<p>I agree…I think single payer is the way to go…</p>
<p>But are people really turned away…</p>
<p>I know insurance companies do…</p>
<p>But do doctors and hospitals…</p>
<p>2040…</p>
<p>A lot of us are going to be lucky to make it to 2040…</p>
<p>I will.</p>
<p>I am wondering about the 2099…“Will that be long enough,” the clerk said. Let’s see…I am going to give my age away: I’d make the guinness book of world records! Over and again once more.</p>
<p>"What happens if I am worth zero and don’t have health insurance? Will my cancer be treated?</p>
<p>“But do doctors and hospitals…”</p>
<p>No (or at least unlikely), and yes, doctors and hospitals turn away patients. Heck, if you have cancer and have Medicaid in my town, you are going to struggle really hard to find a primary care doc, let alone cancer specialist. Hospitals are only required to provide emergency care. </p>
<p>In fact, even if you HAVE insurance, you might not get the best care, based on your insurance status. When my wife was diagnosed, the very FIRST question out of the doctor’s mouth (a friend, by the way) was “Which insurance?” The choice of care was/is dictated by which insurance - we were lucky, as we had the “right one”; he would have been forced to choose a demonstrably less effective option had we had the one more common in our community (supposedly the “best” in the state).</p>
<p>Best medical care in the world.</p>
<p>Post 163 is amusing…post 164 is a little disturbing…for some of us…</p>
<p>Post 164 should be disturbing for everyone.</p>
<p>
</p>
<p>If Medicaid in Washington is anything like Medicaid in Illinois your only choice is to find a non-profit hospital who is willing to write off the services they provide you. Because providers know that they will wait years to even see a small amount of the money Medicaid owes them!</p>
<p>Hospitals are required to provide emergency treatment, because they a) get millions of dollars of state money; and b) most of them are not-for-profit, which means they are tax exempt. Providing emergency treatment means emergency, not on-going general treatment. </p>
<p>Note also that physicians are not required to do anything for you, unless they’re employed in the emergency room, or are employees of the hospital. Most physicians are self-employed. If you’re in the hospital without means to pay, chances are you’ll only get a resident.</p>
<p>However, even if hospitals are required to provide emergency care regardless of ability to pay, they can still go after you for payment. If they choose to, they can go after every cent you have, until you’re bankrupt. </p>
<p>Most bankruptcies result from medical issues for a reason.</p>
<p>
</p>
<p>Months, perhaps. Years, no. The average hospital depends on Medicare for roughly 40% of their patient revenue. There’s no way they wait longer than a year for payment. Just pull up the financials online and take a look at their accounts receivable and you’ll see that the uncollected funds are not due from Medicare.</p>
<p>“Because providers know that they will wait years to even see a small amount of the money Medicaid owes them!”</p>
<p>Do you just make this stuff up? What planet to you live on? I work for the Department of Social and Health Services. Medicaid is REQUIRED to pay in 60 days following the month of service delivery, and they do. My office provides Medicaid-paid services - here it is less than 30 days. Private insurance? Could take months and months and… And in the meantime, in order to bring more pressure on private insurance, they will go after the patient. You have no concept of how much more efficient the public sector is than the private one. They are short funds, that’s all.</p>
<p>Many of the patients on Medicaid HAD private insurance (I gave you, in detail, the case of my friend). Their private insurance bankrupted them, and when they became unable to work, lost their private insurance all together. </p>
<p>“If Medicaid in Washington is anything like Medicaid in Illinois your only choice is to find a non-profit hospital who is willing to write off the services they provide you.”</p>
<p>Wrong again. In providing the certificate of need that allows hospitals (both for-profit and non-profit) to deliver services, the state department of health (both in Illinois and in Washington) sets down requirements for both acceptance of Medicaid referrals, and for levels of charity care. (What is true is that the for-profit hospitals are a very powerful lobby, and will scream bloody murder when they are denied a certificate of need. The result, which I wrote earlier, is that more hospitals than needed have to shil to provide high-profit services - the profit margins are high, but the inefficiencies are higher).</p>
<p>Medicaid does provide a lower level of reimbursement (usually around 72%) than Medicare. Where I live, the chief blockage is at the level of the primary care doc - the one that would provide the initial referral for a cancer specialist. And, yes, many die for lack of (adequate) care.</p>
