Good luck fighting with your insurance company if you get truly sick. I'm sure they'll pay.... eventually, assuming you crossed all your t's and dotted all your i's on your original application. And then good luck with your new premiums that reflect your new risk level to your private insurance company.
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A wiff of truth about Single Payer and Medicare
- Thread starter truehawk
- Start date
Good luck fighting with your insurance company if you get truly sick. I'm sure they'll pay.... eventually, assuming you crossed all your t's and dotted all your i's on your original application. And then good luck with your new premiums that reflect your new risk level to your private insurance company.
Quote from Random.Capital:
Medicare looks efficient by the standard measure because it spends virtually no resources dealing with fraud. If you add the cost of all those unnecessary procedures - or often completely fictitious ones - Medicare does not look good at all.
The cost of the fraud is already IN THE PRESENT COSTS.
Medicare would look VASTLY better then the insurance companies if the fraudlent claims could be reduced. But it presently looks better than the private insurers in SPITE of the fraud.
But it is not either-or what precnet of the claims submitted to private insurers involve fraud?
Quote from truehawk:
The 500 billion they are talking about is the difference between what it would cost if those Medicare Advantage participants were returned to regular Medicare and what it costs with the 15% subsidy they receive now.
If we have single payer there will be less money for the insurance companies can mean more for the actual providers.
But I think that you should also read the Dartmouth Health Outcomes study. In some locations, say Redwood City California in the middle 2000s, you stood a chance of getting bypass surgery if you went to the emergency room with a case of heartburn due to H pylori, because heart surgery was/ is highly compensated and there was an aggressive bypass practice there.
Really? There are 9 million enrollees in Medicare Advantage (part C). So that works out to over $55,000 per enrollee in savings.
Quote from truehawk:
Medicare Advantage, private insurance paid by Medicare costs Medicare 15% more than government run fee-for service Medicare. The government run program is more efficient than the private HMOs.
September 27, 2009
Editorial
Medicare Scare-Mongering
It has been frustrating to watch Republican leaders posture as the vigilant protectors of Medicare against health care reforms designed to make the system better and more equitable. This is the same party that in the past tried to pare back Medicare and has repeatedly denounced the kind of single-payer system that is at the heart of Medicare and its popularity.
For all of the cynicism and hypocrisy, it seems to be working. The Republicans have scared many older Americans into believing that their medical treatment will suffer under pending reform bills.
The general public believes that, too. The latest New York Times/CBS News poll of 1,042 adults found that only 15 percent believe changes under consideration would make the Medicare program better, while 30 percent think they would make it worse.
That does not mean that Medicare will be untouched under the Democratsââ¬â¢ plans. The Obama administration and Congressional leaders are hoping to save hundreds of billions of dollars by slowing the growth of spending in the vast and inefficient Medicare system that serves 45 million older and disabled Americans. The savings would be used to help offset the costs of covering tens of millions of uninsured people.
ââ¬Â¢
But far from harming elderly Americans, the various reform bills now pending should actually make Medicare better for most beneficiaries ââ¬â by enhancing their drug coverage, reducing the premiums they pay for drugs and medical care, eliminating co-payments for preventive services and helping keep Medicare solvent, among other benefits.
The main exception, a fully justified one, is that some of the 10 million people enrolled in private plans that participate in Medicare ââ¬â the Medicare Advantage program ââ¬â might suffer a dilution or elimination of the extra benefits they get that other beneficiaries do not.
To help them compete against the traditional Medicare fee-for-service program, Congress granted these plans large overpayments, essentially subsidies. Most are required to use part of the subsidy to reduce charges to their beneficiaries or to add extra benefits, such as vision and dental benefits, or even gym memberships.
This often makes them a better deal for beneficiaries. But it is unfair to force those enrolled in traditional Medicare to help foot the bill ââ¬â currently $43 a year extra for each participant ââ¬â to help subsidize the private plans. Federal taxpayers have contributed heavily as well.
These private plans didnââ¬â¢t start out costing the government more. For most of the 1980s and 1990s, the assumption was that private health maintenance organizations could do a better job of coordinating care and saving money than the government. The private plans were paid 95 percent of what the same services would cost in traditional Medicare with an assumption that even that money would allow them to deliver extra benefits.
Then after budget cuts imposed in 1997 drove many private plans to drop out of the program, Congress steadily raised their payments. Today Medicare pays the private plans, on average, 14 percent more than the same services would cost in traditional Medicare.
The bill being considered by the Senate Finance Committee is projected to cut the subsidies to Medicare Advantage companies by more than $100 billion over 10 years. Although Republican rhetoric has triggered fears that Medicare Advantage enrollees might lose their coverage entirely if private plans drop out of the system, the real effect of the bill would likely be modest on average.
The value of an enrolleeââ¬â¢s added benefits would shrink by more than half from current levels but would not disappear; they would still be worth about $500 a year in 2019.
Douglas Elmendorf, the director of the Congressional Budget Office, told the committee that, under the bill as proposed by the committee chairman, he expected that almost all Medicare Advantage plans would continue to operate and almost all of their current enrollees would stay enrolled. Total enrollment in Medicare Advantage would creep up by 200,000 over the next decade ââ¬â that is, about 2.7 million fewer new enrollees than expected under current trends, a real chance for savings.
