General Discussion
In reply to the discussion: A Doctor Delivers Bad News--today's LA Times. [View all]King_Klonopin
(1,305 posts)Medicare, as it exists now, is not single-payer and does not exist in a vacuum.
It co-exists in a mishmash of for-profit, "non-profit", private, state and federal
government delivery and payment systems. Our health care system is so
complicated that it boggles the mind. There is so much gamesmanship regarding
billing practices, price determination, and actual reimbursement that the numbers
mean nothing.
It is difficult to extrapolate how a single-payer system would fare, based on our
experiences with Medicare.
If we had single-payer, all things would become more uniform and simplified.
Health care providers would bill for a service, but no longer dictate an arbitrary
cost for reimbursement.
Removing the profit-motive would make it easier to determine true costs and fair
reimbursement rates -- no more games by the insurance, drug, or hospital
corporations.
Removing profit from the equation would mean more money is available for actual "care".
The OP example of a $10,000 E.D. bill for a kidney stone demonstrates the problem
of a lack of uniformity. The rub lies in determining the reimbursement rates of "a service".
Using the above example, $10,000 was an egregiously greedy over-charge. Alternately,
if an insurer decided to reimburse a hospital E.D. only $100 for treating a kidney
stone, then hospitals would go out of business in a hurry. Fairness lies somewhere in
the middle. The true cost (without profit) for treating that kidney stone was probably
around $3,000 (Ultrasound of kidney $1,000, labs $800, MD fee $500, plus overhead of
$700 for meds, IV fluids, and general nursing care)
I can say this from my own experience: Medicare is a better provider than the other
insurers. Medicare costs less to administrate. Customers are more satisfied. It is easier
for hospitals to manage, much less adversarial. All of us should be so fortunate.