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U.S. companies hoard record amount of cash

We are not just talking about big corporate hospitals like the Cleveland Clinic, Sport. Most medicare patients don't go there. We are talking about the average medicare patient who makes a routine appointment with an average doctor who treats medicare patients usually at his own practice. He/she is now being reimbursed at a rate less then it costs to actually treat them. He/she is billing for service provided and cannot wait around for "outcome based reimbursement". He has to pay the light bill, business taxes, nurses, rent, supplies, etc. The result is that a significant number of doctors are now foregoing taking on new medicare patients. This is quickly leading to a shortage of medicare doctors.

Just simply not true.

At least in the real world we all live in, as opposed to the fake ACA disaster land you imagine yourself in.
 
and before it. wage stagnation is nothing new.

View attachment 67182681

As Mark Twain said: There are lies, damned lies and then statistics.

So we understand this meme about average hourly compensation. Have you ever actually thought about it for a second. Do you know a teacher, firefighter, union electrician, accountant working at the same job for 20 years to get no raises for 20 years.

The truth of the matter the reality is that people who have had stable careers in just about anything fared much better than the above chart suggests.

Then you have many displaced workers. Thanks to American greed we traded cheaper shirts and higher corporate profits for manufacturing jobs here.

So we have an economy where most people are not effected by the above, while many are faring materially worse and wish they would have done as the chart suggests.
 
Nice try, however, it is also a pathetic attempt at deflection. I am talking about the government reimbursing legitimate costs for treating medicare patients. You are bringing up examples of medicare fraud. The government does go after medicare fraud. If you had personal experience with such, you should have reported it. Reimbursing doctors who treat medicare patients at a rate less then it costs to treat them is a new concept. It is a result of the Obama Administration pulling half a trillion in funding from medicare to help finance obamacare. Do stay focused.

In the financial crisis, were many of the actions taken by Wall ST. banks really fraudulent criminal acts, or were they just "mistakes in judgement"? Was it criminal or just dumb? Can it be PROVEN in a court of law that it was criminal?

Similarly, was a test or procedure that was done "necessary" or just padding the bill? Is it fraud or just simple waste? Try to prove that in a court of law.

Medicare spending, left unchecked and growing much faster than the general rate of inflation for decades, will break the nation. What is your other plan to bring spending in line with what the nation can afford?

If the provider cannot treat the patient for the amount provided by medicare, maybe the problem is that the provider is inefficient and needs to change their process, like Cleveland Clinic has already done.

While these retail clinics are generally working to successfully solve
the value equation by providing cost-effective care for common conditions,
some traditional, trailblazing provider organizations are working
the other end of the spectrum. They are contracting with payers and
employers to treat complex conditions for entire populations
, sometimes
without regard to the geographic location of patients.

For example, the Cleveland Clinic has entered into a deal with
Lowe’s® to treat all of its complex heart patients. By bundling all
costs for the surgery under one negotiated price and offering expertise
that lowers the odds of complications, Cleveland Clinic is able
to deliver on the value-based promise: Better care at reduced costs.

In fact, the provider is able to deliver a level of savings that makes it
possible to cost-effectively fly patients, as well as family members,
into Cleveland from locations across the country—instead of allowing
a less experienced, and therefore less cost effective, local specialist
to treat them.


It’s a win-win-win for patients, employers and the hospital,” said
Michael McMillan, Cleveland Clinic’s executive director of market and
network services. “The patient has no out-of-pocket responsibility, employers
have a better long-term financial result, and we get patients
.”8
Similarly, Wal-Mart® instituted a program that flies patients and family
members to six premier providers
, including the Cleveland Clinic,
Virginia Mason Medical Center in Seattle, and Scott & White Memorial
Hospital in Temple, Texas, for heart, spine, and transplant surgery.
http://www.infor.com/content/whitepapers/preparing-for-new-value-based-world.pdf/

It is not stealing. It is about incenting providers to change the way they operate, to lower cost and still deliver high quality care. Why do you think we should spend a half trillion dollars more than we need to in order to obtain quality health care when there is clearly a better way, shown by Cleveland Clinic, who apparently is taking business away from many local hospitals by being smarter, more aggressive in cutting cost, and by monitoring quality.

I'm focused, and I'm the only one posting supporting documentation that demonstrates my position. You are merely stating personal opinions while wanting to hold onto the old system that will break the nation.

Everyone says we need to cut govt. spending, why not do it where you can cut spending without cutting services, by becoming more efficient (and by the way, a huge bipartisan majority in the house has already voted to phase in value based pricing for medicare)?

Or don't you agree that unchecked medicare growth will break the nation if costs are not brought under control?
 
