U.S. Specialty Physicians Turn Away Two-Thirds of Children With Public Insurance, Study Shows

reply to post by SusyQ30

according to an audit study of specialty physician practices in Cook County, Ill.

Think on that for a second. Consider that source. Consider the ramifications of that source. Then do a little digging yourself.

Originally posted by ExPostFacto
reply to post by Maxmars

 

Personally, to solve this dilemma I would advocate for those that wish to become doctors should be allowed to have education free of expenses. Then following their education they should be required to work off their debt by providing medical services to the public. Once their debts are repaid they can proceed to make profits; although, I would speculate many doctors get in the business because their is great pay and not because their sole reason is to help people in need. Much like lawyers now days. They want your money first, then they will help you.

Gouging is also another area that seems crazy. When one day in the hospital can fund rent for 4 years in a common rent neighborhood, something needs to done. I personally am in favor of services that are necessities to live, liberty or the pursuit thereof to operate not for any profit. It would eliminate much of the greed associated with these large organizations.

I hear you, and I kind of like the rationale behind the idea. Raise the standards of admission (i.e. no "buying" your way into medical school.... every doctor knows one) make it free; part of the doctorate involves a reasonable amount of time serving the public in their medical capacity. Once 'tenured' they are free to charge as much as they like..... let them compete... this is capitalism after all.

I suspect the predatory nature of the culture will manifest itself as it does now. It always will where materialistic consumerism is the only socially acceptable paradigm of success.

Originally posted by sonofliberty1776
reply to post by SusyQ30

 

according to an audit study of specialty physician practices in Cook County, Ill.

Think on that for a second. Consider that source. Consider the ramifications of that source. Then do a little digging yourself.

I apologize if it seems dense of me to ask. But I don't quite follow. Are you referring to Cook County? I am not familiar with the demographics there, I assumed it had to do with the scope of the research funding ...

Wanna know why?

Because when you accept Medicare payments (or other government health programs), you agree to play by their rules. If you do not choose to accept these payments, then you are not liable to their rules.

By "rules" i refer to governmental laws. If you make a mistake, you face heavy fines and possible jail time for "medicare fraud". And the hoops you have to jump through on what amounts to be an obstacle course for a billing platform make it almost guaranteed that unless you hire a specialist in medicare billing (at a hefty cost) you will be in violation of a law.

It is not worth the liability if your practice can do a brisk enough business without it. If you make a mistake with BCBS, the worst that will usually happen is a brief probationary period where you get some audits, or maybe even are not allowed to accept BCBS claims for a year. But rarely would you see jail time, unless there was just overt fraud going on.

Like many of us in the "freedom" movement, they realize that not playing by the game means you are free from government rules. That is always preferrable.

Originally posted by Maxmars

Originally posted by sonofliberty1776
reply to post by SusyQ30

 

according to an audit study of specialty physician practices in Cook County, Ill.

Think on that for a second. Consider that source. Consider the ramifications of that source. Then do a little digging yourself.

I apologize if it seems dense of me to ask. But I don't quite follow. Are you referring to Cook County? I am not familiar with the demographics there, I assumed it had to do with the scope of the research funding ...

Let's try one more bread crumb and then see if you can blaze your own trail.

Cook County is a county in the U.S. state of Illinois, with its county seat in Chicago.

Originally posted by ExPostFacto
reply to post by Maxmars

 

Personally, to solve this dilemma I would advocate for those that wish to become doctors should be allowed to have education free of expenses. Then following their education they should be required to work off their debt by providing medical services to the public. Once their debts are repaid they can proceed to make profits; although, I would speculate many doctors get in the business because their is great pay and not because their sole reason is to help people in need. Much like lawyers now days. They want your money first, then they will help you.

I see. What about their living expenses while in school? Food, car, rent etc...? Or does that hold no value?

Definition of INDENTURED SERVANT
: a person who signs and is bound by indentures to work for another for a specified time especially in return for payment of travel expenses and maintenance

So basically you propose they accept a status about one step above slavery?

Or maybe you mean this?

Debt bondage (or bonded labor) is a form of contemporary slavery in which a person pledges themselves against a loan.[1] In debt bondage, the services required to repay the debt may be undefined, and the services' duration may be undefined.[1] Debt bondage can be passed on from generation to generation.

