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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Fri December 22, 2017 2:07 am 
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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Fri December 22, 2017 2:10 am 
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It's pretty hilarious these say out of pocket only.


Insurance companies don't cover anything as it is.

Everything is out of pocket, being a member only slightly reduces the absurd made up price.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Fri December 22, 2017 2:11 am 
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Why did the chicken cross the road?

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I really hope we get this figured out soon


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Thu April 26, 2018 12:03 am 
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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 7:46 pm 
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https://abcnews.go.com/Health/wireStory/study-medicare-bill-estimated-326-trillion-56906940

I heard a carbon tax will solve this.

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I really hope we get this figured out soon


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 7:56 pm 
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Bi_3 wrote:

“Combining these effects results in projected personal health spending in 2022 of $3.849 trillion, a slight decrease of $10 billion,” says the libertarian think tank about the concept of universal healthcare. What a damning summary.

Always read the paper, not the interpretation.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 8:03 pm 
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Bi_3 wrote:

Quote:
The Mercatus study takes issue with a key cost-saving feature of the plan — that hospitals and doctors will accept payment based on lower Medicare rates for all their patients.
This seems like the whole crux of the plan. What does the the study do for these cost estimates?


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 8:16 pm 
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McParadigm wrote:
Bi_3 wrote:

“Combining these effects results in projected personal health spending in 2022 of $3.849 trillion, a slight decrease of $10 billion,” says the libertarian think tank about the concept of universal healthcare. What a damning summary.

Always read the paper, not the interpretation.


What is the context of that quote? I only read the summary pdf and found what I assumed to be an unbiased news report on it

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Last edited by Bi_3 on Mon July 30, 2018 8:21 pm, edited 1 time in total.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 8:20 pm 
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elliseamos wrote:
Bi_3 wrote:

Quote:
The Mercatus study takes issue with a key cost-saving feature of the plan — that hospitals and doctors will accept payment based on lower Medicare rates for all their patients.
This seems like the whole crux of the plan. What does the the study do for these cost estimates?


It’s cagey about it, but:

“M4A would markedly increase the demand for healthcare services while simultaneously cutting payments to providers by more than 40 percent, reducing payments to levels that are lower on average than providers’ current costs of providing care. It cannot be known how much providers will react to these losses by reducing the availabil- ity of existing health services, the quality of such services, or both.”

There is an assumption in most of single payer plans that the market would adjust to Medicare/Medicaid rates by elimination of the insurance middleman, but they are short on details of how.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 8:23 pm 
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Bi_3 wrote:
McParadigm wrote:
Bi_3 wrote:

“Combining these effects results in projected personal health spending in 2022 of $3.849 trillion, a slight decrease of $10 billion,” says the libertarian think tank about the concept of universal healthcare. What a damning summary.

Always read the paper, not the interpretation.


What is the context of that quote? I only read the summary pdf

The findings are that the result of such a plan would be an entire nation with health insurance for $10b less than we as a nation are currently on track to spend annually, but that the transfer of obligation from businesses and individuals to government would mean a change of payment (from plan purchasing to taxes).

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 8:27 pm 
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That said, even some of the authors of the ACA are quick to respond to this by saying that there would be disruptions to the pharmaceutical industry that are hard to draw conclusions about. But the study, by a think tank which opposes the very idea, does not appear to represent a prediction of increased costs.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 8:28 pm 
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McParadigm wrote:
Bi_3 wrote:
McParadigm wrote:
Bi_3 wrote:

“Combining these effects results in projected personal health spending in 2022 of $3.849 trillion, a slight decrease of $10 billion,” says the libertarian think tank about the concept of universal healthcare. What a damning summary.

Always read the paper, not the interpretation.


What is the context of that quote? I only read the summary pdf

The findings are that the result of such a plan would be an entire nation with health insurance for $10b less than we as a nation are currently on track to spend annually, but that the transfer of obligation from businesses and individuals to government would mean a change of payment (from plan purchasing to taxes).


Thats the point of the study though, right? To illustrate the actual cost of the idea. That it might save an insignificant about of money doesn’t matter.

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I really hope we get this figured out soon


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 8:29 pm 
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Bi_3 wrote:
elliseamos wrote:
Bi_3 wrote:

Quote:
The Mercatus study takes issue with a key cost-saving feature of the plan — that hospitals and doctors will accept payment based on lower Medicare rates for all their patients.
This seems like the whole crux of the plan. What does the the study do for these cost estimates?


It’s cagey about it, but:

“M4A would markedly increase the demand for healthcare services while simultaneously cutting payments to providers by more than 40 percent, reducing payments to levels that are lower on average than providers’ current costs of providing care. It cannot be known how much providers will react to these losses by reducing the availabil- ity of existing health services, the quality of such services, or both.”

