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Posts Tagged ‘Medicare

Health Care Reform Helps Insurance Companies Profit

We could subsidize Health Care service providers:

The cost of giving every licensed physician $100,000 would only be $90 billion per year.  This sounds ridiculous and expensive.  Ninety billion dollars spent with no detailed government oversight. People would have to pay co-pays and buy medical insurance without Government assistance.  Poor folk would get the same care without a lot of paperwork.  Dissolving Medicare and Medicaid would allow a free market to sell services for about fifty bucks a month per person. Yes, current payroll deductions would continue in order to augment compensation for all medical personnel relegating catastrophic health insurance to be bundled with car and home insurance schemes.


No one seems to like the idea of giving tax dollars to doctors, nurses, and healthcare professionals.  No…, no, no, we can’t do that–our politicians, (and voters), would rather give insurance companies your tax dollars.  The enlightened goal is to provide everyone with a ‘plan’.  We are fated to accept the voters demand for subsidized health care insurance.

Payment of your medical bills gives dividends to stockholders and companies who are in business to make a profit.  They need to give higher dividends, don’t they?  After all, the yearly compensation for the Aetna CEO was a paltry twenty-seven million in 2016.  Stock options helped a lot.

Our health plans subsidize insurance companies in order for them to make money from your illness.  Sounds harsh, doesn’t it?  Your medical bill – if you can figure it out – includes profit for the stockholders, compensation for insurance sales persons, insurance executives pay, insurance buildings, advertising costs, and finally – your doctor’s salary.  The bookkeeping and bureaucratic overhead alone adds only about thirty percent to your bill.  The government argues that their portion of overhead is low.  That bears some truth because the bureaucratic efforts are made by the providers, (more on that later).  The government must ensure the fair and correct spending of your taxpayer dollars and their oversight requires massive record keeping and the development of forms.  Just remember–the government is here to help… to help…to help.

Some details collected from Justfacts.com:

Roughly, 60 minutes of paperwork are performed for every hour of emergency department care, 36 minutes of paperwork for every hour of surgery and acute inpatient care, 30 minutes of paperwork for every hour of skilled nursing care, and 48 minutes of paperwork for every hour of home health care. “Each time a physician orders a test or a procedure, the physician documents the order in the patient’s record. But the government requires additional documentation to prove the necessity for the test or procedure.”

  • “Many forms … must be completed daily by clinical staff to submit to the government to justify the care provided to skilled nursing facility patients.”
  • Medicare and Medicaid “rules and instructions” are more than 130,000 pages (three times larger than the IRS code and its associated regulations), and “medical records must be reviewed by at least four people to ensure compliance” with Medicare program requirements.
  • “A Medicare patient arriving at the emergency department is required to review and sign eight different forms—just for Medicare alone.”
  • “Each time a patient is discharged, even if only from the acute unit of the hospital to the on-site skilled nursing unit, multiple care providers must write a discharge plan for the patient. This documentation, as long as 30 pages, applies to all patients, regardless of the complexity of care received within the hospital or required post-hospital setting.”
  • In addition to regulation by state and local agencies and private accrediting organizations, hospitals are regulated by nearly 30 federal agencies.

Our government cannot think about giving tax dollars to health care professionals when paper pushers are more necessary to guarantee profits for insurance companies.  The massive government database contains items for every illness to include getting bitten by a duck or walking into a lamppost. They even have an item designation for walking into a lamppost for the second time.  Yes, the government will document your lamppost ‘problem’.

Who pays for all this?  You do.  Does the doctor really make out financially?  The admin persons at the hospital can make more than a surgeon.  Do you want that Admin professional in the operating room?  Don’t worry – admin is always there in spirit.  Someone must ensure the stockholders make a profit.  Is your deductible paid?  How much will the government kick in?  Does the patient ‘plan’ ensure this procedure is cost effective?  Everyone should be concerned with the last statement.  What happens if the procedure is not cost effective?   Does the cost/benefit/risk analysis allow a bone marrow transplant for a patient deemed terminal, (without one)?  Ask the insurance company or hospital admin – the only case I know of concerns a deceased mother of two who did not meet the criteria.

Whatever health care system you like should exclude stockholder dividends.  Your bill should not include a dividend to stockholders gambling on making money from your illness.  Some CEO should not be making millions each year by managing insurance schemes that profit from people requiring medical attention.  People are actually demanding government-sponsored monopolies because politicians tell them there is nowhere else to go and no other method of eliciting professional service.

All hospitals, including Non-profits, currently absorb the costs of services provided to the poor.  (Insurance covers costs in order to make a profit and do not include non-paying patients).  For example: According to the research by the research of Craig Garthwaite, Tal Gross and Matthew J. Notowidigdo, the cost of each poor patient in Tennessee is over a thousand dollars.  The hospitals lose money unless Medicaid shares the burden.  Your taxes pay for that as well.

A single payer plan will allow the Government to ‘help’ everyone by raising taxes and dictating the costs of all benefits.  ‘Medicare for all’ is a mantra for single payer advocates.  Sounds good, doesn’t it?  Cuba and Canada enjoy the benefits of single payer.  You may experience Canadian relatives taking residence in the USA in order to get medical attention but such activities would never happen if Our government took over health care and dictated the compensation to all medical providers.  Our government has a proven and cost effective record of … ‘helping’.  You can relax and feel secure when your doctor enters the operating room and tells you, “I’m from the government.  I’m here to help.”  Hopefully, you can understand the language used.

Twenty percent of our doctors currently come from foreign countries and there is a predicted shortage of doctors in our future but never fear – government insurance schemes will provide succor and it will only cost a couple TRILLION dollars.  Of course, we may have to deal with the government directing our lifestyles in order to keep premiums low and profits, um, manageable. Drinking soft drinks and eating meat may become as unhealthy as owning guns.  Government mandated bicycles could replace electric cars and who would want to go to school for 14 years to become a low paid doctor employed by the government?  A small increase in taxes, perhaps an extra TRILLION, might cover the expense but don’t worry, we can always raise taxes.

