IT'S TIME FOR UNIVERSAL HEALTH CARE

@mysteryman,

mysteryman wrote:

Quote:
What is 'the conservative plan"? The fact is there has been none.

That is a flat out lie!!!!!

I have posted a link to their plan, and even quoted some of it.
Now, you can put me on ignore, but I would think that some of your other liberals would be honest enough to point it out to you.

The right has no serious plan. If they wanted reform, why has the right not made any effort at reform since Nixon took an interest in this. The right is now making a half-hearted stab at reform, but only to use it as a counter to Obama's strong effort at reform.

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@roger,

roger wrote:

Here's an example provided by yourself, and recently. The balance of $39,471.03 you cite is the amount the hospital needs to bill to an individual to recover losses from Medicare undercompensation, and losses related to treatments not paid for by anyone.

cicerone imposter wrote:

The bill was $44,471.03, and her co-pay was $93.67, because she has insurance with her employment with the newspaper. The insurance provider, Anthem Blue Cross, paid Stanford only $4,906.33 for her husband's stay, and the remaining $39,471.03 was written off as an insurance adjustment.

you think the $39,000 represents Medicare undercompensation? seriously?

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@mysteryman,

Those are some doozies there MM..
1. We'll let employers pay you less than the mandated minimum wage if they give you health insurance.

2. We'll allow insurance companies to offer plans that don't cover much of anything so you can at least say you have insurance even if it doesn't cover any normal health need.

3. If you can already afford health insurance we'll give you a tax write off. If you can't afford it, tough luck, you get nothing.

4. We will give you a choice of using private companies for your children if your children are eligible for federal health care. Nothing there for anyone else.

5. We will give you a tax cut if you buy insurance yourself. (Never mind that Foxfyre has already said that isn't the GOP plan.)

There is nothing in there to address any of the real issues of health care MM. No plan to help people that can't afford insurance get insurance. No plan to help people that have pre-existing conditions get insurance. No plan to help people keep their insurance if they lose their jobs.

1 Reply

@ehBeth,

Well, I certainly didn't put that at all well.

There is some level of compensation that the hospital must receive to recover costs, and I don't mean the direct, variable cost of delivering service. Those who pay their own bill, in full, with their own money, are being taken for a ride. I do seriously believe they are paying for undercompensation received from Medicare, and individuals who simply don't pay their bills at all.

The rates negotiated between hospital and insurance company probably come closest to the real costs and a reasonable profit. I do not believe Medicare compensation alone would allow most hospitals to remain in business.

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@ehBeth,

I really don't know, but it seemed to me that insurance companies are able to negotiate from the statement down to what we have seen with this reporter for the SJ Mercury News. I think that's SOP for insurance companies. Individuals who pay their own bills are probably screwed, because they don't have anybody to advocate for them.

1 Reply

@roger,

As you have seen in a subsequent post, even the insurance company paid only about 12% of the total bill, so we can't blame only Medicare or the private sector. I believe it's a combination, but then I'm not sure where the blame should be put.

1 Reply

@cicerone imposter,

Quote:

Individuals who pay their own bills are probably screwed, because they don't have anybody to advocate for them.

UM...ya, they are the ones who get charged $7.50 for two aspirin.

1 Reply

@cicerone imposter,

I noticed that. I saw something like a 50% reduction on a hospital bill of my own, and called the insurance company to ask. They said the discount was based on a prenegotiated contract between hospital and insurance company. I am quite sure the hospital did not lose money on the transaction. This leads me (possibly erroniously) to the conclusion that if everyone were in the same insurance pool, the amount paid by the insurance would be the amount paid by everyone - assuming all bills were paid, of course. Hospitals like insurance because whatever is negotiated will definately be paid.

cicerone imposter wrote:

There's an interesting article in today's San Jose Mercury News written by a staff writer about their recent experience when here husband had some tests and "outpatient" procedures that required an overnight at Stanford Hospital..

Now, in the case of something described as an outpatient procedure, I'm not sure medicare would have paid nearly as much. Medicare no longer pays for mistakes, and doesn't permit Medicare patients to be billed for mistakes. This one sounds like a mistake, as "outpatient" doesn't imply an overnight stay.

1 Reply

@roger,

Quote:

Hospitals like insurance because whatever is negotiated will definately be paid

Ya, and I don't see a way to get to profits taking only uninsured (most of whom can't pay) and those on government programs. The ratio of paid work basis free work must be considered, plus the volume of work overall.

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@roger,

roger wrote:

The rates negotiated between hospital and insurance company probably come closest to the real costs and a reasonable profit. .

Reasonable profit? yikes

U.S. hospital bills (after the insurance negotiations) are still at least 10x higher than Canadian hospital bills. I think I'd call it gouging.