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As Mark Twain said: There are lies, damned lies and then statistics.

So we understand this meme about average hourly compensation. Have you ever actually thought about it for a second. Do you know a teacher, firefighter, union electrician, accountant working at the same job for 20 years to get no raises for 20 years.

The truth of the matter the reality is that people who have had stable careers in just about anything fared much better than the above chart suggests.

Then you have many displaced workers. Thanks to American greed we traded cheaper shirts and higher corporate profits for manufacturing jobs here.

So we have an economy where most people are not effected by the above, while many are faring materially worse and wish they would have done as the chart suggests.

if we want to go with anecdotal evidence, then no, i don't know too many people whose salaries have significantly outpaced inflation. before the union was gutted by the state government, my parents received good raises working as teachers, but that has been addressed in recent years by eliminating collective bargaining. construction in my state has a common wage that they are trying to repeal, as well. i work in biotech, and my own wage has kept up with inflation, but hasn't exceeded it by much. i'm currently searching for another job in my area that will hopefully give me better upward mobility.
 
if we want to go with anecdotal evidence, then no, i don't know too many people whose salaries have significantly outpaced inflation. before the union was gutted by the state government, my parents received good raises working as teachers, but that has been addressed in recent years by eliminating collective bargaining. construction in my state has a common wage that they are trying to repeal, as well. i work in biotech, and my own wage has kept up with inflation, but hasn't exceeded it by much. i'm currently searching for another job in my area that will hopefully give me better upward mobility.

Is your chart inflation adjusted?
 
We are not just talking about big corporate hospitals like the Cleveland Clinic, Sport. Most medicare patients don't go there. We are talking about the average medicare patient who makes a routine appointment with an average doctor who treats medicare patients usually at his own practice. He/she is now being reimbursed at a rate less then it costs to actually treat them. He/she is billing for service provided and cannot wait around for "outcome based reimbursement". He has to pay the light bill, business taxes, nurses, rent, supplies, etc. The result is that a significant number of doctors are now foregoing taking on new medicare patients. This is quickly leading to a shortage of medicare doctors.

I guess you don't read the documentation, but the "doc fix" is in the house bill, Sport. see post 390.

The current “doc fix” patch, approved last March, expires at the end of the month. Without finalized congressional action, doctors will see a 21 percent drop in payments for Medicare patients beginning April 1.
Bipartisan Medicare 'Doc Fix' Bill Passes in the House - US News

And they are making the doc fix permanent.

Obamacare does NOT STEAL money from medicare, it just slows its rate of growth, it is still projected to spend almost twice as much in 2020 as it did in 2009.

The bill doesn't take money out of the current Medicare budget but, rather, it attempts to slow the program's future growth, curtailing just over $500 billion in anticipated spending increases over the next 10 years. Medicare spending will still increase, however. The nonpartisan Congressional Budget Office projects Medicare spending will reach $929 billion in 2020, up from $499 billion in actual spending in 2009.
Did President Barack Obama "steal" $500 billion from Medicare? | PolitiFact

But I guess that's not good enough for you, you'd prefer we spend even more in 2020, and increase the deficit even more. You're really making a pathetic conservative, just for the sake of trying to take a shot at Obama. I suppose hate has no limits for some...
 
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Translation: Doctors and hospitals who treat medicare patients will now be re-imbursed at a rate less then it actually costs to treat them. Efficiency does not have a damn thing to do with it.

Sounds like you're not quite getting the significance of what's going on right now. Value-based payment isn't some trick to get out of paying the tab, it's intended to fundamentally improve the way care itself is delivered. And the health sector is getting the message.

Here's the American Hospital Association explaining how this change in payment approach demands a new, better approach to caring for patients:
Myriad factors are driving hospitals and care systems to address the nonmedical determinants of population health. Most notably, the Affordable Care Act implicitly and explicitly promotes a population health management approach to care delivery. Not only does this legislation expand health insurance to a majority of the United States population, it compels hospitals to address the socioeconomic, behavioral and environmental factors that affect people before hospital admission and after discharge. The ACA is accelerating the shift of reimbursement models from fee-for-service to value-based, a structure that promotes better health outcomes, improved quality of care, illness prevention and coordination across the continuum of care. Care systems are now being held accountable for the health of their patient population and are responsible for implementing health improvement strategies to address community health needs. Adopting a population-based approach to care that encompasses the spectrum of determinants of health is essential for care systems to thrive in the ACA era.

Just last week the LA Times took at look at the construction of one of the newest hospitals, asking "how do you build a hospital for the era of Obamacare?"

