Healthcare reform by just removing two words, 'over 65'

Jarod said:
... and anyone who is self pay gets a discount also.
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Say what? WTF you talking 'bout, willis? I've never recieved a discount from a doctor because I was paying. You're gonna need to provide a citation for that claim or I'm calling bullshit
 
ZappasGuitar said:
And why did they use reconciliation?

To bypass obstructionist Republican filibusters.
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Correct .. and once they used reconciliation, republicans were no longer in the way.

HR 676 was waiting for them .. but they passed the cumbersome clusterfuck of a corporatist bill instead that remains unpopular to this day.

It was politically insane.
 
tinfoil said:
Say what? WTF you talking 'bout, willis? I've never recieved a discount from a doctor because I was paying. You're gonna need to provide a citation for that claim or I'm calling bullshit
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then you are getting ripped off, self pay in Florida always gets a discount. I was self pay for a while and I have lots of clients who are self pay.
 
tinfoil said:
Say what? WTF you talking 'bout, willis? I've never recieved a discount from a doctor because I was paying. You're gonna need to provide a citation for that claim or I'm calling bullshit
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You have no insurance and pay top price for your medical care and don't want anything like Obamacare or Medicare for All?

People like you are the problem.
 
PostmodernProphet said:
but how much would it have cost to buy?.......
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It will cost a lot less than the average we pay now.

Medicare For All Cost Per Person

Cost per person in the U.S. = $8,233 (from October 2012 OECD report)
Cost per person as per the average of the other 29 countries (listed) = $3,303
$8,233 / $3,303 = 2.5
http://www.medicareforall.org/pages/Cost_Per_Person_-_details

It only makes sense that it would cost far less ..

Mr. President: Why Medicare Isn't the Problem, It's the Solution
By Robert Reich

I hope when he tells America how he aims to tame future budget deficits the President doesn't accept conventional Wasington wisdom that the biggest problem in the federal budget is Medicare (and its poor cousin Medicaid).

Medicare isn't the problem. It's the solution.

The real problem is the soaring costs of health care that lie beneath Medicare. They're costs all of us are bearing in the form of soaring premiums, co-payments, and deductibles.

Americans spend more on health care per person than any other advanced nation and get less for our money. Yearly public and private healthcare spending is $7,538 per person. That's almost two and a half times the average of other advanced nations.

Yet the typical American lives 77.9 years - less than the average 79.4 years in other advanced nations. And we have the highest rate of infant mortality of all advanced nations.

Medical costs are soaring because our health-care system is totally screwed up. Doctors and hospitals have every incentive to spend on unnecessary tests, drugs, and procedures.

You have lower back pain? Almost 95% of such cases are best relieved through physical therapy. But doctors and hospitals routinely do expensive MRI's, and then refer patients to orthopedic surgeons who often do even more costly surgery. Why? There's not much money in physical therapy.

Your diabetes, asthma, or heart condition is acting up? If you go to the hospital, 20 percent of the time you're back there within a month. You wouldn't be nearly as likely to return if a nurse visited you at home to make sure you were taking your medications. This is common practice in other advanced countries. So why don't nurses do home visits to Americans with acute conditions? Hospitals aren't paid for it.

America spends $30 billion a year fixing medical errors - the worst rate among advanced countries. Why? Among other reasons because we keep patient records on computers that can't share the data. Patient records are continuously re-written on pieces of paper, and then re-entered into different computers. That spells error.

Meanwhile, administrative costs eat up 15 to 30 percent of all healthcare spending in the United States. That's twice the rate of most other advanced nations. Where does this money go? Mainly into collecting money: Doctors collect from hospitals and insurers, hospitals collect from insurers, insurers collect from companies or from policy holders.

A major occupational category at most hospitals is "billing clerk." A third of nursing hours are devoted to documenting what's happened so insurers have proof.

