Vision of Health Care

[aodenkou]

I was doing a bit of reading on Health Care on the web and was looking at what various groups supported. I found the following information interesting and thought provoking. There were quite a few issues raised in the page I will link at the bottom of my post. But I wanted to tackle one small bit, because it really struck home.

"The safety net is seriously shredded. Millions of Americans have Medicare health insurance coverage, but physicians are not required to honor it. Medicare and Medicaid are increasingly becoming unredeemable vouchers. As a result, while a community may have an adequate supply of health care providers, few if any may be willing to see a patient with Medicare insurance, because the provider could see a patient with private health insurance and make much more money."

This is really important in my opinion. Why would a doctor refuse to take Medicare or Medicaid? I can give you specific example, and you can draw your own conclusion. I know of a number of Dentists who have accepted insurance from the State of Illinois and they have not received payment for services provided. Treatment has been completed and payment is over 6 months due, and in some cases over a year.

What if in your job you did not receive payment for your work, and had to pay all of the expenses with your work out of pocket and not get paid for 6 months to a year? How long would you work for that employer? For that matter what if you were forced to take, as an example, 20% lessfor doing the same work, and still not get paid for 6 months to a year? If you did not work for that person, would you consider yourself greedy and uncaring about others? OR, would you want to take care of your family, employees, and yourself and find another employer?

If you are interested in reading more on the policies they support, and to see if you agree with them at:
http://www.cpusa.org/search/SphinxSearchForm?Search=health+care&action_results=Search

They also have interesting reading on what they see as priorities in other national matters at: http://www.cpusa.org/search/PbpSearchForm?Search=platform+president&Author=&action_results=Go

 

[raisindot]

WOW! A B&B member promoting communism on this board!

I admire your chutzpah, sir. In the 1950's you would have had Joe McCarthy and J. Edgar Hoover at your door for promoting opinions like this. It's nice to see that we've reached a point in our political maturity that people feel confident enough to post these kinds of views without the fear of blacklisting.

Jeff in Boston (not a commie, but a believer in the rights of those who want to be).

 

[jazzman]

Please keep in mind that Medicare and Medicaid are extremely different from each other, and that dental care financing in the USA is extremely different from other types of health care financing. Most physicians are very happy with Medicare. There simply is not a problem (now) with people not receiving non-dental health care when they are in the age group covered by Medicare.

Our understanding of these complicated and controversial subjects is not helped when we confuse Medicare with Medicaid.

 

[The Nid Hog]

Our understanding of these complicated and controversial subjects is not helped when we confuse Medicare with Medicaid.

Jeez, next thing you'll be telling me is that information found on the web might be unreliable.

 

[Zenas]

Why would a doctor refuse to take Medicare or Medicaid?

You hit it in your post but I'll go ahead and repeat: because they don't always pay you.

My wife had to do an internship with a PT clinic her senior year. The clinic was required to take medicare patients and they hated doing it. Why? Medicare didn't pay but a fraction of the actual cost of the PT.

In response to the inevitable replies I will likely garner: You can revile me for questioning the current political dogma or goad me because this is one anecdotal instance, but it's clear to me that it does happen. Niether do I care that I disagree with the majority's viewpoint.

I seem to be confused by the point of the post. In it, you question the effectiveness of sociaIistic policies and then punctuate the post with promotion of sociaIism. I have never understood the human tendency to try and fix a problem by adding more of the same problem. See generally Gillete multi-blade razors.

 

[82R100]

You hit it in your post but I'll go ahead and repeat: because they don't always pay you.

My wife had to do an internship with a PT clinic her senior year. The clinic was required to take medicare patients and they hated doing it. Why? Medicare didn't pay but a fraction of the actual cost of the PT.

In response to the inevitable replies I will likely garner: You can revile me for questioning the current political dogma or goad me because this is one anecdotal instance, but it's clear to me that it does happen. Niether do I care that I disagree with the majority's viewpoint.

Isn't the amount Medicare will pay more or less pre-established? In the case you cited, it wasn't a matter of not being paid; it was a matter of the amount.

- Chris

 

[Zenas]

I am very much unconcerned with your nitpicking the anecdote, nor will I offer an apology because my wife didn't work at more clinics so she could dig some more up.

 

[mmack66]

This thread didn't even get a chance to build up steam before it derailed.

 

[82R100]

I am very much unconcerned with your nitpicking the anecdote, nor will I offer an apology because my wife didn't work at more clinics so she could dig some more up.

Wow.

 

[Bertilak]

Now why didn't anyone else think of that -- Communism will solve everything! If only some country would give it a try for, say, seventy years or so, to see how well it works out.

 

[The Nid Hog]

I seem to be confused by the point of the post. In it, you question the effectiveness of sociaIistic policies and then punctuate the post with promotion of sociaIism.

