<p>[Medicare</a> pay: SGR fatigue - amednews.com](<a href=“American Medical Association”>American Medical Association)</p>
<p>First off… I am naked now. Lol</p>
<p>I am going to get dressed in a few minutes. :)</p>
<p>Zoosermom, yeah… I think your post number 100 is great. I think you are right on…</p>
<p>Medicare in NOT a solution. It doesn’t have bargaining clout? it has a “take or leave it” reimbursement policy. It is what is causing the doctor shortage for middle America. Those on it (Medicare) flood to those that will take it - until there isn’t room for any more. That is why concierge medicine (MDVIP) is gaining in popularity. Quality and convenient medical care is becoming another differentiator between the “haves” and “have nots’”</p>
<p>All Obamacare/Medicare expansion will do is ensure 6 hour waits to be seen in the waiting room for everyone!, vs. just in the emergency room for the uninsured.</p>
<p>
I really can’t tell you how amused I am by this. My husband swears his goal in life is to have his kids all launched so he can walk around his house naked just once in his life. </p>
<p>I also wonder if healthcare should be a one-size fits all in terms of geography. It may be necessary to do things that would work remotely in some parts of America but would still qualify, if that makes sense.</p>
<p>My doctor has a really nice practice. I adore him. Never turns anyone away and his office has that real family feel. I had some alarming blood results last year and for some reason his office couldn’t get in touch with me, so they called my mother to get me. Which I was fine with. I have some ongoing health issues and I like the way my doctor handles it. He doesn’t require unnecessary visits and will speak to me on the telephone or by email every few months and will see me if I choose to come in. I generally do once a year or year and a half, but I have had doctors who made me actually come in every three months for something that I will live with for the rest of my life. And also required lots of unnecessary testing. I hated that.</p>
<p>I think there is something in between medicare and the private health care system we have now that may work better for the American peoplle…</p>
<p>I look at the complaints about medicare…</p>
<p>Yeah… I can see doctors want the higher margin business…but when you look at the whole package, are doctors really suffering?</p>
<p>If 50 percent of my business makes nothing, but the other 50 percent makes a lot of money so I net out a very good living, is that really bad?</p>
<p>There are businesses out there where the profits are made by a small segment of sales…</p>
<p>When I was a trader, half the trades were losers, but the profitable trades paid for the losers…</p>
<p>Yeah… I would have liked to eliminate the losers… Just give me the winners. :)</p>
<p>I worry about Medicare.</p>
<p>First of all, in that giant gift to the pharmaceutical industry a few years ago, isn’t Medicare NOT allowed to bargain for the cost of prescription drugs? I remember that being a huge scandal.</p>
<p>Also, when medicare reimburses doctors and hospitals for less than a procedure costs, well, that can be absorbed now if other parties pay, but if that’s all we have then those procedures will either go away, be done less and less frequently (rationing) or be done more and more quickly (less quality) to make them less of a financial drain to the doctor and hospital.</p>
<p>Zoosermom, you tell your husband he is missing out. He has a good goal.</p>
<p>I am not a big fan of unnecessary testing. I guess deciding whether some tests are unnecessary is subjective.</p>
<p>Your doctor is a gem.</p>
<p>From what I read in the article, medicare does not charge less than the cost of a procedure…</p>
<p>There is a section about medicare in the article…</p>
<p>The other side of the coin…the cost of procedures not covered by medicare is hard to explain…</p>
<p>I was playing golf one time with a guy who sold medical equipment. This is just an anecdote, but I like it.</p>
<p>The guy said, “We never change the working parts of the equipment. We just change the cover of the equipment and every year we increase prices 10 to 15 percent a year”.</p>
<p>The patients pay for this…</p>
<p>I am known to be on the right as a matter of philosophy, but I also understand that we have to work with the circumstances we actually have in front of us. The fact of the matter is that going forward our population is going to tilt toward the elderly, who are expensive to care for, with fewer young people. What we may like in theory may simply not be practical in the demographic reality. We have to have rationing (although I would never support penalties for self-pay by choice), and we are going to have to cut spending a lot. The ultimate outcome probably will be less that I would have liked and more skewing to the other side, but there are reasons for that. I read an interesting article yesterday by a man who is very liberal, but who was choosing to acknowledge what he considered an important aspect of the conservative mindset. He said that people on the left should consider the fact that bureaucracies can and often do get out of hand, rather than using that as a point of argument to be defended. Of course, he also said that conservatives were stuck in mud and too unlikely to make needed changes, so he wasn’t drinking any Kool Aid. Point of this is that new healthcare is likely to be government heavy and everyone should be on guard for governmental abuses, which can be just as outrageous as those perpetrated by private companies.</p>
