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What I don't get is why health insurance companies and Medicare don't just take a hard line. They should just say, "This is the price we will pay and if you can't accept that price, we'll go elsewhere." Eventually hospitals will realize they can't keep raising prices if they want to stay in business.
That is exactly what they do. Do you think a provider submits a bill and gets paid? No no my friend, the provider submits and ICD9 code for a procedure and they are told what they will be reimbursed for that procedure.
That is exactly what they do. Do you think a provider submits a bill and gets paid? No no my friend, the provider submits and ICD9 code for a procedure and they are told what they will be reimbursed for that procedure.
I realize that.
What I am saying is that if a hospital or doctor has a history of submitting huge claims, why not refuse to do business with them?
It's precisely those kind of statements the book I am reading talks about.
I am fine with having less expensive technology if it works just as well as the more expensive technology.
If only more people would read Taming The Beast and see how idiotic such fear tactics such as "less innovation" are.
But as the saying goes, "Ignorance is bliss."
I must say your understanding of medical economics is non existent. So your evaluation of some book which proclaims innovation is a bad thing leaves me less than impressed.
I must say your understanding of medical economics is non existent. So your evaluation of some book which proclaims innovation is a bad thing leaves me less than impressed.
It's not saying innovation is bad.
What is bad is constantly demanding more expensive technology when the existing technology is just fine.
There is a documentary put out by PBS which explores the health care system in other countries. Japan has a pretty nice industry of producing low cost medical machines.
It'd be nice if you actually read the book instead of making up stupid claims.
I realize that.
What I am saying is that if a hospital or doctor has a history of submitting huge claims, why not refuse to do business with them?
Huh? Are you claiming Medicare fraud? Otherwise they submit claims for procedures performed and are reimbursed what the government or insurance company will pay.
OK lets try this suppose the government will pay $5,000 for a procedure. The doctor performs the procedure and submits a claim. On that claim is an ICD9 code, not a dollar amount. It is not as if the doctor submits a $10,000 bill to Medicare and gets paid. No Medicare sees the ICD 9 code and then pays $5,000 because that is what that code pays.
It's not saying innovation is bad.
What is bad is constantly demanding more expensive technology when the existing technology is just fine.
There is a documentary put out by PBS which explores the health care system in other countries. Japan has a pretty nice industry of producing low cost medical machines.
It'd be nice if you actually read the book instead of making up stupid claims.
Saying existing technology is just fine is silly. In instances where exisiting technology is better than new technology, the new technology will not be adopted. You and the author seem to think new technology is accepted simply because it is new.
As for over use of technology institute tort reform and you would see that fixed pretty quickly.
Cosmetic surgery isn't covered under insurance and that still is affordable.
Why do you think ? (hint: because there is no insurance..all costs are out of pocket so they have to be reasonable).
Just like years ago when you only needed insurance for hospitalization. Doctor visits were reasonable; prescriptions were reasonable; treatment was reasonable. Why ? Because they had to be paid out of pocket. Once the middle man came in (insurance) costs skyrocketed and the higher they got, the more everyone needed insurance just to go for a doctor visit.
Government run anything is much less efficient than private enterprise. Rationing of services will occur, it must happen if 30 million more people will be insured and costs go down. CEOs don't make enough to cover 30 million more people.
Once you get rid of the profit motive quality and innovation drop.
Your rationale is illogical.
Rationing of services already occurs even with top of the line coverage.
Quality & Innovation in insurance? Quality is pay the bill. The only innovation they have at their disposal is inventing ways to exempt themselves from a claim, causing doctors to hire a full blown administrative staff to chase them down like children for basic contract obligations. How much do you suppose that costs, since every realized cost ultimately gets passed down to consumers?
Anyone else concerned about rates going up-- tell me when they failed to go up exponentially since 1990. I worked for a fortune 500 company with excellent bennies but kept paying more and more for less and less policy until it stopped being a bennie. My corporation had considerable bargaining power and were frustrated to no end attempting to negotiate. They went shopping around and found they were in Russia because there was only one brand with a different label. Small business doesn't stand a shot in the dark winning a fair policy if fortune 500 can't manage.
Contrast my insurance premiums with the story of that Doctor in NYC who put his patients on a pre emptive payment plan for regular care- something like $25 odd a month. The NYS insurance commissioner frowned. Wonder who blew the whistle on him? Guaranteed it wasn't his patients who otherwise could not afford any doctor. Why would insurance companies be so vexed when Doctors cut out the middleman?
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