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jc...
What If Doctors Got Paid Only Medicare Rates?
By Dr. Nilesh Kalyanaraman August 31, 2011 at 1:52pm Categorized in: Payment Reform
Whenever I think of our health care system I think of Dr. Frankenstein’s monster, assembled from an assortment of parts, trying to find and give love but reviled by all. Short of killing the monster, how do you fix it?
One of the biggest problems with our health care system is the unchecked growth of health care costs. We know that Medicare does a better job of controlling health care costs than private insurers. Along with this comes lower reimbursement rates for doctors which leads to the oft reported phenomenon of doctors not accepting new Medicare patients or dropping out of Medicare altogether.
Every time I read one of these stories I wonder why doctors can’t make a living based on their reimbursements. What would happen if we were paid Medicare rates for every patient we see? Would we really lose money or would we just be getting less than what we’re getting now? If so, how much less?
I was pleasantly surprised when about a month ago I came across a study looking at just this question: What if every doctor was paid Medicare rates? This study was published in March 2010 (I can’t believe I missed it) by the Urban Institute and the Medical Group Management Association for the Medicare Payment Advisory Commission (MedPAC). It used reported physician compensation along with RVUs to calculate what annual compensation (take home pay) would be if all services were paid for under Medicare rates. They took into account regional payment differences, practice expenses, and non-RVU based income.
They projected that if the average physician accepted payment based on the Medicare Fee Schedule her annual compensation (her take home pay) would be roughly $240,000. That’s sounds like a very nice yearly income. So why do some doctors not like Medicare reimbursement rates? It’s because that total represents a 12% loss in income from $272,000.
Let’s look at some more data. Take a look at the annual incomes for the following specialties and think about whether you consider these amounts fair compensations:
Orthopedics: $457,000
ENT: $380,000
Neurosurgery: $689,000
Radiology: $488,000
Those look like great incomes to me, and in fact, all four of these incomes would put you in the top 4% of incomes in the U.S. I picked these four because these would be the hardest hit under a universal Medicare payment plan, they all would take over a 20% hit in annual income. Here’s what the table looks like with the change in income:
Orthopedics: $362,000 -20.8% from $457,000
ENT: $282,000 -25.6% from $380,000
Neurosurgery: $462,000 -32.8% from $689,000
Radiology: $389,000 -20.2% from $488,000
Lest you think I’m unfairly biased against specialties, here’s what will happen to the three primary care fields:
Family medicine: $169,000 -10.6% from $189,000
Internal medicine: $175,000 -7.9% from $190,000
Pediatrics: $180,000 -8.5% from $197,000
These are not insignificant drops in income and I’m sympathetic to the idea that this would be a deep hit to doctors, myself included. If we’re going to curb health care costs (overall health care costs are rising at an unsustainable rate) we’re going to have to look at not just how doctors get paid but also how much they get paid. The point of highlighting this paper is to show that Medicare rates for all, on an absolute level, would provide an excellent income for doctors. It’s only because we get paid so much more that Medicare rates seem stingy.
It may be painful but at some point, we as a profession need to recognize that we are getting compensated very well and that we too will have to make sacrifices to maintain the solvency of our health care system. One of our duties in caring for our patients is making sure they can afford the care they need and if that means that I have to drop from the 94th to the 92nd percentile in income, I’m willing to take the hit.
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Sounds like they need a union. 
And into the forest I go, to lose my mind and find my soul. - John Muir
#GMSTRONG
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Here's one thing they ought to do: Ban advertising for drugs.
Let the doctors decide what's best - don't go advertising.
I actually like hearing about new drugs.. at this time the only condition I suffer from is that I'm a diabetic. If something was advertised that was supposed to make a positive effect on that condition, it might be the only way to hear.. so I'd ask my doc about it.