I think it's amazing what the healthcare and insurance industries in the U.S. have been able to convince people is reasonable. They've got fabulous marketers and lobbyists.

~~~

After OHIP kicks in, consumers here are responsible for $45 (Cdn) on an ambulance bill. The full bill (if you're not covered by OHIP) is just under $300. The ambulance bills I see coming up from the U.S. tend to be in the $2,000 - $6,000 (U.S) range. I estimate $10,000/day for U.S. hospital charges on files I review (that's without the doc bills or any 'real' treatment). The uninsured cost here is in the $500 - $1200 range (including most types of treatment and doctor services). Surgeries themselves have similar differentials.

We certainly pay for that OHIP coverage through various taxes, but the overall effect on our income is nothing like the cost of healthcare premiums charged in the U.S.

~~~

Those lobbyists are certainly value for money.

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@ehBeth,

$45.00 sounds like big city cab fair. I'm not at all defending the $3,500.00 at the top of my own statement for a three mile ride, but you also can't maintain and ambulance, driver, and two EMTs at $45.00 per three mile trip. You've got some sort of subsidy going on, and it would be interesting to know what it was. Problem is, those subsidies are very difficult to pin down.

I wish I had kept that statement, but co-pay and insurance benefit totaled less than 10% of the total bill.

1 Reply

@roger,

The $45 is what is charged to people who have OHIP coverage. The provincial insurance plan (OHIP) picks up the balance of the ambulance bill. That is the other amount I referenced in that post.

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@ehBeth,

ehBeth wrote:

