Religious Freedomz in the USA

[Riot]

Originally Posted by Clip-Clop

How long do you think the medical world would survive while "not making any money and losing a ton"? Think anyone will want to be a Dr.? Think pharmaceutical companies will continue to make wonder drugs that keep you alive? Wake up.

What are you talking about? If everyone had Medicare, health care would still be provided by private hospitals, doctors, etc. They wouldn't be broke. Pharmaceutical companies would still develop drugs. What would be removed is simply the price gouging.

[Clip-Clop]

Originally Posted by Riot

What are you talking about? If everyone had Medicare, health care would still be provided by private hospitals, doctors, etc. They wouldn't be broke. Pharmaceutical companies would still develop drugs. What would be removed is simply the price gouging.

C'mon, you are a Dr. If you had to go through all kinds of govt red tape to get paid what they thought was fair for what you were doing would you? Do you let clients decide what procedures should cost? Of course not.

[Danzig]

from a GAO article from a year ago"

GAO has designated Medicare and Medicaid as high-risk programs because they are particularly vulnerable to fraud, waste, abuse, and improper payments (payments that should not have been made or were made in an incorrect amount). Medicare is considered high-risk in part because of its complexity and susceptibility to improper payments, and Medicaid because of concerns about the adequacy of its fiscal oversight to prevent inappropriate spending. In fiscal year 2010, the Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare and Medicaid--estimated that these programs made a total of over $70 billion in improper payments



70 billion improperly paid in one year alone. that is absolutely dreadful.

[Riot]

Originally Posted by Danzig

from a GAO article from a year ago"

GAO has designated Medicare and Medicaid as high-risk programs because they are particularly vulnerable to fraud, waste, abuse, and improper payments (payments that should not have been made or were made in an incorrect amount). Medicare is considered high-risk in part because of its complexity and susceptibility to improper payments, and Medicaid because of concerns about the adequacy of its fiscal oversight to prevent inappropriate spending. In fiscal year 2010, the Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare and Medicaid--estimated that these programs made a total of over $70 billion in improper payments



70 billion improperly paid in one year alone. that is absolutely dreadful.

It is, but they changed the definition of "improper", too:

According to the report, the Bush administration from 2005 to 2008 reported improper payments of about 4 percent in the fee-for-service program, or about $17 billion total in 2008. Government officials at the time, however, typically did not consider a Medicare payment improper if the medical documentation was incomplete or a doctor's signature was illegible.

But now they do.

4% is too high, but that's not "rampant". That's 96% proper payments made. And other safeguards were put into the program in 2010. The ACA cuts $500 billion in 10 years in duplication.

[Riot]

Originally Posted by Clip-Clop

C'mon, you are a Dr. If you had to go through all kinds of govt red tape to get paid what they thought was fair for what you were doing would you? Do you let clients decide what procedures should cost? Of course not.

Right now, human doctors have tons of staff dedicated only to cutting through the red tape of the various insurance companies. They hate it. Insurance companies dictate the actual practice of medicine - what a doctor can do for a patient - by what they will reimburse for or not. Private insurance companies dictate what tests will be reimbursed for what coded conditions, and how much that will be, and what tests will NOT be covered for certain conditions.

Medicare is a piece of cake compared to that. If doctors offices only had to deal with one insurance reimbursement agency, rather than multiple different ones, they would be thrilled!

Insurance companies only pay "what they think is fair" (or what they negotiate with the network the doctor is in) exactly as the Medicare network does. And that nice huge profit margin goes, not to us, but to the insurance company.

Medicare costs only about 9% for administration, and that is comparable to what other first world countries cost to insure their citizens. Private insurance companies are 17% of our GDP. That's outrageous. That's why we have the most expensive health care in the world - without even having all our citizens covered, and without providing the best outcomes in the world!

Except Obamacare just changed one thing: now insurance companies must spend 80% of patient premiums on patient health care - not insurance company profit.

[Clip-Clop]

Originally Posted by Riot

Right now, human doctors have tons of staff dedicated only to cutting through the red tape of the various insurance companies. They hate it. Insurance companies dictate the actual practice of medicine - what a doctor can do for a patient - by what they will reimburse for or not. Private insurance companies dictate what tests will be reimbursed for what coded conditions, and how much that will be, and what tests will NOT be covered for certain conditions.

Medicare is a piece of cake compared to that. If doctors offices only had to deal with one insurance reimbursement agency, rather than multiple different ones, they would be thrilled!