#GMSTRONG
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Yeah, that's what I want. Ticked off doctors who took a pay cut or not the best and the brightest becoming doctors because the time and money invested isn't worth the return. I'd like to know how much of that nice salary goes to malpractice insurance. From just doing some quick Google searches, general surgeons and OBGYN's are between 50 and 100k depending on the county in Ohio. That's a big chunk of their income. If we could reduce frivolous malpractice suits and reduce the cost of being insured maybe a pay cut would be possible. Cutting doctors pay is not the solution to this problem.
#gmstrong
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How much of the cost of a hospital stay is the doctor's pay? I bet not much.
What we need first is a schedule of costs for services. The current system of every hospital having it's own charges is counter-productive to controlling costs. This doesn't not mean we remove the profit form the health care business, just control it so if they take me to hospital A I pay the same as I would at hospital B that's 5 miles up the rode.
The other issue I see is the tug of war between the provider and he insurance company. The provider knows the insurance company is only going to pay 60% of the bill they get sent, so they add additional charges to it to be sure they get paid the $$ amount fo the services provided. This goes back to the schedule of services. If everyone is on the same page as far as how much to charge for each service, and reimbursement is for that amount, there are no need for phony charges unless the provider is being dishonest (a whole other issue).
We also need more incentive for the creation of free and/or low-cost clinics. Places to go for those minor things, and allow our ERs to be for real emergencies.
Hospital visits are one for those things where when you need it, you don't really have the luxury of shopping around, and even if you do, has anyone ever gotten an answer when they called and asked how much an appendectomy will cost, and got a written quote?
We don't have to agree with each other, to respect each others opinion.
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Mac do those figures take into account the expense of the DR for keeping their practice open? Rent, utilities, saleries for staff, supplies, etc, etc, etc?
I AM ALWAYS RIGHT... except when I am wrong.
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Mac do those figures take into account the expense of the DR for keeping their practice open? Rent, utilities, saleries for staff, supplies, etc, etc, etc?
Malpractice insurance ......
Micah 6:8; He has shown you, O mortal, what is good. And what does the Lord require of you? To act justly and to love mercy, and to walk humbly with your God.
John 14:19 Jesus said: Because I live, you also will live.
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Mac do those figures take into account the expense of the DR for keeping their practice open? Rent, utilities, saleries for staff, supplies, etc, etc, etc?
I have two doctors in the family.. based on what they say, it's the price of malpractice insurance that keeps them in the hole.
So while a surgeon might make 500k, I wonder how much of that goes right out the window for Malpractice ins.
#GMSTRONG
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Hey D, if you know two doctors who are "in the hole," they're doing it wrong. To me, the biggest problem is the cost of services to the uninsured compared to the costs to the insured and insurance companies. If I could get the "network discounts" that insurance companies get, I wouldn't need insurance. But if I didn't have insurance, I couldn't afford health care. 
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Quote:
Quote:
Mac do those figures take into account the expense of the DR for keeping their practice open? Rent, utilities, saleries for staff, supplies, etc, etc, etc?
I have two doctors in the family.. based on what they say, it's the price of malpractice insurance that keeps them in the hole.
So while a surgeon might make 500k, I wonder how much of that goes right out the window for Malpractice ins.
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Average Cost States Pennsylvania malpractice insurance falls in the middle with respect to average cost. Rates differ between the major insurers due to demographic and claims differences. In 2009, base rates for general surgery could be as low as $28,000 annually or as high as $50,000. Internal medicine malpractice insurance costs varied between around $6,000 to $11,000. Obstetricians/gynecologists could find themselves paying up to $64,000 or more for coverage.
Read more: The Average Cost for Medical Malpractice Insurance | eHow.com http://www.ehow.com/about_5514154_average-cost-medical-malpractice-insurance.html#ixzz209QJjveH />
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Hey D, if you know two doctors who are "in the hole," they're doing it wrong.
To me, the biggest problem is the cost of services to the uninsured compared to the costs to the insured and insurance companies.
