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Gerry Clinchy
07-04-2010, 03:00 PM
From my local newspaper
http://blogs.mcall.com/watchdog/2010/06/index.html

You'll want to read the original column that explains how Medicare obtains wheelchairs for its patients

http://www.mcall.com/news/local/watchdog/mc-watchdog-medicare-wheelchair-20100619,0,3051459.column

The kicker is at the end where the one son of a deceased patient wonders how many times the same wheelchair has been re-sold to multiple Medicare patients.

It is stunning to me that for all the years that Medicare has been functioning, such an obvious over-expenditure took so long to discover; and is taking so-o-o long to be corrected even after it was discovered.

The tip of the iceberg?

dnf777
07-04-2010, 03:49 PM
At least we have someone looking into it now, and trying to bring costs down!

Gerry Clinchy
07-04-2010, 07:31 PM
The problem is that they've been "looking into it" for quite a while!

The article states that Medicare was putting into a place a bidding system, that was "supposed" to start 2 years ago, but Congress put a halt to it due to "concerns".
Now it's supposed to start in 10 metro areas next year (total 3 yrs of "looking into it") and the article says will "eventually" reach our area here ... but will not include manual wheelchairs, just power chairs.

How many manual wheelchairs that cost $219 will continue to be purchased for $1300 before they "fix" this monumental waste of money? At a rate of 100,000 chairs a year that's $100,000,000 each year ... and no end in sight to that.

Dave, as a dr. ... think about this ... Medicare wants to pay doctors less so they can continue to overpay for manual wheelchairs & there is no plan to fix that inequity. What is wrong with that picture?

Doc E
07-04-2010, 08:15 PM
There is a HUGE amount of fraud in the Medicare system --- not just wheelchairs.



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depittydawg
07-04-2010, 08:29 PM
There is a HUGE amount of fraud in the Medicare system --- not just wheelchairs.



.

Probably true. But our private healthcare system has even more fraud and waste than does Medicare. In fact, about 30% more.

M&K's Retrievers
07-05-2010, 12:42 AM
Probably true. But our private healthcare system has even more fraud and waste than does Medicare. In fact, about 30% more.

Facts please. This should be good.

dnf777
07-05-2010, 05:24 AM
Facts please. This should be good.

Just google "united health care settlement", and you'll get 5,080,000 hits in 0.13 seconds. I believe this was former senate leader Bill Frists' company, but check me on that. Bundling charges, and downgrading services were just the beginning. Both gov't run AND private payors have their share of corruption. I feel no need to defend either!

Gerry Clinchy
07-05-2010, 06:34 AM
It would appear that all of us have a responsibility to be proactive about what we are being billed for in health care services.

Whether private or govt program, in the end we are paying for it ... either by mandatory taxes that continue to increase or by higher premiums (unless we are not personally responsible for either ... Medicaid or uninsured).

I think this is at least part of the issue, for many of us, with a totally govt-based health coverage system, single-payer system, or outright govt-provider system.

The first subject in the article in this thread was outright concerned about the inefficient use of tax dollars (this was NOT fraud; it was perfectly legal). Unless this stuff (and fraud as well) is "fixed", putting govt in charge of more comprehensive care is likely to suffer from the same inefficiencies.

It appears that we are 2 years (and one more year to go) into the "fixing" process just for this wheelchair thing. (with no plan to fix the situation for manual wheelchairs at all). There is no mention in the article as to how long it had taken previously to get to the "fix" that Medicare proposed 2 years ago. That's $300,000,000. (Close to the amount scheduled to be funneled away from Medicare into Obamacare). And I used a modest guess-timate of 100,000 wheelchairs/year.

dnf777
07-05-2010, 06:42 AM
As an "insider", I'll tell you Gerry, its nearly IMPOSSIBLE to look at a medical bill and figure out what the hell you're paying for! I get it from both sides, as I spend time trying to get my own care payed for, and also trying to get my services paid for. Both are equally a PITA. I feel sorry for the elderly and the challenged, trying to negotiate this impossible maze of payors, payees, gaps, supplementals.....on and freakin' on!

I will say this however: Medicare may not pay much, but they DO PAY. I hear patients praise their medicare often compared to their private gap and supplementals.

Tough subject...I certainly don't have the answers....not sure anyone does.

depittydawg
07-05-2010, 12:00 PM
Facts please. This should be good.

