Yeah!! My health insurance is only going up 13% this year.

Quote from politicaljunkie : Well, i come from a family of medical providers, including my current spouse. I've done a hell of a lot of research and discuss this issue frequently with countless doctors, nurses, administrators, etc. Not to mention, i have doctors, etc. as clients. Aaaaaanyways... Yes, i would agree that was a problem back in the day. But since it was the case then but not now, then how exactly did M&M increase the costs by creating a floor?

So you agree tha historically medicare paid too much right? but now you cant seem to understand how medciare increased costs and created a floor?

Quote : Fact is, if M&M is underpaying, M&M isn't a floor that pushes up costs.

it can be in some situations. say you come in to see me for a visit and you tell me you are poor can I see you for free. it is ILLEGAL for me to see you for free. I must bill you for NO LESS than i bill medicare. are you aware of this medicare rule? Are you aware it is considered fraud to do this?

So, you understand that in some cases, medicare is the floor?

Quote from travfar : Considering it was up 30% or so last year and 40% or so the year before, 13% is puny. It's still ridiculous that with no real inflation and stagnant wages that healthcare cost magically still go up 13%. There's something rotten with the system.

not to worry ObamaCare will "bend the cost curve" and "lower future costs"

Quote from DJPlayer : not to worry ObamaCare will "bend the cost curve" and "lower future costs"

Uh huh, kinda like the Pan Am business model...

Every seat filled costs us money. But we'll make it up in volume!

Quote from SigX : So you agree tha historically medicare paid too much right? but now you cant seem to understand how medciare increased costs and created a floor?

Back then, sure. But how is that happening now?

Quote : it can be in some situations. say you come in to see me for a visit and you tell me you are poor can I see you for free. it is ILLEGAL for me to see you for free. I must bill you for NO LESS than i bill medicare. are you aware of this medicare rule? Are you aware it is considered fraud to do this? So, you understand that in some cases, medicare is the floor?

I have a very hard time believing it is illegal to provide free healthcare. I have never ever heard such a thing. Do you have some sort of citation for this requirement? You may be right, but i have never heard of this before.

Quote from politicaljunkie : Back then, sure.

good. so we at least agree on something.

Quote : But how is that happening now?

medicare still pays well for some surgical and certain imaging services. it most poorly for most other things (vast majority).

Quote : I have a very hard time believing it is illegal to provide free healthcare. I have never ever heard such a thing. Do you have some sort of citation for this requirement? You may be right, but i have never heard of this before.

i am looking for a easy link, most of what google is bringing back is legal speak. there is a way aroun it. for example, i can create a pre-existing rule for "forgiving" balances owed to me for people who make less than x dollars. BUT, i have to apply this rule to everyone that comes in the door. so, i still must charge the patient, and send the patient bill. and after 90 days i can "forgive" the money owed (and unpaid) to me by the patient. But, it would be illegal to just do it for free and never charge the patient.


But seriously. the biggest problem we face today is skyrocketing demand for services. people are sicker than ever, mostly from "modifiable risk factors"... obesity, sedentary lifestyle, tobacco, drugs, alcohol, etc. etc. but nobody wants to change any of that. heck 2-3 years ago on this forum I presented scientific evidence that helmet laws for motorcycle riders would save 1 billion dollars per year nationally. for what, people using helmets.... seems pretty easy way to save money and pain/suffering/disability.... but of course I was attacked as a freedom hater.

Quote from SigX : good. so we at least agree on something.

Oh, we agree on more than that. See below.

Quote : medicare still pays well for some surgical and certain imaging services. it most poorly for most other things (vast majority).

Yeah, for now.

i

Quote : am looking for a easy link, most of what google is bringing back is legal speak. there is a way aroun it. for example, i can create a pre-existing rule for "forgiving" balances owed to me for people who make less than x dollars. BUT, i have to apply this rule to everyone that comes in the door. so, i still must charge the patient, and send the patient bill. and after 90 days i can "forgive" the money owed (and unpaid) to me by the patient. But, it would be illegal to just do it for free and never charge the patient.

Fair enough.

Quote : But seriously. the biggest problem we face today is skyrocketing demand for services. people are sicker than ever, mostly from "modifiable risk factors"... obesity, sedentary lifestyle, tobacco, drugs, alcohol, etc. etc. but nobody wants to change any of that. heck 2-3 years ago on this forum I presented scientific evidence that helmet laws for motorcycle riders would save 1 billion dollars per year nationally. for what, people using helmets.... seems pretty easy way to save money and pain/suffering/disability.... but of course I was attacked as a freedom hater.

Amen. And to think Michigan just voted to allow people to ride w/o helmets. People all scream for personal responsibility--except when people have to take responsibility for their health.

Problem is, how do we encourage people to be healthy? Government shouldn't mandate it. That would be nuts. When Michele Obama tries to get people to exercise and eat better, they criticize her for it. It's amazing how stupid we are as a country.

If you stay with the same insurer, expect them to keep jacking up rates.

Familiarity breeds contempt.

Quote from Lilian : If you stay with the same insurer, expect them to keep jacking up rates. Familiarity breeds contempt.