Trying to slow the rise in Medicare costs doesn't deal with any of this. It will just limit the amounts seniors can spend, which means less care. As a practical matter it means more political battles, as seniors - whose clout will grow as boomers are added to the ranks - demand the limits be increased. (If you thought the demagoguery over "death panels" was bad, you ain't seen nothin' yet.)

Paul Ryan's plan - to give seniors vouchers they can cash in with private for-profit insurers — would be even worse. It would funnel money into the hands of for-profit insurers, whose administrative costs are far higher than Medicare.

So what's the answer? For starters, allow anyone at any age to join Medicare. Medicare's administrative costs are in the range of 3 percent. That's well below the 5 to 10 percent costs borne by large companies that self-insure. It's even further below the administrative costs of companies in the small-group market (amounting to 25 to 27 percent of premiums). And it's way, way lower than the administrative costs of individual insurance (40 percent). It's even far below the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

In addition, allow Medicare - and its poor cousin Medicaid - to use their huge bargaining leverage to negotiate lower rates with hospitals, doctors, and pharmaceutical companies. This would help move health care from a fee-for-the-most-costly-service system into one designed to get the highest-quality outcomes most cheaply.

Estimates of how much would be saved by extending Medicare to cover the entire population range from $58 billion to $400 billion a year. More Americans would get quality health care, and the long-term budget crisis would be sharply reduced.

Let me say it again: Medicare isn't the problem. It's the solution.
http://readersupportednews.org/opinion2/272-39/5605-medicare-for-all-is-the-solution
 
blackascoal said:
Health Care Reform: Remove Over 65 from Medicare

Obamacare, aka The Affordable Care Act signed into law by President Barack Obama in 2010, is said to have some 1,147,271 words in the bill’s language. I have just two words that would dramatically change and fix our health care system for good. Remove “Over 65″ from current law regarding Medicare.

While the benefits of reforms in Obamacare far outweigh those of our previous health care system, I must admit it could have been even better. Since the law is now in jeopardy with a potential partisan Court ruling in July, perhaps we should start talking about this two-word plan.

With Americans paying directly from their paychecks like they already do with Medicare, we know that the costs of medical services would be spread out, and dramatically less for everyone. With one single coverage provider, essentially a government insurance company, taking profits out of the equation, additional cost savings would be seen by all. Paul Krugman said it best:

The great advantage of universal, government-provided health insurance is lower costs. Canada’s government-run insurance system has much less bureaucracy and much lower administrative costs than our largely private system. Medicare has much lower administrative costs than private insurance. The reason is that single-payer systems don’t devote large resources to screening out high-risk clients or charging them higher fees. The savings from a single-payer system would probably exceed $200 billion a year, far more than the cost of covering all of those now uninsured.
http://thenevadaview.com/3452/health-care-reform-remove-over-65-from-medicare/

The healthcare debate is not over .. and the solution has always been right in front of us.
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I agree with you that the ACA would have been better for removing the "over 65" and it would have been better with a single payer system and it would have been better with price controls but the practical reality was that it would have not have passed through the legislature and it would not have become law and we would be back to where we were before the ACA with little hope and any substantive change in the immeadiate future.

The ACA, flaw, warts and all does establish a precedent and given time our political system will adopt the major reforms of universal coverage, single payer system (or a non-profit insurance system) and price controls as the rest of the industrialized world has.
 
Superfreak said:
While I agree that would have been the smarter play vs. Obamacare, keep in mind that it is the private sector that subsidizes those 'lower costs' of Medicare. You put everyone on Medicare type insurance and you will see what the true costs are.
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Not if you implement cost controls.
 
Mott the Hoople said:
Not if you implement cost controls.
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But....But.... But, ya, people might get better access to health care.... but then how would my Doctor afford his multi-million dollar house on the water? How would he be able to afford to take Tuesdays and Thursdays off for golf? How would pharmaceutical sales representatives drive BMW's as a company car?
 