If I could get the "network discounts" that insurance companies get, I wouldn't need insurance.
But if I didn't have insurance, I couldn't afford health care.
Yeah, you missed the point completely.. 
#GMSTRONG
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"Alternative facts hurt us all. Think before you blindly believe." Damanshot
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Did I? I answered your "I wonder" just above your reply.
Next time you think "I wonder," try replacing it with "I'll Google."
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Did I? I answered your "I wonder" just above your reply.
Next time you think "I wonder," try replacing it with "I'll Google."
and you still missed it...LOL
#GMSTRONG
“Everyone is entitled to his own opinion, but not to his own facts.” Daniel Patrick Moynahan
"Alternative facts hurt us all. Think before you blindly believe." Damanshot
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Quote:
Quote:
Mac do those figures take into account the expense of the DR for keeping their practice open? Rent, utilities, saleries for staff, supplies, etc, etc, etc?
I have two doctors in the family.. based on what they say, it's the price of malpractice insurance that keeps them in the hole.
So while a surgeon might make 500k, I wonder how much of that goes right out the window for Malpractice ins. At the high end, $50k in an average state (10%) which would be a buisness expense written off for taxes.
Please help. What am I missing?
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Hey D, if you know two doctors who are "in the hole," they're doing it wrong.
To me, the biggest problem is the cost of services to the uninsured compared to the costs to the insured and insurance companies.
If I could get the "network discounts" that insurance companies get, I wouldn't need insurance.
But if I didn't have insurance, I couldn't afford health care.
Have you tried?
I get the same prices from my doctors right now as I did when I had insurance. (as far as the price I pay and my insurance company used to pay)
2 of my prescriptions are still the same price they were with insurance. One is much more expensive (out of pocket), but I am paying the same price as what I paid as a co-pay, and the insurance company paid.
If my doctors wouldn't have worked with me, I would have found new doctors who would. I picked pretty decent doctors though.
All of my recent hospital bills have a phone number for their department that handles middle to lower income people without insurance. You can be free, or get a deeply reduced rate if you don't have insurance.I had insurance for all of my surgeries, so I never got to try it ..... but it's there nonetheless.
Micah 6:8; He has shown you, O mortal, what is good. And what does the Lord require of you? To act justly and to love mercy, and to walk humbly with your God.
John 14:19 Jesus said: Because I live, you also will live.
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That's awesome, YT. Glad you found some good people to work with. 
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What we need first is a schedule of costs for services. The current system of every hospital having it's own charges is counter-productive to controlling costs. This doesn't not mean we remove the profit form the health care business, just control it so if they take me to hospital A I pay the same as I would at hospital B that's 5 miles up the rode.
I don't think so....What if Hospital A is one of the top hospitals in the World, Country, State...whatever....It is a hospital that has an excellent reputation and is an excellent hospital.....and Hospital B is falling apart, give poor service, have bad nurses, doctors...etc...And you want to have them paid the same???
I don't think so....
That is like saying we have a Honda Fit and a Bentley Arnage...and the Bentley boys are going to have to accept the "standard payment for transportation" for their vehicle.
I thought I was wrong once....but I was mistaken...
What's the use of wearing your lucky rocketship underpants if nobody wants to see them????
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I agree with PETE... hospitals cost of services should be at their discretion, but I believe should be the same to all payers.
FloridaFan, one good thing that is in the ACA is now hospitals must publish their cost of services, so consumers can compare pricing.
Last edited by CleveSteve; 07/09/12 03:27 PM.
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Neurosurgery: $689,000
Those look like great incomes to me, and in fact, all four of these incomes would put you in the top 4% of incomes in the U.S. I picked these four because these would be the hardest hit under a universal Medicare payment plan, they all would take over a 20% hit in annual income. Here’s what the table looks like with the change in income:
Neurosurgery: $462,000 -32.8% from $689,000
Boo freakin' hoo... somebody makes a lot of money.. it's not fair.. they could live on 20% less and be just fine.... they make more than me... where is the freakin' crying baby gif?
