You do own some life insurance, right?
Mitt Romney’s ambitious plan to rein in federal Medicare spending would give America’s seniors a choice: choose government insurance or use a federal voucher to buy medical insurance from private companies. The idea, according to Romney, is to drive down costs by introducing market competition.
“Romney wants to privatize a program seniors depend on and end Medicare as we know it.’’
Douglas Holtz-Eakin, president of American Action Forum and former director of the Congressional Budget Office, thinks the plan will achieve Romney’s goal of reducing Medicare costs.
“It will control the federal budget because it caps the taxpayers’ exposure,
True, but only if the seniors on Medicare do not pay taxes.
All this proposal does is shift the cost of care from Medicare to the patient. Items not paid by Medicare and Georgia Medicare supplement plans are paid by the Medicare patient.
This is nothing more than rearranging the deck chairs.
Image via Wikipedia |
I love it when the government supports my theory. The theory in this case is that we will go metric before we go ICD -10. Towards that end the government announced on Thursday, November 17, 2011 that that first piece of moving towards ICD-10 has been delayed.
All physicians were to begin electronically billing using the new updated form, version 5010. That was to begin in Jan. 2012. It has been moved to March 2012.
As easy as running a four minute mile (no I do not know the metric equivalent, America never went metric).
“The very first time I went to the Nashville VA hospital, I had made my appointment and waited my two months. I showed up and I waited in the lobby for about an hour and 45 minutes — almost two hours — before I just left,” Betts said.
Obama circumvented the Senate confirmation process, appointing Berwick while Congress was in recess in July 2010.
The move, which hardened GOP opposition, meant Berwick had to step down by the end of this year.
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Post by Pete Dworjanyn |
I am a longstanding health professional (an M.D.) and I knew this charge was way over the top. I asked for an itemized bill. There were many examples of excesses. To me, the most outstanding was $48 for one 100mg dose of Zoloft. At the local pharmacy, a generic form of the drug costs well under $1. The hospital does have legitimate extra charges, but nowhere near $47. It went on and on. I wanted a second opinion. Another cardiologist came to WVU, relieving the shortage well after my procedure was done. He had been in private practice. I asked what the charge of my procedure would have been in the area of West Virginia where he had practiced. He said it would have been around $10,000. In my case, Medicare paid $8,318.33.
Had I been a private-pay patient, I’m sure the $53,000 plus would have been what I had to pay.
Around 1980 and since, Managed care groups (Health Maintenance Organizations — HMOs) became very popular. We were told that they would save money. HMOs built on venture capital, saw health care as a low-risk, highprofit industry. We have seen medical care turn into a profit making business — mostly privatized with shareholders and highly paid CEOs.
Getting old has some advantages, but one disadvantage is recalling the government stepping in to establish price controls and fighting against price fixing when confronted with outlandish charges
“…insured patients began to request that the [medical offices] bill their health insurance before making payments on their accounts. [The patient] agreed to pay the balance due after the carriers determined the insurance portion of the claim. Each insurance company had a unique set of billing requirements. The complexity of the new billing procedures greatly increased paperwork and practices had to, therefore, increase the size of their billing staff [or add a billing staff which had heretofore never existed in the medical practice]”These changes dramatically affected how Americans viewed health care. First, by not paying the premium, they no longer had the knowledge of the true cost of those premiums. Secondly, by not paying for the medical care at the time of service, they no longer had the knowledge of the true cost of health care. The organizational culture of healthcare changed and the organizational memory has been lost by the American populace.
“We are in the midst of an economic crisis and efforts to reform the health care system have centered on controlling spiraling costs. To that end, many economists and policy makers have proposed that patient care should be industrialized and standardized.”Patient care became standardized when insurance companies began telling physicians how much their services are worth. No longer is a physician paid based on the financial needs of the physician’s business, but instead on a government produced fee schedule based on a formula called RVU’s. Physicians have not had a raise in their fee schedule from Medicare in over a decade, and the docs are so appreciative that each year the fee is not cut that they don't realize that they did not receive any increase.
“The problem ... is that the special knowledge that doctors and nurses possess and use to help patients understand the reason for and remedies to their illness get lost in a system that values prepackaged, off-the-shelf solutions that substitute "evidence-based practice" for "clinical judgment."What Hartzband and Groopman do not understand is that the patient does not want to pay for the physician to develop an evidence-based plan of care. Today’s exam averages 15 minutes. A physician cannot do the type of work that Hartzband and Groopman want in 15 minutes. That is the reason that more and more medicine is pre-packaged, and it works for the majority of the population. For the minority of patients that need the more protracted appointment and care, there is resentment that they should have to pay more for their care than someone else.
“Even more troubling ... is the impact of the new vocabulary on future doctors, nurses, therapists and social workers who care for patients. Recasting their roles as providers who merely implement prefabricated practices diminishes their professionalism.Here, Hartzband and Groopman are correct: individuals who desire to make a contribution to society, and to be rewarded for this contribution financially, will steer away from medicine. Since insurance companies pay the inadequate physician the exact same as the extraordinary physician, what is the incentive to become a physician?
Reconfiguring medicine in economic and industrial terms is unlikely to attract creative and independent thinkers with not only expertise in science and biology but also an authentic focus on humanism and caring.”