Do your own research. Or take it from me. The cost of Private Health Insurance about 30% more than Medicare.

M&K's Retrievers
07-05-2010, 01:22 PM
Do your own research. Or take it from me. The cost of Private Health Insurance about 30% more than Medicare.

Most here back up their statements of "fact" with links to verify said statement. Opinions are one thing. Representations of fact are another. I'm in the health insurance business for a living so believe me I'm up to my ass in research. Post a link, say it's your opinion or better yet, just shut up when you don't know what your talking about and save the rest of us from your ill advised rhetoric.

Now, where did I put those grand kids?

road kill
07-05-2010, 01:49 PM
Most here back up their statements of "fact" with links to verify said statement. Opinions are one thing. Representations of fact are another. I'm in the health insurance business for a living so believe me I'm up to my ass in research. Post a link, say it's your opinion or better yet, just shut up when you don't know what your talking about and save the rest of us from your ill advised rhetoric.

Now, where did I put those grand kids?

He would remain silent.........



rk:D

depittydawg
07-05-2010, 02:55 PM
Most here back up their statements of "fact" with links to verify said statement. Opinions are one thing. Representations of fact are another. I'm in the health insurance business for a living so believe me I'm up to my ass in research. Post a link, say it's your opinion or better yet, just shut up when you don't know what your talking about and save the rest of us from your ill advised rhetoric.

Now, where did I put those grand kids?

Then you would not deny that the cost of delivering healthcare is 30% higher in the private sector than it is for medicare. Are you going to deny that?

depittydawg
07-05-2010, 02:57 PM
He would remain silent.........



rk:D

By way, have posted links to data on several occurrences on this website many times, If you have an opinion back it up. I challenge you to show me data that says private healthcare costs less than Medicare. Go ahead, back up what you say for once. I've already done the research and I will post it as soon as you post something other than your opinion.

M&K's Retrievers
07-05-2010, 04:47 PM
By way, have posted links to data on several occurrences on this website many times, If you have an opinion back it up. I challenge you to show me data that says private healthcare costs less than Medicare. Go ahead, back up what you say for once. I've already done the research and I will post it as soon as you post something other than your opinion.

I'll show you mine if you show me yours.:rolleyes:

I have made no claims one way or another. I questioned your blanket, know it all statement. Prove up your statement as fact not your opinion or pipe down.

depittydawg
07-05-2010, 05:19 PM
I'll show you mine if you show me yours.:rolleyes:

I have made no claims one way or another. I questioned your blanket, know it all statement. Prove up your statement as fact not your opinion or pipe down.

Ok, here is:
http://www.cahi.org/cahi_contents/resources/pdf/CAHIMedicareTechnicalPaper.pdf
The Federal government usually reports its Medicare administrative costs at about 2% of total payments under the program while private costs vary dramatically from market to market, but frequently are cited to be in the 15-20% range on average.
http://krugman.blogs.nytimes.com/2009/07/29/medicare-versus-insurers/
Medicare versus insurers
I notice from comments that a fair number of readers think that Medicare has had runaway costs. What you need to ask is, runaway compared to what?

Here’s the raw fact, from the National Health Expenditure data: since 1970 Medicare costs per beneficiary have risen at an annual rate of 8.8% — but insurance premiums have risen at an annual rate of 9.9%. The rise in Medicare costs is just part of the overall rise in health care spending. And in fact Medicare spending has lagged private spending: if insurance premiums had risen “only” as much as Medicare spending, they’d be 1/3 lower than they are.
http://content.healthaffairs.org/cgi/content/full/hlthaff.w2.311v1/DC1
A common theme running through the debate is that Medicare ought to be more like private insurance, which is depicted as being effective in controlling costs and providing beneficiaries with the kinds of health care choices they might desire. In the mid-1990s, when private health insurance spending was increasing at a slower rate than that of Medicare spending, the short-term trends were cited as evidence that Medicare could achieve savings by adopting private managed care techniques. In the late 1990s, however, Medicare spending grew at a slower rate than did private insurance spending. Long-term trend analysis reveals that Medicare and private outlays tend to grow at similar rates over time.6
We don’t have a Medicare problem — we have a health care problem.

