LBJ Centennial Conference on Medicare
By John Goodman Filed under Uncategorized on April 28, 2008 with 4 comments
Today I’m at the Centennial Conference on Medicare at the LBJ Library in Austin. All the usual suspects are here, and you can watch a live webcast. Here is something for you to ponder and even wager on: How many speeches will we have to listen to before someone says:
- This should be a day for atonement, not celebration, since the Trustees just announced that the unfunded liability in Medicare is $85 trillion and rising. (That’s trillion with a “t”.)
-
The only way to control health care costs is for someone to choose between health care and other uses of money.
- We cannot continue elderly entitlements based on chain-letter finance; instead, each generation must save and invest and pay its own way.
Odds are, you won’t hear anything nearly this sensible until yours truly approaches the podium around 4:00 pm.
Yes, I know. They probably won’t invite me back next year.
Heh. Hope they enjoyed your talk. 🙂
COST OF HEALTH CARE ACCESS v. HEALTH INSURANCE
In the United States ACCESS TO HEALTH CARE and HEALTH CARE COSTS are controlled by the ENORMOUS COERCIVE POWER of the Federal Government, State Governments, Local Governments, and the Health Care Insurance Companies.
Health Care providers are required to establish prices for their services by law.
The Government, the largest consumer of Health Care, then tells the providers that if they want to provide service to the millions of people presently covered by MEDICARE or the State’s equitant they must provide the service at the Government’s established price, a price that has no relationship to the provider’s actual cost of providing the service.
The Health Insurance Companies then tell the Health Care Provider that if they want to provide services their insured they must accept an arbitrary set discounted amount and pre-set co-pay and/or co-insurance amounts, again with no regard to thr provider’s actual cost of providing the service.
Te un-insured are then left to pay the price established by law and if the can not pay have their account sold to a collection company a discount. The Collection Company then bills the recipient of the Health Care at the full price at a 21% or higher compound interest rate.
I can not envision a MORE COERCIVE nor MORE OPPRESSIVE Health Care Delivery System.
Example hospital claim:
Total $ 8,555.00 Ins Paid: $ 344.50 Co-Pay $ 30.00
$18,852.52 $1,166.00 $150.00
What is wrong with everyone paying the same price for the same service to the same Health Care Provider? What free market Health Care – that’s absurd! What would all the government employees and contract employees do.
Health Insurance could become just that and no longer discounted access to health care.
A Health Insurance Policy would provide payment of a maximum amount of health care for a given premium. Ye, I would welcome some Government involvement in the construction of the insurance pool. The concept of insurance is to spread the risk across as large a pool as possible. If Health Insurance covered all health Care including accidents, genetics, life style induced care. There would be no subrogation of claims and thus fewer legal costs.
Government organizations could subsidize the costs related to life style induced care by by taxes on Cigarette Manufactures, increases license fees for cycle riders without helmets/protective equipment, taxes on high-risk amusement activities. Etc.
Government’s could also assist any below the poverty level with the purchase of Health Insurance.
Government’s and local or national charitable organizations could help those in need pay any co-pay or coinsurance.
No medical bill from any provider would be marketable. I would expect that the Health Care provider’s rate calculation would include a calculation for write-off of un-collectable bills.
Might this approach give the Health Care Consumer more say in who their the Health Care Provider(s) are based on the cost of service. Would this alone help to drive down costs?
Perhaps another approach would be for corporates to invest in health funding mechanisms such as special purpose health funding trusts. There are many innovative ways that this could be accomplished and robust and sustainable models that could be adopted, that would not tax those that were unable to afford health services.
What is wrong with everyone paying the same price for the same service to the same Health Care Provider?
The uninsured and underinsured should qualify for lower prices based on the mass, however, unfortunately, they only account for about 5% of the national hospital bill (most recently published HCCUP data). Should the amount of healthcare expenditure of these groups collectively equal or exceed the level of private health care, then through collective bargaining, it may be possible to those that are uninsured and underinsured to end up paying less than those that are insured privately, for hospital services.