A recent CNN poll showed that 80% of Americans are concerned that the new Health Care Bill will impact the deficit. So, where do we stand today? The House has a public option, while the Senate Bill doesn’t. We’ve seen the Congress claim that cuts to Medicare and CMS will result in enough savings to support the bill and will be budget neutral. Obama has made strong stances on Illegals coverage, coverage for Abortions, and most importantly in my opinion the impact to our deficit. Do you remember, “I will not sign a bill that adds one penny to the deficit”? How easy we forget, YOU LIE!, sorry I couldn’t help myself. I’d like to provide a perspective on the inner workings of Health Care reimbursement, which similar to other industries, drives the market.
One of the things that I can’t help but think about is the lack of this administration listening to the Will of the People. I feel like a majority of Americans have expressed that Jobs should be the main focus of our Administration, not Health Care. Small Business Owners are concerned about the potential impact of Government Health Care, so the decision to employ additional workers is put on the back burner until the Bill is finalized. Just like Guantanamo, putting a deadline on something like this doesn’t change the problem at hand. There are many variables impacting Health Care, from empty promises to unrealistic solutions, but the issue of the cost associated with Govt Health Care concerns 80% of Americans.
Since the Govt is banking on the reduction of fraud and waste to pay for its Bill, here’s some interesting lesser known information about how funding health care works:
- Physicians bill for services primarily based on the acuity of the patient, not on their proper diagnosis or treatment
- Providers of Health Care are paid based on contracted rates or per diem, which is reimbursed through the CMS system. If Medicare or Medicaid, there is no incentive to improve functionality or a reduction in clinical necessities.
- The cost of caring for a Medicaid patient is approximately 38% more than the reimburse amount paid by CMS
- Medicaid is controlled by each state in the union, the rates differ between states, if a state’s budget is running at a deficit (California) providers receive I.O.U ‘s. Pushing the burden of Health Care to the states is a the primary objective proposed in the House Bill to increase Medicaid availability
- Payment to Hospitals and Health Care Providers is based on the degree of illness and services needed for care. Once again there is no incentive to improve quality of care, because each Medicaid patient is cared for at a loss, and it’s commonplace for Providers to increase Medicare services to make up the costs of Medicaid
*** These are just a few common financial issues that face our Health Care system. I believe that you should be reimbursed in Health Care just as you are in other industries, by the quality of your work or what people are willing to pay in exchange for the value they recieve. While in contrast to CMS, Insurance companies are far worse, by cutting patients too soon, reducing services, etc.
The Health Care debate has become more about political clout than actually solving the problems with Health Care. If it was truly about fixing the system, our Congress would tackle the costs associated with providing appropriate services, access for the uninsured, and coverage for individuals for catastrophic care. I’m sure there will be a ton of pork and increased control by the government, which is unfortunate, because there are a lot of problems with our system. So how will all of this impact our deficit? There’s no way to tell… you can’t actually put a dollar amount on the cost of health care or predict the costs associate with adding 40 millions people to a system that doesn’t reward for quality of Health Care. I guess that’s my overall point; I believe that rewards/punishments are the biggest motivator for people, so unless we fix how reimbursement works, the scoring of Health Care becomes arbitrary. As bizarre as this sounds, Health Care, just like the Govt, is a business and for a business to succeed it must work towards profitability. If we’ve learned anything from the most recent recession, it’s that we must budget and get lean with our operations. Health Care is no different, you are naive to think that insurance companies, providers, and clinicians wouldn’t adhere their practices to allow the possibility for increased profit, and even more naive to think that the Govt wouldn’t operate the same way. As you can probably tell I’m against Health Care ‘Reform’, because I don’t think the current legislation will change the problems we have, it’s just become a clam shell game to push political ideology.
Brando,
Can you briefly explain what CMS is?
I agree with your premise, and believe there are too many issues within our complex system to think the massive overhaul they are proposing with be nothing but problematic. I think their focus is wrong and should be geared towards what you describe, “costs associated with providing appropriate services, access for the uninsured, and coverage for individuals for catastrophic care”
Also, so you dont think removing some of the profit incentive within our Health Care system would work?
I think profit is good in any business/industry, it’s hard not to question making a profit for health care, but you are still providing a service and money is a big motivator.
CMS is the payment system the Govt has for Medicare, it’s merely the entity the Govt uses for payment.
My comments are kinda all over the place, but everyday I see holes in the system and I’ve read a lot of the different Bills proposed and it’s frustrating because the problem I see, as well as others, aren’t being solved in the proposed Bills, it’s become a political Bill, more than a solving the Health Care problem Bill, it’s just another platform to disappoint me on how politics and the means are just not right.
I mostly agree with your post, although I think your ideals for government are nice in theory, but fact is govt doesn’t opperate like that.
Example- “Govt like a business and reward punishment…. motivator”
Why not… the process like you said and because our legislators are much more interested in pursuing a cause than cleaning up or cutting existing programs. You didn’t hear anyone say we should decrease the deficit with that extra money left over from the stimulus.
Do you not want any Health Care reform? …. or just this one currently being proposed.
Obama on 60 minutes last night, claimed this would be deficit nuetral. He was also asked about the complexicity of the bill… in which he replied with an excuse… “you know seven presidents have been unsuccessful in reform and we are this close”
Basically saying he doesn’t care he just wants it pushed through.
Number 1, on your list of how health care is funded really bothers me. It is the window that allows for the various charges and price inflation to enter into the health care.
Recently we saw the doctor while I was changing jobs. We were being billed as if we didnt have insurance, then it was our responsibility to go back through and have the claims picked up by our eventual coverage.
So in the process of care, I asked the doctor a few times if it was necessary to do that and how much it costs. Well that didnt go over well… He couldn’t explain any of it and sort of chastised our position and what he could do.
Well of course, the next day we recieved bills for three thousand dollars from six different departments. It was a mess and nearly impossible to tell what we paid for. We got it covered, but it shows how convaluted the payment is.
I do want reform in Health Care, but it’s absolutly ridiculous to think we can have a deficit neutral Bill. To have a platform that is based on cutting waste to pay for the Bill is “Stupid”, if it was so simple it would have already been done.
It’s upsetting to think that the Govt can operate not like a business with no accountability on spending or budgets, but that’s just reality, a sad reality. My point that if we used typical capitalism with rewards and punishment as a motivator maybe the reform could work, I see this everyday at work, where the system is abused with fraudulent billing practices, but the current system doesn’t properly improve the quality of care, which is somehow not important in all of this. The debate is consistently over costs and control, very little discussion about actually improving the quality of care provided.
I have this fear, that Obama will come out after the Bill passed and make some claim that,”Sometimes you need to concede your values or individual thoughts to pass legislation of this magnitude for the greater good” or some BS like that to make up for him allowing Illegals to have coverage, Abortions apart of the Bill, and adding to deficit, etc.
I just think that if you reward for quality of care provided in reimbursment and tackle the real issues we might be actually able to reform Health Care. It’s going to become another SS ponzi scheme.