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View Diary: Now this is a HCR Floor Speech I can Support!!! (314 comments)

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  •  Dallasdoc, question? What impact would this have (2+ / 0-)
    Recommended by:
    Bridge Master, divineorder

    on the physicians and hospitals regarding their present cost structures?

    Some providers are unhappy with Medicare payouts now, but if there were a major shift of the populace toward Medicare I can see the cost of medical care soon shifting down significantly as a large proportion of patients would be covered by Medicare and - well, volume matters - otherwise they'd be restricted to a much smaller universe of patients and possible much lower income.


    •  Medicare needs to be fixed (0+ / 0-)

      Medicare rates are less than private insurers, but many providers like it because it doesn't  impose a lot of arbitrary and frequently-changing rules.  Medicare rules are followed by everybody else, and they tend to be stable.

      The biggest problem with Medicare is that Congress periodically plays chicken with pay rates, imposing significant cuts in budget bills and then arguing over unrelated items using Medicare pay cuts as a cudgel to beat each other over the heads with.  This drives docs and hospital administrators nuts, because they don't understand it's all kabuki and it will be ironed out in the end.  It just imposes cash flow problems for providers.

      If Medicare became a bigger program, there would be more pressure for Congress to fix this game of chicken.  Fixes have been proposed over and over again, including in various versions of this health care reform bill, but they've never passed.  Congress finds the leverage that playing chicken with providers' pay gives them too useful.

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