Get The Super Greeedy Wealth Extractors Out Of Health Care. We Need Single Payer NOW!

I keep hearing that but I have not found it difficult to get a doctor when you are on Medicare.

I don't think it is difficult, but there is a growing number (I found the percentage once). I think it is a worse problem for Medicaid because payments are lower. In my area some of the family pharmacies have gone under because of payments. My optometrist no longer takes my Humana Medicare Advantage plan.
 
Hello Fentoine Lum,



I don't think it is really possible to have competition in something like health care. When you need it you're not in a position to shop around. and they know it, so they stick it to ya.

The competition is at the ins co level as most are in group policies. They compete for those groups. But despite large revenues the profit margins are not large.

How Much Do Health Insurers Profit?
If we look at average profit margins by industry, health insurance companies are in the single digits. For perspective, the legal, real estate, and bookkeeping industries have average profit margins in excess of 17 percent. As far as health care goes, there are certainly some very profitable sectors, including medical and diagnostic laboratories and the pharmaceutical industry.
https://www.verywellhealth.com/health-insurance-companies-unreasonable-profits-1738941
 
There are billions of Medicare billings--there is no way to check even a small number of those. Law requires payments to be made within a specified period and even if inspectors find fraud the company is using a new address and name.

Much of it is not actually fraud but waste. For example, chiropractors who send vans around picking up kids after school and giving them back adjustments (in offices with food and video games) or dentists who give children root canals or companies who provide seniors with access equipment.

A solution is to only allow equipment and supplies to be provided by established vendors with competitive bidding but that was rejected because it would primarily benefit the larger businesses and small medical supply vendors would lose business. There is a trial program in some areas allowing competitive bidding which has saved 40%.

Medicare doesn't even cover root canals for seniors so I am fairly sure your dentists with vans of children thing isn't true.
 
Hello Fentoine Lum,



I don't think it is really possible to have competition in something like health care. When you need it you're not in a position to shop around. and they know it, so they stick it to ya.

There has been a considerable price drop in those areas where customers can shop around--lasik surgery, plastic surgery......
 

It doesn't surprise me but that is self-evident from the piece----it is because reimbursement rates are too low. They cannot stay in business without churning procedures. It is the fundamental problem with medicare/medicaid for all that gets completely ignored by democrats. Unless you either take over the entire industry on all sides or spend significantly more money than we currently are, you cannot overlay single payer onto a for-profit system and have medical providers stay in business and quality of care. medicare/medicaid only do what they do because for profit insurance companies subsidize their patients by creating enough profit for the providers to tolerate some free rider patients. I live in a 1 hospital town and that hospital will only treat medicaid patients through the ER. Unless it is life or death, you have to go somewhere else for surgery. They are almost as bad with medicare patients but they can at least kick them out to nursing homes for "rehab" when they hit their stay window or pawn them off onto long term stay hospitals the day after they become entitled to the full patient co-pay. My state's medicaid is horrible. It is why I say medicaid is almost as good as having no insurance whatsoever because virtually nobody other than the ER will see them. A lot of doctors locally also limit the number of medicare patients they will take for the same reason.
 
It doesn't surprise me but that is self-evident from the piece----it is because reimbursement rates are too low. They cannot stay in business without churning procedures. It is the fundamental problem with medicare/medicaid for all that gets completely ignored by democrats. Unless you either take over the entire industry on all sides or spend significantly more money than we currently are, you cannot overlay single payer onto a for-profit system and have medical providers stay in business and quality of care. medicare/medicaid only do what they do because for profit insurance companies subsidize their patients by creating enough profit for the providers to tolerate some free rider patients. I live in a 1 hospital town and that hospital will only treat medicaid patients through the ER. Unless it is life or death, you have to go somewhere else for surgery. They are almost as bad with medicare patients but they can at least kick them out to nursing homes for "rehab" when they hit their stay window or pawn them off onto long term stay hospitals the day after they become entitled to the full patient co-pay. My state's medicaid is horrible. It is why I say medicaid is almost as good as having no insurance whatsoever because virtually nobody other than the ER will see them. A lot of doctors locally also limit the number of medicare patients they will take for the same reason.

Not a question of staying in business, but maintaining their high profit rates. You don't lose money in healthcare in the US,.
 
Not a question of staying in business, but maintaining their high profit rates. You don't lose money in healthcare in the US,.