Originally posted by Miraj
reply to post by Americanist

 

I'm sure the internet will sue your wounds shut and cut tumors out of you when you have cancer.

What ignorance.

You mean sew? It's pretty easy to sterilize and stitch together wounds with a decent first aid kit. I happen to own one. You seem to pass off history as well as the pioneers of this country. Did they require drugs causing more side effects than the actual ailment? Hardly... And as far as cancer is concerned, find some products without mercury tainted HFCS, stick to an alkaline diet, and get a full body MRI every 3-5 years. If they find something, your best bet would be to hop on the internet first. You won't be able to perform evasive surgery on yourself, but you can narrow down the proper surgery without wasting thousands of dollars and precious time.

Take my grandmother for example. She went to the doctor because the skin on her whole body became irritated and discolored. Her specialist suggested she use a petroleum-based product in the form of baby oil. Do you think baby oil properly kills fungus and bacteria, or would only exacerbate the problem? Better yet, do you think this condition would be a result of a body sweating out poison and bodily waste? To clue you in further... It happened to be the latter. She had a tumor developing in a bowel duct around her liver/ pancreas. Unfortunately, her medical condition got worse over the course of two months as she bounced between a couple of specialists (including Mr. Baby Oil himself). Perhaps if he was "sued," it might change his tune the next time around. What ignorance? How about ignorance that leads to an untimely death.

I have plenty more stories to go.

Originally posted by neo96
i hate to break it to you all

but private healthcare will always better better than public

and i am an advocate for a profit based system because if they are not making money they cant provide the goods and services and to pay and give that pro bono stuff.

every single day the healthcare industry is being told what to do and how to do and their costs rise daily.

if they are not making any money that cant provide those goods and services or hire quality doctors.

medicare and medicaid suck because they are public it stinks but thats the way it is.


turning away children does stink but in my opinion thats out of fear of the government or not having what they need to render care.

the healthcare industry is just like any other industry competition the more people competting to bring those goods and services to the market lower prices and increase the quality of what your buying constrasted by what those people get from government care.

everyone has a heart just get government out of it and stop creating the heartlessness that leads to studys like these.

my 2 cents.

edit on 16-6-2011 by neo96 because: (no reason given)

I have the perfect job for you. Be the Claims Adjuster that digs through medical files while getting paid a salary plus bonus/ commission to deny patients on any type of technicality/ pre-existing condition you can whip up.

You'd be taking a little off the top, but there's enough money privately held to build your own healthcare fund. Although, it would be a damn tragedy, if you happened to bump into one of those families afterwards. Be sure to purchase their lunch instead. It'll be cheap with less mouths to feed.

reply to post by Americanist


as opposed to the medicaid and medicare scam that makes people wait 2 hours for a 15 minute visit that charges thousands of dollars that other people have to pay for and dictates how much compensation those doctors get.

get real i really dont like people telling me what i should be doing.


i have little patience or time for posters just love to make other posters the topic of threads.

So is this going to end up degrading into the usual bickering about the evils of medicine vs the evils of socialized medicine vs the evils of the insurance companies?

It always seems that way, anyway.

Guess it doesn't matter. not much to discuss. Facts are facts, the rest is our usual conspiracy theorist conjecture, most of which if true would have caused human extinction 40 years ago.

reply to post by neo96


Just a way of explaining the subtle nuisance of your contributions to this thread along with healthcare as a for-profit industry.

I don't know about your family, but my parents are at an age to go the public route. They've also had money deducted out of their paychecks. It's only fitting they partake.

reply to post by sonofliberty1776


I wouldn't hire someone who made master and then quit improving on his craft once he got his title.
After 15 years your work is as polished as it is likely to get.

reply to post by sonofliberty1776


Yes that is what I mean, although totally voluntary of course. And if you had money and wanted the private education, go right ahead and work for the big guys that will make you tons of money to repay your debt. You are not against more competition in the medical industry are you? Afraid the prices will drop so much, the quality of healthcare will dwindle? I guess then people would have a choice on which doctor to see then. Right now there is little choice if a person has no money.

reply to post by sonofliberty1776


The source of the study is two schools out of the U of Penn. The location of the study is probably what you meant. And so what? It's Chicago. Are you going to try and tie this to Obama in some way, these doctor's refusing service to children?

