Koch backed think-tank finds Medicare for all would cut health care spending

[Steeleballz 7,550]

6 minutes ago, Satisfied said:

So what happens when the majority of hospitals opt out?  Insurance dictates the payout now.  How is it any different?

 

I don't mind being proven wrong.  I have nothing to offer here but my own opinion about what will happen.  Do you have anything in writing that proves my opinion wrong, or shows how the medical system you are suggesting will actually work and not cost us more than we are paying today? Because I would be all for a better healthcare and insurance system... but I am not willing to part with more of my money than I currently do.

 

    If medicare was the only payor, it's hard to envision every hospital opting out. The ones that do would be accepting cash only patients. Not every hospital would survive doing that.  They would lose all federal funding, which some rely on. There are also many non profit charitable health  systems who would not opt out as it is there mandate to treat everyone.

 

    That said, I doubt we would be looking at single payer under the scope of existing regulation. Opting out may not even be an option. Reimbursement may be better than current medicare rates. Some if the current systems may have to merge and consolidate, or close. There would be a lot of changes.

   

[The Nature Boy 7,659]

I think we can all agree what we are doing now is broke. The answer is debatable. 

 

This brought to you from the middle of the road 

[yuna628 9,707]

17 hours ago, Steeleballz said:

 

   They will accept medicare or opt out (if that is still an option). That would be there decision. 

 

    My doctor just retired and sent us a goodbye letter. It says 80% of his patients were medicare and he suggested specific doctors for them to switch to. I have seen his car and his house, and we have talked occasionally over the years about our kids and hobbies and interests. I get the impression their office is not doing too bad by medicare. 

This is not the same for every practice just keep in mind. Doctors do tend to live bigger lifestyles, however they do spend many years paying off high debts, and to some degree find creative ways to make money, because some of them don't make enough out of the practice to just pay the bills. My sister's office for instance hasn't seen a raise in years. They have had to fire employees and cut the hours of the rest (it was either that or reduce hours so far to part time they would offer no more benefits). They have had to move into a smaller office, and put the remaining employees under significant pressure to handle greater workload. Big hospitals have been attempting to lure doctors away from personal practices and over to bigger positions so they no longer have to worry about paying employees and day to day operating costs. I know one doctor was being offered a weekend consulting job up far north because they have a lack of a doctor in the field and another regularly is a consultant in court cases for extra money. Their wives still work because they cannot make it on their salary alone. One doctor did not even make enough money last year to actually make a salary, it all went to practice and employees.
 

Some doctors have elected to retire than keep going. Others have decided to go to cash only.

 

[Póg mo 1,749]

2 hours ago, yuna628 said:

This is not the same for every practice just keep in mind. Doctors do tend to live bigger lifestyles, however they do spend many years paying off high debts, and to some degree find creative ways to make money, because some of them don't make enough out of the practice to just pay the bills. My sister's office for instance hasn't seen a raise in years. They have had to fire employees and cut the hours of the rest (it was either that or reduce hours so far to part time they would offer no more benefits). They have had to move into a smaller office, and put the remaining employees under significant pressure to handle greater workload. Big hospitals have been attempting to lure doctors away from personal practices and over to bigger positions so they no longer have to worry about paying employees and day to day operating costs. I know one doctor was being offered a weekend consulting job up far north because they have a lack of a doctor in the field and another regularly is a consultant in court cases for extra money. Their wives still work because they cannot make it on their salary alone. One doctor did not even make enough money last year to actually make a salary, it all went to practice and employees.
 

Some doctors have elected to retire than keep going. Others have decided to go to cash only.

 

A single payer system would benefit doctors as well. They would not have to employ bill coders, bill collection agencies, nor would they always be fighting with multiple agencies to approve medications and treatments.  I would imagine that many doctors devote a lot of time and money that would better used elsewhere. 