While I understand the general point of your post, I think that you're wrong in your characterization of his suggestion. In fact, he is criticizing what you might term a so......t policy and recommending a communist alternative. This is perhaps a subtle distinction, but one that bears closer consideration before response. Moreover, it is important to evaluate the distinction between so......m and what critics have termed "actually existing so......m"--I think that this goes to Robert Paulsen's point as I understand it.

Let me attach a section of Marx's September 18, 1843 letter to his friend (at least at the time of the writing) Arnold Ruge. I might cast some light on this debate. This is not an ideal translation, but one can't quibble when searching the internet:

I am glad that you have made up your mind and, ceasing to look back at the past, are turning your thoughts ahead to a new enterprise.[22] And so – to Paris, to the old university of philosophy – absit omen! [May it not be an ill omen] – and the new capital of the new world! What is necessary comes to pass. I have no doubt, therefore, that it will be possible to overcome all obstacles, the gravity of which I do not fail to recognise.

But whether the enterprise comes into being or not, in any case I shall be in Paris by the end of this month,[23] since the atmosphere here makes one a serf, and in Germany I see no scope at all for free activity.

In Germany, everything is forcibly suppressed; a real anarchy of the mind, the reign of stupidity itself, prevails there, and Zurich obeys orders from Berlin. It therefore becomes increasingly obvious that a new rallying point must be sought for truly thinking and independent minds. I am convinced that our plan would answer a real need, and after all it must be possible for real needs to be fulfilled in reality. Hence I have no doubt about the enterprise, if it is undertaken seriously.

The internal difficulties seem to be almost greater than the external obstacles. For although no doubt exists on the question of “Whence,” all the greater confusion prevails on the question of “Whither.” Not only has a state of general anarchy set in among the reformers, but everyone will have to admit to himself that he has no exact idea what the future ought to be. On the other hand, it is precisely the advantage of the new trend that we do not dogmatically anticipate the world, but only want to find the new world through criticism of the old one. Hitherto philosophers have had the solution of all riddles lying in their writing-desks, and the stupid, exoteric world had only to open its mouth for the roast pigeons of absolute knowledge to fly into it. Now philosophy has become mundane, and the most striking proof of this is that philosophical consciousness itself has been drawn into the torment of the struggle, not only externally but also internally. But, if constructing the future and settling everything for all times are not our affair, it is all the more clear what we have to accomplish at present: I am referring to ruthless criticism of all that exists, ruthless both in the sense of not being afraid of the results it arrives at and in the sense of being just as little afraid of conflict with the powers that be.

Therefore I am not in favour of raising any dogmatic banner. On the contrary, we must try to help the dogmatists to clarify their propositions for themselves. Thus, communism, in particular, is a dogmatic abstraction; in which connection, however, I am not thinking of some imaginary and possible communism, but actually existing communism as taught by Cabet, Dézamy, Weitling, etc. This communism is itself only a special expression of the humanistic principle, an expression which is still infected by its antithesis – the private system. Hence the abolition of private property and communism are by no means identical, and it is not accidental but inevitable that communism has seen other so......t doctrines – such as those of Fourier, Proudhon, etc. – arising to confront it because it is itself only a special, one-sided realisation of the so......t principle.

And the whole so......t principle in its turn is only one aspect that concerns the reality of the true human being. But we have to pay just as much attention to the other aspect, to the theoretical existence of man, and therefore to make religion, science, etc., the object of our criticism. In addition, we want to influence our contemporaries, particularly our German contemporaries. The question arises: how are we to set about it? There are two kinds of facts which are undeniable. In the first place religion, and next to it, politics, are the subjects which form the main interest of Germany today. We must take these, in whatever form they exist, as our point of departure, and not confront them with some ready-made system such as, for example, the Voyage en Icarie. [Etienne Cabet, Voyage en Icarie. Roman philosophique et social.]

Reason has always existed, but not always in a reasonable form. The critic can therefore start out from any form of theoretical and practical consciousness and from the forms peculiar to existing reality develop the true reality as its obligation and its final goal. As far as real life is concerned, it is precisely the political state – in all its modern forms – which, even where it is not yet consciously imbued with so......t demands, contains the demands of reason. And the political state does not stop there. Everywhere it assumes that reason has been realised. But precisely because of that it everywhere becomes involved in the contradiction between its ideal function and its real prerequisites.

From this conflict of the political state with itself, therefore, it is possible everywhere to develop the social truth. Just as religion is a register of the theoretical struggles of mankind, so the political state is a register of the practical struggles of mankind. Thus, the political state expresses, within the limits of its form sub specie rei publicae, [as a particular kind of state] all social struggles, needs and truths. Therefore, to take as the object of criticism a most spe......ed political question – such as the difference between a system based on social estate and one based on representation – is in no way below the hauteur des principes. [Level of principles] For this question only expresses in a political way the difference between rule by man and rule by private property. Therefore the critic not only can, but must deal with these political questions (which according to the extreme So......ts are altogether unworthy of attention). In analysing the superiority of the representative system over the social-estate system, the critic in a practical way wins the interest of a large party. By raising the representative system from its political form to the universal form and by bringing out the true significance underlying this system, the critic at the same time compels this party to go beyond its own confines, for its victory is at the same time its defeat.

