Health Care vs. Health Insurance

[Celticguy]

All huge programs have people who figure out how to steal from it. There was a Florida insurance company that had the biggest Medicare fraud case of all time.
They were fined 1,7 billion bucks. It upset the Florida old people so much that they made the president of the company, Rick Scott, governor and now senator.
https://www.sun-sentinel.com/opinion/fl-op-col-rick-scott-medicare-fraud-20181002-story.html

Who better to deal with the Medicaid fraud which is just as widespread ?

 

[Darth Omar]

Health care is what your doctor does; Health insurance is an administrative function by which your doctor is reimbursed for the treatment they provide you, after they provide it. All Medicare-for-All does is consolidate that administration under one entity that has the added benefit of using its leverage to negotiate for cheaper fees and costs.

Medicare-for-All doesn't eliminate health care; it eliminates provider networks, so you can go see whatever doctor you want, not just those limited to within your provider network because of your insurance company.

Medicare-for-All doesn't eliminate health care; it eliminates private insurance companies that don't serve a role in your health care presently, and never will. No health insurance company takes your temperature, checks your prostate, does a mammogram. No health insurance company removes an appendix, prescribes a drug, or does a blood test. All a health insurance company does is reimburse providers for all those services, while keeping as much as 20% of every dollar you pay in premiums for themselves.

The choice that the Republicans on stage last night were talking about wasn't the choice of doctor, it was the choice of administrator. Single payer provides true choice and freedom; choice of what doctor you want to go to, and freedom from provider networks and drug companies.

You don't have freedom or choice in our current system. You cannot go to whatever doctor you want and not pay exorbitant out-of-network fees in our current system. You might think your current doctor is great, but because private insurance stifles choice and freedom, you don't have the freedom to explore other provider options to compare services. Think of it this way; when you shop for a car, you wouldn't go to just one dealership would you? So why would you not want the freedom of choice to explore different health care options, to compare and contrast with what you currently have? Wouldn't that be taking personal responsibility for your health?

‘Negotiating’ for cheaper fees lol?

I wonder how that will work when the government is the only payer? The government will *dictate* the fees they are willing to pay.

 

[Gonzomin]

Who better to deal with the Medicaid fraud which is just as widespread ?

That makes no sense. You say it is widespread, show it. I know there have been programs instituted to curb crooks the last few presidents. They do not have to steal blatantly.
When I needed knee braces I checked with Medicare to see what could be done. My doctor sent me to a Medicare vendor to get them. They wanted to have me get 2 and metal braces and straps were needed. The cost was nearly 900 bucks. I said no and bought braces at the drugstore for 30 bucks.
Any attempts to cut the costs of hard goods is met with incredible lobbying power and nothing changes.

 

[Celticguy]

That makes no sense. You say it is widespread, show it. I know there have been programs instituted to curb crooks the last few presidents. They do not have to steal blatantly.
When I needed knee braces I checked with Medicare to see what could be done. My doctor sent me to a Medicare vendor to get them. They wanted to have me get 2 and metal braces and straps were needed. The cost was nearly 900 bucks. I said no and bought braces at the drugstore for 30 bucks.
Any attempts to cut the costs of hard goods is met with incredible lobbying power and nothing changes.

And more of this is what you want with Medicare for all or other simple payor schemes ?
Bear in mind your doc wrote the prescription for the braces they were to provide. And you can assume he would have been rewarded.
If Scott worked in Medicare he knows all this.
But Medicaid is run by the states and they have the say in how they run it. CMS publishes rules on mb acimums and mo-gos but a govenor can shape things including fraud monitoring where there is no such control with Medicare.
If you had commercial insurance the rate would have been negotiated far lower.

 

[Mason Melchizedek]

Ever developed country but America has
Solved the healthcare issue.
Why can't we?
Greed!

 

[Teflon Don]

Health care is what your doctor does; Health insurance is an administrative function by which your doctor is reimbursed for the treatment they provide you, after they provide it. All Medicare-for-All does is consolidate that administration under one entity that has the added benefit of using its leverage to negotiate for cheaper fees and costs.