The Affordable Care Act, passed in 2010, embraces the idea of reducing costly hospital visits by keeping people healthy, with checkups and inexpensive preventive treatments. Hospitals, according to this approach, should not be the centerpiece of a medical system, but rather the solution of last resort.
Under changes outlined by the Affordable Care Act, hospitals and doctors' payments are based more on keeping patients healthy. For instance, providers are paid a lump sum to take care of a patient over a period of time, so they profit when they prevent patients from getting sick, avoiding expensive care.

In a sign of the growing shift away from the traditional fee-for-service model, federal officials announced in January that Medicare, the government's biggest health insurance program, would handle half its payments based on quality of care by 2018.

Ghaly views the MLK campus as a set of concentric circles, with the hospital in the center. The facilities around the hospital are buffers sparing people the experience of spending a night amid blood-filled tubes and beeping monitors.

If you end up hospitalized, he says, "you have to be too sick for outpatient services, too sick for the preventative services, too sick for the community-based services."

"We want the hospital to be ... high-quality, safe and patient-centered," he says. "But, truly, we want no one to go."

The health system is becoming a system. And, surprise, it turns out getting people care in the most appropriate and cost-effective setting is both better for them and saves money.
 
Just simply not true.

At least in the real world we all live in, as opposed to the fake ACA disaster land you imagine yourself in.

Denying all of the bad effects of obamacare into perpetuity is not going to make you or the democrat party come off as credible.
 
Sounds like you're not quite getting the significance of what's going on right now. Value-based payment isn't some trick to get out of paying the tab, it's intended to fundamentally improve the way care itself is delivered. And the health sector is getting the message.

Here's the American Hospital Association explaining how this change in payment approach demands a new, better approach to caring for patients:


Just last week the LA Times took at look at the construction of one of the newest hospitals, asking "how do you build a hospital for the era of Obamacare?"




The health system is becoming a system. And, surprise, it turns out getting people care in the most appropriate and cost-effective setting is both better for them and saves money.




man o man you have a lot of cool aid in you....

When discussing Obamacare it is important to ignore anything the government says about it, it was after all crafted in "tortured language" to deliberately deceive "stupid voters", the CBO, and the Supreme court.
'
Looks like you are one of them and I doubt you are a Supreme court justice
 
I guess you don't read the documentation, but the "doc fix" is in the house bill, Sport. see post 390.


Bipartisan Medicare 'Doc Fix' Bill Passes in the House - US News

And they are making the doc fix permanent.

Obamacare does NOT STEAL money from medicare, it just slows its rate of growth, it is still projected to spend almost twice as much in 2020 as it did in 2009.


Did President Barack Obama "steal" $500 billion from Medicare? | PolitiFact

But I guess that's not good enough for you, you'd prefer we spend even more in 2020, and increase the deficit even more. You're really making a pathetic conservative, just for the sake of trying to take a shot at Obama. I suppose hate has no limits for some...

I would prefer that the government would reimburse me for every dollar plus interest that I was forced to pay into medicare...and I would opt out of signing up for it. It is just another government program that has been a failure from the start. Since that is not going to happen, I prefer that the government does not run doctors out of the medicare system as they are doing now. I am not impressed with:

"The legislation gives physicians a 0.5 percent bump each year through 2019. After that, payment rates would remain flat through 2025."
 
In the financial crisis, were many of the actions taken by Wall ST. banks really fraudulent criminal acts, or were they just "mistakes in judgement"? Was it criminal or just dumb? Can it be PROVEN in a court of law that it was criminal?

Similarly, was a test or procedure that was done "necessary" or just padding the bill? Is it fraud or just simple waste? Try to prove that in a court of law.

Medicare spending, left unchecked and growing much faster than the general rate of inflation for decades, will break the nation. What is your other plan to bring spending in line with what the nation can afford?

If the provider cannot treat the patient for the amount provided by medicare, maybe the problem is that the provider is inefficient and needs to change their process, like Cleveland Clinic has already done.


http://www.infor.com/content/whitepapers/preparing-for-new-value-based-world.pdf/

It is not stealing. It is about incenting providers to change the way they operate, to lower cost and still deliver high quality care. Why do you think we should spend a half trillion dollars more than we need to in order to obtain quality health care when there is clearly a better way, shown by Cleveland Clinic, who apparently is taking business away from many local hospitals by being smarter, more aggressive in cutting cost, and by monitoring quality.

I'm focused, and I'm the only one posting supporting documentation that demonstrates my position. You are merely stating personal opinions while wanting to hold onto the old system that will break the nation.

Everyone says we need to cut govt. spending, why not do it where you can cut spending without cutting services, by becoming more efficient (and by the way, a huge bipartisan majority in the house has already voted to phase in value based pricing for medicare)?

