hospitals.
Furthermore.. whether you want to talk about hospitals or not if you don't think hospitals look at the payor mix of the referring physicians and determine that "hey look.. this physician group continues to send nothing but SELF PAY patients".. that hospital won't think about removing their admitting privledges?
Then when that happens.. those same docs.. will just admit through the ER and thus the hospital will eat the bad debt.. which then.. well guess what.. its gonna get passed on to you in the form of increased managed care rates..
So your friends "successful" practice.. makes you pay more. Be sure to thank them next time you see em..
Absolutely. This would also be an enormous help. I think someone else mentioned this too. It would certainly make it a little more palatable for the middle classes. Not sure if it would help the poor much, but better than nothing for sure.
The state lines issue: As it stands right now, each state regulates insurance rates. Hence why someone in, say New York with XYZ company pays $800 @ month, moves to say Idaho and XYZ charges $500 a month. It is based on the risk pool in each state -
Allowing XYZ's "pool" to be nationwide - spreads out the risk. By spreading out the risk, premiums come down. It also allows XYZ company to consolidate their operations for reimbursements etc. As it stands now, XYZ would have to have an office in all 50 states (assuming they are in all 50 states - not all insurance companies are).
The insurance companies are the first ones to tell you that premiums would come down.
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