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Doc
Doc
Joined: Feb 27, 2010
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October 8th, 2012 at 8:06:43 AM permalink
Quote: SOOPOO

Doc.... you know that if you accept Medicare you only get paid 80% of the fee from the government and have to go after the remaining 20% from the patient... If you accept Medicaid, which now pays me FOURTEEN PERCENT of what real insurance pays, you are legally prevented from billing the difference. The same holds true for other government run 'insurances', like No Fault and Workman's Comp. They pay me around 30% of what real insurance pays, and I am forbidden from billing the patient the difference.


I didn't know the percentages, but I think I understood the principles. If you are prevented from billing the difference, and if you consider the 14% or 30% too low for your services, you are still permitted to decline that small percentage and bill the patient directly, are you not? I have known a few physicians who have declined to participate in Medicare, and it wouldn't surprise me if quite a few do not accept Medicaid. Do you just accept the low percentages from patients that you expect would not pay (or not be able to pay) themselves? Under that policy, it seems as if you would be choosing to receive small payments vs. going unpaid vs. declining to provide service. Accepting the lower percentage seems like a charitable service which you can provide or not. Some lawyers do pro bono work, too.
AZDuffman
AZDuffman
Joined: Nov 2, 2009
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October 8th, 2012 at 9:27:17 AM permalink
Quote: estebanrey

As a Brit I'll never understand the opposition to national healthcare you get from large parts of the American right wing. The thought of losing the NHS would scare the hell out of me. I also don't understand why the word 'socialism' is used as an pejorative word in the States either; where I'm from it's just a political viewpoint you can either agree or disagree with. Nor is it an all or nothing like a lot of [paranoid] Americans seem to be (from reading this thread), you can have 'socialised' healthcare alongside private healthcare, nor does having national healthcare mean you're suddenly going to turn into communist China.

Life and health are a human right and shouldn't be dependent on how rich you are. The NHS prioritises by need, the US health system seems to prioritise by the wealth of the patient which is wrong is my opinion.



The part about "prioritize by need" is the scary part. Who is to say who needs what more? To allow people to pay for what they want themselves is most fair. Why should I go without when I am inv to pay just because some burr rat somewhere says someone else 'needs' it more?

Socialism is a dirty word here because we know socialism destroys wealth and initiative while sapping freedom.
All animals are equal, but some are more equal than others
thecesspit
thecesspit
Joined: Apr 19, 2010
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October 8th, 2012 at 9:46:20 AM permalink
Quote: AZDuffman

The part about "prioritize by need" is the scary part. Who is to say who needs what more? To allow people to pay for what they want themselves is most fair. Why should I go without when I am inv to pay just because some burr rat somewhere says someone else 'needs' it more?



"Prioritize" by ability to pay is also scary when it comes to healthcare. Who says you should have a bigger right to a better quality of life because your wallet is bigger? Why should I go with when I am able to pay something, just because some burr rat somewhere else has a more money, and says they can pay more?

It's moot though, as Obamacare isn't socialized healthcare. It's a Frankenstein's beast of a system that solves none of the problems and results in the problems that both private and government run healthcare have. It's quite remarkable in fact, that you could take the system you have (which is quite wasteful and inefficient already (*)) and actually make it worse.

(*) you can tell me all about the wonderful care, but the amount of money that goes to administration is the sort of shocking levels that would get some businesses shut down.
"Then you can admire the real gambler, who has neither eaten, slept, thought nor lived, he has so smarted under the scourge of his martingale, so suffered on the rack of his desire for a coup at trente-et-quarante" - Honore de Balzac, 1829
Paradigm
Paradigm
Joined: Feb 24, 2011
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October 8th, 2012 at 9:57:37 AM permalink
Quote: estebanrey

Nor is it an all or nothing like a lot of [paranoid] Americans seem to be (from reading this thread), you can have 'socialised' healthcare alongside private healthcare, nor does having national healthcare mean you're suddenly going to turn into communist China.