Now may we discuss subsidizing the providers instead of subsidizing insurance companies run for profit and controlled by government bureaucrats?


Medical Insurance

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Who pays for it? Everyone. It is a federal deduction that has no maximum limit although it is higher for those making over 200k per annum. Medicare and Medicaid are both insurance schemes that can be easily confused since both are considered entitlements. Medicaid is concerned with people having very low incomes while Medicare is offered for those over 65 years of age and can be identified by the tax automatically removed in each of your paychecks.
France and Italy rank first and second for medical care in the world. The World Health Organization Ranks the USA as 38th, although we are number one in per capita expenditures. Expenditures for France rank 4th and Italy ranks 11th in cost per person.
The key factor for universal health coverage is that everyone must contribute in order to have a viable national health care system. In America, everyone who works and pays taxes, contributes into our health care system as well as the social security retirement system. It should be observed that almost everyone seems to enjoy the socialist aspects of our country’s current health and retirement entitlements.
Historic Medicare costs or payouts, if you want to look at it that way, are much lower than private health insurance costs by over 25%. The federal VA also has a much better record at buying pharmaceuticals at lower prices. Overall, the Medicare system offers health services for less money than private insurers. There are quite a few reasons for higher health care costs in the private market but this demonstrates a rare occurrence where Government Management actually performs better, (cost wise), than the private purveyors. Since government run programs tend to be excessive in cost – there should be some room for improvement in both areas.
Admittedly, Obamacare was not the right answer to lower costs but the goal was desirable, albeit ineptly designed, administered, and executed under false pretenses. Perhaps, the strict adherence to a form of insurance concept may be part of the problem. Why sell insurance when we could simply pay for services and allow co-pays to be determined by the medical practitioners? By doing so, we could employ both socialistic and capitalistic models. Insurance can step back and offer co-pay insurance instead of examining and quantifying the cost and efficacy of each medical procedure by maintaining a database – (like entry W22.02XA – walking into a lamppost).
National health services can be achieved at a much lower cost than what we currently pay for individual medical insurance. I would recommend States or groups of States review experimental concepts that can be researched, analyzed, and implemented, using plain language regulations that anyone can understand. Paying for services instead of insurance, while including reforms in tort litigation, medical education credentials, and large volume purchasing of pharmaceuticals and equipment will significantly lower the costs of medical service.

Written by poyhonen

December 9, 2014 at 11:18 pm

Resolution for Health Care Reform

with 2 comments

I briefed Congressman Ribble about Medical Coverage Reform for the state of Wisconsin. He is thinking about my suggestions. The Tea Party Patriots asked for a one page summary so I gave them the following input.

One page is barely sufficient to accurately summarize this concept but I’ll try to give you an idea of what is suggested.
Please let me preface this summary with some information that instigated further analysis – I added up all the costs for salaries of all health care workers in our state of Wisconsin – My analysis resulted in about $8 billion.
$8B for all care workers, pharmacists, doctors, nurses, therapists, technicians, bed pan changers. Wisconsin budget and census data agreed with this order of magnitude, however, adding Social Services raised the figure to about 14 Billion. Another key piece of data is the Milwaukee Sentinel report stating that Wisconsinites had spent about 40.9 Billion Dollars on health care. (2009).
There is a glaring 32B difference in salaries of providers vs. service. Even adding social services leaves a spent cost of $26B. $26 Billion dollars for what? Energy, buildings, and equipment for one year?

Key factor: State Insurance is the wrong direction. There is a lot of data to support the purchase of services over the purchase of insurance.

We need to buy health services and abandon the costly health insurance schemes. We can purchase  services using a co-pay methodology that allows doctors to charge whatever they want for a patient co-pay, subsidized by the state, which would have maximums at a small level and outright full payment, (by the state), for expensive procedures, (heart transplants). Concrete example: with a $35 patient and state co-pay doctors having only 800 patients can make $168,000.00 per year after servicing each patient an average of three times a year. That is seeing only 10 patients per day. The total co-pay for every man, woman, child resident of Wisconsin would be less than $200 Million state funded dollars. Ok I’ll stop the preamble here.

Health Care Summary for Wisconsin

Health Services are paid by customer co-pay and State per visit – Minimal Records
Existing health dollars are folded into the new State Health Fund
Medicare, Medicaid, Badger Care, any Federal funding, etc.
Doctors and Patients keep Health records – Doctors bill State for co-pay subsidy.
State buys Equipment, Hospitals, (as needed), Pharmaceuticals, Energy, and vehicles.
All services require co-pay, low income co-pay is determined by the doctor.
State co-pay is a flat rate,($35), but Certain areas may require higher co-pay by State – Option
No Wisconsin resident will be turned away. (State and physician Contract).
Patients can use any insurance (except Medicaid/Medicare) the servicers will accept.
Fees are paid upfront and patient bills insurance company for reimbursement.
Other than Hospitals and major equipment, servicers pay for office facilities.
No limit on number of patients per doctor
Discard B.S. degree requirement for credentials – Exam requirement is acceptable.
Consider giving all facilities non-profit status.
Execute Paul Ryan Tort reform.
Servicing out of state patients does not garner State co-pay.
Discard existing regulations and regulatory agencies, Wisconsin Health Board will make new regulations as needed Wisconsin physicians will be certified by the Wisconsin Health Board.
Lower requirements for licensed health care professionals.
I am trying to keep it short so I’ll stop at this summary. Make changes, ask questions, and share with your representatives!
Mark Poyhonen
Crivitz, WI