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What do you mean by that? I talk with hospital admins all the time as well, know their revenues and what would happen if everything went to medicare rates- they would go broke.
I am not sure where you are getting your information, but it is quite flawed.
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I really think that you are very enamored with a single payer system (I would actually support one as well), but you have quite a bit of false information that leads you to believe that everything would go on as usual in the US under that system.
The US leads the world (always has) in medical innovations and patents. To say Germany is the leader is just blatantly false.
1. If "medicare for all" was initiated, drug innovations would decline. I am afraid that is simple economics- most of the brunt of the cost of new drugs are shouldered by US citizens. If that was no longer available, the pharmaceutical industry would not spend itself into bankruptcy- it would cut back on innovation and crank out low cost generics and markedly limit their research.
Only about 2% of drugs discovered in the pharma industry make it to market. Why in the world would a company go bankrupt for your pleasure?
You can't have things both ways- innovation and research costs money.
2. Again, if medicare rates stayed the same, hospitals and physician practices would go belly up - that is a fact.
For example, I used to have a practice that was 75% commercial payers and 25% medicare. I made $1.3 million per year.
Now, I have a practice that is 80% medicare/Medicaid and 20% commercial. I am currently paid $250K- even with that lower pay, I have to be subsidized (with the same number of patients and procedures per day) to the tune of $20K per month.
If I was to survive, as you want, with medicare only rates, I would have to get paid $0 per year and then barely be able to make overhead.
3. Other nations do not bankrupt their healthcare system with payment rates that would be well below cost. Other nations do not pay "medicare rates" as they have no idea what medicare is!
In the US, if "medicare rates" were applied to EVERYONE, we would no longer have a healthcare system. Payments to hospitals and physicians would have to be increased to maintain solvency.
Is this so hard for you to understand? What group of people works for free?
I really think that you are very enamored with a single payer system (I would actually support one as well), but you have quite a bit of false information that leads you to believe that everything would go on as usual in the US under that system.
This always happens. I never said I never argued and I never believed that things would go on as usual. It can't.
I argued that the idea that doctors would have to work for minimum wage is crap and I argued that the idea that large numbers of doctors and hospitals would go out of business is crap.
I was watching CNN and its clear the MSM have been given orders to try to take down Bernie Sanders for the sake of the chosen candidate. But they have run into road blocks of their own making and I don't think they'll be able to succeed.
One, even if they try to do a 180 and attack Bernie, they can't do it openly. They'll alienate their base and cool off interest in the election entirely. And they risk confusing their viewers big time. So they'll have to do it half heartedly and push the chosen candidate and let's face it, progressives don't do subtlety well and don't pick up on it either. And if they start making Bernie look crazy and stupid, well, progressives eat, drink and sleep crazy. They are all in for crazy and stupid.
And Bernie's the least crazy and stupid out there. So they can't single him out and ignore the other candidates. Even Progressives would wonder about what's going on. If they get the idea that they are being told who to vote for and their votes don't matter, they'll lose the idealists. They do vote lock step and think as told to, but they still have to be conned into thinking its what THEY want to do.
So the question is, will Bernie not back down this time and actually go for it, or will he take a dive( and a big payoff) like he did with Hillary? And Joe Biden has the same question put to him.
The knives are out and nobody does infighting backstabbing and intrigue like the DNC.
I really think that you are very enamored with a single payer system (I would actually support one as well), but you have quite a bit of false information that leads you to believe that everything would go on as usual in the US under that system.
The US leads the world (always has) in medical innovations and patents. To say Germany is the leader is just blatantly false.
1. If "medicare for all" was initiated, drug innovations would decline. I am afraid that is simple economics- most of the brunt of the cost of new drugs are shouldered by US citizens. If that was no longer available, the pharmaceutical industry would not spend itself into bankruptcy- it would cut back on innovation and crank out low cost generics and markedly limit their research.
Only about 2% of drugs discovered in the pharma industry make it to market. Why in the world would a company go bankrupt for your pleasure?
You can't have things both ways- innovation and research costs money.
2. Again, if medicare rates stayed the same, hospitals and physician practices would go belly up - that is a fact.
For example, I used to have a practice that was 75% commercial payers and 25% medicare. I made $1.3 million per year.
