News-Record.com

So the Government requires "everyday low prices", and soon all the suppliers close shop.

Walmart requires "everyday low prices", and soon all the suppliers close shop .. and move to China.

THATS IT .. Bonnie ! Move to China !

Ms. Miller's lte exemplifies why we DON'T need more govt. run insurance. The reimbursement rates are lower so many practices don't take Medicare patients.

JDR, have you ever taken on a new job knowing you were going to lose money? Have you done it more than once? Have you done it almost on a daily basis?
If the answer is no, then why should a practice lose money every day?

Ironic how Ms. Miller discovers that a govt. run health care program is so inefficient that physicians don't want to deal with it, yet her solution is more govt. run health care programs.

"I wonder, unless there is a single-pay system in the future, whether Medicare-insured citizens will continue to be treated as second class when applying for the medical coverage they need. "

That's the great thing about socialism/marxism, Bonnie...there is no 2nd class citizenry...or 1st class...or 3rd class. Everyone is miserable equally. (unless you happen to be a member of the ruling class of course)

Help me out, Dan - I do not see how you conclude the "govt. run health care program is so inefficient that physicians don't want to deal with it ..."

My understanding is the reimbursement is too low .. which is totally different than inefficient.

So help me out, Dan.

It's both JDR,

From 1992, Medicare was cut

http://query.nytimes.com/gst/fullpage.html?res=9E0CE2D8153AF931A25757C0A964958260&sec=&spon=&pagewanted=2

More recently:

http://www.allbusiness.com/health-care/health-care-professionals-physicians-surgeons/5495367-1.html

"Medicare pays too little and doctors charge too much," she sighs. "If they (doctors) would only charge less and Medicare pay more." But Hatch also understands the doctors' frustration with Medicare, particularly its billing method.

BILLING ADDS TO PROBLEM

"If a nurse, when filling out the chart, makes a mistake on the first few things in the billing, then Medicare will kick it back and if they resubmit it with those corrected and there are other mistakes, then they (Medicare) send it back again," Hatch said.

Medicare was cut in '92 and '02 so it can't be blamed on a specific party.

Remember doctors practices are a large chunk of my clientele. Not only is the reimbursement amount not worth their time but the paperwork is inefficient (as quoted above) and the reimbursement times are too long they tell me. I like to be paid in 30-45 days, how about you?

To be fair, private insurance is quite inefficient at times but nothing as compared to govt. programs.

Govt. run anything is almost always less efficient as compared to the private sector. If we are going to pay for seniors health care it would be better to give them money that must be spent on health insurance in a free market.

So why is everyone so upset about Hilary Care?

If it ends up being more of the same, obviously it will be such a horrible system ALL Doctors will refuse it - eventually it will go the way of the 8-track tape.

The only issue left is whether we are wasting money keeping alive a dinosaur: The cost to administer Medicare is 2%-3.6% - there is no advertising, and a single administrative system vs. private insurance which has a much higher cost of overhead - I've heard 30%.

I think I just talked myself into it.

RESTATED:

My understanding is the reimbursement is too low .. TRUE.

Your understanding is Medicare is inefficient .. FALSE

Dan, you say the government pays for seniors health care? Maybe for some! We paid medicare premiums all of our life, now we pay about $200 a month in premiums. Then , we pay a fee each time we go to a doctor .
I guess the best solution would to go to Mexico run back across the boarder.Then you get it free. Rockhead, why do you not tell us why Wally World , buys from Chinia? The correct answer is Wal Mart brought most everything made in American pryor to NAFA. You will also find the same items in K Mart, Target and all the other big box stores.

Ms Miller, I have the same problem, my Dr. is retiring, the ambulance chasing lawyers have made his insurance premiums to high. Wonder why these folks are never mention in health care cost.

"Dan, you say the government pays for seniors health care?"

Didn't say that Dog. I said IF we are going to pay for seniors health care it would be better to give them the money and mandate that it be spent on health care, i.e. a medical savings account.

Your understanding is Medicare is inefficient .. FALSE

JDR, go talk to some doctors about Medicare paperwork and reimbursement waiting times. They aren't refusing Medicare solely for the reimbursement amounts.

I have a few who are refusing any insurance whatsoever. In return they offer lower prices and better service as they are not hamstrung with insurance paperwork.

As previously noted, private insurance isn't perfect either but there is a CHOICE. Our provider has treated us well over the years but I can leave at any time and take my business elsewhere. After all I'm a pro-choice guy (in most instances). Sure the candidates tell us there will still be choice under universal health care. Perhaps there will be at first in the transition phase but the goal they don't mention is Canadian/European style single payer health care.

Dan,

Doctors all over the county are not only not taking new medicare customers, they are throwing out long-term patients as they turn age 65. I know, as I am one of those patients. I visited the same doctor's office for 5 years until I called a few weeks ago for an appointment. I was told that they would no longer see me as I am on medicare. Actually, I have private medicare replacement coverage, which is known as fee for service plan.