Captain Mike D
07-05-2010, 06:00 PM
Do your own research. Or take it from me. The cost of Private Health Insurance about 30% more than Medicare.

I am sure you are happy to see DNF take a 21% hit to shove his finger up your ****. He deserves little to no compensation for the YEARS it took for him to be qualified. Hell cut the rate under medicare a few more times and he may decide to leave the trade.

Better watch out though, the next guy (You should be eligable by then) may be so disenchanted that he takes a nap while evaluating your case

M&K's Retrievers
07-06-2010, 12:29 AM
Ok, here is:
http://www.cahi.org/cahi_contents/resources/pdf/CAHIMedicareTechnicalPaper.pdf
The Federal government usually reports its Medicare administrative costs at about 2% of total payments under the program while private costs vary dramatically from market to market, but frequently are cited to be in the 15-20% range on average.
http://krugman.blogs.nytimes.com/2009/07/29/medicare-versus-insurers/
Medicare versus insurers
I notice from comments that a fair number of readers think that Medicare has had runaway costs. What you need to ask is, runaway compared to what?

Here’s the raw fact, from the National Health Expenditure data: since 1970 Medicare costs per beneficiary have risen at an annual rate of 8.8% — but insurance premiums have risen at an annual rate of 9.9%. The rise in Medicare costs is just part of the overall rise in health care spending. And in fact Medicare spending has lagged private spending: if insurance premiums had risen “only” as much as Medicare spending, they’d be 1/3 lower than they are.
http://content.healthaffairs.org/cgi/content/full/hlthaff.w2.311v1/DC1
A common theme running through the debate is that Medicare ought to be more like private insurance, which is depicted as being effective in controlling costs and providing beneficiaries with the kinds of health care choices they might desire. In the mid-1990s, when private health insurance spending was increasing at a slower rate than that of Medicare spending, the short-term trends were cited as evidence that Medicare could achieve savings by adopting private managed care techniques. In the late 1990s, however, Medicare spending grew at a slower rate than did private insurance spending. Long-term trend analysis reveals that Medicare and private outlays tend to grow at similar rates over time.6
We don’t have a Medicare problem — we have a health care problem.

I'm impressed.:rolleyes: Articles dated 2002, 2006 and a op ed dated 2009. That's some serious stuff right there not to mention they don't refer to your 30% figure. Now because of you, I've wasted some valuable time when I could have been watching Pirates of the Caribbean. Will not happen again. Someone else will have to screw with you in the future.

Gerry Clinchy
07-06-2010, 06:39 AM
Makes me stop and think about why Medicare per capita cost is now increasing less fast than other medical care per capita cost.

1) It appears that Medicare reimbursement to providers has remained more stable than the reimbursement provided by other insurors. If the decreases that had been additionally proposed, but have not been implemented for several years, the costs would be even lower. However, Catch 22 would be that providers would simply not accept new Medicare patients. Or perhaps just limit the # of Medicare patients they accept?

2) Medicare will cover individuals beginning at age 65, but it seems likely that it will not have to care for them for more than about 25 years. In many cases, maybe far fewer years? Private health insurance will be covering individuals (for those who are insured), essentially for the first 65 years ... almost 3X as many years. A lot more time to utilize the advanced technologies available in medicine today.

3) A 75 yr old might turn down expensive chemotherapy that a 35 yr old would not. I'm not implying that it is the cost that determines the 75 yr old's decision, but rather, quality of life considerations in relationship to age. I had a 70 yr old friend who did so.

In a complex area like medical care, it could be quite important to look below the surface of the statistics.

Doc E
07-06-2010, 09:19 AM
Then you would not deny that the cost of delivering healthcare is 30% higher in the private sector than it is for medicare. Are you going to deny that?

That's because the amount that Doctors will be paid is set by medicare.
As an example : Most health care processionals work on a 50% profit/expense rate.
So, if a patient is charged $50, the Doctor's profit is $25............ And if Medicare pays $25,
the Doctor's profit is ZERO.
If you were a Doctor, how would you like to see patients just "for the fun of it" ?

This is why more and more Doctors are dropping out of medicare or not accepting new Medicare patients.



.

