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So you're OK with Medicare claims being denied because you feel seniors abuse the system? Why would a single payer not be abused?
No, didn't say that seniors are solely responsible for Medicare abuse. It is abused so readily because it is ripe for the picking the way that it is set-up; no caps on income, no caps on visits/procedures/testing, etc. Doctors see cha-ching, cha-ching everytime a Medicare patient walks in. Don't believe me? Ask some people who work in doctor's offices, hospitals, clinics. Of course, if anyone would propose any caps on anything, you have Sarah Palin with her "death panel" talk coming to a theatre near you.
And when did I say that I am "ok" with Medicare claims being denied? Some people sure know how to put words in other people's mouths. How about if frivolous office visits are curtailed a bit and thus cutting off the weekly social visits? I believe that was the point of my post. I don't think that people going in for legitimate health concerns (whether they are young or old) should be denied. Going in for your weekly knitting social club at the doctor's office while the taxpayers are paying for it is what I'm talking about.
It would be more helpful if the monetary values were attached but I wouldn't say it's not very meaningful. It does show that Medicare denies more actions than any of the private insurance companies as a percentage of its claims and not total claims. However, I have addressed the weaknesses of jumping to conclusions as well. Read below
Your points are fair. Medicare not only covers more people, it covers more people at higher risk. Medicare treats people who are elderly and generally require more intervention and thus it makes sense they would reject more claims.
Agreed and unfortunately, many patients are justifiably ignorant about how physicians are compensated. Doctors often make no money from the tests they order. They do it in the best interest of the patient. The doctor doesn't own the imaging center or the lab that does these tests. There are fields in which the doctor profits from performing an interventional treatment. However, there are more than enough unhealthy patients that genuinely require treatment that it makes little sense why a doctor would elect to do an intevention in an otherwise healthy patient. Not only would that increase our risk of liability, it risks the patient's health. This is why I disagree with the President's analogy of doctors electing to do unnecessary procedures just to make money.
This is partly true. Yes, it's true, there are some patients that insist on seeing you often. Despite physicians telling them there is nothing wrong with them, they want to be seen. They also have a host of questions they want answered that they printed from the internet. It's easy to dismiss these patients but put yourselves in thier shoes. It's not easy being old. They have a lot of questions and issues and they want to be able to see someone they can trust when they need to. It's easy to say this now but you will be old one day and you might feel differently.
Elderly patients are also on many medications. When we make a change to a medication, we have to see how they are doing on it and thus frequent followup is necesary. I can switch a patient to a different blood pressure medication and if he or she becoming orthostatic, I need to directly visualize this and have their vitals done in my office. The majority of the elderly patients we see frequently are due to this. If I didn't followup with the patient and he or she sufferred a complication, I would be legally liable and would have failed to honor my duty as a physician to these patients.
With regards to the OP's post, it's been my experience that Medicare approves outcomes more than private insurance in general. With that said, there are many private insurance companies that are better than Medicare and many doctors try to work exclusively with these private insurers and not take Medicare at all. That's an almost impossible task which is why you will rarely see a doctor refuse to accept Medicare patietns. Also, the worst offenders are other forms of govt healh administration such as Medicaid, the VA systema and the Indian Health Clinic. Supporters of Obama's plan conveniently ignore Medicaid. For example, an allergist was telling me that Medicaid will not longer allow adults to be skin tested but will still allow children to be skin tested.
To respond to, "it's not easy being old", I say, "it's not easy being green". We are all going to get old. It would be nice to have a system that we're paying into (quite handsomely, by the way) for our generation and the next generations vs. having funds wasted on frivolous visits, tests, and procedures. Yes, I hear you about doctors being fearful of being sued by the patient or their family members if every test/procedure under the sun isn't performed for the patient, at any cost. This is a very real concern.
Thirdly, regarding "supporters of Obama's plan conveniently ignore Medicaid". I didn't know we were talking about Medicaid - that is a different animal. That is a program based on income. If we become destitute enough (or hide our assets good enough), then we can be eligible for it at any age. As far as the Medicaid system not allowing skin of adults to be tested, but allowing the skin of children being tested, I don't know about that. I don't believe everything that I hear, that's for sure. One person's opinion does not make a fact, although it would be interesting to read up on that.
As far as what doctors will accept (Medicare, Medicaid), I have no interest in that. That's THEIR problem. Doctors (and their lobbyist groups) can work that out with Medicare/Medicaid. They can work that out with them the same way that the drug companies have worked out a deal with the FDA to approve medications in a rapid manner. That's a story for another post though. My husband is a pharmacist; his company negotiates with the various insurance companies and Medicare/Medicaid. All I know is that Medicare AND social security (by the way) is one giant ponzi scheme and current generations that are paying into the system are going to be left high and dry in a decade or decade and a half unless a paradigm change occurs in our current systems.
Here's the difference, Medicare gives you an asprin and sends you home to die.
I've never seen that yet. I have seen working people with no insurance or bad insurance self-medicate themselves while still trying to go to work every day, raise their children, and generally continue to function in their everyday lives. I seriously have NO idea where you're coming up with the "Medicare gives you an aspirin and sends you home to die."
I've never seen that yet. I have seen working people with no insurance or bad insurance self-medicate themselves while still trying to go to work every day, raise their children, and generally continue to function in their everyday lives. I seriously have NO idea where you're coming up with the "Medicare gives you an aspirin and sends you home to die."