Forget the fact that a neurosurgeon has 4 years of college, 4 years of med school, 2 years of general internship, 5-7 years of neurological internship and is 33 freakin' years old before he/she can officially open their own practice... and has spent a couple hundred grand at least on education and done internships for little money working 70 hours a week for years... and now literally has a persons life in his/her hands every freakin day... they make a lot more than high school educated Johnny Nutsandbolts down on the factory floor so they should happily take a 32% pay cut...
And at $462K a year, they would make just a little more than James Hoffa, who has never saved a single life.. taken a few maybe, but never saved one.... and well below the $590K for Terence O’Sullivan of the Laborers’ International Union of America....
yebat' Putin
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Like I said in a different thread - this country is full of people that aren't interested in lifting people up - they're only interested in bringing people down to their level.
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well things could always be worse, we could have folks like him running the country....oh wait a sec... 
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I agree. Insurance raises costs. People don't check the cost of care because someone else is paying. If we had food insurance as an example, we would take steak over hamburger. Just look at the loaded down buggy of the person who uses the American Flag "Pass Go for Free" card....they walk away free and I pay $100 for not much of anything. 
If everybody had like minds, we would never learn. GM Strong
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I agee, those games sucked. I spent many hours playing this much more realistic game, which I still have: 
And into the forest I go, to lose my mind and find my soul. - John Muir
#GMSTRONG
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I have that on my iPhone! 
#GMSTRONG
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I agee, those games sucked. I spent many hours playing this much more realistic game, which I still have:
Universal healthcare is going to be solved by by Mattel football! Amazing 
#gmstrong
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What we need first is a schedule of costs for services. The current system of every hospital having it's own charges is counter-productive to controlling costs. This doesn't not mean we remove the profit form the health care business, just control it so if they take me to hospital A I pay the same as I would at hospital B that's 5 miles up the rode.
I don't think so....What if Hospital A is one of the top hospitals in the World, Country, State...whatever....It is a hospital that has an excellent reputation and is an excellent hospital.....and Hospital B is falling apart, give poor service, have bad nurses, doctors...etc...And you want to have them paid the same???
I don't think so....
That is like saying we have a Honda Fit and a Bentley Arnage...and the Bentley boys are going to have to accept the "standard payment for transportation" for their vehicle.
I would hope if they were that bad they would be shut down. So if your being removed from your car and have a steel pipe protruding from your chest, do you have time to determine which hospital is better, and how much they should be able to charge for basic services?
We're not talking Hondas and Bentley in which you can research, test drive, contemplate then decisde to buy neither. And I didn't the idea was perfect or set in stone, just that the current system, using your example, is like picking up the HOnda then waiting for the bill to arrive later without ever knowing what it cost.
But like Ballpeen said, the biggest problem is that since the average user of the system never really sees the costs or has to pay it, they don't care. Hence why I have said many times in numerous threads that we we need get away from health "Covereage" and go back to health "insurance"
We don't have to agree with each other, to respect each others opinion.
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Quote:
Quote:
Neurosurgery: $689,000
Those look like great incomes to me, and in fact, all four of these incomes would put you in the top 4% of incomes in the U.S. I picked these four because these would be the hardest hit under a universal Medicare payment plan, they all would take over a 20% hit in annual income. Here’s what the table looks like with the change in income:
Neurosurgery: $462,000 -32.8% from $689,000
Boo freakin' hoo... somebody makes a lot of money.. it's not fair.. they could live on 20% less and be just fine.... they make more than me... where is the freakin' crying baby gif?
DC...above...and the article, were written by a DOCTOR...not a politician...and obviously a doctor with a "fiscally conservative" point of view when it comes to keeping medical costs down.