Insurance companies only pay "what they think is fair" (or what they negotiate with the network the doctor is in) exactly as the Medicare network does. And that nice huge profit margin goes, not to us, but to the insurance company.

Medicare costs only about 9% for administration, and that is comparable to what other first world countries cost to insure their citizens. Private insurance companies are 17% of our GDP. That's outrageous. That's why we have the most expensive health care in the world - without even having all our citizens covered, and without providing the best outcomes in the world!

Except Obamacare just changed one thing: now insurance companies must spend 80% of patient premiums on patient health care - not insurance company profit.

Why does Medicare lose money? Why even though millions pay into something they will never use they still manage to not have enough to cover those using it?

[joeydb]

Originally Posted by Clip-Clop

Why does Medicare lose money? Why even though millions pay into something they will never use they still manage to not have enough to cover those using it?

Because it's designed to be that way. You can never pay enough. The government decides who gets what - unlike your own money (a.k.a. what the government does not confiscate) which you can spend however you like.

You know - like the 47 million food stamp recipients who buy beer and cigarettes with their "own" money after the sucker of a taxpayer pays for the rest of what they have in the checkout line.

The government approach is always to take from one group and give that which it took to another group, less the non-trivial fee for processing and handling.

All hail the recipient!

[Danzig]

just wait and see what happens if the PPUCA stays on the books. i know it s supposed to be aca, but it will end up unaffordable.
the CBO estimated that six million people covered in small groups will have their employers drop their coverage. that the employer would fint it cheaper to pay the penalty and let their workers go thru a exchange.
however, it is possible that up to 30 million would end up in the exchange. that causes the est. of less than a trillion in new cost over ten yearzs to go well over that, one trillion being the 'magic number' congress had said would make or break the vote.
also, in arkansas for an example, anyone want to guess what percentage of this states total population will qualify for a subsidy? averqage subsidy is five thousand a year. 70~75 percent. because the feds have made an average income chart for income.
now, we all know that cost of living varies widely.
oh...and medicaid? rolls will almost double. right now those up to 75 percent above the fed. poverty level are eligible. it goes to 133 percent above trhat. who will pay for that? most states are already in deep financial straits.

[joeydb]

Originally Posted by Danzig

just wait and see what happens if the PPUCA stays on the books. i know it s supposed to be aca, but it will end up unaffordable.
the CBO estimated that six million people covered in small groups will have their employers drop their coverage. that the employer would fint it cheaper to pay the penalty and let their workers go thru a exchange.
however, it is possible that up to 30 million would end up in the exchange. that causes the est. of less than a trillion in new cost over ten yearzs to go well over that, one trillion being the 'magic number' congress had said would make or break the vote.
also, in arkansas for an example, anyone want to guess what percentage of this states total population will qualify for a subsidy? averqage subsidy is five thousand a year. 70~75 percent. because the feds have made an average income chart for income.
now, we all know that cost of living varies widely.
oh...and medicaid? rolls will almost double. right now those up to 75 percent above the fed. poverty level are eligible. it goes to 133 percent above trhat. who will pay for that? most states are already in deep financial straits.

I like your acronym better: PPUCA, pronounced P-PUKE-AH

[Riot]

Originally Posted by Danzig

just wait and see what happens if the PPUCA stays on the books. i know it s supposed to be aca, but it will end up unaffordable

That's a nice wild speculation. Good luck with that. The rest of us are already enjoying the benefits, the measures that prevent our insurance companies from abusing us, and thousands of Americans are happy to now be paying into their new insurance policies.

You're enjoying that, too, btw: that you are no longer paying for thousands of Americans to not have insurance - they are now paying their own way, purchasing their own insurance, rather than being uninsured.

The ACA is 100% self-funded, btw.

[Riot]

Originally Posted by Danzig

oh...and medicaid? rolls will almost double. right now those up to 75 percent above the fed. poverty level are eligible. it goes to 133 percent above trhat. who will pay for that? most states are already in deep financial straits.

You might read the ACA - because it's paid for in the bill. Yes, the ACA is independently scored as completely self-funding. "Who will pay for it" has never been an objection to this Republican-lobbyist health care reform program, when it was first presented years ago in the 1990's. But it has been updated and improved in the Obama version.

[Riot]

Originally Posted by joeydb

Because it's designed to be that way. You can never pay enough. The government decides who gets what - unlike your own money (a.k.a. what the government does not confiscate) which you can spend however you like.

