Comments on Badtux the Snarky Penguin: RomneyHillaryCare vs. Medicare For All: A comparis...

Good morning, Tux. Have you seen the statistics at...

2007-09-29T06:04:14.670-07:00

Good morning, Tux. Have you seen the statistics at http://reverendmom.blogspot.com/index.html She writes about how many military bases the US has. What's your take on this?

maybe we should just criminalize healthcare and se...

2007-09-26T17:24:22.506-07:00

maybe we should just criminalize healthcare and see what happened. Doctors would no longer have to pay malpractice insurance, but any contractual waiver you were asked to signed by the doc would be null and void because it involved an illegal activity.

Obviously, sending the healthcare industry underground would mainly benefit the strong and wealthy and disadvantage the weaker and poorer-- but I wonder if it would be much worse than Hillary/Romneycare.

The penguin dont really care about human health ca...

2007-09-26T04:23:03.396-07:00

The penguin dont really care about human health care. I know his plan. Check it out: http://www.youtube.com/watch?v=7TVCjheeazo

There are many doctors who aren't taking new patie...

2007-09-21T17:27:54.418-07:00

There are many doctors who aren't taking new patients period, regardless of insurance provider. Low reimbursement rates are a concern, period, Medicare or not. When I lived in Phoenix, I called every single primary care doctor in my PPO's provider book looking for an appointment to deal with a chronic cough. There were three (3) doctors in the entire metropolitan area accepting new patients for this PPO, and the closest appointment I could get was three weeks out. When I objected that this seemed a rather long time given that I could possibly be suffering some life-threatening ailment such as throat cancer, the lady at the other end snapped "then go to the emergency room." Yeah right.

But you can't address the reimbursement rate without addressing costs. Without eliminating the gigantic costs imposed by the private health insurance industry, which is making record profits off the deaths of tens of thousands of Americans who lack health insurance or whose insurance refuses to pay for necessary treatments, there just isn't the money in the American economy to address the reimbursement rate issue. We are spending over 15% of GDP on health care, roughly twice the OECD median. There is no way to raise reimbursement rates without lowering OTHER expenses. And the easiest way to lower other expenses is to eliminate the private health insurance industry as the primary care insurance for Americans, which immediately makes available all of those billions currently going for health care administration and expenses and profits on the part of health insurance companies.

"someone who actually has worked in the medical cl...

2007-09-21T16:48:07.748-07:00

"someone who actually has worked in the medical claims processing field (on the software end of things)."

I worked on the software side of claims processing for a major midwestern facility for 3.5 years. You have got to get all the 'codes' right, no matter the payor. Clerks entering can only do so much without errors. Programmers can only do so much to weed out things that are obviously wrong (eg a pap smear on a male patient, etc). The savings will be in not having to deal with other insurers if you don't want to.

I'm not knocking Medicare 'type' coverage for all. Just that currently there are many doctors that are not taking new patients that have Medicare as primary payor because the reimbursement rates are becoming insufficent to the providers costs of operating. IIRC, the reimbursement rate is around 45% of cost. There's nothing wrong with reasonable co-pays and deductables either.

Medicare/Medicaid's administrative costs run rough...

2007-09-21T12:31:26.145-07:00

Medicare/Medicaid's administrative costs run roughly three percent of budgeted revenues.

No HMO is within a factor of five of that.

Anonymous, I'm going by what I was told by someon...

2007-09-21T11:28:57.985-07:00

Anonymous, I'm going by what I was told by someone who actually has worked in the medical claims processing field (on the software end of things). But now that I think about it, the various "Medi-Gap" insurers that would arise in a Medicare For All plan would be an issue mitigating some of the claims processing savings, so I'm not sure in the end just how big of a savings it will be.

And reimbursement rates are noted. But Medicare's reimbursement rates aren't much different from private insurers' reimbursement rates nowdays. Something has to give here, doctors are starting to go on strike (i.e., refuse to accept new patients and generally winding down their medical practices) because it isn't worth their time anymore to practice medicine. But one thing is clear, the current system isn't going to resolve that problem either, so at least Medicare for All doesn't make it worse.

I'm so glad you took the time & trouble to do this...