There is an assumption in most of single payer plans that the market would adjust to Medicare/Medicaid rates by elimination of the insurance middleman, but they are short on details of how.
does anything attempt to explain that such a system would mean that all patient services would be paid, therefore overall costs would have to come down bc there wouldn't be any deferred cost placed on insured patients (which is what currently creates the pricing mystery)? Likewise, is there any mention that by having everyone insured at younger ages, the cost of care at advanced age should be reduced bc people would be healthier? Every doctor I get the chance to speak with (which is many bc it's my wife's field) always emphasizes the value of preventative care.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 8:33 pm 
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Bi_3 wrote:
McParadigm wrote:
Bi_3 wrote:
McParadigm wrote:
Bi_3 wrote:

“Combining these effects results in projected personal health spending in 2022 of $3.849 trillion, a slight decrease of $10 billion,” says the libertarian think tank about the concept of universal healthcare. What a damning summary.

Always read the paper, not the interpretation.


What is the context of that quote? I only read the summary pdf

The findings are that the result of such a plan would be an entire nation with health insurance for $10b less than we as a nation are currently on track to spend annually, but that the transfer of obligation from businesses and individuals to government would mean a change of payment (from plan purchasing to taxes).


Thats the point of the study though, right? To illustrate the actual cost of the idea. That it might save an insignificant about of money doesn’t matter.

The point of the study is to determine the costs relative to current, yes. The representation of its findings in news articles has been mostly contextless “Hey look a big number,” so...something less than factually informative.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Mon July 30, 2018 9:22 pm 
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elliseamos wrote:
Bi_3 wrote:
elliseamos wrote:
Bi_3 wrote:

Quote:
The Mercatus study takes issue with a key cost-saving feature of the plan — that hospitals and doctors will accept payment based on lower Medicare rates for all their patients.
This seems like the whole crux of the plan. What does the the study do for these cost estimates?


It’s cagey about it, but:

“M4A would markedly increase the demand for healthcare services while simultaneously cutting payments to providers by more than 40 percent, reducing payments to levels that are lower on average than providers’ current costs of providing care. It cannot be known how much providers will react to these losses by reducing the availabil- ity of existing health services, the quality of such services, or both.”

There is an assumption in most of single payer plans that the market would adjust to Medicare/Medicaid rates by elimination of the insurance middleman, but they are short on details of how.
does anything attempt to explain that such a system would mean that all patient services would be paid, therefore overall costs would have to come down bc there wouldn't be any deferred cost placed on insured patients (which is what currently creates the pricing mystery)? Likewise, is there any mention that by having everyone insured at younger ages, the cost of care at advanced age should be reduced bc people would be healthier? Every doctor I get the chance to speak with (which is many bc it's my wife's field) always emphasizes the value of preventative care.


I think this assumption is part of what the study is disputing, but I did not read the whole thing and am by no means an expert on this topic.

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I really hope we get this figured out soon


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Tue July 31, 2018 1:46 am 
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Bi_3 wrote:
elliseamos wrote:
Bi_3 wrote:
elliseamos wrote:
Bi_3 wrote:

Quote:
The Mercatus study takes issue with a key cost-saving feature of the plan — that hospitals and doctors will accept payment based on lower Medicare rates for all their patients.
This seems like the whole crux of the plan. What does the the study do for these cost estimates?


It’s cagey about it, but:

“M4A would markedly increase the demand for healthcare services while simultaneously cutting payments to providers by more than 40 percent, reducing payments to levels that are lower on average than providers’ current costs of providing care. It cannot be known how much providers will react to these losses by reducing the availabil- ity of existing health services, the quality of such services, or both.”

There is an assumption in most of single payer plans that the market would adjust to Medicare/Medicaid rates by elimination of the insurance middleman, but they are short on details of how.
does anything attempt to explain that such a system would mean that all patient services would be paid, therefore overall costs would have to come down bc there wouldn't be any deferred cost placed on insured patients (which is what currently creates the pricing mystery)? Likewise, is there any mention that by having everyone insured at younger ages, the cost of care at advanced age should be reduced bc people would be healthier? Every doctor I get the chance to speak with (which is many bc it's my wife's field) always emphasizes the value of preventative care.


I think this assumption is part of what the study is disputing, but I did not read the whole thing and am by no means an expert on this topic.

It only mentions this:

"For example, in 2014, hospitals were reimbursed just 89% of their costs of treating Medicare patients and 90% of their costs of treating Medicaid patients -- losses that were offset by hospitals collecting private insurance reimbursement rates equaling 144% of their costs."

It then jumps to say that if every patient was only covered at medicare rates then all hospitals would run negative, but the author ignores the gap that currently exists for unpaid patient services. So my question still remains, which this study didn't/couldn't answer, but what would such a plan do for hospitals overall if (1) all services were paid in full & on time; and (2) if more and more patients were getting preventative care/scans/tests, as oppose to emergent care (which is much more expensive)?

