Let's not do what is best for the country.

[flaja]

What we don't want are the wrong reforms, statist reforms, that ignore the role government plays in driving up the cost of HC.

As has been done with food costs post Food Stamps and college tuition post student aid.

 

[flaja]

talk is cheap 8 years of Silence was much louder...

I gather that you are talking about the Clinton Administration.

 

[flaja]

I don't think you understand. Nothing I've outlined would limit the provider's payments in any way.

Then how do you expect costs to not continue going up? If there is an endless supply of money to be spent (something the government would try to provide) the costs of the things that would be bought with that money would also be endless.

 

[Gipper]

At least one of the major parties is owned by special interests. This bill is proof positive of that.

Unlimited government results in too much power and money in the hands of the political class. We are now a nation ruled by elites for elites.

We need term limits as proposed by two R senators.

 

[PLC1]

Then how do you expect costs to not continue going up? If there is an endless supply of money to be spent (something the government would try to provide) the costs of the things that would be bought with that money would also be endless.

I think there are other ways of controlling costs besides cost controls imposed on providers. There is something to be said for market forces.

 

[PLC1]

At least one of the major parties is owned by special interests. This bill is proof positive of that.

Unlimited government results in too much power and money in the hands of the political class. We are now a nation ruled by elites for elites.

We need term limits as proposed by two R senators.

Yes, at least one of the parties is owned by special interests. Two, in fact.

I'll believe term limits when I see term limits.

 

[GenSeneca]

talk is cheap 8 years of Silence was much louder...

Flippant sarcasm is a poor substitute for intelligent discourse.

 

[GenSeneca]

I already said how my plan would be paid for.

You said employers would pay a portion and individuals would pay up to 10% of their income at which point Medicare would kick in and pay 100%.

That does not explain how expanding a program that is already bankrupt would be paid for...

Nothing I've outlined would limit the provider's payments in any way.

You did say expand Medicare, correct? Medicare currently limits payments to providers. Would you change that?

Of course I've controlled the costs, and used the free market to do it.

Explain to me the part in your program that brings down the cost of providing care.

 

[PLC1]

You said employers would pay a portion and individuals would pay up to 10% of their income at which point Medicare would kick in and pay 100%.

That does not explain how expanding a program that is already bankrupt would be paid for...

Medicare is currently serving the most expensive demographic, the one that private carriers would not touch. If it were covering everyone, then the cost per beneficiary would drop dramatically.

You did say expand Medicare, correct? Medicare currently limits payments to providers. Would you change that?

Oh, I see what you mean. Both private insurance and Medicare limit payments to providers, who bill two to three times what they expect to get in order to be paid a reasonable amount. Part of that little game is to make it impossible for people who try to go it alone without insurance of any kind, and part is to make up for people who don't pay. If the price were agreed upon in advance by the provider and the recipient, with the recipient paying the first part out of pocket, then that little game would not have to be played. Providers would bill what the procedure costs, and be paid accordingly.

Explain to me the part in your program that brings down the cost of providing care.

Isn't it obvious? The provider would be billing the patient. The patient would want to know the costs up front, and would be willing to negotiate, shop around, and forego unneeded services. The patient would be the one rationing, not the insurance company as it is now. The patient would then be able to bill Medicare for the costs that exceeded his 10%.

I'd give every legal resident over the age of 18 a card that would be swiped like a credit card on receipt of medical services, and one to the guardians for each minor. The provider would be paid by the credit card company, who would then bill the patient. If the patient could show that his part had been paid already, then the rest would be billed to Medicare.

That would also eliminate providers billing Medicare for services not provided, as has been happening under the current system.

It might not be perfect, but it is a lot better than what we have now.

 

[flaja]

I think there are other ways of controlling costs besides cost controls imposed on providers.

Then explain them. How can we control healthcare costs without imposing price controls a la Nixon.

There is something to be said for market forces.

The free market does not work for something like healthcare for the simple fact that healthcare providers are essentially a monopoly; few people will want to save money when it comes to their health and healthcare providers price their product accordingly.

Furthermore, insurance companies make profits by taking money from customers in premiums and then paying out as little as possible in return whenever an insurance claim is filed. The more an insurance company must pay out the less it makes in profits so it has an incentive to not pay out. I have lost track of how many times over the past 15 years my mother’s insurance has refused to pay for drugs- insisting that her doctors prescribe something cheaper.

 

[flaja]

Medicare is currently serving the most expensive demographic, the one that private carriers would not touch. If it were covering everyone, then the cost per beneficiary would drop dramatically.

So what is it about your average hourly-wage employee at Walmart that prevents insurance companies from writing them a policy while they collect Medicaid?

Oh, I see what you mean. Both private insurance and Medicare limit payments to providers, who bill two to three times what they expect to get in order to be paid a reasonable amount.

Huh? Healthcare providers charge outrageous amounts because they have a captive customer base. A hospital is like a wet bar in a hotel room- except that the hotel customer isn’t always naked in back. If Walmart can sell an aspirin tablet for a fraction of a penny, why do hospitals charge several bucks- because they know people will pay it when they have to have an aspirin tablet.