2007-09-21T10:05:47.890-07:00

I'm so glad you took the time & trouble to do this. I'd do it, but I'm too busy trying to find 'affordable' insurance.

Of course Medicare doesn't cover everything, nor would Medicare For All. Show me the insurance policy that DOES cover everything, 100%.

That's what supplemental insurance is for. Even after single payer, there would still be plenty of profit for the private insurers in that market.

"and drastic reduction of claims processing costs ...

2007-09-21T09:43:56.460-07:00

"and drastic reduction of claims processing costs due to economies of scale."

No not really, it still all has to be documented and processed correctly. All insurance companies use the CPT-IV code book from Medicare (this is the procedure codes, IIRC). Most of the coding for insurance has been pretty well standardized through out. It's the appeals process and the loopholes insurance companies have that cost in processing claims. While quite a bit of appeals will go down.... the claims still have to be correct. Medicare does not cover *everything*, so.....

One problem with going over to having medicare be the 'insurer' is that their reimbursement rate isn't all that good. While they're really fast paying out (3 week turn around time generally for this institution), the pay out doesn't come close to reflecting the true cost to the provider.

i was wondering if you could expand the choices in...

2007-09-20T16:27:32.300-07:00

i was wondering if you could expand the choices in your poll. i'm torn between medicare for all [canadian style] and france's system.

lovely, lovely table. muchas gracias, viel dank, mange takk, and thanks for all the fish.

This was great. I quit my job at the hospital 12 ...

2007-09-20T12:32:21.004-07:00

This was great. I quit my job at the hospital 12 years ago...was the "financial counselor" which is a glorified collector...I had to bleed people dry...including the elderly who couldn't afford care and deserve not to worry at their age and stage of health and income (sorry bbc...cannot agree with you). I HATED my job. I had no plans, two kids, was a single parent and I never looked back. I went to school. Here I am. Self employed and paying way too much for insurance that covers nearly nada.

Great post!

Wow, Evil Spock feels smarter, and a little bit he...

2007-09-20T11:20:49.233-07:00

Wow, Evil Spock feels smarter, and a little bit healthier too.

Thanks for being so thorough!

Two points.1. Since this isn't socialized medicine...

2007-09-20T10:12:05.337-07:00

Two points.

1. Since this isn't socialized medicine doctors don't have to accept Medicare patients, or any other insurance program, so some doctors will be outside the system. A very minor point, but important in the case that this is not a commie plot.

2. There will be huge savings to states as this will eliminate Medicaid, a big burden for many state budgets.

To BBC's point - there are limits to what medicine can do and after 80 many of the cures will kill you. This isn't a major concern until medicine advances a lot more than it has, and at that point 80 may be the new 50. With the current system not enough people make it 80 to be a problem, it only seems like a problem because all of those who have reached 80 tend to want to drive their Caddie at 45mph on the freeway in front of you.

That said, BBC, extending Medicare to all America...

2007-09-20T08:40:38.693-07:00

That said, BBC, extending Medicare to all Americans will not affect the cost of covering the prunes in any way. The costs of end-life care are indeed an issue but one that is hard to address while at the same time you have children dying due to lack of health care (over 10,000 people in America die per year of easily curable ailments such as infections and appendicitis due to lack of health care caused by lack of health insurance, and a significant percentage of them are children).

**BBC said...I think that after 80 a person should...

2007-09-20T07:57:24.029-07:00

**BBC said...I think that after 80 a person should just accept that they are going to die and not to be draining the system of funds expecting it to fix them.**

A tad cold-hearted, bbc? Will you still feel the same way when you hit 80 after all your years of paying into the system? Are you so totally altruistic?

Check todays Prickly City comic. Prickly City

2007-09-20T04:47:06.986-07:00

Check todays Prickly City comic.

Prickly City

One problem with medicare is that everyone will wa...

2007-09-20T04:42:31.898-07:00

One problem with medicare is that everyone will want to be cured of everything no matter how old they are.

I think that after 80 a person should just accept that they are going to die and not to be draining the system of funds expecting it to fix them.

Some of these issues will be hard to resolve, but I'm not keen on the insurance industry being in charge of it all. To much capitalistic greed in it.

They build fancy offices and pay themselves big wages instead of building new and better hospitals.