You know - like the 47 million food stamp recipients who buy beer and cigarettes with their "own" money after the sucker of a taxpayer pays for the rest of what they have in the checkout line.

The government approach is always to take from one group and give that which it took to another group, less the non-trivial fee for processing and handling.

All hail the recipient!

The above rant having zero to do with Medicare, which is paid for by the people eventually receiving the insurance. Hint: that's why it's called an "entitlement" program. Because you contributed into it, you are entitled to take out of it when it's your turn.

[Riot]

..

http://www.healthcare.gov/law/full/

Full Text of the Affordable Care Act (PDF – 2.6 MB)

Read the Affordable Care Act and its amendments. Note: The text is searchable within the PDF file.

The Affordable Care Act, Section by Section

Title IX. Revenue Provisions

The Act makes health care more affordable for families and small business owners by providing the largest middle class tax cuts for health care in American history. Tens of millions of families will benefit from new tax credits which will help them reduce their premium costs and purchase insurance. Families making less than $250,000 will see their taxes cut by hundreds of billions of dollars.

When enacted, health reform is completely paid for and will reduce the deficit by more than one hundred billion dollars in the next ten years.

http://www.healthcare.gov/law/features/

Key Features of the Healthcare Law

Rights and Protections
Insurance Choices
Insurance Costs
65 or Older
Employers

http://www.healthcare.gov/law/timeline/

ACA Timeline - what is changing, and when

Changes to note:

* 50% discount for name-brand drugs in the Medicare "donut hole"
* Expanded coverage for young adults
* Small business tax credits
* Pre-Existing Condition Insurance Plans

[Riot]

Originally Posted by Clip-Clop

Why does Medicare lose money? Why even though millions pay into something they will never use they still manage to not have enough to cover those using it?

Note the date, but still applicable. Yes, the programs need some fixing. They always do. Expecting a medical insurance program set up decades ago to be applicable to todays health insurance industry, especially the most expensive in the world, twice as expensive as other countries, is silly. These programs are outstandingly successful, having saved millions of lives over the years by enabling seniors to get health care. No, the programs do not need to be completely thrown out. That would be absurd. The ACA removes millions (that means millions in savings) in Medicare duplication over the next 10 years. That's an excellent start.

It also provides health care to seniors at half the cost of private health insurance, thus saving us all money. We have the most expensive healthcare system in the world - it's a disaster. We are the only country in the world whose health care system is owned by private insurance companies. Medicare for all would fix that.

Medicare's Financial Problems

Medicare’s financial affairs are handled through two trust funds, the Hospital Insurance (HI, or Medicare Part A) Trust Fund and the Supplementary Medical Insurance (SMI) Trust Fund.

According to current projections, the Hospital Insurance Trust Fund will receive income of $221 billion in 2008 and pay out $230 billion in benefits and administrative expenses, leaving a deficit of $8 billion for the year. At the end of the year, the trust fund will hold $318 billion in assets. Current income and trust fund reserves will be sufficient to pay hospital insurance benefits through 2019, when the reserves are projected to be depleted. At that point, if no changes are made, scheduled HI income will cover 78 percent of estimated expenditures.

The Supplementary Medical Insurance Trust fund is always adequately financed because beneficiary premiums and general revenue contribution are set annually to cover the expected costs of Parts B and D of Medicare for the coming year. However, the rapid rate of growth in program costs will place increasing demands on both beneficiaries (to pay the premiums) and taxpayers (to provide the general revenues).

Medicare’s spending is growing rapidly for the same reasons that private health spending is growing rapidly—increases in the cost and use of medical services. Much of these increases stem from advances in medical practice and technology that have enabled people to live longer and healthier lives. These technological advances have generally raised costs. The aging of the population makes only a small contribution to the growth in Medicare’s costs.

For more information, see:

Medicare Finances: Findings of the 2008 Trustees Report, Medicare Brief No. 18
Financing Medicare's Future, Final Report of the Study Panel on Medicare's Long-Term Financing
The Financing Needs of a Restructured Medicare Program, Medicare Brief No. 5
Matching Problems with Solutions: Improving Medicare's Governance and Management, Final Report of the Study Panel on Medicare's Governance and Management
Should Higher Income Medicare Beneficiaries Pay More for Medicare? Medicare Brief No. 2

The official Medicare website is www.medicare.gov.

http://www.nasi.org/learn/medicare/financial-problems