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retrofade

Medicare for all would... save money?

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2 minutes ago, Jack Bauer said:

I wouldn't take medicare or medicaid if I had my own practice.  They pay/reimburse fine for preventative stuff, but they are a total pita to work with if you want a scan or procedure approved.  They want you to try outdated and nonsense treatments sometimes before they will approve the treatment you want.  I hate dealing with them.    

I'd be shocked if they saved money, I think those projections are bullshit.

Those are the reasons why my dad only accepts a certain percentage of medicare patients. He's a board member of a multi-speciality practice, and they decided to meet some medicare minimum in exchange for x reimbursement. I'm not privy to the details involved obviously though. That being said, he only accepts the minimum required percentage of medicare/medicaid [patients.

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4 minutes ago, Akkula said:

Well...then...how is capitalism supposed to work if there is no demand curve.  What if all the surgeons just got together and said you had to pay all of your money?  I guess we should feel lucky that the medical community just sets the prices at a very painful level but doesn't take 100% of our money....since money is no object....right?  When you have no ability to walk away from a deal if the price gets to high a market based system kinda falls apart...right?

Please google price elasticity of demand. 

If the surgeons got together and said we want all your money for surgery very few people would pay and they would have less money. 

 

 

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Just now, retrofade said:

Those are the reasons why my dad only accepts a certain percentage of medicare patients. He's a board member of a multi-speciality practice, and they decided to meet some medicare minimum in exchange for x reimbursement. I'm not privy to the details involved obviously though. 

Sure.  That's what we see a lot of with them.  In particular, with Medcaid and adults on medicaid.  It makes no sense to play ball with them when you can have a nice, easy private insurance to work with that does pretty much everything in better fashion than Medicaid.  

Many physicians in the multi specialty clinic where I work significant limit or don't accept any adults on medicaid, and limit Medicare.

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1 minute ago, bornontheblue said:

Please google price elasticity of demand. 

If the surgeons got together and said we want all your money for surgery very few people would pay and they would have less money. 

 

 

Please...I have a masters degree in economics.  This is the classic inelastic demand curve where the price has no bearing on the quantity of service demanded.  That was my point.

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3 minutes ago, Akkula said:

Please...I have a masters degree in economics.  This is the classic inelastic demand curve where the price has no bearing on the quantity of service demanded.  That was my point.

So if they charged 500 billion dollars paid in cash upfront for an appendectomy you argue people would pay it? 

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Just now, bornontheblue said:

So if they charged 500 billion dollars paid in cash upfront for an appendectomy you argue people would pay it? 

No...because it is subject to a budget constraint of the purchaser...but they could theoretically ask for 100% of that person's money and borrowing ability...right?  If your choice was death or paying 100% of your money what choice do you have?  Imagine if there was only one surgeon who could perform the surgery.  He could charge you 100%.  The only reason they don't charge that much is that there are other surgeons who compete with them.  The point of the article I posted earlier is that the medical community acts like a cartel to restrict supply of doctors to keep wages high.  

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23 minutes ago, Akkula said:

No...because it is subject to a budget constraint of the purchaser...but they could theoretically ask for 100% of that person's money and borrowing ability...right?  If your choice was death or paying 100% of your money what choice do you have?  Imagine if there was only one surgeon who could perform the surgery.  He could charge you 100%.  The only reason they don't charge that much is that there are other surgeons who compete with them.  The point of the article I posted earlier is that the medical community acts like a cartel to restrict supply of doctors to keep wages high.  

Doctors salary are only a very small part of the health care pie.  You can't be this dumb.

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3 minutes ago, Jack Bauer said:

Doctors salary are only a very small part of the health care pie.  You can't be this dumb.

I understand you have a vested interest in saying "move along...nothing to see here" but salaries are part of the problems....just like cartel drug pricing....defensive medicine...malpractice insurance costs....health insurance.  The biggest reason that insurance premiums are going up is because the cost of care is so high in the USA in comparison to the rest of the world.

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16 minutes ago, Akkula said:

I understand you have a vested interest in saying "move along...nothing to see here" but salaries are part of the problems....just like cartel drug pricing....defensive medicine...malpractice insurance costs....health insurance.  The biggest reason that insurance premiums are going up is because the cost of care is so high in the USA in comparison to the rest of the world.

Doctors salaries are around 10 percent of the pie after the cost invested back in to the practice for maintaining the business.  You decrease physician salaries, and they'll just go back to school or find something else to do.  Most of them are bright people, after all, and don't want idiots like you dictating what we make after years and years of training, debt, and sacrifice to reach where we are at.

Your scenario is so colossally dumb (why not charge 100%?) that it would never occur.  There are always other options for people who will perform your procedure out of pocket or in a concierge service, often at a cost less than what insurance companies would reimburse.