To respond to, "it's not easy being old", I say, "it's not easy being green". We are all going to get old. It would be nice to have a system that we're paying into (quite handsomely, by the way) for our generation and the next generations vs. having funds wasted on frivolous visits, tests, and procedures. Yes, I hear you about doctors being fearful of being sued by the patient or their family members if every test/procedure under the sun isn't performed for the patient, at any cost. This is a very real concern.
I understand but what is the solution? Patients are often the ones who insist on coming back contrary to the doctor's advice. Furthermore, it would be irresposible of doctors to stereotype all elderly patietns and assuming they are coming in to socialize. They may have a genuine complaint and we have a duty to take them seriously and do what we can to treat them. Elderly patients also present differently. For example, many "silent" heart attacks are found in diabetics and the elderly in which they don't present with the typical chest pain.
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Thirdly, regarding "supporters of Obama's plan conveniently ignore Medicaid". I didn't know we were talking about Medicaid - that is a different animal. That is a program based on income. If we become destitute enough (or hide our assets good enough), then we can be eligible for it at any age.
You are talking about Medicaid because it's a form of govt administered health care. People raise the issue of Medicare to exemplify a form of govt controlled health administration that is succeeding but rarely do they examine the ones that are failing. If Obama and his supporters want to be objective, they can't just allude to Medicare without referencing the other systems.
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As far as the Medicaid system not allowing skin of adults to be tested, but allowing the skin of children being tested, I don't know about that. I don't believe everything that I hear, that's for sure. One person's opinion does not make a fact, although it would be interesting to read up on that.
I'm a physician and was at a conference. The person in question was a physician specializing in allergy who told me of this. And that's only one example. If you talk to physicians in any field, they can provide more examples of Medicaid rationing care.
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As far as what doctors will accept (Medicare, Medicaid), I have no interest in that. That's THEIR problem. Doctors (and their lobbyist groups) can work that out with Medicare/Medicaid. They can work that out with them the same way that the drug companies have worked out a deal with the FDA to approve medications in a rapid manner. That's a story for another post though. My husband is a pharmacist; his company negotiates with the various insurance companies and Medicare/Medicaid. All I know is that Medicare AND social security (by the way) is one giant ponzi scheme and current generations that are paying into the system are going to be left high and dry in a decade or decade and a half unless a paradigm change occurs in our current systems.
I provided that example because the public automatically assumes Medicare is always better than private insurance with regards to approving claims. I just want the public to know that isn't always the case. There are insurers that are better than Medicare and there are many that are worse than Medicare. This is why certain physicians can and will prefer to work with a certain subset of insurance companies and not take Medicare at all because this subset is better than Medicare with regards to approving claims
I understand but what is the solution? Patients are often the ones who insist on coming back contrary to the doctor's advice. Furthermore, it would be irresposible of doctors to stereotype all elderly patietns and assuming they are coming in to socialize. They may have a genuine complaint and we have a duty to take them seriously and do what we can to treat them. Elderly patients also present differently. For example, many "silent" heart attacks are found in diabetics and the elderly in which they don't present with the typical chest pain.
You are talking about Medicaid because it's a form of govt administered health care. People raise the issue of Medicare to exemplify a form of govt controlled health administration that is succeeding but rarely do they examine the ones that are failing. The govt. notoriously rations care.
I'm a physician and was at a conference. The person in question was a physician specializing in allergy who told me of this. And that's only one example. If you talk to physicians in any field, they can provide more examples of Medicaid rationing care.
I provided that example because the public automatically assumes Medicare is better than private insurance with regards to approving claims. I just want the public to know that isn't always the case. There are insurers that are better than Medicare and there are many that are worse than Medicare. It's not a unversal truth
As far as Medicaid goes, do states and the feds control what is covered or is just the states?
The reason I ask is that it's possible for different states to control what is covered IF states say what is covered. Medicaid is a mix of state and federal funds, correct?
As far as Medicaid goes, do states and the feds control what is covered or is just the states?
The reason I ask is that it's possible for different states to control what is covered IF states say what is covered. Medicaid is a mix of state and federal funds, correct?
It's adminstered by the states but the federal govt provides the funding and regulates how the states use it. Having practiced in 4 of them (Arizona, California, Oklahoma and Texas) the same type of rationing occurred in each one.
This is just my opinion but it almost seems because these people are poor, rationing is somehow justified in their case which angers me as a physician because we are taught to treat people the same regardless of income status (doesn't always happen but we are taught that nonetheless). And every year, it seems to get worse with regards to restrictions.
It's the states but having practiced in 4 of them (Arizona, California, Oklahoma and Texas) the same type of rationing occurred in each one.
This is just my opinion but it almost seems because these people are poor, rationing is somehow justified in their case which angers me as a physician because we are taught to treat people the same regardless of income status (doesn't always happen but we are taught that nonetheless). And every year, it seems to get worse with regards to restrictions.
All the more reason for single payer, in my book.
In any case, there will always be rationing of care based on income. Even in a single payer system, the rich can afford their own private doctor or they can afford to go to another country for care.
I think as much as our Congress sells us out for corporate interests, the least they can do for the masses is give us a single-payer system.
In any case, there will always be rationing of care based on income. Even in a single payer system, the rich can afford their own private doctor or they can afford to go to another country for care.
I think as much as our Congress sells us out for corporate interests, the least they can do for the masses is give us a single-payer system.
To me, that's the very reason you don't have single payer. I'm afraid it's going to be one large Medicaid in which rationing occurs because the govt. is strapped for money and can't afford to provide healthcare for all these people. I think Medicare is somewhat decent because it's subsidized by our social security and is limited to people above the age of 65
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