Isn't it obvious? The provider would be billing the patient. The patient would want to know the costs up front, and would be willing to negotiate, shop around, and forego unneeded services.

Don’t we already have this provider-payer relationship with the government and insurance companies serving in the role of payer? We do except that the government isn’t interested in saving money and insurance companies are interested in saving money only so they can increase their own profits.

I'd give every legal resident over the age of 18 a card that would be swiped like a credit card on receipt of medical services, and one to the guardians for each minor. The provider would be paid by the credit card company, who would then bill the patient.

So you are going to add another layer of profit to healthcare costs? Or are you assuming that credit card companies will work for free?

 

[PLC1]

So what is it about your average hourly-wage employee at Walmart that prevents insurance companies from writing them a policy while they collect Medicaid?

The employee doesn't need insurance while on Medicaid, and couldn't afford it if he did.

Huh? Healthcare providers charge outrageous amounts because they have a captive customer base. A hospital is like a wet bar in a hotel room- except that the hotel customer isn’t always naked in back. If Walmart can sell an aspirin tablet for a fraction of a penny, why do hospitals charge several bucks- because they know people will pay it when they have to have an aspirin tablet.

They also bill outrageous amounts because they know that they will not get paid what they bill.

And they aren't monopolies. There are multiple health care providers to choose from.

Don’t we already have this provider-payer relationship with the government and insurance companies serving in the role of payer? We do except that the government isn’t interested in saving money and insurance companies are interested in saving money only so they can increase their own profits.

Right. It is the patient who is interested in saving money. The problem with the current system is that the patient often doesn't even know what the charges are.

So you are going to add another layer of profit to healthcare costs? Or are you assuming that credit card companies will work for free?

I think they can collect money a lot more efficiently and cheaply than the government or an insurance company can do it, certainly more effectively than health care providers can do it. They would probably be willing to serve for the interest that they could collect from people who chose to pay by installments, just as they are willing to extend credit for everything else.

 

[flaja]

The employee doesn't need insurance while on Medicaid, and couldn't afford it if he did.

Precisely my point. Anyone who insists that every working person can buy their own health insurance is delusional. If every working person could afford health insurance- or had insurance through their employer- healthcare would not be the political issue it is. The last thing we need is a healthcare reform plan from people that don’t understand why healthcare reform is needed.

They also bill outrageous amounts because they know that they will not get paid what they bill.

You have documentation to support this claim? How many people in this country who cannot afford health insurance and who don’t have insurance through their employer cannot get Medicare or Medicaid?

And they aren't monopolies. There are multiple health care providers to choose from.

When is the last time you obtained a doctor’s services from someone who was not a doctor? Health care is not like fast food where a chicken sandwich can serve the same purpose as a cheeseburger. When you need healthcare, there is no substitute so the providers in the healthcare industry effectively have a monopoly.

Right. It is the patient who is interested in saving money. The problem with the current system is that the patient often doesn't even know what the charges are.

How would knowing the costs help save a patient any money as long as the patient can get healthcare only from the healthcare industry?

I think they can collect money a lot more efficiently and cheaply than the government or an insurance company can do it, certainly more effectively than health care providers can do it.

Don’t know much about credit card companies do you? Credit card services are not free to vendors. In order for a company to accept a particular credit card, they must pay a fee to the lender that issues that card to consumers. This is why some companies require a minimum purchase before you can use a credit card- otherwise the fees they must pay don’t make your business worth the credit card hassle.

They would probably be willing to serve for the interest that they could collect from people who chose to pay by installments, just as they are willing to extend credit for everything else.

First of all, isn’t it illegal to charge interest on unpaid medical bills? And second credit card companies collect interest already on unpaid balances and they still charge vendors for their service.

 

[GenSeneca]

Medicare is currently serving the most expensive demographic, the one that private carriers would not touch. If it were covering everyone, then the cost per beneficiary would drop dramatically.

I still don't understand...

Are you suggesting:

A. Everyone pays a monthly medicare premium of 10% of their income.

B. That they pay nothing in premiums to medicare but medicare only kicks in on the cost of health care when they have spent 10% of their yearly income.

C. Everyone pays a medicare premium AND they have to pay all health care costs up to 10% of their income.

Both private insurance and Medicare limit payments to providers, who bill two to three times what they expect to get in order to be paid a reasonable amount.

Do you have a source on that?

Part of that little game is to make it impossible for people who try to go it alone without insurance of any kind, and part is to make up for people who don't pay.

As I understand it, its because of the people who don't pay that a hospital charges exorbitant amounts for things like band-aids and aspirin, to make up their losses from paying customers.

Isn't it obvious? The provider would be billing the patient. The patient would want to know the costs up front, and would be willing to negotiate, shop around, and forego unneeded services. The patient would be the one rationing, not the insurance company as it is now. The patient would then be able to bill Medicare for the costs that exceeded his 10%.

That still doesn't make sense. I would still have to pay 10% and nothing more, so why would I care how much the total is?

Which brings me to the most important question, where is the other 90% of money coming from?

 

[pocketfullofshells]

Flippant sarcasm is a poor substitute for intelligent discourse.

no I think it made my point clear...Put up or shut up...The Republicans never put up, so they should pick the other now