Now, I have a practice that is 80% medicare/Medicaid and 20% commercial. I am currently paid $250K- even with that lower pay, I have to be subsidized (with the same number of patients and procedures per day) to the tune of $20K per month.
If I was to survive, as you want, with medicare only rates, I would have to get paid $0 per year and then barely be able to make overhead.
3. Other nations do not bankrupt their healthcare system with payment rates that would be well below cost. Other nations do not pay "medicare rates" as they have no idea what medicare is!
In the US, if "medicare rates" were applied to EVERYONE, we would no longer have a healthcare system. Payments to hospitals and physicians would have to be increased to maintain solvency.
Is this so hard for you to understand? What group of people works for free?
Them is the facts of "medicare for all".
1. Lol. Big Pharma spends more on marketing than R&D. In US, most of the difficult part is done at the universities under NIH (taxpayer) funding. Roche, I think spends more, and they are a Swiss company.
2. No.
3. Lol. Payment rates below the cost? Who determines the cost, you? Or "free market"? Sorry, does not work for healthcare.
And 4. Don't like medicare for all, or variety? Ok, the ONLY working, completely insurance based model is the Swiss, and the way you do it, is regulation: premiums, hospitals, etc. This way that 48k allergy test, just does not happen in Switzerland, but it does happen in US.
Considering their low-to-nonexistent debt, it sounds like NHS doctors are far better compensated than American doctors.
Most of my college friends went into medicine. The only ones who could afford to be family practitioners versus higher-paid specialties were people whose families could afford to pay for most of their educations.
You usually go straight from school in to medical school in the UK (although you need very good A level results in Science), and medicl school is generally 5 years yo graduation, after which you start getting paid at Junior doctor rates and do two years paid foundation and then spend many years as a registrar and qualifying in your area of choice.
In the US you have to do a pre-med degree first.
In the UK you can get a Bachelor of Medicine and Surgery degree, however you can also do a degree in other sciences whilst studying medicine and hospital consultants often go on to study Phd's and MD's related to their specialist area.
1. Lol. Big Pharma spends more on marketing than R&D. In US, most of the difficult part is done at the universities under NIH (taxpayer) funding. Roche, I think spends more, and they are a Swiss company.
2. No.
3. Lol. Payment rates below the cost? Who determines the cost, you? Or "free market"? Sorry, does not work for healthcare.
And 4. Don't like medicare for all, or variety? Ok, the ONLY working, completely insurance based model is the Swiss, and the way you do it, is regulation: premiums, hospitals, etc. This way that 48k allergy test, just does not happen in Switzerland, but it does happen in US.
Well...................... having been in practice for 30 years, I think I have a little more direct experience with overhead costs and payments of insurers.
The cost of healthcare IS determined by the market. The overhead costs include rent, supplies, infrastructure, and staff. Those costs do not go away with any system- universal or not. I think that those who pine for a single payer system do not understand that you still need to pay for office rent, equipment, and staff, which all costs money.
Single payer COULD WORK, however, if politicians create it, it probably will not. Medicare rates universally across the nation would cripple the healthcare system, as you would have massive closure of offices and hospitals.
It is really quite simple economics- I wonder why you libs refuse to understand that issue. You should go take a field trip to your local hospital (that is not subsidized by the state or county to remain solvent) and ask them what medicare rates would do their bottom line.
Medicare rates for all would mean healthcare for no one, as the system would collapse. In a single payer system, like others around the world, reimbursement rates would have to be set so that hospitals and practices remain solvent.
How does bankrupting half the healthcare system help anyone?
This always happens. I never said I never argued and I never believed that things would go on as usual. It can't.
I argued that the idea that doctors would have to work for minimum wage is crap and I argued that the idea that large numbers of doctors and hospitals would go out of business is crap.
I agree that physicians in the UK, Canada and Europe do not work for "minimum wage". I never suggested that.
I had paid off my student loans decades ago, so I do not need to make much. As such, I am currently working in a practice that pays me 1/5th what I was making two years ago. Why? It is easier and easier on my health- money is not everything. It is an underserved area in which the patients are appreciative and have a need for quality healthcare.
However, having managed my practice in the past for 30 years and been on the board of a large multi-specialty practice, I know the economics of private practice medicine pretty well.