I have to laugh when I see those who claim to be "conservative(s)"...take a stand FOR higher medical costs. Some of you were complaining about skyrocketing cost of healthcare...but the same people are supporting the high cost of healthcare, insisting that doctors could not possibly take a pay cut.
Next time you "conservatives" complain about GOVERNMENT RUN HEALTHCARE... remember this comment from the article...
"One of the biggest problems with our health care system is the unchecked growth of health care costs. We know that Medicare does a better job of controlling health care costs than private insurers. Along with this comes lower reimbursement rates for doctors which leads to the oft reported phenomenon of doctors not accepting new Medicare patients or dropping out of Medicare altogether." web page
Kind of blows a hole in this idea that Government run healthcare doesn't work to keep costs down.
Also, it seems logical, as the number of members/patients in the system increases, so to does the power to negotiate and control reimbursements, which helps to keep costs down. I'm a big fan of fair compensation, including how much Doctors are paid for services performed.
GM strong...
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and the article, were written by a DOCTOR...not a politician...and obviously a doctor with a "fiscally conservative" point of view when it comes to keeping medical costs down.
So now government regulation and price control equates to fiscally conservative?
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I have to laugh when I see those who claim to be "conservative(s)"...take a stand FOR higher medical costs.
Nobody is taking a stand FOR higher medical costs.. people are taking a stand for a more market driven system than a government controlled system.
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Next time you "conservatives" complain about GOVERNMENT RUN HEALTHCARE... remember this comment from the article...
"One of the biggest problems with our health care system is the unchecked growth of health care costs. We know that Medicare does a better job of controlling health care costs than private insurers. Along with this comes lower reimbursement rates for doctors which leads to the oft reported phenomenon of doctors not accepting new Medicare patients or dropping out of Medicare altogether." web page
Kind of blows a hole in this idea that Government run healthcare doesn't work to keep costs down.
Remove the market driven component to medical care and it will also blow a big hole in the "quality won't go down under government control" argument as well. The fallacy of liberalism is that they still believe that the best and the brightest will choose the same profession and work just as hard for half the money..
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Also, it seems logical, as the number of members/patients in the system increases, so to does the power to negotiate and control reimbursements, which helps to keep costs down.
Quality will go down mac.. wait times will go up.. write it down and wait for it to happen.
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I'm a big fan of fair compensation, including how much Doctors are paid for services performed.
Fair? I guess as long as some bureaucrat gets to decide what "fair" is, a bureaucrat who is elected by the 50% of people who pay no taxes and have no skin in the game.. yea, that's who I want deciding what "Fair" compensation is... So a decent power forward or a guy who makes one decent movie is worth $20 million a year but a guy with 10 years of education, who saves lives, is on call 24 hours a day and works 80 hours a week isn't worth $600K? Or to put it another way, the neurosurgeon isn't worth the same as the guy who runs the Laborers International Union? Is that guy worth $600K a year mac?
This whole notion of "Fair" is really starting to make me sick.. I mean like physically nauseous... I cringe every time I hear my kids use it and I correct them. There was a time in this country, not too terribly long ago, when the guy who didn't support himself, lived off the hard work of others and contributed nothing to society was considered selfish and the guy who made something of his life and made a lot of money in a good honest way was looked up to and respected... somewhere along the line it switched and now the guy who contributes little to nothing is considered to have the moral high ground and the guy who bettered himself, got the education, made something of his life and makes a lot of money is the one who is considered selfish... Welcome to the handbasket. 
yebat' Putin
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DC, That response was AWESOME! 
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Quality will go down mac.. wait times will go up.. write it down and wait for it to happen.
No need to wait, just look at Canada and the UK...
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I just look at the droves of people that build rafts, and float the waters from Florida to Cuba, just to get in on their Universal Healthcare program. 
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j/c
Got a question: For some reason I was under the assumption that hospitals and/or doctors couldn't charge interest to patients (well, patients parents, that is). Apparently I was wrong?
