• OBAMACARE

    From BOB KLAHN@1:123/140 to BOB ACKLEY on Sun Feb 6 13:54:54 2011

    ...

    A friend of mine's Mom works in accounts at a local hospital, the
    "indigent" patients (meaning those who can't pay,) their bill ends up
    getting eaten by the hospital.

    The hospital then has to jack up their rates to cover those losses.

    That's why an aspirin shows up on the bill costing $3.50.

    What the f*ck do you think I've been saying for the past 20
    years??? Now that you apparently understand that fact,
    would you mind explaining it to Klahn?

    I understand it, I don't believe it. No hospital can charge you
    $3.50 for an aspirin just because they have to cover another
    patient's bills. No for profit hospital will charge any less
    than they can get away with whether or not another patients
    bills are covered.

    Recently I've read about a major operation in Florida, hunting down
    and arresting dozens of Medicare fraud crooks.

    "60 Minutes" has a feature on how easy it was to commit fraud on
    Medicare.

    And how profitable Medicare fraud is.

    While it does exist, it's not nearly as rampant as the
    politicos would have us believe. And yes, those who engage
    in it should be locked up for a nice long time.

    I have been of that opinion for a long time. Crooks will defraud
    private insurance just as much as medicare. And the medicare
    frauds seem to tend to be doctors and medical providers, not the
    patients.

    That said, the biggest Medicare fraud is the claim that
    Medicare pays the bills for
    the health care received by the nation's elderly. It
    doesn't, and hasn't for probably
    thirty years. What it pays is a *portion* of those bills.

    My private sector insurance does exatly the same thing. What's
    the difference?

    When Medicare started
    discounting its payments, providers started billing the
    patients for the unpaid balances.

    That is what I do not believe. Those private for profit
    hospitals will charge whatever they can get, regardless of what
    other patients pay or don't pay.

    In a truly competitive market they could not get away with that
    at all. Some hospitals would just not take the medicare payments
    and patients, then cut the bills of their regular patients and
    the ones overcharging would lose business.

    Believe it or not that is how a real free market works. The fact
    that you don't see that at all is the proof there is no free
    market. It is also the proof that the conservative mantra of
    private sector competition is a fraud.

    Said patients screamed to their congresscrooks, who
    promptly made it illegal for providers
    to bill Medicare patitnts for any unpaid charges.

    The providers can't bill me for the discounted part from my
    private sector insurance. What's the difference?

    Medicare is also infamous for slow payment - 90 days is
    *early* to them. Note that
    ...
    and payments were made by EFT. There's no reason on earth
    that an insuror should need
    more than *TEN* days to pay a claim (fraud investigations

    True. So solve that problem. Oh and if the republicans have any
    solutions at all, why didn't they fix that in the 6 years they
    had complete control of the federal government?

    can come later). Yet Medicare
    rarely takes ANY action on a claim for 90 days; then it
    disallows every charge it thinks it
    can get away with and writes itself a humongous discount on
    the remaining balance - only
    rearely does Medicare pay even half of the billed amount.

    My private sector insurance typically pays about 36% or less.
    What's the difference?

    ...

    bill just shy of $50K for my angioplasty and stent back in
    2004. Tricare paid just shy of
    $9,000 of those charges. MY share of those charges was a
    whopping $33.00. The other
    forty grand - EIGHTY PERCENT of the billed amount - went
    where all the other unpaid
    charges go, onto other peoples' bills. And it took Tricare

    Again, I do not believe that. If the hospital and doctors found
    the medicare payments insufficient they would simply refuse to
    do business with them.

    ...

    And unpaid charges - even those for 'uncompensated care'
    and 'charity care' - don't just
    go away because they don't get paid. They get factored
    into everybody else's bills, just
    like shoplifting and employee theft are factored into the
    prices on retail merchants' shelves.

    The big difference is, the hospitals can stop taking medicare,
    store owners can try to stop theft, but they can't just refuse
    to do business.

    About 2/3rds of medical care in this country is paid for by the
    government or insurance. Much of the rest is paid for by the
    patients. Since, in many cases where bills have to be covered
    before treatment will be provided, the patient does have to pay
    the bills, those cover the bills that actually are paid.

    So, about 2/3rds of medical bills are discounted, usually by
    more than 50%. That tells me the other 1/3rd is overcharged. And
    the hospitals can't double the bills of all other patients just
    because of the 2/3rds that are discounted. Ok, That would mean
    just more people who are not paying.