The reason that I was given for no longer being a patient is that the billing issues are too great. Basically, it's not worth their time. Fortunately, I was able to find a doctor's office that would see me about ten miles from my house. They told me that they would bill my insurance company, and I would owe any amounts that the insurance company does not pay, so in essence, JDR is somewhat correct, it is also about rate of reimbursement.

But, in the end, whether it is because of billing problems or reimbursement rates, people who pass age 65 are left in the lurch. My only thought when I went through this is "Welcome to national health care". I now know what it will be like for your health care to be managed by the same people that deliver you public education. People will be told where they have to go for health treatment, what they have to do to get it, and older people will be evaluated for treatment on the basis of whether it is cost justified, and if not, they will not receive it.

Glad to see someone speak from experience ORR. The standard of living we enjoy is due to competition. For the life of me I don't understand why we don't do the same in health care. Third party payer systems invite people to over use the system, I found my own wife guilty of that. Govt. run health care would be even worse.

I'd like to see health care savings accounts for everyone who opts for them. The money could be deducted as are funds for SS and taxes, however it would go into the individuals account and can ONLY be used for necessary health care. No Viagra, breast enlargements, etc.

That money would be used for common medical expenses and the patient would shop around for the best quality/price/convenience, whichever factors are most important to him or her. Then catastrophic insurance could be purchased to cover very expensive events like accidents or serious illnesses.

For those who do cannot work, don't earn enough money, or are retired, Medicare or Medicaid would pay into their accounts for them. Just an idea.

Dan – sometimes you come across as having just finished a Hannity session. Other times you come across as a near-flaming liberal.
See your last post:

“I'd like to see health care savings accounts .. “. I’m assuming you also mean these would be tax free – like the Child Care Credit – which when I used it was $5,000 “off the top”. Hannity might argue .. well it’s YOUR Money. I might agree. But if that’s the case, why would it be “ONLY” for “necessary health care?” If it is in fact my money, when could I not use it for Viagra and my wife for breast enlargements?

THEN you say “For those who do cannot work, don't earn enough money, or are retired, Medicare or Medicaid would pay into their accounts for them.” … so you are spending MY hard earned money on those living in the Land of Plenty who refuse to pull themselves up by the bootstraps.

I think the latter is your real belief – you let your hair down – and the former is just your official stance.

Clarity will be appreciated.

I am sure my new-found logic is flawed .. but here it is:

SINCE “Doctors all over the county” seem likely to stop accepting Medicare … ultimately the system will come to a grinding halt.

Of course that will not be allowed.

My new-found logic is that THIS WILL LEAD to a Two-Tier system. Those with resources will opt’ as ORR has – Private Medicare Replacement Coverage – plus cold hard cash for the difference. Those too tired, too poor, too huddled ... too lazy, too ignorant, too born under a bad sign, etc., will get Universal Health Care, which is “free” - meaning supported by you and I the taxpayers - but featuring crowded rooms waiting for not the best doctors.

Now I’m OK with a Two-Tier system – after all socialism systems are unworkable beyond a couple hundred peoples. But I also think it is not the Best system, in fact it sounds like the Canada systems we hear bashed so often. As a better example, I’m told Germany has the best system:
a workable mix of private and public care.

POINT – stop the BS about “Hillary Care” and Canada Waiting Lines and Government Inefficiency and Ambulance Chasing Lawyers. It's all Bull Sh!t.

Biting Dog:

You pay about $200 a month in premiums plus a fee each time you go to a doctor … OH MY GOD WHAT A FOOL YOU ARE.

Just kidding – but fwiw, both Dan and I pay about $600 a month in premiums plus a fee each time Our Wives take a “sick” kid to a doctor. The only one here-in “without sin” is Neocon – he would die [and in fact will] rather than pay for medical insurance .. except he does have a Cancer policy, so it’s really only “almost-without sin.” Of course when he’s in your shoes but then finds he cannot purchase Private Medicare Replacement Coverage (because – no insurance history - Very Expensive Insurance!) .. like I said, he would rather die.

==

You want talk Wally World? Actually Wally World DOES NOT ANYTHING buy from China. They softly force their suppliers to do so – a fine put important point.

Regardless, it’s all in the name of “Every Day Low Prices”, with K-Mart, Target and many other stores being equally guilty … and it is part of the Two-Tier system … and it has little to do with NAFTA. Wal-Mart brought most everything made in American prior to Sam Walton dying, and prior to hot shot MBA’s taking over American business.

Who is the new royalty of America? The hot shot MBA’s taking over American business. You wanna kiss their ass in the name of “Capitalism is Great, Long Live the King!”. Go ahead. I’m more of a Revolutionary .. the kind that put America at the Top .. the kind that fights for the rights of freedom – freedom from England – sorry, I meant the New Royalty.

http://www.rickgottschalkphotos.com/Revolutionary-War-Heros.htm

Speaking of hot shot MBA’s taking over American business .. How’s your 401K? … but have no fear ... Bush is “On Top of the Situation” in the U.S. Markets.

http://blogs.wsj.com/washwire/2008/03/17/bush-on-top-of-the-situation-in-markets/

… Thank you very much.

