The only reason Medicare is "in trouble" is that our whole health care system is FUBAR.

[99th_Monkey]

I am covered by Medicare, and was covered in Feb. of 2010 when I had open heart surgery. I just received a statement from my insurer (United Health Care) detailing the expenses charged for my care. I was in the hospital for 6 days, and the entire bill came to $104,000.00. Some of the individual items charged by the hospital certainly appear to be conspicuously over-inflated. For example, I was charged nearly $15,000 for "Pharmacy" (I had no pharmacy supplies that were particularly spendy that I recall), and over $19,000 for "supplies" (gold-platted bedpan maybe?), and then another $10,200 for "CCU Charges" (whatever the fuck that means, I haven't a clue), and yet another $4,500 for "Respiratory". Some of the other larger items in the bill are $21,000 for "Operating Room", $7.244 for "Laboratory", $4,400 for "Blood", $11,400 for "Cardiology".

I guess the "good news" if you can call it that, is that I have not been personally charged with any of this, so I'm definitely happy about that from a personal standpoint (politics aside); however it is clear from looking at these charges to Medicare that the hospital is inflating charges and attempting to milk as much as they can from Medicare. This kind of practice is what has Medicare "in trouble" -- to the extent that Medicare really is in trouble, which is debatable -- not because the Medicare program itself is "broken". Rather, it is the entire larger health care system that is broken and needs to stop over-charging Medicare and other health insurers too for that matter.

[jtown1123]

1. Until we address the underlying cause of inflated health care prices, Medicare cannot be "fixed"

[defendandprotect]

3. We need two strong pro-universal health care -- and anti-war candidates in 2012 -- !!!

You know, the kind of people we thought Obama was!!


http://www.stophoping.org

[99th_Monkey]

4. bingo! nt

[defendandprotect]

2. Also creating many disabled workers -- for lack of health care !!!

[99th_Monkey]

6. Well, there's always SSI for the disabled to fall back on.

But wait! The budget-cutting curmudgeons want to cut that program entirely, creating yet another opportunity for Obama to roll over and give them what they want.

never mind.

[defendandprotect]

10. That's exactly what I'm referring to ... article up today -- I posted it on another thread ....

I'll look for it --

At the moment I can't find it -- will keep looking as I go along --

[Cleita]

5. K&R

[cbayer]

7. Medicare sets their own payment rates and doesn't pay what the hospital charges.

As a matter of fact, no government entity or insurance company pays what hospitals put on the bills. They inflate their charges to incorporate non-billable expenses and to stake a negotiating position. Charges are typically three times what they actually receive either from either the government or private insurers. They also inflate charges to reflect costs of patients who have no insurance or resources.

It's important to distinguish private for-profit hospitals from community or publicly funded hospitals. The former find ways to avoid non-paying patients and are focused on rewarding their owners. The latter are hemorrhaging and generally do not make enough to cover their costs.

That being said, you are correct. The whole system is FUBAR, but the hospitals are just a part of the problem. The only way to solve it, imo, is to have a single payer. Until then, it will be patchwork.

[defendandprotect]

11. Thank you --

Also huge losses to corporate criminals --

every one of the drug companies has ripped off Medicare!!

[99th_Monkey]

12. Agreed

I didn't mean to imply that Medicare was actually paying 100% of those charges, so thanks for the clarification.

[DURHAM D]

8. Of that $104K how much did Medicare actually agree to pay?

What the provider bills and what they get reimbursed for are two different things.

[99th_Monkey]

13. Well, I'm not certain actually,

this "notice" (it sez "this is NOT a bill") actually says Medicare paid NONE of the charges, but I doubt that will be the final outcome.

[Gormy Cuss]

9. CCU= critical care unit, the ward where you spent at least some of those 6 days n/t

[WCGreen]

14. They are limited in what they can charge for procedures.

I think they put as much over head as they can on all the other stuff.

Not that I condone this type of accounting, but accounting it is.

[aint_no_life_nowhere]

15. I refuse to call it a system

We have gangster insurance company cartels extorting every last penny they can, while businessmen in white coats otherwise calling themselves "doctors" would kill us all if it weren't for the fear of medical malpractice, something the Republicans would love to eliminate altogether. I know there are very admirable and heroic doctors who give their time to the poor and travel to dangerous places on earth, risking their lives and their health to treat the downtrodden. But those doctors with a sense of duty to humanity are getting rarer and rarer.

[99th_Monkey]

16. Agreed. I am very fortunate

My Doc is the best, doesn't normally take Medicare patients due to not getting full payment, but
he grandfathered me in when I turned 65, cuz I'd been with him nearly 10 years already.

[deaniac21]

17. Absolutely, I'll bet you could of gotten that done for less than

$2000 at the vet.

[99th_Monkey]

18. Don't get me started about the VA

They totally botched a very simple hip replacement on me, almost did it on the
wrong leg (if my wife hadn't noticed the Dr. notes at the foot of my hosp. bed).

I almost never walked again because of their incompetence.

If I hadn't found some extaordinary orthopedic surgeons willing to clean up their mess, I'd be in a wheelchair.

[deaniac21]

19. veterinarian

[99th_Monkey]

20. Oh ....ya, well there is that ... LOL. nt