...
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
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