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Re: WHOA - THIS REPORT SHOULD BLOW THE TOP OFF OF HEALTH CARE COVERAGE SYSTEM TALKS

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@Olderscout66 wrote:

@rk9152 wrote:

However, the "free for all" people have other tricks up their sleeves such as setting the charges that can be levied and approving what treatments can be given, to whom, and when.


And that is EXACTLY what the current system does, only the prices are set by people who keep their jobs by maximizing profits for their employer, NOT by people who keep their jobs by doing what's best for all Americans.

 

The reason our system delivers HALF the level of care the second most expensive system does at TWICE their cost is not because English Doctors are four times as efficient. ITS BECAUSE THEIR SYSTEM IS BASED ON DELIVERING HEALTH CARE, NOT HIGHER PROFITS.


We are not talking about English doctors, we are talking about Obamacare and it's current iteration "Medicare for all" and Obama's treatment for the old lady - "keep her comfortable".

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Re: WHOA - THIS REPORT SHOULD BLOW THE TOP OFF OF HEALTH CARE COVERAGE SYSTEM TALKS

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@rk9152 wrote:

However, the "free for all" people have other tricks up their sleeves such as setting the charges that can be levied and approving what treatments can be given, to whom, and when.


And that is EXACTLY what the current system does, only the prices are set by people who keep their jobs by maximizing profits for their employer, NOT by people who keep their jobs by doing what's best for all Americans.

 

The reason our system delivers HALF the level of care the second most expensive system does at TWICE their cost is not because English Doctors are four times as efficient. ITS BECAUSE THEIR SYSTEM IS BASED ON DELIVERING HEALTH CARE, NOT HIGHER PROFITS.

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However, the "free for all" people have other tricks up their sleeves such as setting the charges that can be levied and approving what treatments can be given, to whom, and when. You may recall that when Obama was asked about an elderly woman needing an expensive treatment, his response was to the effect of, "keep her comfortable". In other words - total control of the health care industry.

 

Now that could be called "Socialized Medicine" but it also is in keeping with the fascist economic model. And to think - it's fans love to call Conservatives "fascists".

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WHOA - THIS REPORT SHOULD BLOW THE TOP OFF OF HEALTH CARE COVERAGE SYSTEM TALKS

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RAND CORP. 05/09/2019 - Private Health Plans Pay Hospitals 241% of What Medicare Would Pay

 

Is it really possible to reduce this down?   That is al lot of difference, isn't it?  Transparency really will open our eyes, at least in this regards.  Yea, I'd say that this is Market Muscle - From the Hospitals, not Insurers.

 

An examination of U.S. hospital prices covering 25 states shows that in 2017, the prices paid to hospitals for privately insured patients averaged 241% of what Medicare would have paid, with wide variation in prices among states, according to a new RAND Corporation study.

 

Some states (Kentucky, Michigan, New York, and Pennsylvania) had average relative prices that were 150% to 200% of what Medicare paid, while other states (Colorado, Indiana, Maine, Montana, Wisconsin, and Wyoming) had average relative prices that were 250% to 300% of what Medicare would have paid.

 

. . . . . If employers and health plans participating in the study had paid hospitals using Medicare's payment formulas, total payments over the 2015-2017 period would have been reduced by $7 billion—a decline of more than 50%.

 

The RAND study found that hospital prices relative to Medicare increased rapidly from 2015 to 2017 in Colorado and Indiana, while they fell in Michigan over the same period. Prices also vary widely among hospital systems, ranging from 150% of Medicare prices at the low end to 400% of Medicare prices at the high end.

 

A large portion of private health insurance contracting for hospitals is done on a discounted-charge basis where the insurer agrees to pay a percentage of billed charges. By contrast, Medicare issues a fee schedule that determines the price it will pay for each service, with adjustments for inflation, hospital location, the severity of a patient's illness and other factors.

 

RAND researchers recommend that private insurers move away from discounted-charge contracting for hospital services and shift to contracting based on a percent of Medicare or another similar fixed-price arrangement.

 

“Employers can also encourage expanded price transparency by participating in existing state-based all payer claims databases and promoting development of such tools,” White said.

“Transparency by itself is likely to be insufficient to control costs so employers may need state or federal policy changes to rebalance negotiating leverage between hospitals and their health plans.”

 

Such legislative interventions might include placing limits on payments for out-of-network hospital care or allowing employers to buy into Medicare or another public option that pays providers based on a multiple of Medicare rates.

 

Hospitals included in the analysis are from Colorado, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maine, Michigan, Missouri, Montana, North Carolina, New Hampshire, New Mexico, New York, Ohio, Pennsylvania, Tennessee, Texas, Vermont, Washington, Wisconsin, and Wyoming.

 

Support for the study was provided by the Robert Wood Johnson Foundation, the National Institute for Health Care Reform, the Health Foundation of Greater Indianapolis and participating employers.

 

Another article located here:

KHN 05/09/2019 - Market Muscle: Study Uncovers Differences Between Medicare And Private Insurers

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