Medicare-for-All doesn't eliminate health care; it eliminates provider networks, so you can go see whatever doctor you want, not just those limited to within your provider network because of your insurance company.

Medicare-for-All doesn't eliminate health care; it eliminates private insurance companies that don't serve a role in your health care presently, and never will. No health insurance company takes your temperature, checks your prostate, does a mammogram. No health insurance company removes an appendix, prescribes a drug, or does a blood test. All a health insurance company does is reimburse providers for all those services, while keeping as much as 20% of every dollar you pay in premiums for themselves.

The choice that the Republicans on stage last night were talking about wasn't the choice of doctor, it was the choice of administrator. Single payer provides true choice and freedom; choice of what doctor you want to go to, and freedom from provider networks and drug companies.

You don't have freedom or choice in our current system. You cannot go to whatever doctor you want and not pay exorbitant out-of-network fees in our current system. You might think your current doctor is great, but because private insurance stifles choice and freedom, you don't have the freedom to explore other provider options to compare services. Think of it this way; when you shop for a car, you wouldn't go to just one dealership would you? So why would you not want the freedom of choice to explore different health care options, to compare and contrast with what you currently have? Wouldn't that be taking personal responsibility for your health?

As always you don’t understand what you are talking about

You don’t understand the concept of insurance

 

[LV426]

‘Negotiating’ for cheaper fees lol?

Yes, idiot.

That's what happens when you have bargaining power because you're the single payer, reimbursing providers and buying drugs.

What a fucking moron.

I wonder how that will work when the government is the only payer? The government will *dictate* the fees they are willing to pay.

Do you understand that is what happens already with insurance companies and providers? That's what they already do, and they do it with an eye on making the most money possible, sucking the most out of the system they can. What do you think a "Chargemaster" is? It's a document of fees worked out between an insurance company and a health care provider. They literally collude, in secret, to set the price in order to make themselves the most money possible.

Like I said before, and like you're proving right now, most people have no fucking idea what an insurance company is, what they do, and how it relates to your health care.

 

[LV426]

As always you don’t understand what you are talking about

You don’t understand the concept of insurance

Ah, so then explain the concept to me; pretend I'm one of your inbred relatives and explain it to me as you would explain it to Cousin-Brother Earl with the cleft palette.

All an insurance company does is administer reimbursement to your doctor. That's it. That's all they do.

 

[Darth Omar]

Yes, idiot.

That's what happens when you have bargaining power because you're the single payer, reimbursing providers and buying drugs.

What a fucking moron.




Do you understand that is what happens already with insurance companies and providers? That's what they already do, and they do it with an eye on making the most money possible, sucking the most out of the system they can. What do you think a "Chargemaster" is? It's a document of fees worked out between an insurance company and a health care provider. They literally collude, in secret, to set the price in order to make themselves the most money possible.

Like I said before, and like you're proving right now, most people have no fucking idea what an insurance company is, what they do, and how it relates to your health care.

So, you like having the government *dictate* reimbursements.

Why doesn’t that surprise me lol.

 

[LV426]

And if they chose not to ?

Then their business can go bankrupt for lack of patients.

 

[LV426]

Yes, you did.

No I didn't you lying sack of shit. If I did, then simply quote where I said that. You won't be able to find it anywhere, because I never said it. But you were just compelled to lie about it.

How come?

 

[LV426]

So now consumers are paying more than ever. This is good ?

Are they?

Right now, anyone who gets insurance through their employer pays an average of $5K a year in premiums and $1,500 a year in deductibles.

So in total, the average person with an employer-sponsored plan pays about $6,500 a year out of pocket for their health insurance.

The highest payroll tax rate bandied about for a M4A plan I've heard is 8% of your total gross income.

So let's do some math (I know you hate math, but we have to do it in order to prove why everythng you say and believe here is bullshit):

The average income in this country is $57,000 a year.

So let's assume that person also gets health care through their employer, and we know that person is spending -on average- $6,500 a year.

Well, an 8% tax on $57,000 a year is $4,560.