M&K's Retrievers
07-06-2010, 09:34 AM
That's because the amount that Doctors will be paid is set by medicare.
As an example : Most health care processionals work on a 50% profit/expense rate.
So, if a patient is charged $50, the Doctor's profit is $25............ And if Medicare pays $25,
the Doctor's profit is ZERO.
If you were a Doctor, how would you like to see patients just "for the fun of it" ?

This is why more and more Doctors are dropping out of medicare or not accepting new Medicare patients.



.

Please don't confuse DS with factual information. No telling what might happen.:D

depittydawg
07-06-2010, 10:05 AM
I'm impressed.:rolleyes: Articles dated 2002, 2006 and a op ed dated 2009. That's some serious stuff right there not to mention they don't refer to your 30% figure. Now because of you, I've wasted some valuable time when I could have been watching Pirates of the Caribbean. Will not happen again. Someone else will have to screw with you in the future.

Where's your data? You have none because you are wrong on this issue, as usual. So far your just an a_hole with an opinion. But then, that is what is to be expected from you.

cheers

david gibson
07-06-2010, 10:06 AM
Where's your data? You have none because you are wrong on this issue, as usual. So far your just an a_hole with an opinion. But then, that is what is to be expected from you.

cheers
isnt that what we all are here?? what takes you far and above the level of just having an opinion? do you have any formal education on this? are you a recognized medicare consultant? if you were, you wouldnt be here embarrassing yourself like you do on a daily basis.


and when you get flustered you resort to name calling.

but then, that is to be expected from you. ;-)

M&K's Retrievers
07-06-2010, 10:14 AM
Where's your data? You have none because you are wrong on this issue, as usual. So far your just an a_hole with an opinion. But then, that is what is to be expected from you.

cheers

I don't need any data. I have yours. Try reading you own stuff, kid or refer to post #20 in this thread. Are you getting a little testy? Can't defend yourself? Frustrated? I'll never know.:D

dnf777
07-06-2010, 12:13 PM
That's because the amount that Doctors will be paid is set by medicare.
As an example : Most health care processionals work on a 50% profit/expense rate.
So, if a patient is charged $50, the Doctor's profit is $25............ And if Medicare pays $25,
the Doctor's profit is ZERO.
If you were a Doctor, how would you like to see patients just "for the fun of it" ?

This is why more and more Doctors are dropping out of medicare or not accepting new Medicare patients.



.

My business manager would leap for joy if we could turn that kind of number! We consistently collect 27 cents on the dollar we bill. And we bill based on insurance and medicare tables.....what THEY SAY they'll pay us....and still end up under 1/3 receivable. So, at the end of the day, I see one patient that pays....then two "for the fun of it"! :(

depittydawg
07-06-2010, 01:31 PM
I don't need any data. I have yours. Try reading you own stuff, kid or refer to post #20 in this thread. Are you getting a little testy? Can't defend yourself? Frustrated? I'll never know.:D

You don't need data? Why is that? Do you chose to remain ignorant on the issue? Oh, I forgot. Your close minded. Somebody told you something you wanted to hear, so now you need nothing else. And will continue to ignore information that disputes your belief. It's not that you don't NEED information. You need it desperately. My statement originally was that the cost of administering healthcare through medicare was a lot cheaper than private health insurance. I cited several sources that placed that cost at around 20%. I've also seen estimates as high as 30%. You disagreed and demanded the supporting data. I gave it to you. Its your turn.

SHOW THE DATA THAT SAYS PRIVATE HEALTHCARE COSTS IS LESS THAN OR EQUAL TO MEDICARE. If you can't deliver the bacon, then its time to quit squealing.

depittydawg
07-06-2010, 01:47 PM
isnt that what we all are here?? what takes you far and above the level of just having an opinion? do you have any formal education on this? are you a recognized medicare consultant? if you were, you wouldnt be here embarrassing yourself like you do on a daily basis.


and when you get flustered you resort to name calling.

but then, that is to be expected from you. ;-)

Don't give me that crap David. Go read the thread. The guy has been hammering for data and sources on every opinion post and insulting at every turn. I have provided substantiating argument when it was demanded from M&K. Meanwhile he, and others around here go on and on insulting, ridiculing, spewing unsubstantiated nonsense... It gets old.

I don't do well around close minded people. Guess I'll just take a hiatus.

gman0046
07-06-2010, 01:50 PM
Dippity, for someone who posted how well your doing under Obongo's Health Care Plan when it's not even in effect yet, I'm surprised how much of an expert you've become on Medicare. I guess your just following the Messiah.