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j/c
Got a question: For some reason I was under the assumption that hospitals and/or doctors couldn't charge interest to patients (well, patients parents, that is). Apparently I was wrong?
Not positive on doctors -- but they do usually send the debts to a collection agency, who can charge interest (and more importantly) large fees.
"When a foreigner resides among you in your land, do not mistreat them. The foreigner residing among you must be treated as your native-born. Love them as yourself, for you were foreigners in Egypt. I am the LORD your God." Leviticus 19:33-34
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j/c
Got a question: For some reason I was under the assumption that hospitals and/or doctors couldn't charge interest to patients (well, patients parents, that is). Apparently I was wrong?
Not positive on doctors -- but they do usually send the debts to a collection agency, who can charge interest (and more importantly) large fees.
Only reason I ask is because my daughter had surgery in March - bill started coming May. Anesthesiologist bill, hospital bill, surgeons bill, the referring doctor, physical therapy bill. The largest individual (single bill) was $1500...........but the doctors office is charging interest. I've paid between $150 to $200 each month on all of them. We're down to the hospital and doctors office - and the hospital doesn't charge interest.
Was just curious.
They'll all get theirs - no doubt. Another 2 months and they'll all be paid.
To them - sorry our HSA ran out. Amazingly though, the hospital - when I speak with them - says "no problem, keep paying - you'll get it."
The doctors office? They send threatening letters along with the bill......the bill that shows $150 to $200 payments each month.
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http://ucatlas.ucsc.edu/spend.phpDespite the wide gaps, higher spending on health care does not necessarily prolong lives. In 2000, theUnited States spent more on health care than any other country in the world: an average of $ 4,500 per person. Switzerland was second highest, at $3,300 or 71% of the US. Nevertheless, average US life expectancy ranks 27th in the world, at 77 years. Many countries achieve higher life expectancy rates with significantly lower spending. The chart below shows the top 30 countries in the world ranked by life expectancy. The red line indicates per-capita health expenditure (right axis), and shows that many countries outperform the US. The chart (right) also highlights the sharp contrast between the US and Cuba. With a life expectancy of 76.9 years, Cuba ranks 28th in the world, just behind the US. However, its spending per person on health care is one of the lowest in the world, at $186, or about 1/25 the spending of the United States. There are other cases where high life expectancies are achieved with low spending on health care. The scattergraph (below) shows the relation between per-capita health care expenditure and average life expectancy for 2000. Countries with higher spending generally have longer life expectancy rates, but there are also many countries that perform nearly as well with much lower spending. http://thepatientfactor.com/canadian-hea...health-systems/Bottom line? We rank 37th in the world in health care. While we pay more for health care per capita than any other country in the world. This health care law may not be the perfect solution, but it's a start in the right direction. I guess maybe inventing the car and the airplane should never have happened since people actually had to tweak and perfect some things before they got it right. Where Obama screwed up is he compromised with big business instead of just taking over health care and paying flat rates for services like they do in Europe. They pay far less per person and have much better rated health care along with longer life expectancies. But then, that would be wrong. Because health care is big business, not a human right. 
Intoducing for The Cleveland Browns, Quarterback Deshawn "The Predator" Watson. He will also be the one to choose your next head coach.
#gmstrong
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Joined: Sep 2006
Posts: 40,399
Legend
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Legend
Joined: Sep 2006
Posts: 40,399 |
Quote:
Bottom line? We rank 37th in the world in health care. While we pay more for health care per capita than any other country in the world.
Unfortunately there are quite a few other variables that affect life expectancy other than how much you spend on healthcare... lifestyle (smoking, drinking, diet, stress), crime rate, risky behavior (skydiving and rock climbing and drag racing)....
This is like saying just because I spend $2000 a year on exercise equipment that I should be in shape...
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Where Obama screwed up is he compromised with big business instead of just taking over health care and paying flat rates for services like they do in Europe.
