<p>If our health care costs anywhere near the % of GDP of other countries the deficit would disappear</p>
<p>No, mini, it certainly can have truth to it. For example, they can approve one billing code but deny others even thugh they are approved codes, adn then pay only a portion of the claim. Then the appeals start and they say its been paid or its a duplicate claim,etc etc etc. This is a very different experience from the provider side. ANd the patient wont help as they have no skin in the game like with private insurance.</p>
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<p>poetgrl, it started during WWII in response to wage and price controls. The controls didn’t extend to fringe benefits, so employers began offering health insurance as a way of attracting employees. Meanwhile, the rest of the world started down the path of citizenship-based insurance.</p>
<p>As early as the mid-1940s, Presidents have been trying to correct course, but for 60 years the insurance companies have had a death grip on our health insurance (and therefore our medical care). It appears they still do.</p>
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<p>To the tune of 13Billion dollars short funds!</p>
<p>And I’m sure my boss just makes things up. Apparently the system is different in Washington as it is Illinois. Hospitals can write that stuff off; private providers cannot. $80-100k behind on payments can shut a company down real fast.</p>
<p>And let’s just raise taxes… that’ll fix the problem! Oh wait, Illinois just did that last year AND THEN told us that money wouldn’t go to pay unpaid bills (like that owed to healthcare!) but instead would go toward new pork projects!</p>
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<p>To answer your question, you may want to read “The Healing of America” by T. R. Reid ([amazon</a> link](<a href=“http://www.amazon.com/The-Healing-America-Global-Cheaper/dp/0143118218]amazon”>www.amazon.com/The-Healing-America-Global-Cheaper/dp/0143118218)). It’s not a long book.</p>
<p>He compares health care in other countries by travelling to them to see how he would be treated for his orthopedic problem and how much it would cost.</p>
<p>The answer to the question includes in part two things that most other developed countries have that we don’t:</p>
<p>1) a mandate that all citizens have at least basic health insurance
2) non-profit insurance companies</p>
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<p>Read in the April edition of Orthopedics Today.</p>
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<p>This is not generally correct. Most (not all) hospitals are not-for-profit, and therefore, as tax-exempt entities, do not pay taxes to write anything off on.</p>
<p>It would be helpful to our conversations about healthcare if more people understood this fact. It is not private enterprise, or various churches, who own the majority of hospitals in our country. Rather, most are not owned at all in the legal sense, but are controlled by trustees operating for the “public good” pursuant to charters from the various states as not-for-profit entities, exempt from taxes. We as taxpayers pay lots and lots of money to support these hospitals, and fund deficiencies in charitable funds by having the state pay millions in uncompensated care. </p>
<p>I’ve heard so many on this board talk about our wonderful “private” healthcare providers. Please understand that while some are, most hospitals are not privately owned. </p>
<p>We as taxpayers subsidize them and we as charitable givers support them. If more people understood this, they would have a better understanding of how potential savings under Obamacare and potential single payers are calculated.</p>
<p>Well hayden…your turn…</p>
<p>Tell us the healthcare system that is possible…and how we get there…</p>
<p>If we can only make small changes…let’s see the small changes…</p>
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<p>Ok so maybe “writing off” is not the proper term so let’s try this out…</p>
<p>Those hospitals have to spend a certain amount of their profits going back into the hospital rather than paying dividends to shareholders like some other companies are able to do. One way for them to “put their profits back” is to provide charity care.</p>
<p>Are you an accountant? Because that doesn’t make sense to me.</p>
<p>hops, you didn’t answer my question from last night: You ruled out single-payer. You ruled out tax increases on the wealthy. But there are costs to staying with our current system which is bankrupting American families and dragging our entire economy down. How do you propose we cover those costs?</p>
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<p>I’ve answered enough questions. Maybe you and mini could try answering the ones the opponents bring up for a change…</p>
<p>hops, yes, I know, that’s one question you have been scrambling to avoid: “What would you do instead?” I have to assume that, like most opponents of reform, you really don’t have a better idea, or any idea at all. Your reaction to the idea of reform is, “No. Period.” Sorry, but that’s no longer good enough. </p>
<p>We have a serious, serious problem. A solution has been proposed. It isn’t perfect, but every country which uses it is doing far better than we are. IMO anyone who takes potshots at the one solution on the table had better have a viable alternative to propose.</p>
<p>Obstructionism is no longer an acceptable response to this crisis.</p>
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<p>It seems to me we in this country are entirely too hung up on a tacit need to believe that we do everything better here than they do anything in any other part of the world. To believe otherwise is tantamount to being traitorous—certainly unpatriotic at the very least—and this has scarcely been more true than it is today, in our hyper-bellicose political climate. It’s all about an ideal that brooks no compromise. We are either a country of by-the-bootstraps, rugged individualists who are entirely self-suffiecient, ala our venerated founders (an ideal more based on myth than the true believers are willing to acknowledge), or we’re a nation on the brink of losing our national identity through the insidious insertion of “socialism.” It really seems to matter more that we hold on to the ideal, than that we do what might actually work better. </p>
<p>And we really are Darwinian about most things. To that end, those who have adequate health care in this country, believe the fault in not having adequate health care lies with those who fail to posses It. That is how it has remained acceptable for people to go bankrupt due to illness. They are somehow to blame for their misfortune. They did something wrong—failed to eat their vegetables, didn’t exercise, smoked cigarettes, cheated on their taxes or spouse (and are somehow receiving their moral comeuppance). Those who have deserve to have it, and those who don’t, have not for the same reason. We really are not a nation that believes we’re all it it together, that everyone is entitled to have certain basic needs met. Only the deserving meet that criterion. How do we recognize the deserving? Simple. They’re the ones that already have.