You can't have it both ways.  You want government control on this, yet fail to realize the government control is why things are inefficient, cumbersome, and the reason why insurance companies are not really competing.  Special interests, as usual, are heavily involved in this and are responsible for the cost.  We can't trust the government to actually do the right thing.

You're probably the one who should "move along, nothing to see here" given your minimal understanding of what's really going on.

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46 minutes ago, Akkula said:

I understand you have a vested interest in saying "move along...nothing to see here" but salaries are part of the problems....just like cartel drug pricing....defensive medicine...malpractice insurance costs....health insurance.  The biggest reason that insurance premiums are going up is because the cost of care is so high in the USA in comparison to the rest of the world.

My man. Doctors are by far the profession with the single most requirements in this country. If the people who are becoming doctors don't become doctors, they'll become very well paid lawyers or accountants or stock brokers. these are the cream. I mean, doctors have to be on top of their game in undergrad and then go to 5 years of tough, competitive school to be qualified to spend another what, 3-8 years often working 80+ hours a week to be able to start making money? Nobody does else does that, it's almost a decade of tertiary education and then years of effective on the job training, but unlike engineers, that on the job training isn't taught at the end salary of a doctor, it is a relatively paltry amount. Again, that's the minimum.

Highly trained people with schools in demand deserve to be paid

Remember that every argument you have with someone on MWCboard is actually the continuation of a different argument they had with someone else also on MWCboard. 

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6 minutes ago, happycamper said:

My man. Doctors are by far the profession with the single most requirements in this country. If the people who are becoming doctors don't become doctors, they'll become very well paid lawyers or accountants or stock brokers. these are the cream. I mean, doctors have to be on top of their game in undergrad and then go to 5 years of tough, competitive school to be qualified to spend another what, 3-8 years often working 80+ hours a week to be able to start making money? Nobody does else does that, it's almost a decade of tertiary education and then years of effective on the job training, but unlike engineers, that on the job training isn't taught at the end salary of a doctor, it is a relatively paltry amount. Again, that's the minimum.

Highly trained people who work on other people with much at stake and with schools in demand deserve to be paid

Let's cut the pay.  It'll help these problems so much.  Also, see bolded.

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2 hours ago, Akkula said:

Please...I have a masters degree in economics.  This is the classic inelastic demand curve where the price has no bearing on the quantity of service demanded.  That was my point.

LOL. 6 months ago it was a master in accounting a year ago it was a masters in computer science. You are so full of shit.

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1 hour ago, happycamper said:

My man. Doctors are by far the profession with the single most requirements in this country. If the people who are becoming doctors don't become doctors, they'll become very well paid lawyers or accountants or stock brokers. these are the cream. I mean, doctors have to be on top of their game in undergrad and then go to 5 years of tough, competitive school to be qualified to spend another what, 3-8 years often working 80+ hours a week to be able to start making money? Nobody does else does that, it's almost a decade of tertiary education and then years of effective on the job training, but unlike engineers, that on the job training isn't taught at the end salary of a doctor, it is a relatively paltry amount. Again, that's the minimum.

Highly trained people with schools in demand deserve to be paid

What about from each according to their ability and to each according to their need?  Everybody should just be given a flat 40k from the state each year.  Problem solved!

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On 7/31/2018 at 6:37 AM, retrofade said:

I read the original study. They are making huge assumptions in their calculations. They are using a 4 percent administrative cost in an industry that has a 20 percent cap on costs. Considering that replacing private insurance without any government infrastructure with respect to delivering services is hardly a small number that they don't account for. Few people realize that Medicare is basically a check writer. They contract with third parties for everything from administrative services to research to delivery of care and everything in between. They have no hospitals, no doctors, no pharmacies etc... People really can't be serious about these numbers...can they?

As an aside, the German system could work here if you got rid of plaintiffs attorneys or at least some type of loser pays tort reform.

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23 minutes ago, halfmanhalfbronco said:

What about from each according to their ability and to each according to their need?  Everybody should just be given a flat 40k from the state each year.  Problem solved!

Universal basic income, der, uh, er......................

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18 minutes ago, NMpackalum said:

I read the original study. They are making huge assumptions in their calculations. They are using a 4 percent administrative cost in an industry that has a 20 percent cap on costs. Considering that replacing private insurance without any government infrastructure with respect to delivering services is hardly a small number that they don't account for. Few people realize that Medicare is basically a check writer. They contract with third parties for everything from administrative services to research to delivery of care and everything in between. They have no hospitals, no doctors, no pharmacies etc... People really can't be serious about these numbers...can they?

As an aside, the German system could work here if you got rid of plaintiffs attorneys or at least some type of loser pays tort reform.

Their assumptions were a bit ambitious, to say the least.

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Just now, Jack Bauer said:

Universal basic income, der, uh, er......................

Wouldn't work.  UBI proposes every gets some money but that the bourgeois can still make money on top of that.  We need to get rid of the evil that is profit incentive completely.  Everybody gets 40k.  No more no less.  We will all be equal. 

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