They pay far less per person and have much better rated health care along with longer life expectancies. But then, that would be wrong. Because health care is big business, not a human right.
As I said, until Americans change the way they live, you could spend $10,000 a person or give away free healthcare and it's not going to matter. I spent a few days at the beach last week and while there were some really nice looking hotties there, I saw more morbidly obese people than you can possibly imagine.. no amount of money is going to make these people healthier.
yebat' Putin
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Joined: Sep 2006
Posts: 50,980
Legend
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Legend
Joined: Sep 2006
Posts: 50,980 |
According to USA Today in 2009 Great Britain had as many as 15,000 people dying prematurely from cancer each year. Further, a drug shown to work against breast cancer that was approved in the US took an additional 4 years to be approved in Great Britain. We already spend the most per person worldwide out of any country. As with government, spending too little is not the problem. Spending on the wrong stuff is. We have massive lawsuit abuses in this country, and that costs a ton of money every year. We have 82 billion (maybe a slight exaggeration) different forms for insurance companies that doctors often must fill out by hand instead of running through the computer. We have limited competition among insurance companies. What good will exchanges and the like do in state's that have access to only 1 or 2 insurance companies? Not one of these very costly items was addressed in the healthcare (so called) reform law. The healthcare (so called) reform law really did very little reform of the healthcare system. Most of the "good " reforms have already taken place. The taxes, fees, penalties, rationing, and all of the other negatives have yet to hit. That's the part that really amazes me. None of the bad stuff has yet to impact anyone (except for the 10% rate increase this year) yet this law is still overwhelmingly unpopular. However, I think that most people see it for what it is ..... which is a massive overreach by government, a misplaced priority, and something that is going to wind up causing as many, or more, problems as it cures. It was a badly written law that was written in such a manner in order to gain the votes necessary for passage. Heck, even Harry Reid insisted on 5 years of full funding for his state before he would vote for this disaster. The rest of the states were only going to get 1 year of full Medicaid funding, then a sliding scale down to 90% or so. That's another problem with this law. It's not going to raise taxes ..... except when the states have to pay out more money in Medicaid costs ........ then what happens? Most states have to balance their budgets annually. That means either service cuts, or tax increases at the state level. States can try to play class warfare and raise taxes "only on those who can afford it", the richer people ..... but it's not that difficult for a rich person to pick up and leave a state. (as happened with many people in New York when their massive state tax increase went into effect) What happens to the states then? Further, if I am paying a partial premium for insurance through work, why would I want that, with deductibles, co-pays, and 80/20 provisions, when Medicaid covers everything like a Cadillac plan with no money out of pocket? Why would employers want to cover the cost of insurance when they can pay a $2000 per employee penalty and be done? What about the family of 3, just over the income limit for the freebies from the government, (credits and such) r worse yet, the single person with no dependents who will get, as usually, raked over the coals with no tax credits and some of the highest effective tax rates, even for somewhat modest incomes? A single person making $50,000 pays about 1/3 of his/her income in taxes already. I have broken this down many times already. That leaves them an income of about $33,000 in truth. Then add in (for me anyway, using the State of Ohio program for a single person with pre-existing conditions) a $500- $800 per month insurance cost (with crappy coverage at that) and now this person loses another $6000-$9600 in insurance premiums. Now this person, doing pretty well for themselves, making a nice income, is making very little. Their $50,000, before they spend a penny on anything they want, not becomes $24,000-$27,000. That's a big chunk gone before they get to spend a dime of the money their hard work earned. But ...... that's what's "fair".
Micah 6:8; He has shown you, O mortal, what is good. And what does the Lord require of you? To act justly and to love mercy, and to walk humbly with your God.
John 14:19 Jesus said: Because I live, you also will live.