Jarod said:
But....But.... But, ya, people might get better access to health care.... but then how would my Doctor afford his multi-million dollar house on the water? How would he be able to afford to take Tuesdays and Thursdays off for golf? How would pharmaceutical sales representatives drive BMW's as a company car?
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You become a doctor to the rich and famous, who believe, the more you pay for something, the better it is...
 
blackascoal said:
It will cost a lot less than the average we pay now.

Medicare For All Cost Per Person

Cost per person in the U.S. = $8,233 (from October 2012 OECD report)
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there are four in my family on my health insurance plan (though my son who has turned 27 will be dropping off in July).......by your numbers Medicare for all four would therefore cost in excess of $32,000.......my insurance, BC/BS of Michigan costs me $634/month, or an annual cost of $7608.....

now, not considering the $5k deductable, the per family premium is less than the per person cost of Medicare.....even considering the deductible, the sum paid for my family is still less than the Medicare cost for my wife and myself......

thus, not only does it NOT cost a "lot less", it costs more......
 
Thithicus said:
It would result in a severe shortage of doctors. Medicare reimburses doctors for around 20 cents on the dollar (if that). If we expand Medicare to everyone, doctors would probably end up making less than $40K/year.
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You don't know what you're talking about. Medicare doesn't pay $.20 on the dollar. Medicare is like any other insurance program. It pays X percent (depending on the plan) and you pay the balance. Many public practices recieve the majority of their income from medicare payments. Medicare does have some cost control aspects.

Second it won't create a shortage of doctors. The AMA and it's inbreeding with Medical Schools has all ready done that. They have purposefully kept the market artificially low in the numbers of physicians and the costs of going to medical school outrageously high so as to keep the numbers of Doctors low. This is why so many US doctors go into specialization and not primary care because that's where the money is at. Unfortunately as skilled as those specialist are, they don't have the over all impact on health outcomes that primary care physicians do who do the majority of the heavy lifting when it comes to prevention and early diagnosis of disease which is the ultimate key to improved outcomes.

So if expanding health care coverage to all would have any impact it would dramatically increase the numbers of primary care physicians that this country desperately needs.
 
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Superfreak said:
I believe your numbers are reversed... I am pretty sure it is about 75-80 cents on the dollar... not 20
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That depends on the plan and the cost but you're essentially correct. Typical Plan B Medicare pays 80% of the Medicare approved cost and the patient pays a 20% copay for things like Doctors visits and 100% for diagnostic and lab costs. Out of pocket costs can be greater if the physician does not accept Medicare but most clinics/phyisicans make up for that by increased volume.
 
blackascoal said:
Perhaps you are unaware the there has been a shortage of doctors in this country for a decade.

Obamacare does nothing to address that, in fact, it explodes it .. Medicare for all Americans / HR 676 / S 703 does.

Medicare supports Graduate Medical Education.

Physicians for a National Health Program has submitted highlights of S703:

Patients go to any doctor or hospital of their choice.

The program is paid for by combining current sources of government health spending into a single fund with modest new taxes amounting to less than what people now pay for insurance premiums and out-of-pocket expenses.

Comprehensive benefits, including coverage for dental, mental health, and prescription drugs.

While federally funded, the program is to be administered by the states.

By eliminating the high overhead and profits of the private, investor-owned insurance industry, along with the burdensome paperwork imposed on physicians, hospitals and other providers, the plan saves at least $400 billion annually – enough money to provide comprehensive, quality care to all.

Community health centers are fully funded, giving the 60 million Americans now living in rural and underserved areas access to care.

To address the critical shortage of primary care physicians and dentists, the bill provides resources for the National Health Service Corps to train an additional 24,000 health professionals.
http://www.healthcare-now.org/whats-single-payer/s-915hr-1200/s-703
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Again, that's an exageration and has little to do with the shortage of primary care physicians in this country. The shortage of primary care physicians has far more to do with the quasi monopoly the AMA has on the profession.
 
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