Rockhead, I just talking about medicare. We also pay 240 a month for our company plan.
Wally World, two biggies told me they can not buy items made in the USA. They simply are not made here. Nor do not think Sams death , made every shoe, umbrella, belt, and other items to made over seas.
I called a lady who's company does not take new medicare patients. Correct answer is to much paper work! My 401k is fine. Of course if the liberals do not bring down the price of fuel, like they promised before the 2006 election, who knows. I understand the private truckers are gettin killed!

How you get "I just talking about Medicare." from "Rockhead, why do you not tell us why Wally World , buys from Chinia?" .. I dunno .. but regardless ...

"two biggies told me they can not buy items made in the USA. They simply are not made here."

That's right. Now WHY not? Because Wal-Mart - the world’s largest employer AND the world’s largest retailer .. say's to a company: You put it on our shelves .. and when it is purchased, we will pay you. Company "A" ... of let's pick Rubbermaid .. say's "OK". The product sells out.

Wal-Mart - the world’s largest employer AND the world’s largest retailer .. THEN say's to the company: Put more on our shelves .. and when it is purchased, we will pay you more - but we want a 10% discount. Company "A" say's "OK". Rubbermaid makes more, the product sells out.

Wal-Mart - the world’s largest employer AND the world’s largest retailer .. THEN say's: This is working GREAT .. Put even more on our shelves .. and when it is purchased, we will pay you more - but we want another 10% discount. Company "A" say's "OK" - because anyone can find 10% of fat .. the product sells out again.

Wal-Mart - the world’s largest employer AND the world’s largest retailer .. THEN say's This is GREAT .. for this next year, we need another 10% discount. Company "A" say's "OK" - looks hard and barely finds 10% .. the product sells out.

Wal-Mart - the world’s largest employer AND the world’s largest retailer .. THEN say's for next year, we need another 10% discount. Company "A" has no more 10% to give ... UNLESS they ship the factory to China. They do.

==

You Wanna know why "two biggies told [you] they can not buy items made in the USA?" THAT's why. It is HIGHLY documented. This pattern is repeated all across American Manufacturing. Look it up.

You wanna argue "Globalization" OK .. but as above .. don't give me bullsh!t .. or tell me Wally World is just an innocent merchandiser. They are INSTRUMENTAL in screwing it up - aided and abetted by the 'fore mentioned hot shot MBA’s.

== You don’t “think” Sam’s death caused items to be made over seas .. I’m sure you’re right, but I’m equally sure he’s rolling over in his grave at how mucked up his vision became.

As foe LIEberals and NAFTA .. tell me who was in complete control of congress when the bill was signed … and tell me how the separation of powers “forced” the CONservatives to accept NAFTA .. yea they were forced alright.

Sorry – you are so partisan you piss me off.

I forgot to mention .. when Wal-Mart askes for that next 10% discount .. Company "A" has the option to say, No Thank You, but as the world’s largest employer AND the world’s largest retailer .. Wal-Mart sells so much product that to refuse the business, Company "A" - overnight - looses 60% of it's volume - closing to doors - or moving the factory to China.

Like I said - look it up. I picked Rubbermaind because they are a well known example - but there are hundreds of examples.

"Dan – sometimes you come across as having just finished a Hannity session. Other times you come across as a near-flaming liberal."

Glad to see I'm keeping you on your toes. You can leave out the flaming lib bit however, that ain't gonna happen.

Let me clairfy for you. The health savings account, first of all, would be voluntary. However if one opts to participate the money would be used for health care, just as retirement plans are used for retirement and college education are used for......you got it, college education!!

Ever take money out of a 401K? I did once for a down payment on my house and had to pay taxes and penalties. So.....if you and the Mrs. want to take money out of your health care plan to build that sunroom then you will pay for it.

Why no Viagra or breast implants? Let's say you and the Mrs. get $20K into the account and decide you guys like larger tatas. So you drain the account (this is just an example, I have NO idea how much breast implants cost) for the procedure.

Now something medically necessary comes up and there is no money in the account because you used it all on something unnecessary. So now the taxpayers have to pick up the tab.

As for TRULY needy people, you fall for the myth that conservatives want needy people to die in the street. I believe the truly needy should be taken care of just as they are now.

Hope that helps.

Thanks for the response, Dan - You hit the key: It all depends on definitions.

"medically necessary." Your kid gets a high fever but the snot is still running clear. Your wife take him to the Dr. anyway where she is told what we already knew - it is a virus and there ain't nothing medical science can do. Meanwhile, my monthly check to BCBS help pay for that visit. You wife will argue that regardless, better safe than sorry and that makes it a medical necessity.

"TRULY needy". Boy is that an open phrase ... but in this very blog you have been much more tight with the definition than you were above.

I understand your point JDR, just throwing out ideas that probably never will come into fruition. People will always try to juke the system anyway.