Medicare and and health care situation

[retro]

I had a long talk with my dad about health care on Saturday while we were eating breakfast after going out golfing. One of the topics of discussion was Medicare and their (lack of) payments to physicians for services rendered. I wasn't aware of this, but apparently Medicare is slated to drop reimbursements to physicians by 20% across the board in 2010, unless something changes before then... which most physician groups are trying hard to get congress to do something about. As part of the "doomsday scenario" that his medical group discussed at their last board meeting (he's the VP of their board, former medical director, and has been there for 17 years now), at the very least the Family Medicine group within the clinic is more than likely going to drop Medicare from their practice completely. Why is this? Because with the wholesale drop in reimbursements, in most cases it is going to cost them money to see Medicare patients, so it isn't a fiscally sound policy to continue to see Medicare patients if it's going to be negative revenue for them.

You can harp about how that isn't ethical of them to simply decide to not see an entire group of patients based on their insurance not paying enough money, but it happens all the time with other insurance companies... that's why some insurances aren't covered at certain doctor's offices. Physicians are people too, and they have their own expenses, their own families to take care of, and like it or not, practicing medicine is a business... physicians go to school for far longer than most of us do in order to gain the expertise and knowledge to treat us all, and they should be reimbursed according to their skills and their work.

To tie this back into Universal Health Care... if Medicare is so insolvent that it's bleeding money and they're reimbursing physicians less and less, how can we expect a UHC system to be any different?

 

[catisland]

Thanks, retro. Always good to hear real human perspective. I know of an OB/GYN who shut her practice down when her malpractice insurance premium went to $400,000 FOR ONE YEAR.. Add to it her cost to run her business, pay employees, worker's comp, unemployment, blah blah blah it is no wonder we're losing good, dedicated physicians who feel that the system is making it impossible for them to practice medicine.

 

[Minor Axis]

To tie this back into Universal Health Care... if Medicare is so insolvent that it's bleeding money and they're reimbursing physicians less and less, how can we expect a UHC system to be any different?

Not a certain answer, but if all these companies start relying on the U.S. government to provide UHC, the money they used to pay to insurance companies for their employees can now be paid in taxes to support UHC.

 

[Alien Allen]

Not a certain answer, but if all these companies start relying on the U.S. government to provide UHC, the money they used to pay to insurance companies for their employees can now be paid in taxes to support UHC.

Huh ???

Explain please.

Who are...."all these companies"

 

[retro]

Not a certain answer, but if all these companies start relying on the U.S. government to provide UHC, the money they used to pay to insurance companies for their employees can now be paid in taxes to support UHC.

That's not an answer because Medicare is already funded by tax revenue, and it's insolvent and bleeding money.

 

[nova]

Not a certain answer, but if all these companies start relying on the U.S. government to provide UHC, the money they used to pay to insurance companies for their employees can now be paid in taxes to support UHC.

And by some voodoo magic, adding another layer of gov't beauracracy in place of the existing insurance co corp beauracracy is going to cost less. Somehow I don't see that happening...

 

[Minor Axis]

That's not an answer because Medicare is already funded by tax revenue, and it's insolvent and bleeding money.

Last I read if nothing changes it will be insolvent in about 9 years. The blame is in large part the gigantic increases in cost of health care that have outstripped all economic indicators. Why? You guys don't really want to talk about that, something that reforming the system might elevate. You just want to rag on it because it is administered by the government and the "government can do nothing right". Something reinforced tremendously by the last Republican Administration that most of you put into office. The irony I tell you. One example- FEMA, a government organization that used to be respected until it was made a laughing stock by an inept appointment.

 

[nova]

Last I read if nothing changes it will be insolvent in about 9 years. The blame is in large part the gigantic increases in cost of health care that have outstripped all economic indicators. Why? You guys don't really want to talk about that, something that reforming the system might elevate. You just want to rag on it because it is administered by the government and the "government can do nothing right".

Oh I'll talk about it, because I've done a lot of research and reading on exactly why the costs are going nuts.

1. People are detached from what their medical spending actually costs because everyone has insulative group policies. There are two areas, LASIK and plastic surgery, that are not typically covered by insurance, and surprise surprise, the real cost has gone down and the quality has gone up. Imagine that. :eek

2. Gov't regulations requiring min coverages, min deductibles, guaranteed issues, community rating, etc etc, drive up the cost of insurance horribly. The average policy increase over the last few years has been 25%. The average in NY where they have guaranteed issue and community rating is nearly 100%. There might be a connection between requiring the Ins. Co to write everyone a policy that costs the same and increased costs but I don't know.

3. The amount people are spending on health care is going up because we have it to spend. The amount spent on veterinary care for pets is going up at about the same rate. Does that indicate a problem with the veterinary care system? No, it just means people have the money to spend and they are ie we as a nation have the $$ to do what we want. The amount we spend on big screen TVs has exploded in the last few years does that mean that needs reform to cut costs too? No it just means people have it to spend so they are choosing to.

Something reinforced tremendously by the last Republican Administration that most of you put into office. The irony I tell you. One example- FEMA, a government organization that used to be respected until it was made a laughing stock by an inept appointment.

Geez, the same tired stupid argument that if someone happens to be for limited gov't (which GWB was not) and a gov't agency screws up, it has to be the fault of the limited gov't guy. As if there's NO WAY that there could have been structural and institutional problems long predating that.

Let met tell you, as someone who lived through multiple hurricanes, including an extended stint at home after Katrina hit the MS gulf coast, FEMA has always been a joke for as long as I can remember. If you were waiting on FEMA to help you were screwed. The only org you could count on was MEMA and the MS National Guard.

 

[Accountable]

To support Nova's point, expecially #1:
Health Care Mystery: What'll That Cost? - ABC News

 

[Staci]

but it is not just medicare that will be cut 20%, it will also be the state funded medicaid system as well. and can i just remind everyone who "hates" the HMO's and thinks all insurance companies are bad.......that is was Sen Kennedy who pushed for these companies to be created

 

[Alien Allen]

I heard a Senator on the radio today state that Medicare and Medicaid account for 61% of the medical costs at this time.

So given the govt has control over 61% of health care it seems they are failing already. Even before the 20% cut.