Doctors are fighting health insurance mergers which are putting pressure on reimbursement. What I don’t understand is that some of these physicians supper a single-payer system. Having a single entity control reimbursement will only magnify this problem.
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I agree. A single payor FOR PROFIT system is definitely not a good idea. But how about expanding medicare to cover all Americans?
lctRegarding expanding Medicare for all, I have a rather simple observation. Medicare is barely able to cover its own current obligations let alone 10 years down the line. How in the world would it manage to survive if it had to more than triple its obligation?
And cost efficiencies gained from H.I.T. is only a temporary crutch. And that’s even if the US gov’t is able to effectively organize and implement H.I.T.
The problem with a gov’t run solution is that any large gov’t run program is inherently prone to pork, and cost inflations. I think most physicians who defend universal coverage are giving the Fed’l gov’t too much credit. I for one haven’t seen any large gov’t program that actually reduces costs.
People cite that the US already spends more per capita on healthcare, even more than any other country that has a universal health system.
But do you really think the US gov’t has a successful track record versus the private sector in reducing costs and improving operating efficincies?
Aside from how many payors there are, I think everyone should pay the same price for the same service.
You can to some extent work this way now, by setting a level below which you will not accept a fee schedule, and sticking with that. If someone else is willing to work for that kind of money, let them.
What we’re seeing locally is that access to doctors in my specialty is getting tougher because of failing practices’ finances. So now we’re getting insurers who we haven’t accepted for years because of crappy fee schedules coming to us wanting to talk turkey.
I still don’t see why, if your schedule is full or mostly full, why you should talk to any of the insurers. I agree that everyone, except where you chose to extend courtesy or charity, should pay the same fair fee.
It seems that the ethical way to charge is to look at what other professionals charge for their time, look at thier training and experience, and set a fair hourly rate accordingly, and then set your fees to collect that rate, and charge the same to everyone.
It remains ever a mystery to me why, upon turning 65, the riches guy in town becomes a charity case a la Medicare fee restrictions–getting a charity rate while the uninsured working stiffs pay 2 or 3 times what he pays and keeps the practices alive that he depends upon.
It is also a mytery to me why anyone would think the government in a single payor system will be any less rapacious, arbitrary, and irrational than a private monopoly. Congress and the administrations ultimately measures the “reasonableness” of Medicares actions by the willingness of private providers to take it. As the finacial darkness deepens and the chickens continue to return to the roost, Medicare is going to squeeze more and more. As long as providers play, they will, no matter how much we cry, say that the terms must be acceptable and squeeze more.
At least now, people do have the option of opting out or rejecting Medicare altogether. It is a radical decision, but remains a possible check on the process. In a single payor system, the only out would be emmigration or a different profession.
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