[Steeleballz 7,550]

2 hours ago, yuna628 said:

This is not the same for every practice just keep in mind. Doctors do tend to live bigger lifestyles, however they do spend many years paying off high debts, and to some degree find creative ways to make money, because some of them don't make enough out of the practice to just pay the bills. My sister's office for instance hasn't seen a raise in years. They have had to fire employees and cut the hours of the rest (it was either that or reduce hours so far to part time they would offer no more benefits). They have had to move into a smaller office, and put the remaining employees under significant pressure to handle greater workload. Big hospitals have been attempting to lure doctors away from personal practices and over to bigger positions so they no longer have to worry about paying employees and day to day operating costs. I know one doctor was being offered a weekend consulting job up far north because they have a lack of a doctor in the field and another regularly is a consultant in court cases for extra money. Their wives still work because they cannot make it on their salary alone. One doctor did not even make enough money last year to actually make a salary, it all went to practice and employees.
 

Some doctors have elected to retire than keep going. Others have decided to go to cash only.

 

 

   Just to clarify, I don't see medicare as it currently exists working well as our single payer system. Hypothetically, I was answering how things would work if our current system transitioned to a medicare only system. I don't actually think that is what would to happen. I think medicare could be adapted to be that system, but it wouldn't be the same medicare we are familiar with right now. I think most people would agree the current medicare system needs some big changes anyway. 

[yuna628 9,707]

2 minutes ago, Póg mo said:

A single payer system would benefit doctors as well. They would not have to employ bill coders, bill collection agencies, nor would they always be fighting with multiple agencies to approve medications and treatments.  I would imagine that many doctors devote a lot of time and money that would better used elsewhere. 

Ah but there arises another problem. If a doctor no longer has to employ a person, that person will find themselves out of a job, which in of itself isn't a very good thing. Its a job that requires a lot of experience and a great deal of skill and on the plus side, overwhelmingly employs women. Bill coders though are still necessary with medicare, some doctors think they can do it themselves and aren't too bright at it. If they don't do it right, medicare isn't going to pay just like an insurer won't.

[yuna628 9,707]

1 minute ago, Steeleballz said:

 

   Just to clarify, I don't see medicare as it currently exists working well as our single payer system. Hypothetically, I was answering how things would work if our current system transitioned to a medicare only system. I don't actually think that is what would to happen. I think medicare could be adapted to be that system, but it wouldn't be the same medicare we are familiar with right now. I think most people would agree the current medicare system needs some big changes anyway. 

Agreed. But I tend to think when someone says ''medicare for all'' our current way of understanding medicare is what people will think of. The average person can barely understand it at all.. but like many types of insurance are equally as frustrated.

[Póg mo 1,749]

1 hour ago, yuna628 said:

Ah but there arises another problem. If a doctor no longer has to employ a person, that person will find themselves out of a job, which in of itself isn't a very good thing. Its a job that requires a lot of experience and a great deal of skill and on the plus side, overwhelmingly employs women. Bill coders though are still necessary with medicare, some doctors think they can do it themselves and aren't too bright at it. If they don't do it right, medicare isn't going to pay just like an insurer won't.

Perhaps, but I am sure skilled people can find themselves alternative work. Otherwise, you are kind of making the case for socialism i.e. keeping people employed for the sake of it.  

Also with Medicare being the only agency to deal with, it would have to make a doctor's life much easier.  In most countries with a single health care provider, the price you see, is the price you pay. No need for medical coders.

[Póg mo 1,749]

2 hours ago, yuna628 said:

Agreed. But I tend to think when someone says ''medicare for all'' our current way of understanding medicare is what people will think of. The average person can barely understand it at all.. but like many types of insurance are equally as frustrated.

This is Americans need to better educated about health care, and not simply believe what ever scare stories they are told by people with an agenda to keep the system as it is. 

[Voice of Reason 10,298]

Totally off the current direction of this topic, but also completely related... I was talking to a co-worker today whose spouse is from Ireland.  They have lived in the US for many years.  Will be retiring in about 6 years.  The spouse is still a citizen of Ireland.  Their plan is to move to Ireland after retiring, and enjoying the state-sponsored health care system.  As well as a government pension offered to the citizen of Ireland.  And after 6 months of living in country, the USC also qualifies for some sort of government benefits.

All of this brought to them by a system that it seems we want in the US to replace what we have now.  And yet... neither of them have paid into that system for the past 40+ years.  How is it fair that they can just waltz into Ireland and reap the benefits like that?  How would that work in a country with 69 times the population of Ireland?  