Medicare rates are quite low compared to commercial insurance. Hospitals and practices remain solvent by these higher commercial payer rates. If Medicare rates were instituted for everyone , it is an absolute certainty that there would be a huge number of hospitals and practices that would go bankrupt. It is a simple issue of revenue not covering costs.
Why is this concept hard for people to understand? Mayo Clinic "discriminates" against Medicare patients and puts them at the back of the line. Why? They would have gone belly up if they had allowed an open door policy for medicare patients- they simply don't reimburse enough overall to keep your doors open.
It's simple to understand:
1. Overhead rates are about 50% of revenues for most practices
2. Medicare rates are anywhere from 1/2 to 1/5th commercial insurance, depending on specialty and location
3. If EVERY patient had medicare, you can easily see that your would not be able to pay your overhead, even with ZERO salary.
4. If our revenue was 1,000 units and our overhead was 500 units and suddenly our revenue was cut to 200-500 units, then we would be under water. Understand? 200 (or 500) units - 500 units = 0 or -300units
I agree that physicians in the UK, Canada and Europe do not work for "minimum wage". I never suggested that.
It was suggested and I was stating that is what I was replying to, not that nothing would change.
Quote:
I had paid off my student loans decades ago, so I do not need to make much. As such, I am currently working in a practice that pays me 1/5th what I was making two years ago. Why? It is easier and easier on my health- money is not everything. It is an underserved area in which the patients are appreciative and have a need for quality healthcare.
However, having managed my practice in the past for 30 years and been on the board of a large multi-specialty practice, I know the economics of private practice medicine pretty well.
Medicare rates are quite low compared to commercial insurance. Hospitals and practices remain solvent by these higher commercial payer rates. If Medicare rates were instituted for everyone , it is an absolute certainty that there would be a huge number of hospitals and practices that would go bankrupt. It is a simple issue of revenue not covering costs.
Why is this concept hard for people to understand? Mayo Clinic "discriminates" against Medicare patients and puts them at the back of the line. Why? They would have gone belly up if they had allowed an open door policy for medicare patients- they simply don't reimburse enough overall to keep your doors open.
It's simple to understand:
1. Overhead rates are about 50% of revenues for most practices
2. Medicare rates are anywhere from 1/2 to 1/5th commercial insurance, depending on specialty and location
3. If EVERY patient had medicare, you can easily see that your would not be able to pay your overhead, even with ZERO salary.
4. If our revenue was 1,000 units and our overhead was 500 units and suddenly our revenue was cut to 200-500 units, then we would be under water. Understand? 200 (or 500) units - 500 units = 0 or -300units
Above you state that it could work but you don't trust politicians. That is understandable. To say it can't work and people do not understand that when it is working elsewhere is something entirely different.
It does work. It's working in many places. Are politicians one of the issues that will have to be dealt with? Absolutely.
Socialized medicine. On average doctors in the USA complete a 4 year undergraduate program, spend 4 years in medical school, and then complete 3-7 years of residency training. Do you honestly believe our best and brightest are going to waste up to 15 years of their life only to end up working for crazy Bernie. I don’t think so, they’ll probably end up choosing a more lucrative career such as a plumber. What we’ll end up having is three stooges for doctors like in Canada.
Here we are again with a recent CD member trying to create a negative image for a single payer system. Why is that?
The truth is the American medical system services only those with the money to pay for it. If you are fortunate enough to have employer paid medical insurance you are in great shape. If you can pay for your medical insurance you are just fine. For those, millions in fact, they have no employee benefits and can barely afford to provide food and shelter for their families. The medical system caters to the those who can afford to pay the skyrocketing medical costs.
Millions reach retirement age with enough assets to live comfortably, but even though they are covered by Medicare the copays start adding up and many end up in bankruptcy and some homeless.
If the current medical system is so great as touted by the OP then why is the US only ranked 37th in healthcare? There is a third world country that ranks higher than the US. The eight leading cause of death in the US is doctors. The third leading cause of death in the US is medical errors.
The OP does make a good point...that our current doctors are more interested in profit than patient care. Please understand the the medical industry makes no money off the healthy or the dead. For maximum profit it is far better for doctors to keep patients sick and in misery.
The truth is that there is no better argument for a single payer system than the current US medical system.
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