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Joined: Sep 2006
Posts: 17,438
Legend
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Legend
Joined: Sep 2006
Posts: 17,438 |
I had a medical experience today to illustrate what will happen in the future. I needed a ct scan. I have crappy expensive cobra ins with high deductables. The bill for me after ins pays their part is 1300. Holy crap. Ins sure pays for a lot, right? So the facility asked me if I would prefer to not use my ins, and then my bill would only be 413. So yes, I did not use the overpriced useless ins so I could have a more reasonable bill. Thats all thats going to happen in the future....people are going to pay large monthy ins rates for health ins that insures nothing, and not even use it because it would cost three times as much. And our dumbass govt is forcing us into this position. 
No Craps Given
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Joined: Sep 2006
Posts: 40,601
Legend
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Legend
Joined: Sep 2006
Posts: 40,601 |
Just remember which dumbass pushed this when you go to vote.
It's all in the vote. If more dumb asses show up to vote for another dumb ass, dumb ass rules.
If everybody had like minds, we would never learn. GM Strong
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Joined: Sep 2006
Posts: 50,980
Legend
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Legend
Joined: Sep 2006
Posts: 50,980 |
5 House Democrats vote to repeal the Obamacare law ...... I wonder how it would do if Harry Reid wasn't the cowardly scarecrow (sorry, can't see him as a lion, even a cowardly one) and if he would put it up for a vote? House approves ObamaCare repeal in first vote since Supreme Court ruling | Fox News http://www.foxnews.com/politics/2012/07/...e-court-ruling/House lawmakers voted Wednesday to repeal the federal health care overhaul -- the latest in a long line of anti-ObamaCare votes, but the first since the Supreme Court upheld the law and defined one of its key provisions as a "tax." The House has voted more than 30 times to scrap, defund or undercut the law since Obama signed it in March 2010. As with those bills, the repeal bill approved Wednesday on a 244-185 vote faces certain demise in the Democrat-controlled Senate. But Republicans were looking to get lawmakers back on record on the law in the wake of the high court ruling last month. The ruling upheld most the law as constitutional, but in doing so it determined that the controversial penalty on those who do not buy insurance technically qualifies as a "tax" and not a "penalty" as the administration had claimed. That definition fueled GOP criticism of the law, and put some Democrats in a politically tricky position. Five Democrats ended up defecting Wednesday. Reps. Mike Ross, D-Ark.; Dan Boren, D-Okla.; Mike McIntyre, D-N.C.; Larry Kissell, D-N.C.; and Jim Matheson, D-Utah, all voted yes. In a show of party unity, all Republicans voted for the bill. "This law epitomizes Washington at its very worst: intrusive mandates, higher costs, red tape, unaffordable spending, taxes on employers and families and control of personal health care decisions by boards, bureaus and agencies in Washington," said Rep. Fred Upton, R-Mich., chairman of the House Energy and Commerce Committee. But Democratic leaders panned Republican efforts as a waste of time. "It's unfortunate that the Republican leadership has chosen to set jobs aside -- not just this week, but essentially every week that they've been in charge ... to spend time on partisan messaging only," House Democratic Leader Nancy Pelosi said Wednesday. She added: "Politics be damned." White House Press Secretary Jay Carney called the vote an exercise to score political points, saying this is the kind of display Americans "loathe about politics in Washington." The health care law was Obama's signature domestic achievement, but it remains unpopular as a whole and divisive among the public, according to opinion polls. Democrats argued that erasing the law would eliminate the more popular individual elements -- a guarantee on coverage for those with pre-existing medical conditions, a requirement allowing children up to age 26 to remain on their parents' coverage and the reduction of seniors' Medicare prescription drug costs by closing the "doughnut hole" coverage gap. Republicans say other provisions, like requirements that some employers provide health care, will harm the economy at a particularly fragile time. The Associated Press contributed to this report.
Micah 6:8; He has shown you, O mortal, what is good. And what does the Lord require of you? To act justly and to love mercy, and to walk humbly with your God.
John 14:19 Jesus said: Because I live, you also will live.
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