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King_Klonopin

(1,305 posts)
72. This thread is very confusing.
Mon May 9, 2016, 02:41 AM
May 2016

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.

This is the kind of problem that Medicare-for-all won't fix. Our health care costs pnwmom May 2016 #1
It SHOULD fix it elleng May 2016 #2
Thank you for this excellent post, my dear elleng... CaliforniaPeggy May 2016 #3
It's the best, Peg. elleng May 2016 #6
It's the program we thought ACA would use as a backup bigbrother05 May 2016 #90
Right. elleng May 2016 #105
I second that! Eleanors38 May 2016 #109
But that's not how Medicare works. Millions of seniors would object to changing the system, pnwmom May 2016 #5
The question of 'upheaval' is always with us; elleng May 2016 #8
But Medicare isn't getting very good rates because Congress refused to pass a law pnwmom May 2016 #10
Exactly. elleng May 2016 #12
I was talking to a 79 yr old full-time RV'er this morning ErikJ May 2016 #24
Good he's able to get them. elleng May 2016 #39
Yes he's got bronchitis and emphysema and has to be on ErikJ May 2016 #40
I'm currently paying 122 a mo for two asthma rescue inhalers passiveporcupine May 2016 #68
I was surprised at the new price of a prescription I hadn't needed for years. pnwmom May 2016 #70
I know, and I sympathize. passiveporcupine May 2016 #71
I need albuterol, too, alas. pnwmom May 2016 #73
price negotiating and the bill Craig234 May 2016 #38
Thanks for all the info. So it was even worse. pnwmom May 2016 #69
Yes, I knew this passiveporcupine May 2016 #74
The real reason why our health care is SO broken! - Must Read - You won't believe this! Baobab May 2016 #101
millions of seniors would object to service fees going down and a real prescription benefit? Warren Stupidity May 2016 #20
They would object to having their doctors retire and not being replaced. And most of these costs pnwmom May 2016 #31
lets unpack that derp, 'kay? Warren Stupidity May 2016 #45
There is a large group of doctors near retirement age right now. And if the government suddenly pnwmom May 2016 #46
So many assumptions. So little data. nt Gore1FL May 2016 #49
There actually is data. pnwmom May 2016 #52
I believe the apostrophe is ruining the link. cui bono May 2016 #88
If a phsycian can choose to retire early, maybe that physican is overpaid? hedgehog May 2016 #107
Maybe from our perspective but not from theirs. n/t pnwmom May 2016 #108
Single-payer/Medicare for all is useless... Bigmack May 2016 #51
That dud of a fighter jet for $2.3 trillion? (Yes, trillion) Lydia Leftcoast May 2016 #54
You said it: the AMA would scream Recursion May 2016 #78
Which raises, for me, the central question of the health care issue: malthaussen May 2016 #91
What about Nurse Pactitioners and Physician Assistants trudyco May 2016 #95
You do realize that Medicare does not pay what most docs and hospitals charge, right? passiveporcupine May 2016 #67
Single payer has to be free to the end user, (otherwise you would have to create a tiered system to Baobab May 2016 #100
There is no free lunch StarzGuy May 2016 #63
Right, there is no free lunch. elleng May 2016 #64
Sure, but look at Medicare Part D: no negotiations Recursion May 2016 #75
Medicare, as presently set up, is NOT the answer; elleng May 2016 #77
Under Bernie's plan for Medicare for all passiveporcupine May 2016 #79
Actually, Medicare can't negotiate prices -- but companies that provide Part D coverage, can and do. Hoyt May 2016 #80
exactly. Fast Walker 52 May 2016 #89
Doesn't Medicare set maximum allowable charges for specific services? MH1 May 2016 #4
It would be a good start. Warren Stupidity May 2016 #21
And doctors hate it. They can rip private insurers off, not Medicare. YOHABLO May 2016 #25
OTOH they can lobby Congress and not Aetna Recursion May 2016 #76
Many private insurers pay less than Medicare. Most others allow Medicare + say 10 or 25%. Hoyt May 2016 #81
Yes, for part-a and part-b services. Part d for drugs, no maximum. JustABozoOnThisBus May 2016 #97
