HER2 Support Group Forums - View Single Post - House bill would make health care a 'right, responsibility'

Rich66 · 08-16-2009, 01:56 PM

FYI, you posted most of that last post previously in this thread. But this portion was new:
"There is often very little relationship between the bill and the cost of providing medical services. In reality, combined hospital/doctor payment is much closer to what the services are worth. Hospital list price rates are often five to six times what they routinely accept as full payment from insurers. A friend had a surgical procedure done on an outpatient basis. The list price of the bill for the hospital, surgeon and anesthesiologist came to about $14,000. Insurance paid 18% of the hopsital charge and 31% of the doctor's fees with both accepted as full payment."

What insurance did your friend have? Perhaps the scenario you describe is akin to stores that advertise a 25% off sale but their prices have been marked up to compensate.
I think the real issue is whether Medicare reimbursement is less than private insurance and if so..would reducing reimbursement rates further while extending these rates into the previously non-Medicare arena negatively impact the quality and availability of care. As an example..would there even be any Tomotherapy or Cyberknife facilities in operation? What is the wait for the few that exist? Would the next generation of innovative but expensive machine be created? If reimbursements go down, will the medical field be able to increase the numbers of already limited primary care physicians?

I'm not sure removal of the public option would eliminate competition as much as its existence would. I understand Federal employees have many competing plans to choose from...none public option. Maybe extending their plan options to the rest of us would broaden the insurers pool and reduce costs. The largest portion of the uninsured is younger folk who may to some degree be skipping insurance because they think it's not necessary or they don't understand the value of even high deductible plan with catastrophic coverage. I remember a conversation with a young co-worker a while back who initially thought insurance was too expensive until I told him the cost of my policy..at which point he revised his statement to "I just don't think I should have to pay".
Maybe we need to require everyone "in" to the extent of at least catastrophic coverage plans so that we have more healthy folk contributing and spreading the pool of risk.

08-16-2009, 01:56 PM	#8
Rich66 Senior Member Join Date: Feb 2008 Location: South East Wisconsin Posts: 3,431	Re: House bill would make health care a 'right, responsibility' FYI, you posted most of that last post previously in this thread. But this portion was new: "There is often very little relationship between the bill and the cost of providing medical services. In reality, combined hospital/doctor payment is much closer to what the services are worth. Hospital list price rates are often five to six times what they routinely accept as full payment from insurers. A friend had a surgical procedure done on an outpatient basis. The list price of the bill for the hospital, surgeon and anesthesiologist came to about $14,000. Insurance paid 18% of the hopsital charge and 31% of the doctor's fees with both accepted as full payment." What insurance did your friend have? Perhaps the scenario you describe is akin to stores that advertise a 25% off sale but their prices have been marked up to compensate. I think the real issue is whether Medicare reimbursement is less than private insurance and if so..would reducing reimbursement rates further while extending these rates into the previously non-Medicare arena negatively impact the quality and availability of care. As an example..would there even be any Tomotherapy or Cyberknife facilities in operation? What is the wait for the few that exist? Would the next generation of innovative but expensive machine be created? If reimbursements go down, will the medical field be able to increase the numbers of already limited primary care physicians? I'm not sure removal of the public option would eliminate competition as much as its existence would. I understand Federal employees have many competing plans to choose from...none public option. Maybe extending their plan options to the rest of us would broaden the insurers pool and reduce costs. The largest portion of the uninsured is younger folk who may to some degree be skipping insurance because they think it's not necessary or they don't understand the value of even high deductible plan with catastrophic coverage. I remember a conversation with a young co-worker a while back who initially thought insurance was too expensive until I told him the cost of my policy..at which point he revised his statement to "I just don't think I should have to pay". Maybe we need to require everyone "in" to the extent of at least catastrophic coverage plans so that we have more healthy folk contributing and spreading the pool of risk.