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Today, about 13 percent of Americans are over age 65. By 2030, more than 20 percent of Americans will be in that group. By 2050, about 89 million Americans will be over age 65, more than double the number today. Source
Originally posted by crimvelvet
I have read through this entire post and I have a few questions. I am hoping the people who did the research can clarify these points.
First hospitals, nursing homes etc are going to be looked at in terms of "quality " of care. Those that do not meet standards are cut from the government program. Is this correct?
Doctors and their families may keep their investments in hospitals and other facilities but they may not INCREASE that investment. In other words doctors can not put another dime into facilities. Is this correct?
Hospitals are not allowed to add operating rooms or patient rooms. The loop hole is community demand. This means either an advertising campaign to gain support or waiting times so long it gets the general population's attention. Is this correct?
Did anyone see anything about how new hospitals are going to be built, old hospitals are going to be repaired or how new state of the art equipment is going to be purchased? Is this going to be done by the government or private enterprise?
I do not see the mechanism that allows new facilities to be built and older facilities to be brought up to date. More importantly I do not see HOW it will be paid for.
Second topic: I see several additional programs added to basic health care. First the perscription change another poster mentioned also:
1. End of life counciling every 5 years. That may not seem like much until you look at this
Today, about 13 percent of Americans are over age 65. By 2030, more than 20 percent of Americans will be in that group. By 2050, about 89 million Americans will be over age 65, more than double the number today. Source
That looks like over 40 million additional consultations in the first year if all those over 65 receive the mandatory talk and 5 to 10 million a year there after. Where are the doctors performing these consultations coming from and who is paying?
2. Home parenting visits. I think this is something brand new. How are these people being trained and where are they coming from?
3. Expanded health care at schools. Who pays for the facilities? Where do the doctors come from?
4. Task force to track and analyze medical devices. This looks like it will be a HUGE on going study. where do the doctors/researchers come from? Who is paying for the trust that funds this.
5. Preventative care studies (and implementation) This looks like another HUGE on going study.
6. Quality of care and whether a treatment actually works. Again both of these are HUGE on going studies. Where do the doctors/researchers come from? Who is paying for the studies.
With all these additions to the cost of "healthcare Insurance" I do not see how the actual costs to the consumer will go down without denying care to the elderly at the very least. I also do not see where new hospitals to replace the old are coming from. No Venture Capitalist is going to front the money and if the government is trying to hold down costs, building new facilities and buying new equipment is going to be very low priority. Also if a treatment is new how do you show the government gate keepers it works without it being implemented so the gate keepers can do their study thing (#5 above)
My biggest question is how this is going to be paid for. The USA just got her credit card yanked, foreigners will not buy any more of the US of A's treasury bonds. US citizens are hurting so they are not buying bonds and with increasing unemployment overall tax revenue is down. If this program wipes out private insurance and this program tanks what happens to the US citizens health care?
An additional tax of 6% for $50,000 a year generates 3000 dollars in additional revenue. That will not buy health insurance. When I was self insured I was paying 500 a month and that was over ten years ago. I just can not see this costing Americans less than 15% to 20% in actual taxes. A tax on your employers payroll is really a tax on you because he will adjust his wages accordingly or go out of business. (Business taxes are the way Congress hides the true cost of a program, with the side effect of driving business overseas.) Again any comments?
Originally posted by Jenna
Originally posted by exile1981
Actually I take it to mean that if I own company A and I higher company B to do work for me under contract then the amount of my payroll and the amount paid to B will be combined as far as determining my tax rate. I think this is to stop someone from making all of there employees contract employees and thereby reducing "payroll" and tax rate.
You could be right. I've never had to mess with payroll, aside from being on the receiving end of it , so I don't understand the mechanics of it aside from the basics. I didn't know that payroll could be reduced by calling your employees contractors.
Originally posted by crimvelvet
I have read through this entire post and I have a few questions. I am hoping the people who did the research can clarify these points.
2. Home parenting visits. I think this is something brand new. How are these people being trained and where are they coming from?
2. Home parenting visits. I think this is something brand new. How are these people being trained and where are they coming from?
The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State—
‘‘(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
‘‘(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
‘‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that—
‘‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;
‘‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;....
15 SEC. 155. SEVERABILITY.
16 If any provision of this Act, or any application of such
17 provision to any person or circumstance, is held to be un
18 constitutional, the remainder of the provisions of this Act
19 and the application of the provision to any other person
20 or circumstance shall not be affected.
I know one doctor who’s quit taking payment from insurance programs, and quit carrying malpractice insurance. He’s transferred his assets to his wife’s name in an attempt to render himself “judgment proof”. (He has a notice at the front desk warning all comers of this. Those who object are welcome to take their business elsewhere.) But his charges are quite low, since he doesn’t have to split them with a malpractice insurance provider.
Whether this is effective or not … I’m not prepared to say. It hasn’t been tested yet. But in a big way, he’s definitely dropped out of the system.
I accepted Medicaid for about 2 months of my practice. Even thought the reimbursement was substantially lower than my stingiest insurance, I figured it would allow me to treat kids that needed it and at least cover my staff costs. How wrong I was. They denied procedures all the time, delayed billing ( I didn’t get paid for up to 8 months post-op) and were a pain in the ass generally. The support was rude and clueless. Now insurance companies suck too, but Medicaid was like dealing with Nazi nurse Wratched. So I dropped out and now just see poor kids for free. No way in the world I will ever deal with a Government controlled care system again. Ever.
If we want to create shortages of medical services here in the US, single-payer care is the way to go. The red tape of Medicare and Medicaid is already creating such shortages among those patients the system is designed to help.
Hells Bells Captain, that’s pretty much the whole (unstated) point of nationalized health care in the first place. Why are you surprised? The point is to ration health care. One way of doing that is to explicitly refuse to pay for various tests and treatments. But, another is to just make it plain hard for patients to get in to see a doctor. That’s something that the HMOs have done for many years by refusing to allow certain competent physicians on their panels even though those physicians would have been happy to accept the level of reimbursement the HMO was offering.
This is a disaster waiting to happen. Americans are not going to tolerate the kind of system they have in Canada or the UK. Too bad most of them won’t have a choice. I don’t think the Democratic Party has any idea how much damage nationalizing health care is going to do to them.
I am the head of a Nuclear Medicine department here in East Texas. We recently stopped doing Octreotide studies, a cancer and infection-seeking test we had offered for more than 19 years because our cost for the procedure was about $1500.00 and our reimbursements were south of $700.00. Even with the hospital donating all services, we were losing money on the Indium 111 radioactive dose. After losing tens of thousands of dollars in 2008 on this procedure, I was informed that we no longer offered this service. Now my patients are referred to a facility 60 miles away, a difficult and uncomfortable drive if you are sick and miserable. I don’t blame my hospital; we are laying off and cutting costs just to stay viable in our network. We know who is to blame; Medicare and Medicaid reimbursement.
It’s not just that doctors stop seeing Medicare patients. Sometimes, hospitals stop doing procedures which Medicare will not reimburse them for. I remember when the hospital I worked for stopped doing cataract surgery because we had so many Medicare patients, and the reimbursement didn’t begin to cover the expense. So we stopped doing them. I believe we are doing them again now, but it’s because we now have a smaller percentage of Medicare patients.