<p>
</p>
<p>Would you believe he is almost 7 feet tall and has flaming red hair? True story.</p>
<p>
</p>
<p>It reminds me of a House episode where he gives a speech about a new drug that he knew it was good since its old version was good and the new one is the same except the price.</p>
<p>Many illuminating comments on this thread. After the healthcare reform or non-reform in 2009, I feel worn out, defeated.</p>
<p>I agree… We have to be on guard…</p>
<p>The main reason govt spending is likely to rise as a percentage of gdp over the next 30 years is the aging population.</p>
<p>We should deal with this in a practical way. </p>
<p>Zoosermom, your posts are quite good. I really don’t have to say much after reading your posts. You are saying things very well.</p>
<p>Igloo, I remember that House episode.</p>
<p>Zoosermom, I have to admit that I never imagined your doctor looking like that. Wow…</p>
<p>Here’s what doctors do to make Medicare pay more. My friend had three (non-life threatening) skin cancers. The doctor had her make three visits to have them removed one at a time. Must have something to do with the billing codes.</p>
<p>TatinG, that could still be a lower cost than private costs.</p>
<p>Is the reason to have a patient come back multiple times to make more money?</p>
<p>dstark, I really appreciate that. There has to come a point when the animosity has to stop (I’m not talking about CC) because we have real problems.</p>
<p>As a personal matter, I love, love, love to hear from other people. I like to know what they think, what they value, what they detest. Particularly if it’s different from what I think because, frankly, I already know what I think. That’s why I do have friends who are (gasp!) liberal and even some self-professed, honest to goodness commies. There is often some common ground if one looks for it, and even if there isn’t, most people are fine people doing the best they can and don’t deserve to be hated and demonized. Different isn’t necessarily scary, sometimes it can be spicy! And what’s even more fun is when you meet someone who is smart, interesting, insightful and doesn’t fit into the box of your expectations. When I first came to CC I was genuinely surprised by how many people didn’t know that there were liberal (in the social sense) Christian denominations and thought we were all going about picketing funerals or something. </p>
<p>Anyway, back to the topic . . .</p>
<p>:)…</p>
<p>“As a personal matter, I love, love, love to hear from other people. I like to know what they think, what they value, what they detest. Particularly if it’s different from what I think because, frankly, I already know what I think. That’s why I do have friends who are (gasp!) liberal and even some self-professed, honest to goodness commies”</p>
<p>You and me both. 
</p>
<p>I don’t think I have any commie friends. I do live in Marin County where people live republican and vote democrat…the old Ted Kennedy line. </p>
<p>I do have some conservative friends and I have to admit…sometimes they say things and I wonder, “How can I be your friend?” They probably think the same thing about me. Lol</p>
<p>If I didn’t have pinko friends I would be very lonely, dstark. Besides, I find it my job to give them a reality check from time to time! And they remind me of the importance of idealism.</p>
<p>I’m having lunch with one of my dearest friends of decades tomorrow. Can’t wait. He is the person who is so close to Justice Sotomayor that we have been at the same parties/family events for this mutual friend over the years. He is as credentialed of a liberal as you can get and we spar, argue, debate, disagree and deeply love each other. My life would not be better if I had turned my back on him and I know he feels the same way. Were I ever in trouble he would be my first call. Interestingly, he represents two of the entities that are the left’s greatest bogeymen of the right.</p>
<p>:)…</p>
<p>Even under my private BCBS insurer, a MD is paid more for 3 separate visits than just one visit. It is interesting to see the difference coding and billing makes. One MD had me billed for a MD visit for each and every allergy shot I got (2/week for many, many months). The other billed me for an office procedure for the same allergy shots. Reimbursements were quite different for the two offices.</p>