What the Republicans arenââ¬â¢t saying ââ¬â and what the Democrats clearly arenââ¬â¢t saying enough ââ¬â is that in important ways, coverage for a vast majority of Medicare recipients, those in traditional Medicare, should actually improve under health care reform.
The House legislation, the only bills in near-final form, would reduce and ultimately eliminate a gap ââ¬â the so-called doughnut hole ââ¬â in Medicare drug coverage that currently forces more than three million beneficiaries to pay for drugs entirely out of their own pockets once they hit specified spending levels. That would also benefit many other beneficiaries who pay high premiums for coverage in the gap that they never end up using.
The House bills would also waive deductibles and co-insurance for preventive care that can head off serious illness, expand eligibility for programs that assist low-income beneficiaries and provide incentives for doctors and hospitals to coordinate care, improve quality, and lower costs. All that should benefit many if not most Medicare beneficiaries. And delivery system reforms should benefit the private plans as well.
Republican opponents have also been warning that planned cuts in payments to hospitals and other health care providers might make them less willing or able to serve Medicare patients. If true, that is a problem that Congress will have to address in the future.
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We have long championed Medicare. And we believe elderly Americans, and all Americans, should closely examine the proposed health care reforms.
But the Republicans have done far too good a job at obscuring and twisting the facts and spreading unwarranted fear. It is time to call them to account. President Obama and the Democrats in Congress have to make the case forcefully that health care reform will overwhelmingly benefit Americans ââ¬â including the millions of older Americans who participate in Medicare.
nice piece of bullshit propoganda
except there are several giant wholes:
doctors worth their salt are dropping medicare patients like the plauge
Medicare pays 15% less because it does. Nothing more than glorified pice control. Big fucking deal
You can thank Medicare for the fucking inflationary mess of our healthcare system. Medical costs started rising exponetially after they got invovled.
If central planning for Cost control is such a wonderful mechanism why not centrally plan our food supply, housing or auto industry.
No matter how many horrible deaths central planning dies there is always some dumbass to come along and tout it's magical powers for ushering in the utopia.
Quote from Arnie:
Really? There are 9 million enrollees in Medicare Advantage (part C). So that works out to over $55,000 per enrollee in savings.
Good point, evidently the prospective savings from eliminating charges for services that are charged but not delivered are included, which would impact the providers trying to game the system, but not the recipient.
Also the prospective savings are over a period of 10 years.
Quote from Random.Capital:
There is no evidence to support this, as all the official numbers are doing apples-to-oranges comparisons.
Really?
What evidence do you have that the both the private insurance and the Medicare costs do not include fraud, because as I read it, both numbers are gross, including fraud, and the fraud %s are estimates.
The reality of the fraud in both systems is estimated but in reality unknown.
So the comparison is apples to apples, both numbers include costs for fraud and administration, and in the the insurance company case, infrastructure dedicated to denying you claim and finding a way to retroactively cancel you insurance when your claims approach 100K.
Quote from lrm21:
nice piece of bullshit propoganda
except there are several giant wholes:
doctors worth their salt are dropping medicare patients like the plauge
Medicare pays 15% less because it does. Nothing more than glorified pice control. Big fucking deal
You can thank Medicare for the fucking inflationary mess of our healthcare system. Medical costs started rising exponetially after they got invovled.
If central planning for Cost control is such a wonderful mechanism why not centrally plan our food supply, housing or auto industry.
No matter how many horrible deaths central planning dies there is always some dumbass to come along and tout it's magical powers for ushering in the utopia.
Exactly.
Quote from lrm21:
nice piece of bullshit propoganda
except there are several giant wholes:
doctors worth their salt are dropping medicare patients like the plauge
Medicare pays 15% less because it does. Nothing more than glorified pice control. Big fucking deal
You can thank Medicare for the fucking inflationary mess of our healthcare system. Medical costs started rising exponetially after they got invovled.
If central planning for Cost control is such a wonderful mechanism why not centrally plan our food supply, housing or auto industry.
No matter how many horrible deaths central planning dies there is always some dumbass to come along and tout it's magical powers for ushering in the utopia.
Yada Yada, Yada,
Okay, lets see, you are arguing that
Medicare pays 15% less, thus it is inflationary?
Please don't let me type words in your mouth, but I don't think paying LESS makes something an inflationary mess.
And somehow the UK and European countries manage to smoke, drink and consume more saturated fats, and still have higher life expectancies. And don't tell me about fast food.. Nutritionists have nightmares about the level of salt and fat in English and German pub food. About the only difference is that the Europeans and those in the UK appear to WALK a lot more, and stress levels are lower.
Stress levels count when one is sick and they don't have the stress of fighting the insurance companies and facing possible bankruptcy when they are deathly ill.
Perhaps you should google "conditional probability of rescission". I have read that the chance of one's insurance being canceled if your claim is over 100K is about 50%.
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A little competition from public health care is not a bad thing, the bad thing is someone will make health-care into scarcity, so they will make more profit from it.
A little competition from public health care is not a bad thing, the bad thing is someone will make health-care into scarcity, so they will make more profit from it.