Tell that to Partner's Healthcare that has lost 100's of millions in recent years. It is a question of staying in business when you have to pay a mint before you make the first dime of profit. A no-frills strip mall bay alone in our area will run you between $5K-$10K per month. People who don't know shit about running businesses don't know shit about how expensive overhead can be before the first dime of payroll gets covered. It is why rural access to healthcare is in such huge danger.

"In most rural communities, the hospital is the first or second largest employer, but only if the hospital can keep its doors open. More than 44% of rural hospitals operate at a loss and 30% operate below a -3% margin. 83 rural hospitals have closed since 2010, and 674 are vulnerable to closure. If all 674 vulnerable hospitals close, we will lose 99,000 direct health care jobs, 137,000 community jobs, and $277 billion in GDP. Per-Capita annual income in rural communities will decrease by $703, while rural unemployment would increase by 1.6 percentage points." https://www.ruralhealthweb.org/blogs/ruralhealthvoices/february-2018/rebuild-rural-the-importance-of-health-care-in-in
 
It doesn't surprise me but that is self-evident from the piece----it is because reimbursement rates are too low. They cannot stay in business without churning procedures. It is the fundamental problem with medicare/medicaid for all that gets completely ignored by democrats. Unless you either take over the entire industry on all sides or spend significantly more money than we currently are, you cannot overlay single payer onto a for-profit system and have medical providers stay in business and quality of care. medicare/medicaid only do what they do because for profit insurance companies subsidize their patients by creating enough profit for the providers to tolerate some free rider patients. I live in a 1 hospital town and that hospital will only treat medicaid patients through the ER. Unless it is life or death, you have to go somewhere else for surgery. They are almost as bad with medicare patients but they can at least kick them out to nursing homes for "rehab" when they hit their stay window or pawn them off onto long term stay hospitals the day after they become entitled to the full patient co-pay. My state's medicaid is horrible. It is why I say medicaid is almost as good as having no insurance whatsoever because virtually nobody other than the ER will see them. A lot of doctors locally also limit the number of medicare patients they will take for the same reason.

If what you are saying is that reasonable healthcare cannot be obtained for everyone under our system of capitalism...(AND THAT DOES SEEM TO BE WHAT YOU ARE SAYING)...

...then dump our system of capitalism and install something that can.

We are the ONLY major industrialized nation that has the kinds of problems we do with healthcare for EVERYONE.

If the system is the problem...

...GET RID OF THE FUCKING SYSTEM.
 
If what you are saying is that reasonable healthcare cannot be obtained for everyone under our system of capitalism...(AND THAT DOES SEEM TO BE WHAT YOU ARE SAYING)...

...then dump our system of capitalism and install something that can.

We are the ONLY major industrialized nation that has the kinds of problems we do with healthcare for EVERYONE.

If the system is the problem...

...GET RID OF THE FUCKING SYSTEM.

Over half of US hospitals are non-profit. Of the other half, only about half are for profit and half are government owned facilities. So our perceived problem only involves less than 25% of the hospitals. My better half's non-profit hospital operates at about a $250M/year surplus on close to $3B in revenue. That $250M gets combined with about $100M per year in investment income from a foundation to subsidize the losses of two other hospitals in rural areas that are part of the same system, as well as provide free healthcare to communities through clinics, health fairs and the like. It doesn't matter what system you have. To provide hospital care alone for free would require the government to come up with an extra trillion dollars a year in tax revenue which would require a 33% roughly increase in federal tax revenues alone. That does not include non-hospital care that will be another $1T beyond what the public already covers. Then you have to pay for the infrastructure and physical plants of either building new hospitals or using the takings clause to buy up all the existing ones. It is a lot easier to sit at home and proclaim things on the internet than it is to actually make them happen. We can't balance the federal budget now, let alone doubling it just to keep up with tiny little European countries whose nationalized healthcare's success largely involves being a freerider on the US R&D to begin with.
 
Hello Althea,

Their argument is R&D costs, but the truth is dividends and CEO pay/bonuses eat up tens of millions per year.

They also spend a lot on advertising.

That seems ridiculous.

If a patient needs a drug, it is up to the doctor to prescribe it.

With a single payer system we can put an end to the absurdity and wasted health care dollars spent on advertising.
 
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Hello Althea,



They also spend a lot on advertising.

That seems ridiculous.

If a patient needs a drug, it is up to the doctor to prescribe it.

