lpnmajor Loc: Arkansas

Whoever thinks that Medicare is the poster child for efficiency in Government, is either not on Medicare, or suffering from dementia. My State has 4 or 5 Medicare districts, each with different rules and provider payment criteria, now multiply that by 50 or so. This is a perfect plan - for job security for employees of the Centers for Medicare and Medicaid Services.

A more credible idea, would be to contract with, let's say Blue Cross Blue shield, to take over Medicare and Medicaid. Having the Federal Government be the guarantor for every American's healthcare is reasonable, as long as it does not interfere between Doctor, Patient and the insurance carrier. The Government would be responsible for collecting the Premium payments from all Americans, denying tax refunds for those who don't pay up.

For profit insurance carriers are much more efficient at curbing healthcare costs, negotiating with providers, spotting fraud and prosecuting the same. The problem with rising healthcare costs is NOT about insurance, it's about what providers are charging for services. After a heart attack in 2013, I found $12,000 in fraudulent charges on my bill. I tried reporting this fraud to Medicare, and was directed to a volunteer group who investigate such things. Medicare paid it's 80% of the bill and I never heard back from them on the fraud. That means that I owed 20% of that $12,000, and would be taken to court if I didn't pay. Multiply that $12,000 by 100,000,000, and you'll see why Medicare is lucrative for providers.

If you're having trouble paying for the fuel for your small 4 cylinder sedan, you don't solve that problem by trading up to a full size SUV with the largest V8 available.

Canuckus Deploracus Loc: North of the wall

Somebody has their thinking cap on...

This is an excellent post...With a very realistic suggestion...

Happy Easter...

emarine

All good points Major buddy … the cost of services is the main issue... an hour in outpatient surgery this year was 40k for a 40 minute procedure plus the surgeons 3k...

MarvinSussman

Republican Presidents Reagan, Bush, and Trump have been firing federal auditors by the thousands.

ACP45 Loc: Rhode Island

Agreed.

This is a complicated problem, and you are never going to please all constituents. The t***sition from what we have now, to where we want to go, will not be easy. There are certain economic principles that apply to all things. If you subsidize something, or give it away for free, people will abuse it. If each person is responsible for managing their own health care expenses, they will do a better and cost effective job than the government, or for profit insurance carrier. Treat health care costs the same way you would treat any other consumer's purchasing decision. (Some people can afford a Mercedes or BMW, some can afford a Kia or a Ford. That is an unfortunate fact of life). Many illnesses or diseases are affected by life style choices. Why should society have to pay for your poor lifestyle choices (improper diet, smoking, drug abuse)?

IDEAS:
1) implement a fairly priced catastrophic insurance plan available to everyone,
2) Allow individuals to put aside tax deductible funds into a Health Savings account they will manage for themselves.
3) Mandate plain language, t***sparent pricing for medical services, doctors procedures, and hospital stays 4) Allow true free market competition (consumers can choose from any states insurance plan)
5) allow consumers to purchase their drug prescriptions from any jurisdiction (Europe, India, Canada, etc) they choose.

The government or charitable organizations may need to take care of a small segment of the population who are unable to manage their own affairs.

lpnmajor Loc: Arkansas

Many times, even the most cost conscious, fiscally conservative, expert budgeter, can be forced into bankruptcy with a single illness. The best insurance still pays only 80% of "covered" charges. I put covered in quotation, because there are more and more exclusions in every policy, even Medicare. The point is, we keep focusing on insurance, rather than on the costs the insurance is paying. A round of chemo, radiation and related therapies for a curable cancer can easily top $2,000,000, which will result in the patient incurring at least $200,000 in copay.................assuming they've already met their $5000 - $7000 deductible.

I never suggested that the government pay for someone's healthcare, I suggested the government be the guarantor, collect premiums from EVERYBODY and forward those funds to whichever insurance carrier wins the contract, who will then negotiate between providers and patients and pay covered charges. There is no such thing as a free and competitive healthcare market, nor is there likely to ever be one. 80% of our population relies on rural/county hospitals and clinics. There is no incentive to lower costs by pharmaceutical, medical device manufacturers, medical supply manufacturers, or providers.

As long as we focus singularly on insurance, costs will continue to rise.

Wonttakeitanymore

Pharmaceutical companies are theives! My dr prescribed a new diabetic med for me! The pharmacist told me it was 500.00 ! I paid 37.00. So I guess Medicare gets hit with the rest!

ACP45 Loc: Rhode Island

And why is it that Medicare cannot negotiate an agreed upon price with the pharmaceutical company? Why should the US subsidize all the R&D and let other countries get the benefit of favorable pricing? Why can't the US consumer purchase their drugs from a Canadian pharmacy, or Indian pharmacy if they wish to do so? Ask Corey Booker that question, and he will tell you that the Canadian equivalent of our FDA does not offer sufficient consumer protections (while he is the largest recipient of campaign contributions from the pharmaceutical industry).
http://www.rollcall.com/news/politics/pharma-booker-canada

lpnmajor Loc: Arkansas

Congress specifically forbad Medicare to negotiate drug costs AND made it a crime to purchase drugs from out of the US.

teabag09

You and I find common agreement. Good post. Mike

ACP45 Loc: Rhode Island

I realize that, but isn't that a foolish idea or decision on the part of government? Why make it a crime for a US citizen making a conscious economic decision to purchase their prescription drugs from a Canadian (or any other lower cost country's pharmacy) if they wish to do so? Why continue to subsidize the profits of the pharmaceutical industry?

It is an insult to the American public to have corrupt members of congress who are paid off in the form of political campaign contributions and use the phony argument that they are only "protecting" us from purchasing the same identical drugs from an out of country pharmacy.

lpnmajor Loc: Arkansas

We are being auctioned off at every turn.

ACP45 Loc: Rhode Island

Rose42

Maybe our government would get serious about it if they lost their benefits and had to use what we have to use and pay what we have to pay. They are out of touch with the rest of us.

promilitary

Medicare is grossly represented; i.e., ads promoting Medicare claiming that it pays 80% if the bill.

I've been on Medicare for several years and it's NEVER paid 80% of anything. First, it's "80%" of
what they "approve" and then it's NOT 80% paid.
It's my medicare supplement that pays the bills. If I didn't have a supplement I
would be bankrupt.