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Godi
Guest
No your dealing with Liberal Fascism.
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Ridgerunner
Guest
Yesterday I heard a utilization review officer of a large insurer explain how the cost of lumbar MRIs in a particular region was negotiated down to about 20% of “retail” (which the uninsured pay). Medicaid pays 33% and Medicare pays 60%. His company pays about 15% of “retail” for a particular surgical procedure.
His utilization review program is very good (and expensive) and, even with all of the discounts, providers tried to overbill millions that were caught.
The healthcare system is profoundly predatory in pricing, and the government is complicit in it. Seems to me the politicians’ focus in the healthcare crisis is utterly misdirected.
His utilization review program is very good (and expensive) and, even with all of the discounts, providers tried to overbill millions that were caught.
The healthcare system is profoundly predatory in pricing, and the government is complicit in it. Seems to me the politicians’ focus in the healthcare crisis is utterly misdirected.
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vern_humphrey
Guest
Ah, your usual miscasting of other people’s arguments.
The argument is that those who expect (and try to force) other people to pay the freight have an obligation to pay their share.
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Ridgerunner
Guest
Hate to follow myself, but I meant to add the following.
When you consider that Medicare and private health insurance both have deductibles and co-pays, and that the same are based on “retail” (“Reasonable and Necessary”), but that both government and insurers pay costs discounted from “retail”, the patient is paying much more of the true cost than seems to be the case on the surface.
If, indeed, healthcare providers can operate comfortably on the deep discounts big insurers get, plus deductibles, they’re getting really fat on Medicare, which pays even more. Medicaid seems to be about the same as what such insurers pay, give or take a little. But there are no deductibles or co-pays with Medicaid which, one might assume, is why lots of providers don’t particularly favor taking more than a certain quota of Medicaid patients. No cherry on top of that sundae. Since “covered” care is most of the care provided, it is not hard to understand how providers can afford the lavish facilities one has seen going up in recent years, or the princely salaries the upper echelons make. And, of course, the “pea and shell game” of discriminatory pricing supports lots of utilization review companies.
And, of course, that’s without even considering overutilization, which is encouraged by both Medicare and Medicaid, exacerbated by television ads for enticing, but often worthless products.
Medicare, it seems, is the cornerstone of the whole edifice.
Of course, politicians are lobbied by healthcare providers in a significant way, and have no incentive to limit the latters’ pork intake. One can reasonably fear that a new government-provided health insurance program will simply allow the politicians to offer a bigger barrel.
Unfortunately, that’s the direction in which we are headed.
When you consider that Medicare and private health insurance both have deductibles and co-pays, and that the same are based on “retail” (“Reasonable and Necessary”), but that both government and insurers pay costs discounted from “retail”, the patient is paying much more of the true cost than seems to be the case on the surface.
If, indeed, healthcare providers can operate comfortably on the deep discounts big insurers get, plus deductibles, they’re getting really fat on Medicare, which pays even more. Medicaid seems to be about the same as what such insurers pay, give or take a little. But there are no deductibles or co-pays with Medicaid which, one might assume, is why lots of providers don’t particularly favor taking more than a certain quota of Medicaid patients. No cherry on top of that sundae. Since “covered” care is most of the care provided, it is not hard to understand how providers can afford the lavish facilities one has seen going up in recent years, or the princely salaries the upper echelons make. And, of course, the “pea and shell game” of discriminatory pricing supports lots of utilization review companies.
And, of course, that’s without even considering overutilization, which is encouraged by both Medicare and Medicaid, exacerbated by television ads for enticing, but often worthless products.
Medicare, it seems, is the cornerstone of the whole edifice.
Of course, politicians are lobbied by healthcare providers in a significant way, and have no incentive to limit the latters’ pork intake. One can reasonably fear that a new government-provided health insurance program will simply allow the politicians to offer a bigger barrel.
Unfortunately, that’s the direction in which we are headed.
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cynic
Guest
You are denied ongoing treatment. If you are uninsured and get cancer, then there will be no chemotherapy.
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vern_humphrey
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Bull!
You’ve made that claim, now prove it.
Or maybe you’re talking about the woman who died because she didn’t have $100 to pay the hospital – you know the one I mean, the one that’s become an issue in the current political campaigns.
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rlg94086
Guest
The first thing that came to mind to me is the wonderful charitably supported hospitals and organizations - Mayo Clinic (cancer), St Jude’s (children), Shriner’s hospital (crippled children and burn centers). Are they Catholic? No (St. Jude’s was however founded by a Catholic, Danny Thomas), but they are the ones that came to mind immediately.Bull!
You’ve made that claim, now prove it.
Or maybe you’re talking about the woman who died because she didn’t have $100 to pay the hospital – you know the one I mean, the one that’s become an issue in the current political campaigns.
My younger brother was born with a physical birth defect, and my family (single Mom raising three boys on a secretary’s salary) is forever thankful to the Shriners.
Someone has to tell me why it would have been better for my brother if there was a national health system. Would he have gotten “free” care? Yes, at a greater burden to every taxpayer. Did he get free care? Yes, thanks to loving charity of many people who gave from their hearts.
As I have posted several times, I think it may make some sense for some basic/clinical care to be state supplemented for those who don’t have comprehensive insurance, as it might help lessen some of the more serious illnesses. But, I don’t see why it is necessary to nationalize everything.