Or don't you agree that unchecked medicare growth will break the nation if costs are not brought under control?

And there ladies and gentlemen we have the dirty little dark sercret of Obamacare. From the beginning health economists have been saying Obamacare is not sustainable, and that costs were bound to rise dramatically when it was implemented, growing over a five to seven year period after introduction.

Obama has to bring those costs down, "efficiencies" in service will be the fist target, and small, independent clinics will be hit first.

Prepare for more legislative arm twisting as your government determines what is adequate treatment. This is just the beginning.

We have been through this.......
 
I would prefer that the government would reimburse me for every dollar plus interest that I was forced to pay into medicare...and I would opt out of signing up for it. It is just another government program that has been a failure from the start. Since that is not going to happen, I prefer that the government does not run doctors out of the medicare system as they are doing now. I am not impressed with:

"The legislation gives physicians a 0.5 percent bump each year through 2019. After that, payment rates would remain flat through 2025."

If the reimbursement gets too low, congress will enact a new "doc fix". They have done it every year, now we won't have to do a 21% increase over the legal rate to keep them in every year.
 
Just simply not true.

At least in the real world we all live in, as opposed to the fake ACA disaster land you imagine yourself in.



Wow...

After watching and listening for six years I find that post remarkable in it's level of self denial and "Bagdad Bob" propaganda.

From here, smugly entrenched in one of the best health care systems in the world, every prediction the "right" has made about this dog's breakfast has been true.

Every claim, every one, made by its proponents must be weighed through a sieve if five things: "you can keep your plan", it was deliberately written in"tortured language", is designed to fool the "stupid voter" and it had to be amended 22 times before being implemented AND it had to be held back until AFTER the election or Obama would not be a two term disaster.

So "fake" disaster is an outright lie.

It also has to be weighed against the fact Republicans have been saying much the same thing Canadian health economists, who clearly know a **** load more than Obama's people, and those Canadian health economics tend to be socialists.

In the end, what is being imagined is not the horror of having the worst health care plan on the planet, nor the rising costs that have yet to even impact, but rather that everything is fine, the emperor has clothes and a conscience and an iota of honesty.

When most of the word, left AND right, is on the same page and you are not, it's technicolor dream time.
 
However the democrats are still doing the "Bagdad Bob" act. Obamacare has led them to losing control of the house of reps and the senate, the majority of state governships, the majority of state legislatures, they have lost the gerrymandering advantage, yet their thoughts are:

All is well here...Hillary will be coronated, and will only have to run against Jeb Bush, and Obama is handing out amnesty to illegal immigrants like candy, and that will cause a change in demographics that will put us back in power forever :2razz:

I hope for America's sake they keep thinking that way. Hillary is quite beatable and very damaged. Get her in a one-on-one with Jeb Bush and she'll be toast.
 
And there ladies and gentlemen we have the dirty little dark sercret of Obamacare. From the beginning health economists have been saying Obamacare is not sustainable, and that costs were bound to rise dramatically when it was implemented, growing over a five to seven year period after introduction.

Obama has to bring those costs down, "efficiencies" in service will be the fist target, and small, independent clinics will be hit first.

Prepare for more legislative arm twisting as your government determines what is adequate treatment. This is just the beginning.

We have been through this.......

And your other plan was..........

Everyone wants to cut govt. spending, just nobody wants the cut to affect THEM.

Cleveland Clinic is leading the way in reorganizing how healthcare gets delivered, and it CAN be more efficient and still high quality.

My high school friend who became an MD needed a heart valve repaired, he did his research and he chose Cleveland Clinic, flew from Louisiana and he was very happy with the outcome. Houston is closer and the medical center here has renowned heart specialists (Dr. Denton Cooley did the first heart transplant in the US at St. Luke's/Houston in 1968), but for quality and cost, he chose to go to CC. That says an awful lot to me.
 
We are not just talking about big corporate hospitals like the Cleveland Clinic, Sport. Most medicare patients don't go there. We are talking about the average medicare patient who makes a routine appointment with an average doctor who treats medicare patients usually at his own practice. He/she is now being reimbursed at a rate less then it costs to actually treat them. He/she is billing for service provided and cannot wait around for "outcome based reimbursement". He has to pay the light bill, business taxes, nurses, rent, supplies, etc. The result is that a significant number of doctors are now foregoing taking on new medicare patients. This is quickly leading to a shortage of medicare doctors.

Doctors and hospitals still have a steady revenue stream, they have a cashflow under value-based payment. But they're also incentivized to re-think the organization of care delivery, the appropriateness of the care setting, and focus on the longitudinal health of their patients (not just the immediate problem presenting on a given day). Because that kind of deliberate, long-term strategic thinking about the health of their patients becomes essential to their long-term revenue.