<p>All insurance companies are required to pay within a specific time period (usually 30-45 days) but that does not mean they do, Mini, and that includes Medicaid. In my state, there are 4 Medicaid carriers - the traditional Medicaid and 3 contracted providers (can’t recall the names off the top of my head). I have heard stories from many providers as to the protracted payment problems they have faced. They may get a response from Medicaid in the allowable period, but it may have any of a variety of reasons for non payment ( e.g.,patient didnt provide correct coverage documentation for that period even when the information provided was correct and their coverage was in place, a statement that the services werent authorized when they were, etc etc) Please don’t tell me that these issues are all the providers fault. On occasion Medicaid has admitted to a computer coding/claims edit problems, but for the mostpart the denials and payment delays are incorrect, requiring multiple timely refiling, written letters of appeal, more delays, denials, you name it. If you think this system works smoothly and with few glitches, it is not the other poster you were responding to (hops scout) who lives on a foreign planet.</p>
<p>[Taiwan</a> Takes Fast Track to Universal Health Care : NPR](<a href=“http://www.npr.org/templates/story/story.php?storyId=89651916]Taiwan”>Taiwan Takes Fast Track to Universal Health Care : NPR)</p>
<p>
</p>
<p>Really good link, Mini, thanks, and great ideas. This will cost them 8% of GDP. Ours currently costs 16%. Half as much. Even if you toss in a percentage point for larger admin costs, larger population, less efficiency, it seems we should be less arrogant and way less political and way more open to new and better ideas. It seems so simple to me.</p>
<p>In our state, the providers wrote the Medicaid payment program along with the state. It is called Provider One. It has its kinks, and problems. The documentation problems you speak of are precisely the same as those which exist in the private sector. We had the “contracted billers” too, and got rid of them - they were used to acting as if they were working for a private insurance company, with all that means. </p>
<p>The difference is in the incentives. In the private sector, there is a clear incentive not to pay, or to pay slowly, or to deny coverage. Or to drop coverage. Medicaid has no such incentive - which is why it is more efficient than the private systems.</p>
<p>No, Medicaid does not always “act smoothly”. But there is data - all kinds of data - on payment records of Medicaid v. private insurers, and (at least in my state) it isn’t even close to comparable.</p>
<p>“It seems so simple to me.”</p>
<p>It really IS that simple. Again, I had a business office in British Columbia. It really IS that simple. All it takes is political will. We have the system we have because we choose to have it.</p>
<p>There were problems here that took months and months and more months to get straightened out. Sure private carriers are often in the “slow pay-no pay” mode (dont get me started about problems with UHC- they are the worst), but the point was that so is Medicaid. No reason to paint it like some beautifully greased wheel with few if any kinks. That just hooey, and attacking a poster by asking if they make it up or it they live on another planet is simply uncalled for.</p>
<p>OTOH, claims for the uninsured never get paid.</p>
<p>BTW hayden, it did indeed take me 2 years (yes, years) to get paid on several cases with UHC. The amount of time and energy it took with sending records, letters, documentation, appeals, more appeals (had to go to the PO and stand in line to send it certified b/c they only gave PO numbers, not street addresses, so couldnt use Fedex) , phonecalls, more phonecalls, etc etc was un friggin believable.</p>
<p>
</p>
<p>You said it, Sister.</p>
<p>Jym26 -</p>
<p>He wrote:</p>
<p>“Because providers know that they will wait years to even see a small amount of the money Medicaid owes them!”</p>
<p>You know - personally know - that this is patently untrue - and it is untrue in every state in the union. Yes, there are cases that take a long time to resolve. But the idea that it will take years for providers “to even see a small amount of the money Medicaid owes them” is just BS. You know it is BS. I know it is BS. The poster knows it is BS. (And the idea that is “worse” in the government-run programs is also BS - and there is very good data on that one. And for good reason - the incentives are different.)</p>
<p>It’s just anti-government screed. It’s BS. He made it up.</p>
<p>"One of the stupidest things we do is tie insurance to employment rather than citizenship. </p>
<p>You said it, Sister. "</p>
<p>Agree.</p>
<p>The fact that you can work 40 years and lose your job to cancer and lose your health benefit right when you need it shows how illogical our system is.</p>
<p>
</p>
<p>Right? Who came up with this? </p>
<p>“Hmm. let’s see. If someone is too sick to work, then THEY won’t need healthcare.”</p>
<p>Is this the case in any other country in the world? I mean, it’s bizarre that we have decided to put people’s employers in charge of choosing their health plans. So odd. I can’t even figure out how this happened.</p>