    Oh, I just recently paid cash for a doctor bill that was not
    covered by insurance. The bill was reduced by something like
    40%. So, how can doctors cut bills for cash payments if they
    have to make up for third party discounts?

    My suspicion, the original bill is jacked up to allow for the
    discounts.

    And once everyone is covered by insurance I believe they won't
    be able to do that anymore, since eveyone will know what will be
    paid in advance.

    So, Obamacare is the answer even to that.



    BOB KLAHN bob.klahn@sev.org http://home.toltbbs.com/bobklahn

    ... DOOR:(n). Something you throw Windows out of.
    --- Via Silver Xpress V4.5/P [Reg]
    * Origin: Doc's Place BBS Fido Since 1991 docsplace.tzo.com (1:123/140)
  • From BOB KLAHN@1:123/140 to BOB ACKLEY on Sun Feb 6 14:16:00 2011

    I look forward to see what legal gymnastics Holder does in his
    appeal.

    One judge, making his ruling.

    It'll be appealed, I have no doubt it'll be brought all the way to
    the Supreme Court.

    And you believe it is constitutional to force people to buy health
    care or be fined or jailed ?

    Of course he does. Note that it's very unlikely that he will have to
    purchase it, most likely it will be furnished to him free - unlike
    even those of us on Medicare (for those unaware I pay just under
    $100/month for Medicare out of my Socialist Security).

    The uninsured in this country are overwhelmingly the working
    poor. They are the ones being hurt now, and the ones the right
    want's to keep out of the system.

    Ditto. And a medication I take for blood pressure just took an OOP
    jump of 600%, as of the first of the year.

    ...

    There's a really easy way for the government to cut the
    price of health care in this country,
    quickly, too. And it will probably have far more effect on
    insurance premiums than Obamacare
    was supposed to (Obamacare was supposed to REDUCE premiums
    by expanding the pool; in

    Obamacare was supposed to reduce costs through the public plan.
    That was killed. The increase in the pool doesn't take effect
    until 2014.

    fact it INCREASED the premiums because it converted what
    had been insurance into another welfare program - and a big
    hunk of the pool expansion was deadbeats and others that
    won't or can't pay the premiums anyway).

    Whose medical costs are paid for anyway, according to you. So
    that is obviously false. The big hunk of the uninsured are
    working poor, not deadbeats. You are partly right, they can't
    pay the premiums, because they are poor. That has always been my
    objection to the mandate.

    Since the mandate does *NOT* take effect for two more years, any
    insurance company that claims that's the cause of premium
    increases is committing fraud.

    Anthem Blue Cross has admitted their massive insurance premium
    increase is due to healthy young people falling out of the
    system because they are losing their jobs, or can't find jobs.
    It's the economy... one more time.

    All the government had to do was require that insurors =
    specifically including Medicare - pay health claims, in
    full, within 30 days of submission; the only allowable

    If the government has to pay in full, why shouldn't insurance
    companies. Your theory was applied to drug suppliers under
    Bush's drug payment program, no negotiating lower prices. The
    result has been a disaster.

    Medical costs will soon be 20% of our GDP. If they have to pay
    bills in full that 20% will probably jump to 40%. Another
    disaster.

    Payment within 30 days should be required, but will have
    relatively little effect on overall costs.

    discount would be 10% if the bill is paid within 10 days of
    submission. Simple, easy to understand, and it doesn't
    require a couple of hundred thousand bureaucrooks to run it.
    Among other things, it would eliminate "cost shifting"

    Yeah, they will just hold all prices high. Remember, cost
    shifting would not be possible in a truly competitive market in
    the first place. So, that proves medical care is not any sort of
    competitive market, so costs will not come down if the
    government is required to pay in full.

    (which places those unpaid charges on
    everybody else's bill) and would eliminate at least one
    incentive for fraud. It would also

    The only incentive for fraud necessary is profit. That won't be
    eliminated, it will be increased.

    renmder unnecessary the phalanxes of Medical Records
    specialists whose only purpose is to
    insure that patients' diagnoses are coded to ensure the
    maximum possible reimbursement (coding has become a
    recognized subspecialty of that field). Most folks don't

    That is completely false. If they pay in full it will still be
    profitable to code for maximum payment, even more so in fact.

    ...

    BOB KLAHN bob.klahn@sev.org http://home.toltbbs.com/bobklahn

    ... Great! My bunny's been cashing my reality checks again..
    --- Via Silver Xpress V4.5/P [Reg]
    * Origin: Doc's Place BBS Fido Since 1991 docsplace.tzo.com (1:123/140)