And like McP pointed out, the study finds that overall M4A would reduce costs from what they're expected to be without a change to the system.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Tue July 31, 2018 1:33 pm 
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elliseamos wrote:
(2) if more and more patients were getting preventative care/scans/tests, as oppose to emergent care (which is much more expensive)?

That sounds good, but I'd be concerned that increased tests and screening would lead to more false positives and more treatment for conditions that wouldn't have affected the person's quality of life had they not been discovered. I imagine that this in turn could lead to more not less treatment.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Tue July 31, 2018 1:38 pm 
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4/5 wrote:
elliseamos wrote:
(2) if more and more patients were getting preventative care/scans/tests, as oppose to emergent care (which is much more expensive)?

That sounds good, but I'd be concerned that increased tests and screening would lead to more false positives and more treatment for conditions that wouldn't have affected the person's quality of life had they not been discovered. I imagine that this in turn could lead to more not less treatment.

This is true, but earlier treatment will (in most instances) be less costly than an individual's system failure later on down the line. As I've been told, the two biggest drivers of absurd costs within the current US system of medicine is unnecessary emergency care and caring for the elderly.


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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Tue July 31, 2018 1:53 pm 
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elliseamos wrote:
4/5 wrote:
elliseamos wrote:
(2) if more and more patients were getting preventative care/scans/tests, as oppose to emergent care (which is much more expensive)?

That sounds good, but I'd be concerned that increased tests and screening would lead to more false positives and more treatment for conditions that wouldn't have affected the person's quality of life had they not been discovered. I imagine that this in turn could lead to more not less treatment.

This is true, but earlier treatment will (in most instances) be less costly than an individual's system failure later on down the line. As I've been told, the two biggest drivers of absurd costs within the current US system of medicine is unnecessary emergency care and caring for the elderly.

Of course I agree that earlier treatment is usually less costly. On an individual level that's certainly true but I wonder if it still holds for society as a whole if you greatly increase the preventative/testing/screening, etc. across the board. I'm just thinking out loud, I don't have any data I'm referring to. It would seem to me that at some point that so much could be spent on the upfront preventative stuff on healthy people that it could outweigh the decreases in emergency care. I have no idea where that threshold would be, but it seems like it should likely exist at some point.

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 Post subject: Re: Healthcare Thread (really "Sickcare" in America)
PostPosted: Tue July 31, 2018 2:03 pm 
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elliseamos wrote:
Bi_3 wrote:
elliseamos wrote:
Bi_3 wrote:
elliseamos wrote:
Bi_3 wrote:

Quote:
The Mercatus study takes issue with a key cost-saving feature of the plan — that hospitals and doctors will accept payment based on lower Medicare rates for all their patients.
This seems like the whole crux of the plan. What does the the study do for these cost estimates?


It’s cagey about it, but:

“M4A would markedly increase the demand for healthcare services while simultaneously cutting payments to providers by more than 40 percent, reducing payments to levels that are lower on average than providers’ current costs of providing care. It cannot be known how much providers will react to these losses by reducing the availabil- ity of existing health services, the quality of such services, or both.”

There is an assumption in most of single payer plans that the market would adjust to Medicare/Medicaid rates by elimination of the insurance middleman, but they are short on details of how.
does anything attempt to explain that such a system would mean that all patient services would be paid, therefore overall costs would have to come down bc there wouldn't be any deferred cost placed on insured patients (which is what currently creates the pricing mystery)? Likewise, is there any mention that by having everyone insured at younger ages, the cost of care at advanced age should be reduced bc people would be healthier? Every doctor I get the chance to speak with (which is many bc it's my wife's field) always emphasizes the value of preventative care.


I think this assumption is part of what the study is disputing, but I did not read the whole thing and am by no means an expert on this topic.

It only mentions this:

"For example, in 2014, hospitals were reimbursed just 89% of their costs of treating Medicare patients and 90% of their costs of treating Medicaid patients -- losses that were offset by hospitals collecting private insurance reimbursement rates equaling 144% of their costs."

It then jumps to say that if every patient was only covered at medicare rates then all hospitals would run negative, but the author ignores the gap that currently exists for unpaid patient services. So my question still remains, which this study didn't/couldn't answer, but what would such a plan do for hospitals overall if (1) all services were paid in full & on time; and (2) if more and more patients were getting preventative care/scans/tests, as oppose to emergent care (which is much more expensive)?

And like McP pointed out, the study finds that overall M4A would reduce costs from what they're expected to be without a change to the system.


Reducing an estimated $10B from an estimated $3,200B is not significant enough to be a point in this debate and the external costs to the economic structure of the country might not even be estimable.


But your quote above misses an important point from this and nearly every study on the topic, that Medicare rates are too low to be profitable for most hospitals and doctors. So even if they were being paid 100% of the time, they would still be losing money on most interactions:

Image


Now take those numbers and magnify across the entire population...

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