After OHIP kicks in, consumers here are responsible for $45 (Cdn) on an ambulance bill. The full bill (if you're not covered by OHIP) is just under $300.

~~~

Those lobbyists are certainly value for money.

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@ehBeth,

Nobody can tell me that a bill for $2,000 to $6,000 for an ambulance is close to actual cost; I agree that it's gouging, and hospitals are guilty of the same practice. I remember when my mother-in-law lived with us many years ago, and my wife took her to the hospital, she was charged $12 for a band aide. That's not only gouging but irresponsible billing.

I hope health care reform fixes this kind of inflated billings.

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@parados,

Did you go to the website I linked to and read EVERYTHING they are proposing, or are you just going by the few examples I posted?

1 Reply

@hawkeye10,

hawkeye10 wrote:

Quote:
Individuals who pay their own bills are probably screwed, because they don't have anybody to advocate for them.

UM...ya, they are the ones who get charged $7.50 for two aspirin.

Actually I have had the exact opposite experience. Since my deductible has always been very high, maybe around $5,000, I pay for routine things, and I have been able to negotiate bills down below what an insurance company may pay. I have done this several times now.

On one occasion that I remember distinctly, I requested a meeting with the hospital billing department to go over a billing line by line. The end result was the elimination of hundreds of dollars, perhaps over a thousand dollars, I don't remember exactly, because they were unable to verify the service or treatment was actually used. One item was an ambulance ride, which did not happen, and that was a few hundred dollars. All of the fraudulant charges would have been paid by the insurance company because they have no way of verification. I am convinced that many if not most hospitals use a system of padding the bills to help cover for uncollectible bills from a percentage of the people that don't pay. I suspect the overbilling is sort of built into their system, and the conversations that I have had with people that work in the industry tend to agree with my suspicions.

On a couple of occasions, we asked the doctor if he gave discounts for cash from the patient with a high deductible, and pointed out we would be paying, and the answer was yes, and it knocked off a few hundred dollars.

It is simple common sense that in a free enterprise system, the more directly the user of the service deals with the provider, the more efficient the service and price will become.

We already know the Medicare and Medicaid systems are riddled with corruption, and it just comes with the territory, and perhaps it could be reduced but anyone that claims it can be eliminated is nuts. It is just the nature of the beast.

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@okie,

A few hundred dollars for an ambulance ride? No way, jose. They're usually about $1,000 and up - unless you live someplace with voluntary workers.

This is from Yahoo Answers:

Quote:

Resolved Question

What is the average ambulance cost (in the United States)?
-If you have no insurance.

* 1 year ago

Best Answer - Chosen by Voters
An ambulance ride costs around 1000.00. At least that's how much it was where I am (NY) b/c insurance didn't cover it. If you have no choice (it saved my life) then you have to use it and can pay the bill off. We worked out payment plan (if that is what you are worried about). Hope this helps.

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My buddy from the Franken campaign sent me this.

1) I'm impressed with how well Franken fields questions on the fly
2) I think it's great seeing public office holders having this kind of face time with people, and not just giving speeches from podiums.

T
K
O

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@mysteryman,

Most of them had even LESS to do with health care for everyone than the ones you cited.
one gives money to women to try to stop abortions
at least 3 talk about health care for veterans. One of those increases the health benefits for a family of a soldier that dies.
At least 3 of those listed are about tort reform

It's funny but the only ones I found interesting are already part of the Democratic bill.
Two call for pooling of people with no insurance. (That sounds like part of the current Democratic bill which no Republican is supporting.)
One calls for the electronic billing and a reduction in paperwork. (I seem to recall this being part of the current legislation)

That leaves HR2520 which I doubt a majority of Republicans would support.

Quote:

H.R. 2520 - Patients’ Choice Act
(Ryan, R-WI)

Introduced: May 20, 2009

Summary: The Patients’ Choice Act would transform health care in America by strengthening the relationship between the patient and the doctor by using the forces of choice and competition rather than rationing and restrictions. It seeks to ensure universal, affordable health care for all Americans.

The Patients’ Choice Act invests in prevention by establishing an Interagency Coordination Committee that will develop a national strategic plan for prevention. It also requires the development of a science-bases nutrition counseling brochure to be distributed to food stamp recipients and prohibits the purchase of foods that do not meet science-bases standards for proper nutrition.

This legislation outlines the requirements for certification of state-based health care exchanges to facilitate the purchase of innovative private health insurance. States are not required to create exchanges but have the option to do so. Any health insurance plan licensed in the state may participate in the exchange, but plans are not required to participate. Plans may still sell health insurance outside the exchange.

Under this bill, States may develop automatic enrollment procedures to ensure that any individual seeking health coverage has the opportunity to enroll in a plan of their choice. No one will be required to enroll in health insurance coverage. Plans offered through this exchange may not discriminate based on pre-existing conditions, so individuals are guaranteed access to a health insurance plan through the exchange.

Qualifying individuals will be eligible to receive an advanceable, refundable credit of at least $2,290 and $5,710 respectively in 2010, with subsequent annual cost-of-living adjustments. Should the credit exceed the cost of a health insurance product, the excess amount will be deposited into a medical savings account, or a health savings account.

The current individual income tax exclusion for employment-based heath benefits will be converted into a tax cut for taxpayers. The exclusion of health benefits from FICA payroll taxes remains. Contributions made by employers toward employee health care are still deductible as a business expense deduction.

Long-term services in Medicaid will be expanded to include an array of services, including assistive technology, community treatment teams, recovery support, and transitional care without the need for federal waivers. The legislative reorganization includes authorization of $100 million annually in new grants to states for program integrity. It also includes authorization of $100 million in outreach grants and transition rules to ensure seamless transition and effective continuation of care.

The legislation also aids low income families. Each eligible family that enrolls in the supplemental health care assistance program shall be issued a debit card with a dollar-amount value that may be used to pay for qualifying health care expenses. Families whose annual income does not exceed 100% of the poverty level will be provided $5,000. Families whose annual income is between 100% and 120% will receive $4,000. An additional $1,000 is made available for each family in which there is a pregnancy during a 12-month period. An additional $500 is made available for each member of the family under the age of 1 year old.

Fixing Medicare is also a key part of this legislation. Inefficiencies will be eliminated to increase choice in Medicare Advantage. Wealthy Medicare beneficiaries will be required to contribute a little more for their care under Medicare Part D, and all seniors will be rewarded for preventative healthy behaviors.

Reform to tort litigation for medical malpractice claims is also a key part in reigning in out of control health care costs. Funding will be available for States to establish review panels or health care tribunals. Qualifying review panels will be comprised of medical experts and attorneys appointed by the state who review health care claims and make a determination as to the liability of the parties involved. Parties may reject the determination and file a claim relating to the injury in a state court. Any party filing in state court forfeits awards from panel determination. Qualifying health care tribunals are composed of judges with explicit expertise in health care litigation who review cases at the request of individuals who have a health care claim. After review of the case, the tribunal would make a determination as to the liability of the parties involved. Parties may reject the determination and file a claim relating to the injury in a state court. The third option allows states to utilize a combination of the review panel and health care tribunal.

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@okie,

okie wrote:

One item was an ambulance ride, which did not happen, and that was a few hundred dollars. All of the fraudulant charges would have been paid by the insurance company because they have no way of verification.

I should think at least a none-ambulance ride should be easily noticed.
As well as others - here, insurance companies look over the bills (besides that they don't pay more than previously negotiated; otherwise, clear medical reasons must be noted).
Don't American health insurers have something like an auditing/revision department?

2 Replies

IT'S TIME FOR UNIVERSAL HEALTH CARE

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