[Steeleballz 7,550]

7 minutes ago, Satisfied said:

Totally off the current direction of this topic, but also completely related... I was talking to a co-worker today whose spouse is from Ireland.  They have lived in the US for many years.  Will be retiring in about 6 years.  The spouse is still a citizen of Ireland.  Their plan is to move to Ireland after retiring, and enjoying the state-sponsored health care system.  As well as a government pension offered to the citizen of Ireland.  And after 6 months of living in country, the USC also qualifies for some sort of government benefits.

All of this brought to them by a system that it seems we want in the US to replace what we have now.  And yet... neither of them have paid into that system for the past 40+ years.  How is it fair that they can just waltz into Ireland and reap the benefits like that?  How would that work in a country with 69 times the population of Ireland?  

 

  Perhaps they have a treaty or agreement that covers this. I know people in Canada who qualified based on US social security. The agreement adds qualifying time in either country. Canada has provincial limits on the time you must reside there before you can qualify for health care, but it used to be 1-3 months depending on the province.

 

  I'm not sure about Ireland, but it may be there is a similar agreement with the USA.

[Voice of Reason 10,298]

17 minutes ago, Steeleballz said:

 

  Perhaps they have a treaty or agreement that covers this. I know people in Canada who qualified based on US social security. The agreement adds qualifying time in either country. Canada has provincial limits on the time you must reside there before you can qualify for health care, but it used to be 1-3 months depending on the province.

 

  I'm not sure about Ireland, but it may be there is a similar agreement with the USA.

I’m sure you’re right, but it hardly seems fair.  I mean, I paid into SS, and I deserve that money when I retire. But if I take my SS and go to a foreign country and take advantage of their health care or government pension programs... man, I just don’t think I could do that, considering I gave nothing in.

I’ll try to query him more tomorrow on how/why he would get any benefits.  And how much.  Might be a pittance that really amounts to nothing.  We did not really go into details today.

[Póg mo 1,749]

1 hour ago, Satisfied said:

Totally off the current direction of this topic, but also completely related... I was talking to a co-worker today whose spouse is from Ireland.  They have lived in the US for many years.  Will be retiring in about 6 years.  The spouse is still a citizen of Ireland.  Their plan is to move to Ireland after retiring, and enjoying the state-sponsored health care system.  As well as a government pension offered to the citizen of Ireland.  And after 6 months of living in country, the USC also qualifies for some sort of government benefits.

 

 

 

I don't know about that. I was under the impression that in order to receive a pension in Ireland, you need to have contributed during your working life to. The US doesn't have a pension treaty with Ireland, so I don't think your friend will get very much money, unless he contributed before he left Ireland or in a third country with a pension treaty with Ireland.

 

 

1 hour ago, Satisfied said:

 

 

 

All of this brought to them by a system that it seems we want in the US to replace what we have now.  And yet... neither of them have paid into that system for the past 40+ years.  How is it fair that they can just waltz into Ireland and reap the benefits like that?  How would that work in a country with 69 times the population of Ireland?  

I am not sure Ireland is as generous as all that. I could be wrong though. The Irish immigration system is certainly a lot less complicated, that's for sure.

[Steeleballz 7,550]

 

   Actually Ireland is on the list of countries that have SS agreements with the USA.

 

     https://www.ssa.gov/pubs/EN-05-10137.pdf

 

This may not be a reciprocal benefit or treaty. It can just mean he is eligible to continue getting his SS benefits while in Ireland. The caveat is these lists can change.

[Póg mo 1,749]

14 hours ago, Steeleballz said:

 

   Actually Ireland is on the list of countries that have SS agreements with the USA.

 

     https://www.ssa.gov/pubs/EN-05-10137.pdf

 

This may not be a reciprocal benefit or treaty. It can just mean he is eligible to continue getting his SS benefits while in Ireland. The caveat is these lists can change.

That's not quite what I was referring to when I said the US doesn't have a pension treaty with Ireland. Ireland has various agreements with multiple countries where someones income earned overseas, is counted towards their Irish contributory pension, and Visa versa for foreign Nationals living in Ireland.