Now, is $4,560 > or < $6,500 in Conservatardia today?

 

[LV426]

Considerably less than you

How so?

We know you're uninformed because you have no idea about the costs of health insurance.

We know you're dumb as shit because you got conned into carrying Trump's baggage.

So since we know both those things, what makes you think you're smarter or savvier than anyone here?

 

[LV426]

Yes they spend little effort on fraud so you want to punch that up further raising the cost.

They spend "little effort" because you've defunded the agencies that go after the fraud.

So you deliberately make it possible for fraud to go unchecked because you cut funding to the agencies meant to stop the fraud.

BTW - that's still less fraud than exists in the private health insurance market.

Wow. This is just getting more and more of an election loser by the minute.

Only if you're a fucking idiot who pulls shit out of his ass as a debate strategy.

 

[LV426]

LOL Obamacare was sold as healthcare when all it was was a handout to the insurance industry. You twist reality, bruh, Not surprising with that tiny cranial cavity

WTF are you talking about?

Can you stay on one topic, or is that too much to ask.

Before you move on to this talking point, you need to answer for the fact that you think people are smart enough to explain health insurance, and not conflate it with health care.

Obamacare wasn't health care reform; it was partial health insurance reform.

Why are you trying to retcon it?

 

[LV426]

So, you like having the government *dictate* reimbursements.

Someone has to administer reimbursement because the most efficient way of providing health care for everyone is to pool premiums together into one large pool, and then reimburse all providers from that pool.

And yes, the bargaining power the single payer has would result in lower fees and costs.

As I said, and as you ignored because you're a lazy fuckmook who hasn't had to work for anything in your miserable life, insurance companies and providers already do this among themselves, and they're doing it trying to suck the most money out of the system for themselves while providing you with the least amount of care, at the highest price that they work out together in order to make money.

 

[LV426]

Why doesn’t that surprise me lol.

What doesn't surprise me is that you are determined to maintain the status quo simply because you're not smart or informed enough to know what the fuck you're talking about.

You're like, "WAAAAH! THE GUBMINT WILL DICTATE FEES"...Oh, you mean like the insurance companies and providers already do with one another, for the sole purpose of enriching themselves?

That's a system you want to defend and preserve? Well, you are a fucking moron who got conned by a reality TV show host into carrying his baggage, so probably.

 

[Darth Omar]

Someone has to administer reimbursement because the most efficient way of providing health care for everyone is to pool premiums together into one large pool, and then reimburse all providers from that pool.

And yes, the bargaining power the single payer has would result in lower fees and costs.

As I said, and as you ignored because you're a lazy fuckmook who hasn't had to work for anything in your miserable life, insurance companies and providers already do this among themselves, and they're doing it trying to suck the most money out of the system for themselves while providing you with the least amount of care, at the highest price that they work out together in order to make money.

Dude, spare me the posturing. One of us actually delivers healthcare and works in the system.

And it ain’t you.

 

[LV426]

Dude, spare me the posturing. One of us actually delivers healthcare and works in the system.And it ain’t you.

It's not you either, obviously, since all this is apparently new information to you.

So now you are trying to rely on a fake anecdotal backstory for your message board character so you don't have to reconcile the fact that you don't know what the fuck you're talking about.

What do you think a "Chargemaster" is? Let's start there, Mr. Self-proclaimed Health Care expert....

 

[Darth Omar]

It's not you either, obviously, since all this is apparently new information to you.

So now you are trying to rely on a fake anecdotal backstory for your message board character so you don't have to reconcile the fact that you don't know what the fuck you're talking about.

What do you think a "Chargemaster" is? Let's start there, Mr. Self-proclaimed Health Care expert....

You’re the supposed ‘guru’ lol.

So mister tranny healthcare/health insurance guru, why is it Medicare/Medicaid reimbursements suck? Why is there a trend amongst doctors to set up their own free standing clinics to keep from having to deal with Medicare; it’s bureaucratic morass and it’s reimbursements that have been stagnant since 2001[!]?

More importantly, why do you think single payer will improve things?