Fiscal Cliff

@cicerone imposter,

cicerone imposter wrote:

There are many ways that I've mentioned on these threads in the past. They can begin with waste by providing medical supplies through competitive bidding. Penalize doctors who cheat the system with harsh penalties. Then offer services on a sliding fee scale. Increase the payroll deductions - increase the age of benefit , and finally, congress must pay for GW Bush's extended drug benefit.

The government intervention itself destroys the free market and any semblance of customer selection based on price and quality. If you think government administered competitive bidding is effective then I've got a few other things I'd like to sell you.

Penalties for fraud are already high, but Medicare and Medicaid fraud eclipses insurance fraud by orders of magnitude.

How would you administer the application of "sliding fee scales" for medical services? Would we need another IRS to determine what individuals must pay? How much will that cost?

3 Replies

@Miller,

The longivity of Americans are increasing, but our gov't fails to change payroll deductions as more baby boomers begin to qualify for benefits. The math just doesn't work when our workforce shrinks at the same time.

0 Replies

@roger,

roger wrote:

I'll bite. How can the growth in Medicare be fixed?

Outcome based payments to providers vs fee-for-service will (hopefully) help a lot.

1 Reply

@JPB,

Not sure if you've read Paul Krugman's op ed piece in today's NY Times, JPB, but it is an excellent one...and covers some of this territory the way I think you see it.

1 Reply

@georgeob1,

My guess is that most so-called Medicare/Medicaid fraud is actually just doctors "expanding" things so they get what they consider a fair price for their services rather than what the schedules set out.

The thing that I think most important is: Even if the set-up has a cost in the "quality of care"...almost always "some care" will beat out "no care."

The notion of nurse practitioners who will handle minor illnesses at a cost less than a doctor would charge...will eventually come into play. Increased use of computer generated initial diagnosis will also come into play.

But your take on how "government administered" medicine is off, in my opinion. The administrative costs for Medicare and Medicaid seem to be a fraction of what they would be if run by private enterprise.

We'll get a handle on this...and I suspect it will be sooner rather than later. I thank the people who are working toward that goal.

0 Replies

@Frank Apisa,

No. I'll look for it.

0 Replies

@cicerone imposter,

cicerone imposter wrote:

The GOP don't give a shi... who they harm.

Neither does Obama or his treasury. If they did, they would have gone with the platinum coin, which is harmless and would have defused the Republican hostage crisis in an instant.

3 Replies

@Thomas,

I heard it was the Fed that nixed it. Neither Obama nor the Treasury control the Fed.

1 Reply

@georgeob1,

georgeob1 wrote:

but Medicare and Medicaid fraud eclipses insurance fraud by orders of magnitude.

that's a lovely piece of opinion - do you have ANYTHING to back it up?

(it's not the real-life experience here)

0 Replies

@Miller,

Miller wrote:

medical professionals to use electronic record keeping in hospitals and clinics, in order to save money ( primarily medicare and medicaid. Guess what?

guess what - it's not being pushed to save money. It's been pushed (and the standard of practice in many developed countries for years) to improve quality and consistency of patient care.

1 Reply

@JPB,

JPB wrote:

I heard it was the Fed that nixed it. Neither Obama nor the Treasury control the Fed.

Nope, that was the treasury.

1 Reply

@ehBeth,

and is still in its infancy. The EHR programs that exist today are not at all what they need to be.

0 Replies

@cicerone imposter,

cicerone imposter wrote:

However, defense spending that continues to increase our deficit doersn't get peep fr the GOP. That's where the biggest savings can be had. We are not the world's police.

this is an interesting conflation I see a lot from U.S. posters. Defense spending and military spending. They are not necessarily the same thing.

Hang on to defense spending and cut U.S. military spending.

There is no need for the U.S. to get involved in everything they see - it's like a magpie seeing something shiny - ohhhh, a disagreement, let's go there.

1 Reply

@Thomas,

Yeah, Treasury announced that the WH had decided.... (after the Fed said no). I've no proof other than Congressional media twitter feeds but that's the rumor.

1 Reply

@Miller,

Miller wrote:

Appy (sic) common sense to the practice of medicine at all levels. For instance, do 90+ year old females really need to have pap tests and mammograms each and every year?

true. Pap tests aren't even recommended for 35 y.o. women on a yearly basis.

Part of it is the need of the U.S. to catch up with international standards of practice. Bizarre that's it's behind in so many areas. Leading edge in a few areas, lagging way behind in others. It's puzzling.

0 Replies

Quote:

@DavidMDrucker Cantor: "Next week, we will authorize a three month temporary debt limit increase to give the Senate and House time to pass a budget"

That's something at least.

0 Replies

@georgeob1,

georgeob1 wrote:

Easy to say: very hard to do. How do you go about avoiding "expensive tests"? Will we establish a bureaucracy or a formula to second guess Doctor's judgments? How will they (and the patients like that? Folks here repeatedly scream about similar things when iunsurance companies do them.

ok - insurance companies do it. why shouldn't the government do the same thing?

(though the real-life experience is that government medical plans question much less than private insurers do)

1 Reply

Interesting... I kinda like the idea of no pay for Congress. Can we add their staff to that too?

Quote:

The House will also seek to prevent members of Congress from being paid if the two chambers do not pass a budget resolution.

“We are going to pursue strategies that will obligate the Senate to finally join the House in confronting the government’s spending problem,” Boehner said. “The principle is simple: no budget, no pay.”

Majority Leader Eric Cantor (R-Va.) said the House would vote next week on a three-month extension of borrowing authority.
“If the Senate or House fails to pass a budget in that time, members of Congress will not be paid by the American people for failing to do their job. No budget, no pay,” Cantor said.

Read more: http://thehill.com/homenews/house/278007-house-gop-aims-to-tie-senate-action-on-budget-to-debt-limit-increase#ixzz2ILnvS8kw
Follow us: @thehill on Twitter | TheHill on Facebook

0 Replies

@JPB,

JPB wrote:

Yeah, Treasury announced that the WH had decided.... (after the Fed said no). I've no proof other than Congressional media twitter feeds but that's the rumor.

This says it was both the Fed and Treasury independently.

Quote:

The Treasury Department and the Federal Reserve, both independent of one another, each concluded this was not a viable option.

"Neither the Treasury Department nor the Federal Reserve believes that the law can or should be used to facilitate the production of platinum coins for the purpose of avoiding an increase in the debt limit," said Treasury spokesman Anthony Coley in a statement.
Reuters

0 Replies

Quote:

Regardless, the platinum coin frenzy "was fun while it lasted," says Philip Klein at The Washington Examiner. But killing the gambit is a winner for Obama. Minting a platinum coin "would have been a huge political gift to Republicans," giving them a big fat target to "mock and attack as a new power grab by Obama" while playing risk-free brinksmanship. Now the onus rests with GOP leaders to keep us from economic chaos. If they fail, America will know who to blame. Why the Fed killed the $1 trillion platinum coin

1 Reply

Related Topics

Quick Links

My Account

able2know