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mapleoak
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I know of a wonderful family with 10 adoptee children from various countries all with medical problems of some sort, amputees, burn victims and the like. They are extremely greatful for the charitable generosity extended to them, not just from the people around them, but from the hospitals as well. Many of these children are receiving ongoing treatment and corrective surgery from hospitals, specialty treatment centers, and burn clinics, as far as three states away. I’d be knockered if the government would do that for them.
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rlg94086
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Ridgerunner
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I agree in principle that more attention needs to be given to catastrophic illness care. But I truly don’t think any national healthcare plan is going to work until some kind of rationality is brought into the multi-tiered and deceptive system that is American healthcare. Outside that system, nobody seems to know what healthcare really costs. Certainly the government does not, or doesn’t care. Healthcare providers get away with predatory pricing that no retail chain could possibly get away with.
If Congress wasn’t so beholding to the healthcare industry, it would be holding outraged hearings on it. Until some light is shed on this system, governmental universal coverage might be the worst thing we could possibly have.
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rlg94086
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Hi Ridgerunner,
I am of the absolute opposite mind, but I understand your reasoning. A lot of “catastrophic care” is preventable. I spoke with a retired doctor on a very long plane trip coming home from China, and he explained to me that a very high percentage of certain diseases/illnesses (heart disease, diabetes, etc.) can be prevented with certain treatments (I think another poster said something about statins?).
So, while it seems logical to put the emphasis on catastrophic care, I think the better thing to do for our overall medical costs is to focus our public funds on prevention, and then use private insurance (and charity) to handle catastrophic care. This way, people who choose by their own irresponsibilty to lead lifestyles (e.g. self-created obesity, smoking, etc.) that leads to a catastrophic illness is responsible financially for their own care.
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Holly3278
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Personally, I am totally for socialized health care. My family would greatly benefit from it. I know many other people who would greatly benefit from it as well.
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rlg94086
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No offense, Holly, but that isn’t really the right way to assess whether something is right. I could say “I am totally for every family with 4 kids getting a $1 Million stipend from the government, because my family would greatly benefit from it,” but that wouldn’t make it the right thing for society.
We need to look at equitable solutions. A fully nationalized system, IMHO, is not the best thing to do. Some illnesses are very much determined by the person’s lifestyle choices. A person who exercises, eats healty, doesn’t smoke or drink excessively, gets regular check-ups, etc., should not have their taxes supporting the extraordinary amount of healthcare that someone who does the opposite will require.
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cynic
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the only free treatment the uninsured get is that provided in the ER. I’m pretty sure they don’t do ongoing chemotherapy treatment in an ER. Note posts below yours by rlg and mapleoak - the only cancer treatment the uninsured might get is that sourced from charity.Bull!
You’ve made that claim, now prove it.
Or maybe you’re talking about the woman who died because she didn’t have $100 to pay the hospital – you know the one I mean, the one that’s become an issue in the current political campaigns.
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cynic
Guest
and that’s at the heart of the matter. You don’t wan’t to be forced to pay for others treatment, even for something as serious as cancer. In other words, someone may have to die in order to not be a burden on the taxpayer.
So he got free care on the basis of chance, while living close enough to a charitably funded hospital. Do you think that all the uninsured in the U.S could be treated this way, if many of them were to get cancer? I think there would be limits as to how many they could treat.
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rlg94086
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Please show me an article about someone who was turned away by the Mayo Clinic or St Jude’s. You are making rather uncharitable and rude comments.
Chance?! Unbelievable! What kind of Christian are you? Is charitable giving just a matter of chance? I am thankful for the giving heart of others.
It is posts like yours that drive me further and further away from the middle ground. Your comments show a complete lack of gratefulness for the charity and love of mankind. You are demonstrating a dark, Calvinist, “people are all evil” attitude.
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Ridgerunner
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Still, knowing what I know, I would like to see initial attention on the cost itself. Offering to pay more from the government is not going to do that.
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cynic
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Yes chance, whether people *decide *to give, and whether enough people decide to give.Please show me an article about someone who was turned away by the Mayo Clinic or St Jude’s. You are making rather uncharitable and rude comments.
Chance?! Unbelievable! What kind of Christian are you? Is charitable giving just a matter of chance? I am thankful for the giving heart of others.
It is posts like yours that drive me further and further away from the middle ground. Your comments show a complete lack of gratefulness for the charity and love of mankind. You are demonstrating a dark, Calvinist, “people are all evil” attitude.
I don’t think uninsured individuals should have to be depend on this, not when it comes to life threatening illnesses. Sorry about that.
But I’m not really into debating some theological point, the statement was that if you are uninsured in the U.S and get cancer you will not receive chemotherapy in a mainstream hospital. Nothing about your reply leads me to believe any different. Forty million people in the U.S are uninsured, and you talk about one clinic here or there offering free treatment from charity, as if that were an answer. This is unbelievable.
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cynic
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I also agree that serious healthcare should be a right - or as much of a right a society can make it - and not a commodity.
It should be paid for by people who can afford to pay, which may end up being most of us. But the government should ‘steal’ from my income, along with others, to make *sure *that those who geniunely cannot pay get treatment
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rlg94086
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Thanks for the laugh…never let ignorance of the charities/hospitals named get in the way of your argument.
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