buffalo Loc: Texas

So is private, for profit health INSURANCE corporations subsidized with tax money. More privatizing profits while socializing losses.

Super Dave Loc: Realville, USA

Private isn't perfect by a long stretch.

But it's significantly better than Socialism.

buffalo Loc: Texas

Medicare isn't socialism. The VA is what socialist health CARE looks like.

Super Dave Loc: Realville, USA

I'm a disabled veteran and I know about VA healthcare.

It's a metaphysical certainty that Medicare could not maintain the current level of service without being propped up by private care.

Idaho

NASA has so thoroughly blotted it’s copybook in becoming a tool for the Global Warming activists and wrecking the integrity of its published weather statistics in pursuit of that agenda, that it might more productively be shut down and defunded altogether.

This new branch will be military, not quasi-public.

buffalo Loc: Texas

Would you care to elaborate as to how "private care" props up Medicare?

https://www.medicare.gov/about-us/how-medicare-is-funded/medicare-funding.html

Super Dave Loc: Realville, USA

Seriously?

You seriously didn't know Medicaid and Medicare both cut payments to Doctors who raise the rate on private insurance patients to make up for I the cuts? Have you been on a coma?

buffalo Loc: Texas

Dave, my brother is a medical doctor. He told me where to look for this info. Your the one that is seriously lacking in knowledge. Most doctors inflate their rates knowing they will be reimbursed at a lower rate. That way they can write off the difference as a loss and lower their tax liability.

"History. The resource-based relative value scale (RBRVS) was introduced in the Omnibus Budget Reconciliation Act of 1989. The intent was to create a uniform and objective payment system to address the large payment disparities produced under the traditional usual, customary, and reasonable (UCR) standard. The new scheme was adopted over a five-year transition period.

NOTE: The sustainable growth rate (SGR) was part of the Balanced Budget Act of 1997 and is separate.

Relative Value Units (RVUs) and CPT codes. Three RVUs are assigned to each CPT code:

Physician work RVU: A relative measure of the time, skill, training, and intensity required to provide a specific service The goal is for each CPT code to be reviewed at least every five years in order to make adjustments to reflect changes in the components of the service.

Practice expense RVU: Addresses expenses associated with providing the service. The direct costs (staff allocation, supplies, and equipment) of the service are calculated; indirect costs (any costs of operations not directly involved in providing the service) are allocated. A new method of calculating practice expense was fully implemented in 2010, after a transition period.

Malpractice RVU: Costs associated with professional liability expenses.

Who sets RVUs? CMS sets RVUs based upon the recommendations of the Specialty Society Relative Value Scale Update Committee (RUC). The RUC is made up of 29 physicians, 23 of whom are nominated by professional societies. Almost all are specialists. CMS is not bound to accept either the professional society nominees or the RUC's recommendations, but it has historically approved more than 90 percent of RUC recommendations.

(Get that a committee of 29 physicians recommends reimbursement rates, PHYSICIANS!)

The process has been criticized for a lack of transparency. There are also those who argue for more representation by primary-care providers, private insurers, and employee health plan purchasers.

Geographic Practice Cost Indices (GPCI). A GPCI is calculated, by CMS, for each of the RVU components. The GPCIs are reviewed every three years and attempt to take into account the different costs associated with different areas of the country.

Conversion Factor (CF). The CF translates RVUs and GPCIs into actual dollars. It is updated annually according to a formula specified by statute.

CMS may not, by statute, increase its total annual budget by more than $20 million. If shifts in the RVUs would increase CMS' budget by more than $20 million, the CF is used to achieve, essentially, budget neutrality.

Non-Facility Payment Amount. A non-facility is a freestanding physician's office, as well as other freestanding settings. Inpatient facilities, hospital outpatient clinic settings, and off-site hospital-owned locations are considered "facilities."

The payment for each CPT code in a non-facility is calculated as follows:

Payment = [(Physician Work RVU X Work GPCI) + (Non-Facility Practice Expense RVU X Practice Expense GPCI) + (Malpractice RVU X Malpractice GPCI)] X (Conversion Factor, adjusted for budget neutrality)

Beginning in 2015, CMS will establish separate payments for managing a patient's care outside of face-to-face contact.

Private Payer Reimbursement. Most, if not all, private payers tie their reimbursement rates to Medicare's. Contrary to widespread perception, private payers often reimburse at rates lower than Medicare."

(Did you get that last little tidbit? MOST, IF NOT ALL, PRIVATE PAYERS (YOUR PRECIOUS PRIVATE, FOR PROFIT HEALTH INSURANCE CORPORATIONS) TIE THEIR REIMBURSEMENT RATE TO MEDICARE. CONTRARY TO YOU BULLSHIT, PRIVATE PAYERS OFTEN REIMBURSE AT RATES LOWER THAN MEDICARE) Shows what you DON"T know.

That is why more and more physicians are supporting Medicare for All (HR676) and eliminating the profit extracting middleman of private, for profit health INSURANCE corporations along with the $600 BILLION they rob from the US health CARE system.

http://www.physicianspractice.com/fee-schedule-survey/how-medicare-other-payers-determine-physician-reimbursement-rates

So, just keep proving how full of it you are...

Super Dave Loc: Realville, USA

We all can't wait for Full Soviet Healthcare..

Especially the morticians.

buffalo Loc: Texas

What is your problem with Medicare? It is a very popular program among the elderly. And it is NOT free. I think they would take issue with you comparing it to Soviet health CARE. Only the uninformed and reactionary can't see the advantages and improvements it would bring to the US health CARE system.

Super Dave Loc: Realville, USA

You Libs/Progs/Whatever crack me up....

You always serm to think that the reason Socialism has never achieved as much as the free market is that you weren't in charge.

Keep yer damned Nanny-State for yourself and everyone else too stupid and lazy to take care of themselves.

Americas don't need you.

Iamdjchrys Loc: Decatur, Texas

Amen.