Works well for the rest of the modern world. We must get private insurers rhett o rick May 2016 #13
In many countries, doctors are state employees. The difficulty here is persuading doctors pnwmom May 2016 #15
bullshit. The UK is an outlier. Warren Stupidity May 2016 #18
Yes In England but I don't believe that's true in Canada, France, and Germany. nm rhett o rick May 2016 #19
... Gore1FL May 2016 #50
Doctors that give a damn about their patients are for single payer - ReasonableToo May 2016 #53
That simply is not true. coyote May 2016 #85
It is exactly the sort of crapfest that a single payer system can fix. Warren Stupidity May 2016 #17
That's another misleading statement Android3.14 May 2016 #30
We have to bow out of the trade deals we are pushing to tie our own hands. Baobab May 2016 #102
"gap in her health insurance" Motown_Johnny May 2016 #35
Bullshit. Cassiopeia May 2016 #93
yes it would fix it, and the INSURANCE INDUSTRY creates that waste BY WASTING TONS OF TIME Baobab May 2016 #99
Of course it would fix it arikara May 2016 #104
we've become a nation of gangsters Fairgo May 2016 #7
Everybody is somebody else's ATM Tsiyu May 2016 #9
What is telling for me... Fairgo May 2016 #11
Most modern countries realize this Tsiyu May 2016 #14
+5 appalachiablue May 2016 #28
Ha! Tsiyu May 2016 #29
Fairgo above, 'We've Become A Nation of Gangsters', plus yours appalachiablue May 2016 #32
This could be our big break! Tsiyu May 2016 #48
I thought about it. Go for a Reality Show, only way to do it right. We gotta Think Big. appalachiablue May 2016 #62
On the reality show I was half way teasing, Cafe Press stuff is great! :) appalachiablue May 2016 #106
I am working on a show with one of my kids Tsiyu May 2016 #110
I leave it all to creative commons Fairgo May 2016 #86
Good deal! appalachiablue May 2016 #98
+5 appalachiablue May 2016 #27
Gangster: "Your money or your life!" Sounds about right... Califonz May 2016 #43
Henry Miller Fairgo May 2016 #87
Jack Benny: "I'm thinking!" n/t malthaussen May 2016 #92
Part of the problem is zalinda May 2016 #16
Thats the way to do it. It would take care of itself over time. Just put the option on the table. litlbilly May 2016 #23
Another part of problem is that corporations get better treatment than individual humans lostnfound May 2016 #42
"There will never, ever be single payer healthcare in the US" Doctor_J May 2016 #58
^^^ Ding ding ding ^^^ Duppers May 2016 #61
We have Universal Health Care SCantiGOP May 2016 #22
This is no longer true. zalinda May 2016 #65
medical industrial complex. pansypoo53219 May 2016 #26
+10 appalachiablue May 2016 #33
I went in for a broken collar bone, and came out with angstlessk May 2016 #34
Kicked and recommended! Enthusiast May 2016 #36
My husband and I go together Duval May 2016 #37
As long as the government allows Thespian2 May 2016 #41
I basically agree, but you'd never hear the end of it if the government refused to cover a drug Hoyt May 2016 #82
I moved to a socialist country... Thespian2 May 2016 #111
Half of 10K could still.. zentrum May 2016 #44
I recently had two separate discussions with conservatives who oppose Obamacare. I learned this Algernon Moncrieff May 2016 #47
The medical cartel... scscholar May 2016 #55
I read on du that Gingrichcare is an accomplishment that surpasses the cra and the VRA and Doctor_J May 2016 #56
Urgent care centers cover IV fluids and prescription pain killers IronLionZion May 2016 #57
So you agree that healthcare should be like buying a used car. Doctor_J May 2016 #59
When did you stop beating your wife? IronLionZion May 2016 #60
Last time I went to ER the bill was $850 WITH insurance. Triana May 2016 #66
This thread is very confusing. King_Klonopin May 2016 #72
My husband had an emergency root canal while we were biking in the Netherlands eridani May 2016 #83
ACA is the stop gap for Single payer. marble falls May 2016 #84
What the Rs refuse to acknowledge... freebrew May 2016 #94
We should have the Federal Insurance Plan trudyco May 2016 #96
In this particular case Gman May 2016 #103
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