With a single payer system we can end to absurdity and wasted health care dollars spent on advertising.
Notice the ads always end with 'ask your doctor about'.

That's not by accident.
 
Hello Celticguy,

The competition is at the ins co level as most are in group policies. They compete for those groups. But despite large revenues the profit margins are not large.

They could reduce the cost of insurance by reducing executive pay. Also, if they are running on such thin margins, running so efficiently, and coverage just can't be delivered for any less, then they should have no problem beating any deal available from a government Public Option run by government which conservatives say 'can't do anything right.' So why do they fight that so hard? It really looks like they are afraid that government can do it cheaper.
 
Tell that to Partner's Healthcare that has lost 100's of millions in recent years. It is a question of staying in business when you have to pay a mint before you make the first dime of profit. A no-frills strip mall bay alone in our area will run you between $5K-$10K per month. People who don't know shit about running businesses don't know shit about how expensive overhead can be before the first dime of payroll gets covered. It is why rural access to healthcare is in such huge danger.

"In most rural communities, the hospital is the first or second largest employer, but only if the hospital can keep its doors open. More than 44% of rural hospitals operate at a loss and 30% operate below a -3% margin. 83 rural hospitals have closed since 2010, and 674 are vulnerable to closure. If all 674 vulnerable hospitals close, we will lose 99,000 direct health care jobs, 137,000 community jobs, and $277 billion in GDP. Per-Capita annual income in rural communities will decrease by $703, while rural unemployment would increase by 1.6 percentage points." https://www.ruralhealthweb.org/blogs/ruralhealthvoices/february-2018/rebuild-rural-the-importance-of-health-care-in-in

Rural access is tough because they do not have the customer base. it is not about their start up costs, That is why rural folks have to drive to a city to get almost anything,
 
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Over half of US hospitals are non-profit. Of the other half, only about half are for profit and half are government owned facilities. So our perceived problem only involves less than 25% of the hospitals. My better half's non-profit hospital operates at about a $250M/year surplus on close to $3B in revenue. That $250M gets combined with about $100M per year in investment income from a foundation to subsidize the losses of two other hospitals in rural areas that are part of the same system, as well as provide free healthcare to communities through clinics, health fairs and the like. It doesn't matter what system you have. To provide hospital care alone for free would require the government to come up with an extra trillion dollars a year in tax revenue which would require a 33% roughly increase in federal tax revenues alone. That does not include non-hospital care that will be another $1T beyond what the public already covers. Then you have to pay for the infrastructure and physical plants of either building new hospitals or using the takings clause to buy up all the existing ones. It is a lot easier to sit at home and proclaim things on the internet than it is to actually make them happen. We can't balance the federal budget now, let alone doubling it just to keep up with tiny little European countries whose nationalized healthcare's success largely involves being a freerider on the US R&D to begin with.

Like I said...if we cannot provide adequate healthcare for everyone using the system we have...

..shitcan it...and create a new system.

Perhaps we can borrow the systems used by all the other industrialized nations of the world...because thy are providing that.
 
Hello Nordberg,

Drugs are made in 60 countries and for a few number of corporations. The idea that the US is different is wrong. It is only in what we permit PHARM and medical corporations to do.When PHARM decides the price we get what we have looting and fleecing. We do not permit Canadian drugs to enter. We pretend they are lower level drugs and people believe that. It is amazing how well we can be fooled .
It is past time to have universal non profit medical care in the US. Without that many Americans will suffer and die so medical corporations can mae more money.

I agree.

Just imagine how much it costs us to have so many sick people who don't get proper care. How much lost productivity do we suffer because people are not as healthy as they can be?

How many people go to work sick, and spread their illness to others, because we don't have a national paid sick leave policy?

We need the best healthcare system and policy we can have, because unchecked illness hurts the USA!

Our current health care system is a for-profit business. The goal is to make money.

That's the WRONG GOAL!

We need a health care system whose goal is to keep the nation healthy.

OK? Imagine!

There is a basic fundamental difference there.
 
Not a question of staying in business, but maintaining their high profit rates. You don't lose money in healthcare in the US,.

Many (83) rural hospitals have gone out of business due to lower subsidies under Obamacare. I live in a county of 85,000 and our one hospital recently closed. I don't think they would have closed if they were making money. Many doctors have closed their private practices and joined larger groups due to higher administrative and overhead costs.
 
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