Re: OT: Here Comes Socialism

On Jan 22, 3:10 pm, Lutemann <lutem...@xxxxxxx> wrote:


 Here's an idea, make medical education free and then pay MDs
half as much. That should both increase the the number of doctors (no
huge student loans) and bring down the cost of health insurance.

That's a joke. The fees Dr's charge are largely irrelevant. For
example, my wife's billing rate was around 60% last year - for every
dollar of service she supplied she got 0.60 cents. Now, I'm sure there
are those who feel that $35 is alot to pay for a visit to see the
doctor, but hey she only got $29. If you the patient were on medicaid
she got $17. You see the reality is that the insurance companies
decide what they are going to pay for the services and the Doc can
basically take it or leave it - and that's only once the insurnace
company decides that treatment was appropriate (yes, there are some
doc's who treat inappropriately but that's a minority and not the
norm). Furthermore, here in the state of Vermont Dr's cannot bill the
patient for the difference between the cost of service and what the
insurance company pays - so take it or leave it (curiously, this is
not true for Dentists - they can bill the difference between the cost
of service and what the insurance pays). Some Dr's are moving to fee
for service - they don't take insurance, you pay cash and you fight
with your insurance company. Not an option up here where 40% of the
customer base is on medicaid. Also a laugh last year when Bush wanted
to cut medicaid re-imburstments to Docs. In my wife's case that would
have cut the $17 almost to single digits.

One might ask why the fees charged cannot be lowered. One large
component of any physician's cost structure is the malpractice
insurance. As long as we americans want to hold on to our god given
right to sue, and juries see fit to keep issuing large settlements,
that cost is going to trickle down to the individual consumer of
health services (all of us eventually). There is no shortage of
doctors out there, and I am betting that there are many who would be
more than happy to provide free or reduced services for the "un" or
"under" insured - but when you have to fight daily with insurance
companies to get 60% of your billings and still pay your staff and
expenses that doesn't leave much time left to donate - and don't
forget, if you treat someone for free they can still come back and sue
the pants off of you.

No, there is only one solution - universal healthcare administered by
a single, non-profit entity. If you want to insure everyone the whole
country must be put into a single risk pool, and insurance companies
can't make money unless they can cherry pick who they cover. The rich
will have their own 'cash only' docs and hospitals and the rest of us
will be served by the public health service. We are basically at that
state now, we just have to get by the fantasy that all the money we
lay out for private health insurance is actually buying us anything
special, it is not.

What health insurance does is get you in the door and guarantees the
bare minimums if you are lucky so as to maximize the profits of the
insurance company so that the executives get their bonuses for doing
such a good job of controlling costs. The waste and inefficencies in
the system were squeezed out in the 90's when HMO's came on the scene.
There is all this talk about EMR and technology making further cost
savings - don't believe it. For one, implementing those technologies
is going to cost big $$ will will take time to re-coup, and secondly
there isn't alot of waste in the system. So what is really happening
is to make the profit targets services are being denied. Payments due
to providers are held up routinely until every stalling tactic has
been exhausted (must make cash flow look better on the balance
***?).

And people in this country buy the argument from the right that the
liberals want to put the government between you and your doctor. Well,
right now we have insurance companies standing between us and our
doctors, with the insurance company in many cases dictating who the
doctor will be. I'll take my chances with the government. It may be
wasteful, but at least I have a vote.

John L.
.