I think the main problem is that you have the government in Obamacare telling insurance companies what they can and can't offer me. Maybe I don't care if less than 85% of my premium dollars are going to actual healthcare.

I have an HSA plan right now that covers essentially none of the first $5000 of my medical expenses and as a result the premiums as compared to a PPO type plan are roughly $400 per month cheaper. I put those premium savings in my own HSA account and use the dollars to pay my out of pocket expenses. I shop for my medical care because I am paying for the first $5,000 each year. Some years are better than others and I can roll dollars over to the next year. Others not so great.

From what I have read, this HSA plan as is, will fail this 85% test and the insurance co. will have to change the plan to cover more care and as a result increase my premiums for the increased care coverage. I don't want that, I want coverage for catestrophic type stuff and I will bear the burden of the $5,000 per year. High deductible plan options are going to go away under Obamacare.

We need changes to the system as is. Portability of insurance is a key component that needs to be addressed. If you provide portability of insurance, the pre-existing condition problem will go away over time. Those with pre-existing conditions today need to have an option for insurance they can afford, not sure how that problem is solved but it needs to be.

But penalties for lack of insurance, forcing insurance companies to allow kids on their parents plan till age 26 (why is that so important again.....get them their own plan when they are healthy and young....what exactly is the gameplan for these "kids" when they turn 27, force the ins. co's to keep them on until they are 40!), telling a private insurance company how they are to spend their premium dollars, ect. some of the provisions of Obamacare are just not the right approach in my opinion
buzzpaff
buzzpaff
Joined: Mar 8, 2011
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October 8th, 2012 at 10:06:16 AM permalink
" We need changes to the system as is." Not about to happen. Just empty promises. Like both candidates talking about closing
loopholes. Not gonna happen !
AZDuffman
AZDuffman
Joined: Nov 2, 2009
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October 8th, 2012 at 10:49:25 AM permalink
Quote: thecesspit

"Prioritize" by ability to pay is also scary when it comes to healthcare. Who says you should have a bigger right to a better quality of life because your wallet is bigger? Why should I go with when I am able to pay something, just because some burr rat somewhere else has a more money, and says they can pay more?



It is called freedom and a free market. Why should you not get a house you want because you are outbid? Just because it is "health care" makes no difference.

Quote:

(*) you can tell me all about the wonderful care, but the amount of money that goes to administration is the sort of shocking levels that would get some businesses shut down.



A decision for the stockholders, not the government.
All animals are equal, but some are more equal than others
rxwine
rxwine
Joined: Feb 28, 2010
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October 8th, 2012 at 11:06:59 AM permalink
Quote: AZDuffman

It is called freedom and a free market. Why should you not get a house you want because you are outbid? Just because it is "health care" makes no difference.



Well then, you get the short supply of a cancer drug before a 5 year old kid maybe. Donald Trump gets a heart, and some families 16 y/o kid dies waiting for one.

That's the party of mean, that I recognize.
Quasimodo? Does that name ring a bell?
rdw4potus
rdw4potus
Joined: Mar 11, 2010
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October 8th, 2012 at 11:08:54 AM permalink
Quote: AZDuffman

It is called freedom



How does the absence of options brought on by poverty equal the presence of freedom?
"So as the clock ticked and the day passed, opportunity met preparation, and luck happened." - Maurice Clarett
AZDuffman
AZDuffman
Joined: Nov 2, 2009
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October 8th, 2012 at 11:14:53 AM permalink
Quote: rxwine

Well then, you get the short supply of a cancer drug before a 5 year old kid maybe. Donald Trump gets a heart, and some families 16 y/o kid dies waiting for one.

That's the party of mean, that I recognize.



Why should either of them go to the front of the line?
All animals are equal, but some are more equal than others
AZDuffman
AZDuffman
Joined: Nov 2, 2009
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October 8th, 2012 at 11:16:36 AM permalink
Quote: rdw4potus

How does the absence of options brought on by poverty equal the presence of freedom?



Freedom does not mean equal outcomes.

The ussr tried "to each according to his needs" and all they got was poverty and starvation.
All animals are equal, but some are more equal than others

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