It would be nice if you could react to their jacking your rates by telling them that there are hundreds of insurers out there who will sell you insurance at a lower rate but unfortunately we can't buy insurance across state lines.

Quote from politicaljunkie : If anyone tries to pin ONE reason why healthcare is expensive, they're either naive or willfully ignorant. Here is a short list: 1) unhealthy american habits 2) lack of focus on preventative care 3) administrative costs are outrageous (from both government and private insurance) 4) drug patent games (with extending patents) 5) disconnect between who pays, who delivers and who receives the care 6) government has assumed the liability for the most expensive part of our lives--and with spiraling costs, they try to push costs down by regulating costs/increased oversight/etc. 7) medical malpractice (and the expectation that people receive PERFECT healthcare) 8) insurance providers (both healthcare and malpractice) 9) over-delivery of healthcare 10) fraud 11) uninsured 12) overuse of emergency care (inefficient allocation of medical resources) 13) cost of medical degrees etc., etc., etc.

well put.

Quote from SigX : i am looking for a easy link, most of what google is bringing back is legal speak. there is a way aroun it. for example, i can create a pre-existing rule for "forgiving" balances owed to me for people who make less than x dollars. BUT, i have to apply this rule to everyone that comes in the door. so, i still must charge the patient, and send the patient bill. and after 90 days i can "forgive" the money owed (and unpaid) to me by the patient. But, it would be illegal to just do it for free and never charge the patient.

So all the doctors who volunteer at free clinics [cbslocal.com] are breaking the law unless they bill the patients?

I saw cost of medical degrees listed above..

I don't see that as a very big factor whatsoever. I've spoken to my family doctor several times about this and he admits that he doesn't get 6 digits. His wife is a doctor also and her scenario the same. He has admitted that if he flipped fields (to a specialized area) he would make x2 the income. But that wasn't his interest. He recently left his family practice because of the speed being asked to see patients at. Now he's on call 365/24x7 for all a group of patients that pay a flat fee out of pocket (I believe your healthcare might cover a portion). He even got into the ObamaCare issue and feared he would end up having to see x2 as many patients at twice the speed shortly. Said he didn't become a doctor so he could treat patients as if they were customers at a drive through fast food window.

Quote from 124nic8 : So all the doctors who volunteer at free clinics [cbslocal.com] are breaking the law unless they bill the patients?

Only applies if the clinic accepts Medicare/Medicaid.

Quote from DJPlayer : I saw cost of medical degrees listed above.. I don't see that as a very big factor whatsoever. I've spoken to my family doctor several times about this and he admits that he doesn't get 6 digits. His wife is a doctor also and her scenario the same. He has admitted that if he flipped fields (to a specialized area) he would make x2 the income. But that wasn't his interest. He recently left his family practice because of the speed being asked to see patients at. Now he's on call 365/24x7 for all a group of patients that pay a flat fee out of pocket (I believe your healthcare might cover a portion). He even got into the ObamaCare issue and feared he would end up having to see x2 as many patients at twice the speed shortly. Said he didn't become a doctor so he could treat patients as if they were customers at a drive through fast food window.

It is a factor. Not a huge factor, but a factor. The problem with the healthcare problem is that it is death by a 1000 cuts. There is NO silver bullet and unless someone can find a consensus that the problem addressed is a major factor and the remedy is the perfect remedy, nothing happens. Fact is, we have a ton of problems that together make a huge problem.

Is malpractice a MAJOR problem? No. Is the Healhcare insurance companies' profits a MAJOR problem? No. But these are all problems that need to be remedied.


When doctors have to go through 4 years of college, 3 years of EXPENSIVE medical school, many have 100K of loans before they hit their 2-3 years of residency making 40k a year--where they need to defer their student loans (which screws them on interest rates)--and THEN they get to practice (if they don't do a fellowship). By the time they're practicing, they're well over 100k i debt, 30 years old and unless they got into a great specialty, will only make 150k per year.

It's a problem because unless we lower their costs, they'll continue to need extremely high salaries to attract smart individuals to invest 10+ years of their lives to practice medicine.

Quote from politicaljunkie : It is a factor. Not a huge factor, but a factor. The problem with the healthcare problem is that it is death by a 1000 cuts. There is NO silver bullet and unless someone can find a consensus that the problem addressed is a major factor and the remedy is the perfect remedy, nothing happens. Fact is, we have a ton of problems that together make a huge problem. Is malpractice a MAJOR problem? No. Is the Healhcare insurance companies' profits a MAJOR problem? No. But these are all problems that need to be remedied. When doctors have to go through 4 years of college, 3 years of EXPENSIVE medical school, many have 100K of loans before they hit their 2-3 years of residency making 40k a year--where they need to defer their student loans (which screws them on interest rates)--and THEN they get to practice (if they don't do a fellowship). By the time they're practicing, they're well over 100k i debt, 30 years old and unless they got into a great specialty, will only make 150k per year. It's a problem because unless we lower their costs, they'll continue to need extremely high salaries to attract smart individuals to invest 10+ years of their lives to practice medicine.

So you're suggesting we give breaks to only M.D.'s? How about people in other fields with M.S.'s and PhD's? What sort of break do those people receive? Can it be retroactive?