I understand that Doctors take that oath and what not but that does not mean they have to work for free…or even a reduced rate just because the government arbitrarily sets one.

Imagine if other industries were run like health care – for example I run a dairy.

I make about 15-30 cents per gallon profit on the bulk milk I sell which is about a 10-12% profit margin. I sell milk to everyone at the same price regardless of their circumstance.

However, if the government were to step in and require me to say accept the vouhers they provide for milk to some people at a price that was below what it cost me to raise it because they were indigent but entitled to milk somehow; to keep the same profit margin I would have to charge all the regular customers more to compensate for this loss.

Further, if I had to treat everyone to a free glass of milk if they came into my dairy in a “milk emergency” even if they had the money to pay or not, I would have to raise prices even more and soon the regular customers would be paying a lot more for their milk to subsidize the milk for others who did not.

This is how our medical system is run – we can have the entitlement to life liberty and pursuit of happiness argument and try and locate the verbiage that entiles people to health care some other time but for now there are no provisions in the constitution that require a person to provide a service for free (regardless of what that service is) or at a reduced cost for people who are poor.

There is no provision in the constitution with regard to the collection of public funds to provide for the medical care of people of a certain status regardless of how grave their need may be. It is simply the result of a congress who wanted to help people by overstepping their bounds in the name of “for the good of the people”. That and a good dose of buying votes from teh public treasury.

I would argue that requiring doctors to accept a rate for their services that is below what they would otherwise charge is a form of indentured servitude which is prohibited under the constitution.

If a doctor has the ability to make profit and still accept Medicare, Medicaid and other government program rates then more power to them for the altruistic nature. However, if they can’t sucks to be sick and poor I guess. Every man has to eat and no man is the slave to another - we don't have any obligation to support out neighbors or to provide for them.

How many of us who are entrepreneurs would do business with people who paid you 55% or less of what the rest of your good customers paid for the same product in the name of charity and how long could you do it before your went broke. Me…not very long.

Also, like someone said, add the layers of extra hoops (regulations and standards) to the regular cost of business just for the privilege of having to accept the 55% payments from the government vouchers.

I honestly don’t know why anyone would accept the government payment schedules…I wouldn’t.

reply to post by Golf66


You set forth a weak argument. The healthcare industry has profit margins closer to nightclubs than dairy. There's also a large portion which is service related. 10-15% vs. 300-400% isn't much of a comparison now is it? Furthermore, you can always put down the drink or stop a$$ grabbing on the dance floor. Try doing the same with a life-threatening illness. Everyone is locked into the healthcare industry whether they like it or not. This isn't for personal entertainment or to enjoy cereal with... It's a continual matter of life and death.


Need I mention the sales aspect with drug reps or subsidies and research grants? Probably not...

Operating Profit Ok, I’ll keep this short and to the point. Based on simple Google searches one can scan quickly and see that the profit margins for most hospitals average 3-5% and private practice profit margins which is what the OP is addressing regarding specialty doctors is an average of 7% or so.

Private practice Average profit margin Google search

large hospital profit margin Google Search

Also here is the industry trend magazine Hospital Operating Trends
Quarterly] look at the graph the average is 3-5%.

Although hospital operating margins have remained steady over the last several years, following a cyclic pattern of increases in the first half of the year and decreases in the second half (Figure 1), they did fall slightly in the most recent year studied, from 3.3 to 2.8 percent between the third quarters of 2009 and 2010.

Further in this document America's Most Profitable Hospitals ; The evidince suggests that most hospitals barely even break even while even the most profitable do not make more than 25%.

The average American hospital barely breaks even. But some are enormous profit centers. Forbes' first-ever survey of America's most profitable hospitals reveals that some American hospitals make 25 cents or more for every $1 in patient revenue they take in.

Originally posted by AmericanistTry doing the same with a life-threatening illness. Everyone is locked into the healthcare industry whether they like it or not. This isn't for personal entertainment or to enjoy cereal with... It's a continual matter of life and death.