M&K's Retrievers
07-06-2010, 02:21 PM
You don't need data? Why is that? Do you chose to remain ignorant on the issue? Oh, I forgot. Your close minded. Somebody told you something you wanted to hear, so now you need nothing else. And will continue to ignore information that disputes your belief. It's not that you don't NEED information. You need it desperately. My statement originally was that the cost of administering healthcare through medicare was a lot cheaper than private health insurance. I cited several sources that placed that cost at around 20%. I've also seen estimates as high as 30%. You disagreed and demanded the supporting data. I gave it to you. Its your turn.

SHOW THE DATA THAT SAYS PRIVATE HEALTHCARE COSTS IS LESS THAN OR EQUAL TO MEDICARE. If you can't deliver the bacon, then its time to quit squealing.

DS, you are incredibly slow on the uptake. Did you read #20 and DNF's post about provider reimbursement? Many providers refuse to see Medicare patients because of the shitty reimbursement-your so called savings. Many more providers will refuse to see Medicare patients under your beloved obamacare. I told you before that your links don't support your "findings" and are out of date.

As others have pointed out, you do have a flair for name calling when called out. Keep it up.

Son, stick a fork in you. Your done.

david gibson
07-06-2010, 02:23 PM
Don't give me that crap David. Go read the thread. The guy has been hammering for data and sources on every opinion post and insulting at every turn. I have provided substantiating argument when it was demanded from M&K. Meanwhile he, and others around here go on and on insulting, ridiculing, spewing unsubstantiated nonsense... It gets old.

I don't do well around close minded people. Guess I'll just take a hiatus.

getting testy again are you? and you are never close minded?

you are only open minded when others agree with you. when they dont, you accuse them of being close minded. getting old.

you have to understand that the majority of americans with half a brain cant stand this prick of a president and all the crap he keeps doing. the only reason he got elected is because of the useful idiots, he knows that, and he knows he has lost so many of them he now has to buy the latin vote.

the VAST majority of people that hunt, fish, and hold all our values so dear oppose him as well. i, as well as almost everyone i know, especially those with like-minded outdoor activities, despise him and we truly think anyone who is has similar ideals and values must be totally nuts to support him.

so, of all our "ilk", either you are of the teeensy minority that is so much smarter and more enlightened than the rest of us, and only you can see the genius of this administration, or, you are the teeensy minority who was duped and still are duped and for some reason we cant figure out why you are following this guy like a moronic zombie. i'll you make the choice.


so why would we ever agree with anyone of who we hold with such little regard?

Gerry Clinchy
07-06-2010, 03:06 PM
Many providers refuse to see Medicare patients because of the shitty reimbursement-your so called savings. Many more providers will refuse to see Medicare patients under your beloved obamacare.

If this were to take place, it would be utter disaster.

If Medicare participant could not use their Medicare benefit, their only option would be to pay out of pocket. Only a very wealth few could do that. Since Medicare supplement coverages only are operational for what Medicare does not pay, these seniors would essentially be left without any medical coverage at all.

If even half of the Medicare participants were placed in that situation, it should pretty much even out all the other people that will gain coverage through Obamacare.

Now those seniors would be placed in the same position as the uninsured of today ... using emergency rooms and requiring care that would be totally unpaid for.

Since Obamacare won't really go into effect until 2013, but the Medicare issue is immediate, (temporarily fixed only until the end of this year). This would be an incredible mess unless Congress makes a permanent fix. Or will they just continue to pass the buck until Obamacare goes into effect ... and try to roll it all together into one package?

M&K's Retrievers
07-06-2010, 03:41 PM
If this were to take place, it would be utter disaster.

If Medicare participant could not use their Medicare benefit, their only option would be to pay out of pocket. Only a very wealth few could do that. Since Medicare supplement coverages only are operational for what Medicare does not pay, these seniors would essentially be left without any medical coverage at all.

If even half of the Medicare participants were placed in that situation, it should pretty much even out all the other people that will gain coverage through Obamacare.

Now those seniors would be placed in the same position as the uninsured of today ... using emergency rooms and requiring care that would be totally unpaid for.