Just ask them. They already have good health care insurance. If you don’t, well, that’s your problem, isn’t it?</p>
<p>Poetsheart…I love your post.</p>
<p>""“Because providers know that they will wait years to even see a small amount of the money Medicaid owes them!”</p>
<p>“No, mini, it certainly can have truth to it.”</p>
<p>Jym - you know this ism’t even close to being true. Does Medicaid owe folks money? Yes. As a percentage of total owed? Much lower than private insurers. (we have LOTS of data on that one). Do “providers know that they will wait years to even see a small amount of the money Medicaid owes them!”</p>
<p>You know that isn’t even in the same universe of truth. No provider who is still in business is going to wait “years to even see a small amount of the money Medicaid owes them” while accepting 72% of the Medicare rate. They would - you would - be out of business a very long time again. It isn’t true, it isn’t close to being true - you know it, I know it, Hops-scout knows it - it’s just the usual anti-government screed. This is not an unexplored question. Medicaid has its problems. But on average it pays faster, and a higher percentage of claims, than private insurance. And the reason for that is simple: the private insurers have a direct interest in not paying. Medicaid can be less inefficient than we’d like, but lacks that incentive.</p>
<p>It is not true. </p>
<p>“Maybe you and mini could try answering the ones the opponents bring up for a change.”</p>
<p>The answer (one of many): a system with 3% overhead that serves the highest cost part of the population, and (I think) is close to the largest single-payor system in the world. It’s right here in the U.S. It’s not perfect. It’s not close to being perfect. But it’s not leaving a quarter of its population unserved or intermittently served. It works. It works really well. It could be better. Put everyone under that umbrella, and improve on it.</p>
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<p>I agree, and the excellent book fignewton mentioned, “The Healing of America” by T. R. Reid ([Amazon</a> link](<a href=“http://www.amazon.com/The-Healing-America-Global-Cheaper/dp/0143118218/ref=cm_cr_pr_product_top]Amazon”>http://www.amazon.com/The-Healing-America-Global-Cheaper/dp/0143118218/ref=cm_cr_pr_product_top)), speaks to this point. And if you don’t like single-payer, there are other systems that manage full coverage. It’s not an either/or choice; where’s our great American creativity?</p>
<p>The book was originally going to be titled “We’re Number 37!,” but I guess the publisher thought that wouldn’t fly. When faced with WHO statistics that don’t show we’re on top, Americans are likely to just blame our poor showing on something else–diet, exercise, bad behavior, too much cell phone spending. Somehow we always find the money (without new taxes) for wars and Homeland Security. </p>
<p>If you prefer video, PBS’s Frontline also did a report with Reid, “Sick Around the World.” Full video, transcript, and related materials are [available</a> online](<a href=“http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/]available”>http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/).</p>
<p>And then there’s the [music</a> video interpretation](<a href=“http://www.youtube.com/watch?v=yVgOl3cETb4]music”>http://www.youtube.com/watch?v=yVgOl3cETb4).</p>
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<p>^^ I have only one thing to say, mini: Bingo!</p>
<p>I’ve realized something about opposition to single-payer. The argument seems to be: It’s not perfect. Implicit in that argument is the idea that we cannot make ANY changes until we find THE perfect solution. Which doesn’t exist. Therefore, NO changes, EVER. (This message brought to you by the only party who flourishes under the current system: Big Insurance.)</p>
<p>As LasMa says, no system is perfect. However, dstark asked me to say which system I favor, so I will.</p>
<p>I favor a combination of initiatives, since no one activity in isolation accomplishes our goals. First, I would open up Medicare to those under 65, with a deductible to discourage overuse. This would accommodate the needs of people who want access to lower cost catastrophe coverage. I would also have Medicare form different plans, not just one.</p>
<p>Regardless of what SCOTUS does, we should keep Obamacare’s prohibition of pre-existing conditions, along with Obamacare’s rules about EMRs, kids under 26, ACOs, etc. These are all great initiatives.</p>
<p>We also need to do something stronger about insurers. The rule that mandates 85% of revenues go toward patient care in the Obamacare law is too loose, since the insurance companies are right now running around trying to say that CEO salaries are somehow patient care related.</p>
<p>Lastly, we need to do something about rising cost of medical equipment. Reinstituting the Certificates of Need would be a start.</p>
<p>It always cracks me up when someone tells ME what I know. What I know, from being on the provider side, is that Medicaid allows about 20 cents on the dollar for what I do. They cap the fee and the number of hours they will “allow”. And sorry to disappoint you but they often do NOT pay correctly the first time the bill is submitted, requiring resubmissions, forms, documents, phonecalls, you name it. And unfortunately many of the patients did not keep their appointments as scheduled, which leaves large unfilled hours in the schedule. The no-show rate was quite high. I was asked by some case managers to engage in illegal billing, which I of course politely declined to do (eg bill for a service in one calendar year before the service was to be provided in the next calendar year. Um, NO.) So I chose to longer be a Medicaid provider. If I was, I probably couldn’t keep my doors open, even if they paid as they are supposed to. The providers I know who do accept any of the 4 Medicaid insurance will have a mixture of payor types in their practice so that they won’t go broke waiting for payments from any particular carrier.</p>
<p>You can continue to live in fantasy land, but please stop telling me what I KNOW. What I know is that Medicaid is as broken, if not moreso, than other insurers.</p>
<p>Jym, do you have any recourse with regard to no-shows?</p>