Is Health care constitutional?
I don't know.
Is undeclared war that goes on and on?
For physicians, the fundamental problem of Medicare is that the rates are too low. For other types of providers, Medicare rates are often the highest they receive relative to other insurers. By the way, Medicare claim administration expenses run about 2%, which is a small faction of the cost of most private plans. One of the reasons is that private pans incur substantial costs trying to determine if another payer might be responsible for the cost (coordination of benefits, subrogation of benefits, split claims, etc.).
For institutional providers, the biggest nightmare of Medicare is uncertainty concerning the rates that will be paid. Prices are based of complex cost analyses and the rates paid are simply estimates pending a future audit. The rate setting process does nt encourage efficiency and can result in significant surprises when audits are complete.
Medicare actually pays the intermediaries in advance, providing them with trust accounts against which claim payments are drawn pending periodic reconciliations.
And yes, healthcare is expensive, and will likely recieve 100% of the blame for any forthcoming tax increases, but let's not forget about two wars, one in particular, that has cost more than all this healthcare combined thus far, and has had the net effect of replacing one untrustworthy president with another. Pardon me, replacing TWO untrustworthy presidents with TWO more!
I'm quite sure you get pissed off when people outside your profession take potshots at your expertise. I'm sure you'll understand when an insurance professional feels the same way. If insurance companies were making so much money raping and pillaging the public, their would be a lot more of them competing for the gravy. There will be even fewer now.
By the way, what drives the cost of insurance up? Could it be the cost of the care, the paperwork, the mandates, litagation, CYA testing?
Yes, I do get peeved when people take unjustified shots at my profession, but not when they are justified, which unfortunatley is sometimes the case. Medicine, especially surgery, is the most regulated, policed (self and otherwise), and scrutinized profession I can think of, except maybe pesticide application under a democratic EPA. ;-)
I wouldn't neglect to include American's fatty, caloric-packed, processed-food diets in the blame game of health care costs. The fact our life-expectancy is anywhere near where it is, is a testament to the miracle of modern medicine! Think of how much that "we" eat that comes in boxes, wrappers, cellophane bags, or handed to us from a teenager in a window wearing a headphone.
Five weeks following the renewal date we received a letter from HealthNet stating that all coverage had been terminated effective as of the prior renewal date because of "non-payment of premium" and a decision not to renew policies with small businesses. At its annual meeting that year, HealthNet announced the successful strategy they had followed to terminate coverage for unprofitable small business accounts and awarded a bonus to the staff person who had come up with the idea.
To rub salt in the wound, the fact that the cancellation was made retroactive meant that everyone covered had been without coverage for more than 30 days. Given my own medical problems, I went without insurance for four months until I managed to join an association plan during an open enrollment period. Everyone else obtained policies but with prior condition exclusions.
Nobody has specifically mentioned what this does to our personal freedoms.
1) We presently can choose to purchase health insurance or not. That option will be removed with a tax penalty. (Although if you're going to have a penalty, I think it should be upon an individual rather than their employer. And the penalty should be a substantial one, no a slap on the wrist compared to the cost of actually purchasing coverage).
2) If someone wants to buy catastrophic coverage only, with a high deductible or a co-pay, it will simply no longer be available. Even Medicare has a co-pay.
Private insurors supplement Medicare with policies that absorb the co-pay. No need for that kind of private industry support with a program that has no co-pay.
3) A young, healthy person who is not married; or unable to have children; or doesn't want to have children, will not be able to purchase a policy without maternity or pedicatric care. Neither will a woman who is past child-bearing age.
4) Since there will no longer be any financial advantage for those people who don't smoke, stay slim, and avoid substance abuse (no pre-existing conditions are excluded), I'd bet the farm that the govt eventually comes up with some kind of "tax" or "penalty" for smoking, obesity, and alcohol consumption. In Japan, there is already a monitoring of waist-size with a penalty attached.
I thought this provision was interesting (if accurate)
Why would this not also apply to non-physician owners? This provision is ancillary to the limitation of physicians owning hospitals unless they are approved Medicare providers by Feb. 2010 (oops, too late under the Senate bill, but extended to Dec. 2010 under the "reconcilation").Quote:
If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a county where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).
The Senate bill provided for $750/employee penalty for employers of 101 or more) for not providing insurance, but that is raised to $2000 or $3000 under the reconcilation. Quite a difference between the two.
Do we really expect that taxes on medical device mfrs and pharma companies will yield a long-term cost reduction? Costs of additional taxes are usually passed onto the consumer of the products. Of course, govt holds the purse-strings in determining reimbursements or Medicare and Medicaid; and likely, at least indirectly, under these new programs (via the rate restraints on private insurors as long as the private insurors remain in this business).
So, those companies producing those goods, if compelled to offset those penalty charges on their balance sheet & unable to raise prices ... it seems logical that they will have to trim other expenses. R&D maybe? Lay off some employees maybe?
No problem those people can always go to work for the IRS, which will need 16,000 more employees to make sure everyone pays their penalties or for their health insurance.
In addition to the 10% tax on tanning salon services, there is a 5% tax on cosmetic surgery. That last tax is likely only to affect those that can afford elective cosmetic surgery .. the rest of us will just stay ugly :-)