Since Obamacare won't really go into effect until 2013, but the Medicare issue is immediate, (temporarily fixed only until the end of this year). This would be an incredible mess unless Congress makes a permanent fix. Or will they just continue to pass the buck until Obamacare goes into effect ... and try to roll it all together into one package?

I'm afraid you nailed it. Obamacare will probably be responsible for a large exodus of providers especially among the ranks of the more experienced physicians who don't have to put up with the BS. In fact, several of the physicians I've talked to say they are glad they are 50 and not just starting out with many saying they would probably do something else if they were younger.

I]Note to DS. This is not a scientific study but an observation based on discussions with clients and friends who are physicians.[/I]

dnf777
07-06-2010, 03:55 PM
In fact, several of the physicians I've talked to say they are glad they are 50 and not just starting out with many saying they would probably do something else if they were younger.

I've been hearing that since pre-med in 1988! If enough docs refuse to see medicare patients, congress or the states will merely make participation a prerequisite for licensure. There will be (already is) a decline in quality of care for many. The billions spent by clipboard carrying nurses in quality improvement committees is all to try and show how peachy things are, not to actually improve care. Don't believe it? Google "SCIP" and see how much that multi-million dollar pain in the arse actually improved outcomes! But we're still doing it!

sinner
07-08-2010, 09:37 PM
An alert! My internist of the past 12 years is going to leave his present group and go with MDVIP. It will cost me $125/month not covered by insurance and he will only have 600 patients (Gross $900,000) What do I get: access to him by telephone and the internet, an enhanced physical, wellness preventive care. He did inform me I can deduct it from my income tax.
I have to continue to purchase my present insurance to get comprehensive care.
This may be the new face of health care if you can afford it. And you think Obama is the problem? How do you spell GREED?
Check out MDVIP.net. By the Way I am an allied health care specialist. You might want to read Not What The Doctor Ordered

M&K's Retrievers
07-08-2010, 11:42 PM
This may be the new face of health care if you can afford it. And you think Obama is the problem? How do you spell GREED?
Check out MDVIP.net. By the Way I am an allied health care specialist. You might want to read Not What The Doctor Ordered

Another example of docs leaving regular practice because of obama care. With this they are not required to file insurance, jack with Medicare, reduce fees, etc. Pretty smart for GPs. Probably sucks for specialists. Hey, Dave, who is gonna pay $125 a month for a good ass poking?

mjh345
07-09-2010, 05:36 AM
.
Hey, Dave, who is gonna pay $125 a month for a good ass poking?

More people than you could imagine; including some "conservative family values Congressmen", and Bush's onetime spiritual leader the Rev Ted Haggerty

YardleyLabs
07-09-2010, 06:11 AM
An alert! My internist of the past 12 years is going to leave his present group and go with MDVIP. It will cost me $125/month not covered by insurance and he will only have 600 patients (Gross $900,000) What do I get: access to him by telephone and the internet, an enhanced physical, wellness preventive care. He did inform me I can deduct it from my income tax.
I have to continue to purchase my present insurance to get comprehensive care.
This may be the new face of health care if you can afford it. And you think Obama is the problem? How do you spell GREED?
Check out MDVIP.net. By the Way I am an allied health care specialist. You might want to read Not What The Doctor Ordered
My doctor of 25 years did the same, but with an annual fee of $2000, payable in advance. I now have a better doctor.;-)

Hew
07-09-2010, 06:17 AM
...and Bush's onetime spiritual leader the Rev Ted Haggerty
Good grief. Do you even believe that utter nonsense?

sinner
07-09-2010, 07:56 AM
My retirement plan isn't as good as the docs!
I am looking for a new MD even though I have (had) a dood one. Read Jeff Bauer's book "Not What the Doctor Ordered"! He predicted this problem 15 years ago.
Buy the way if you have back or neck problems read Treat Your Own Back by Robbin McKenize. Works in about 80% of my patients and I won't charge you anything.
See you at a field trial!

Doc E
07-09-2010, 08:20 AM
How do you spell GREED?

No, it's called Free Enterprise. It's called being able to treat your patients without intervention of a non-medical trained person telling you what diagnostic tests and treatment plans you can and can't use. It's called not having to take huge reductions in what you are paid. It's called not having to hire an extra person just to deal with payment denials.

Gosh -- as Americans, we certainly don't want people to
run their own lives and businesses as they see fit do we.......................................



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