Hence, nothing prevents us from making criticism of politics, participation in politics, and therefore real struggles, the starting point of our criticism, and from identifying our criticism with them. In that case we do not confront the world in a doctrinaire way with a new principle: Here is the truth, kneel down before it! We develop new principles for the world out of the world’s own principles. We do not say to the world: Cease your struggles, they are foolish; we will give you the true slogan of struggle. We merely show the world what it is really fighting for, and consciousness is something that it has to acquire, even if it does not want to.

The reform of consciousness consists only in making the world aware of its own consciousness, in awakening it out of its dream about itself, in explaining to it the meaning of its own actions. Our whole object can only be – as is also the case in Feuerbach’s criticism of religion – to give religious and philosophical questions the form corresponding to man who has become conscious of himself.

Hence, our motto must be: reform of consciousness not through dogmas, but by analysing the mystical consciousness that is unintelligible to itself, whether it manifests itself in a religious or a political form. It will then become evident that the world has long dreamed of possessing something of which it has only to be conscious in order to possess it in reality. It will become evident that it is not a question of drawing a great mental dividing line between past and future, but of realising the thoughts of the past. Lastly, it will become evident that mankind is not beginning a new work, but is consciously carrying into effect its old work.

In short, therefore, we can formulate the trend of our journal as being: self-clarification (critical philosophy) to be gained by the present time of its struggles and desires. This is a work for the world and for us. It can be only the work of united forces. It is a matter of a confession, and nothing more. In order to secure remission of its sins, mankind has only to declare them for what they actually are.

 

[KarthVader]

Well, in the case of not being the full amount by Medicare/Medicaid, I know that insurance companies don't always pay the full amount. Because of that, doctors and other mid-level providers (PAs, NPs) always bill more for a service than the actual cost. For example, if a surgical procedure actually cost $1000, the insurance company will get a bill for $3000. However, the insurance company will actually pay out a fraction of this cost.

I'm pretty sure that Medicare and Medicaid have very strict guidelines for billing and I don't believe that they are doing the same thing that insurance companies are doing.

I also read this article a while ago and I thought it would appropriate to post. Whether you are for or against universal healthcare, the article is worth a read:
http://www.nytimes.com/2010/02/09/h...scp=4&sq=hospital%20not for profit&st=cse

 

[tsmba]

"The costs do not go away simply because the government refuses to pay them".

That statement (a quote, but I cannot remember who from) pretty well sums up the problem. Many medical businesses refuse these programs because they are tired of being 1) underpaid, 2) having to wait a long time for repayment, and 3) they grow tired of the hassle. A big part of the reason so many medical expenses are high is due, both directly and indirectly, because of these massive programs.

 

[airplanedoc]

I just saw a article in the local news where many dr's are no longer offering shots of any kind. By the time cost of the shot, storage, interest payment, needle, spoilage, paperwork, etc is all factored in the Dr. loses money. Many said that storage, paperwork, and spoilage were the largest contributing factors. While I don't remember the exact figures given for one particular shot used as the example, medicare/medicade pays $70 and in total the cost of shot is $110. So now many Dr's are sending patients to the county health dept to get any shots needed.

The fact that the government is not paying their bills is not anyting new, nursing homes, schools, businesses have all been complaining for some time that the government is behind in its obligations to them.

Many school districts in our area have displayed on their digital billboards in front of the school how much the state is behind in payment and suggesting that you should call your state representive.

 

[Bertilak]

"The costs do not go away simply because the government refuses to pay them".

That statement (a quote, but I cannot remember who from) pretty well sums up the problem. Many medical businesses refuse these programs because they are tired of being 1) underpaid, 2) having to wait a long time for repayment, and 3) they grow tired of the hassle. A big part of the reason so many medical expenses are high is due, both directly and indirectly, because of these massive programs.

That's the truth.

My late father tended to pile up lots of medical bills that got sent to Medicare. These often went six months or more before the doctors would get reimbursed. It would then go to his secondary coverage to make up (some of) the difference. That could take another month at which point we would get a bill for the remainder, for something that happened over half a year ago -- something we can't even remember!

Your first impulse is to get mad at the doctor who sends such a late bill but you need to realize that he's the one who was without the money for six months or more and it isn't his fault. He has to pay for his staff, rent, insurance, supplies, etc. six months ahead. That's a lot of capital to have tied up for such a long time. And his poor office people then need to deal with irate patients calling up an asking why they STILL owe money even after paying their co-pay!

 

[TimmyBoston]

This topic already has been covered ad nauseam. This thread is already off to a very bad start. I'm not going to let it turn into an all out disaster. Thanks.