With regard to this comment I can say that it is entirely irrelevant what the service is or the relative need of the individual concerned there is no authority in the constitution under which the government can take money from the treasury and use it to pay for the medical expenses of those it deems to be in need.

Certainly people need health care as everyone will at some point in their lives; however, they are not entitled to receive it at a free or reduced rate.

Further, they cannot require doctors to operate at a loss so that the poor can receive care at the public expense.

Originally posted by Americanist You set forth a weak argument.

I think my argument is a pretty good one and can be applied to almost any industry by asking the simple question –

If the government paid you 55% of your asking price for a service, would you take it to serve the poor at the expense of your regular better paying customers...the answer from most businessmen would be...no.

I love runing my dairy but damed if I'll do it at a loss becasue some have a hard time affording milk.

Why should a Doctor be any different even considering their oaths they are businessmen who need to feed their families and pay their bills like the rest of us.

reply to post by Golf66


You're excluding peripherals... Ambulance service: Does literally placing someone on a gurney with an oxygen mask and transporting them 3 mins away cost $885.00? I know gas is expensive, but go ahead do the math.

Once at the hospital: Does 45 minutes in the ER with a glucose iv solution cost $2,200? Blood work at the lab billed separately for $65.00. The answer to both questions is yes it does. Where do those numbers come from though? You could step outside and bill a passerby $20.00 for just looking in your general direction. Do them a service by gracing them with your smile.

As for budgets... I know the score on accounting. Every company wants to be operating at or near a loss. It's a scam to cheat taxes. Moreover, you could easily have a $1 billion reserve then turn around and manage a $100 million budget. When you're over that $100 million you show a deficit, but of course... There's still plenty of money to burn.

Linking google with poor profit margins on hospitals really? Find out who these are owned by. What accounting firm is used? Since it's mostly all the same players involved, I'm sure you'll get something similar to GE's story.

Which leads us to the final point... Big corps, banks, etc., etc. have very little interest with fully healing anyone. There's less money involved when everybody's at the ballpark. Peal away the parasitic business model and healthcare would actually mean... Helping people at any cost. That's the true brilliance behind being alive.

Originally posted by AmericanistYou're excluding peripherals... Ambulance service: Does literally placing someone on a gurney with an oxygen mask and transporting them 3 mins away cost $885.00? I know gas is expensive, but go ahead do the math.

I appreciate your zeal; however, I am going to just go with the Forbes article that indicates most Hospitals barely break even and even the most profitable make 25%. Hardly the Night Club margin you were implicating.

As for the data - while I have neither the desire nor the time to look at the raw data they used for their study; I assume that they wrapped up all of a Hospital's services into one bundle for analysis of profit and loss since Forbes isn't really into puffing up numbers to make certain industries look better or worse. They have a pretty good reputation as a straight shooter.

Anyway, cheers - my analogy still stands; regardless of the industry any introduction of government regulation "for the good of the people" - (read that poor people) hurts business in the long run.

People do not have a right to my milk, my produce or my livestock - unless they can pay. However, some will argue that food is a human right.

People only have the right to provide for themselves what they need using their own skills and/or property or provide for their needs by exchanging skills/labor/items of value they do have for things they themselves cannot produce.

For example, people have no right to health care any more than they have a right to any other service provided by a private person unless they can pay the asking price.

In this case the government, who is overstepping the bounds of it's authority in providing health care to the indigent is not paying the asking price for the service and the providers are no longer willing to operate at a loss. I can't fault a man for that decision.

reply to post by Golf66

People do not have a right to my milk, my produce or my livestock - unless they can pay. However, some will argue that food is a human right.

People only have the right to provide for themselves what they need using their own skills and/or property or provide for their needs by exchanging skills/labor/items of value they do have for things they themselves cannot produce.

Well, at the heart of this debate the question is... What do you consider a human right? Doesn't take much common sense to realize history is riddled with conquerors. You might count those blessings of yours the dairy farm wasn't overrun by a bunch of masked gunman bent on slaughtering your entire family inside a land grab.

I'll give you rights... Might equals right. What are you going to do about it? Put up an electric fence and stay up all night? There's at least one pre-existing condition you're bound to get denied on. I'll give you one more shot, but so far you've displayed nothing but narrow-mindedness.