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View Diary: Medicare Cuts Coming: Proven (57 comments)

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  •  Bull hooey - Docs will take what we give them (2+ / 0-)
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    kalmoth, Quicklund

    We make the laws.

    Didn't you read the post?

    Are you with Romney and the $716 billion cut from Medicaire is too much? or the rest of us that see American has an out of control bloated system set up to enrich the 1%.

    How big is your personal carbon footprint?

    by ban nock on Fri Nov 16, 2012 at 06:56:45 AM PST

    [ Parent ]

    •  The problem is private insurance (9+ / 0-)

      And Medicare for all would have solved the 17.6% problem.  Going the other way will fail.  Spectacularly.  How do I know this?  Because no other country has managed to make our system work.

      •  not really, they are the problem (1+ / 0-)
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        they only shift the costs to taxpayers and off the backs of other tax payers. Don't get me wrong, I like the redistributive affects but I don't like that there is no incentive to reduce costs.

        Single payer was the compromise and best left in the dustbin, we should be keeping our eyes on the ideal which is single provider. Take the profit out. No profit for fire fighting, police, libraries, health care.

        How big is your personal carbon footprint?

        by ban nock on Fri Nov 16, 2012 at 07:23:53 AM PST

        [ Parent ]

      •  Docs don't have to serve the old & the poor. (6+ / 0-)

        They can decide to take patients with insurance and not accept the rest. Med students can avoid going into residencies that serve the old and the poor.

        We have a shortage of physicians that is made up by docs working very long hours. They will cut their hours and work only for patients that pay if Medicare & Medicaid reimbursements are cut. Many docs don't take Medicare and Medicaid now because they do better without them.

        A lot of folks just don't get it.

        look for my eSci diary series Thursday evening.

        by FishOutofWater on Fri Nov 16, 2012 at 07:29:53 AM PST

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        •  This diary suggest cutting out that which MDs hate (0+ / 0-)

          When contemplating the effects of proposed changes ... one has to comprehend that changes have been made. That in turn means old assumptions are no longer valid.

      •  We are moving in that direction TJ (0+ / 0-)

        We didn't get there in one go. Not getting there in one go does not prove movement in the other direction.

      •  There are many models in other countries that (5+ / 0-)

        prove universal comprehensive medicare works. It means a healthier population, less chronic illness, more prevention. As a Canadian I can't even imagine the psychological torment of having to worry about medical bills on top of being sick.

        ❧To thine ownself be true

        by Agathena on Fri Nov 16, 2012 at 08:09:47 AM PST

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    •  It's not really the doctors who are milking the (5+ / 0-)

      system - it's the makers of medications, medical supplies, insurance companies, medical equipment, etc that are making things so expensive.

      I've seen where a ballpoint pen is labeled ergonomic in one package and labeled handicapped accessible.  The first would cost $2 and the second $5.  Why??  Because the company knows it can collect more because it's 'helping' handicapped people and insurance/medicare will pay it.

      There are sensible ways to cut medical expenses, not paying the doctors and their staffs isn't one of them.

      •  I didn't say not pay, and I didn't say staff (0+ / 0-)

        How about if we limit them when they are structured as a business? Why should I pay for third houses in the Caribbean with the health of my children in the balance?

        How big is your personal carbon footprint?

        by ban nock on Fri Nov 16, 2012 at 07:25:34 AM PST

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        •  I am a nurse and work with many hospitalists (3+ / 0-)

          and general practice doctors. The kind that we as a country need more of.  These Physicians do not have third houses in the Caribbean, not even close. They make a good living, but they also pay high insurance rates, they employ and pay a staff at their offices, and the more we make it uneconomical to accept medicare patients the more medicare patients will have to go to larger clinics where they receive less personal attention. Medicare needs to be able to pay an amount that fits the cost of a patient for the office/hospital.

    •  Docs will take private insurance (8+ / 0-)

      Hospitals and doctors who serve poor and old people will fail because the costs of serving those patients are high.

      Hospitals and docs that serve young people with insurance will do very well if Medicare and Medicaid cuts go ahead.

      Single payer and systemic restructuring to promote health are the solution, not cuts to services for the old and poor.

      I know this from the experience of trying to manage the business side of a solo medical practice.

      look for my eSci diary series Thursday evening.

      by FishOutofWater on Fri Nov 16, 2012 at 07:21:13 AM PST

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    •  Some docs (6+ / 0-)

      are ditching insurance altogether and taking cash only.  Some other docs are working on a concierge program, I think they call it, where patient pay a certain amount of money per month.  Subscriber program, essentially.

      No, not all doctors will just take what they are given.  That would only happen if there was no other option or if the supply of doctors was very high in comparison to demand. And that is NOT the case, nor has it ever been in my lifetime.  

      Some kinds of docs, family docs and internal medicine docs are already accepting a pittance based on negotiated contracts.  There are other specialists who get paid a ridiculous amount, but that's another story.  And many doctors will not just accept what Medicare or insurance pays, they will bill the patient for the  difference.  So the result will be that they
      1) stop accepting Medicare and Medicaid
      2) Bill the patient for the difference resulting in more medical debt or people sacrificing other essential needs to get care
      3) Bill the patient for the difference resulting in people not getting medical care because they can't afford it

      "Justice is a commodity"

      by joanneleon on Fri Nov 16, 2012 at 07:46:18 AM PST

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      •  The point is, (0+ / 0-)

        what will providors think of an improved system?

        That is teh excercize before us: improve the system. Using past attitudes to predict reaction to improvements is shall we say contra-logical.

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