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Price transparency is a whole other problem, and you will find no argument from me there. One reason Medicare works is due to central price controls. And price almost doesn't matter to most Medicare beneficiaries.
Medicare doesn't really work in the economic sense. Among a host of other issues medicare reimburses hospitals around 84% of actual per patient costs. IOW medicare does not function without cost shifting.
Medicare doesn't really work in the economic sense. Among a host of other issues medicare reimburses hospitals around 84% of actual per patient costs. IOW medicare does not function without cost shifting.
Where does the 84% come from? 84% of the actual costs to care for hospital inpatients? And how are those numbers derived? And what about other sources of review and income for the hospital? Your number may be correct for all I know. But...
Medicare works for the people/patients. And Medicare works for the hospitals. No typical hospital could survive without it. Who ends up losing? Or better yet, who pays 'more than they should' to the hospital?
Where does the 84% come from? 84% of the actual costs to care for hospital inpatients? And how are those numbers derived? And what about other sources of review and income for the hospital? Your number may be correct for all I know. But...
Medicare works for the people/patients. And Medicare works for the hospitals. No typical hospital could survive without it. Who ends up losing? Or better yet, who pays 'more than they should' to the hospital?
Well, the fact that every other country provides their healthcare covering everyone for a per-capita cost of roughly half what your country does would seem to bolster your point about your country and it's singular insurance model.
BUT, were they to adopt a similar model to others, whereupon all the government does is re-imburse private suppliers and allowed to bargain costing models for pharma and services to keep costs down, remove all of the tedious bureaucratic nonsense and duplication, you would ALL have full coverage and at half what ALL of you are paying, regardless if you're insured or not.
You do know that once your tax dollars are collected, you're in the pool whether you're swimming or not, and you are paying for all of those who are not paying anything at all, along with the various parasites of cubicle denizens providing nothing but having their input within your existing system.
Nope. We spend more on healthcare because we have a population that is fat, overmedicated and generally does a terrible job taking care of themselves.
Also, we're talking about the U.S. Government here. The United States is NOT "every other country". Costs would triple. Quality of care would fall off a cliff. Simple as that. ALL attempts at any kind of Single-Payer system at the state level failed miserably. There is ZERO reason to believe that it will be any different at the federal level.
Also did you miss the part where I ran the numbers and found that UKNHS would cost me TWICE what my current health plan costs?
Lastly, I do not trust the US Government not to be corrupt and wield healthcare as a weapon against whomever the crony in chief doesn't like. Until that is fixed, Hard Pass on any single payer option.
Last edited by albert648; 04-12-2022 at 05:59 PM..
Those on the long end of subsidies always believe the subsidies work/are needed/are good.
I can't see how the majority of hospitals shorted by medicare would be anything but better off without those patients.
Everyone else pays more.
Ultimately, Medicare will also pay more. There's no way patients aren't being upsold on unnecessary tests/procedures/care etc or "list prices" aren't being raised to inflate "what they spent".
There's no such thing as a free lunch. The consumer bears the full cost of the products and services consumed, one way or another.
The last is not all true. For instance Medicare is about 1/3 funded by the beneficiary, about 1/3 through the federal gov't, and the rest essentially blue sky. That being a combination of central price controls, and new debt. Of course you are free to call new debt other people's money. But if it's Fed money and never paid back like much of our national debt, it is functionally blue sky until eternity.
So 2/3 of the cost is made up with other people's money.
That proves my point exactly.
NOTHING will address the cost of healthcare until we address the cost of healthcare. No amount of middlemen will change this. And once the cost of care is addressed and people can afford to pay OOP to see a doctor, the cost of insurance will naturally take care of itself.
Those on the long end of subsidies always believe the subsidies work/are needed/are good.
I can't see how the majority of hospitals shorted by medicare would be anything but better off without those patients.
Everyone else pays more.
The hospitals are not only 'shorted' by Medicare. Also Medicaid. With Medicaid we found out that a lot of low payments is better than no payments. Obamacare plans too. And those are private payers who negotiated lower payments.
For instance my wife on Obamacare had over $5M in medical and surgical billings since 1/1/17. And all told her insurance paid about 1/3 of the billings with the providers' acceptance.
Thing is most hospitals make money. And most likely where they make it up with Medicare and Medicaid is through their outpatient departments. I can tell you that my hospital sees a lot of Medicare since we are a retirement community. And significant Medicaid since ours in of the poorest counties in the USA. But we still make good money. So someone I guess is being squeezed. I just don't know who, because they didn't seem to be my patients or my acquaintances. You might be able to tell me. No doubt my hospital CFO could.
Ultimately, Medicare will also pay more. There's no way patients aren't being upsold on unnecessary tests/procedures/care etc or "list prices" aren't being raised to inflate "what they spent".
There's no such thing as a free lunch. The consumer bears the full cost of the products and services consumed, one way or another.
Ultimately everyone will pay more. That is the nature of first world HC. More seniors, more technology, longer lives, better QOL, seniors using so much more technology. But 'upsold' makes little sense. Local docs and hospitalists don't make more money doing unnecessary testing. Hospitals would love it of course in the outpatient dept., and they would love to avoid it with inpatients. But hospitals provide, not order.
So 2/3 of the cost is made up with other people's money.
That proves my point exactly.
NOTHING will address the cost of healthcare until we address the cost of healthcare. No amount of middlemen will change this. And once the cost of care is addressed and people can afford to pay OOP to see a doctor, the cost of insurance will naturally take care of itself.
No, 1/3.
Most hospitals and doctors make good money. Take away the 1/3, and many won't.
Most people can pay OOP to see a doc. That is not where the big money lies. It is what the doc orders that is expensive. Testing, treatments, scans, x-rays and drugs. Hospitalization is where the big money lies.
Most hospitals and doctors make good money. Take away the 1/3, and many won't.
Most people can pay OOP to see a doc. That is not where the big money lies. It is what the doc orders that is expensive. Testing, treatments, scans, x-rays and drugs. Hospitalization is where the big money lies.
No, it's 2/3.
You said 1/3 comes from beneficiaries, 1/3 comes from FedGov (I assume you mean outside the Medicare Trust Fund), and the final third from thin air.
The way insurance works is that typically money is pooled into a trust fund, and losses are reimbursed out of that trust fund+incoming premiums.
If incoming premiums+trust fund comprises only a third of the Medicare spend, 2/3 is coming from somewhere else - in other words, other people's money.
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