Anyway, it isn't just Medicare--change is sweeping the industry. Looking just at accountable care organizations, they're blooming.

More and more of them are forming all over the country:

Total Public and Private Accountable Care Organizations, 2011 to January 2015
Muhlenstien-Exhibit-1.jpg


More and more people are directly impacted by them (and millions more are indirectly):

Number of ACO Covered Lives, 2011 to January 2015
Muhlenstien-Exhibit-2.jpg


And more and more health insurers (beyond Medicare) are helping to support them:

Number of Payers Participating in Accountable Care, 2011 to January 2015
Muhlestein-Exhibit-8.jpg
 
man o man you have a lot of cool aid in you....

When discussing Obamacare it is important to ignore anything the government says about it, it was after all crafted in "tortured language" to deliberately deceive "stupid voters", the CBO, and the Supreme court.
'
Looks like you are one of them and I doubt you are a Supreme court justice

I don't know what this has to do with the post you quoted. Unless you're under the impression the AHA is "the government" and not a trade association representing the nation's hospitals.

Regardless, the ongoing transformation of health care delivery is very real and readily apparent at this point. The shift toward smarter care is impacting the design of new hospital complexes, it's affecting the choices existing hospitals are making, and finally getting everyone rowing in the direction of better care and slower cost growth.
 
And your other plan was..........

Everyone wants to cut govt. spending, just nobody wants the cut to affect THEM.

Cleveland Clinic is leading the way in reorganizing how healthcare gets delivered, and it CAN be more efficient and still high quality.

My high school friend who became an MD needed a heart valve repaired, he did his research and he chose Cleveland Clinic, flew from Louisiana and he was very happy with the outcome. Houston is closer and the medical center here has renowned heart specialists (Dr. Denton Cooley did the first heart transplant in the US at St. Luke's/Houston in 1968), but for quality and cost, he chose to go to CC. That says an awful lot to me.


Why the **** would I have a plan for dog ****? I do not care about individual stories or petty complaints.

Your "health plan" is garbage. These things you are now in hysteria about were forecast, we told you this would happen. I have posted hundreds of posts saying this very thing. if I knew, the dumb ****s you support who drafted this waste of pulp should have known and been honest about in the first place.

Instead it was hidden, you were LIED TO, and now the government is trying to use back door regulations to patch work quilt a solution to a problem that is not solvable in that system.

You have the worst system on the planet. Your "friend's" story is one of millions about to happen.



Pay attention:

You have been lied to.
 
I don't know what this has to do with the post you quoted. Unless you're under the impression the AHA is "the government" and not a trade association representing the nation's hospitals.

Regardless, the ongoing transformation of health care delivery is very real and readily apparent at this point. The shift toward smarter care is impacting the design of new hospital complexes, it's affecting the choices existing hospitals are making, and finally getting everyone rowing in the direction of better care and slower cost growth.



You. Haven't. Seen. Anything. Yet.

for six years I have been posting the quotes of Canadian health economists on Obamacare and no one on the left reads them.

The law was based on a lie, sold by a lie, was amended 22 times and delayed in implementation.

You can cherry pick all the reports needed to "sell" this law two years after the fact, but in the end, you still an over priced, out of reach, bureaucratic nightmare that doesn't even transfer wealth.

It's cool aid friend
 
If the reimbursement gets too low, congress will enact a new "doc fix". They have done it every year, now we won't have to do a 21% increase over the legal rate to keep them in every year.

Where do you get such faith that the government will keep patching a broken system into perpetuity? At some point the whole house of cards will fall.
 
I hope for America's sake they keep thinking that way. Hillary is quite beatable and very damaged. Get her in a one-on-one with Jeb Bush and she'll be toast.

Jeb is not my choice...however by the time the email scandal dies down, the Gollum character from the Trilogy "Lord of the Rings" could beat her.
 
You. Haven't. Seen. Anything. Yet.

Sure we have. We've seen about 98% of American hospitals (per the AHA) moving in the direction of the population health management philosophy, not only re-orienting care around keeping people healthy but also extending the reach/responsibility of the hospital beyond its own walls through partnerships with entities in the community.

As a result we've already seen preventable readmissions dropping as people get care (and preventive interventions) when and where they need it, we've seen hospitals get safer as they take a more systematic approach to patient safety, and we've seen hospital prices starting to drop. Performance on quality indicators tracked by the Joint Commission, CMS, you name it is starting to improve. Meanwhile new hospitals are being built to directly embody this philosophy where expensive inpatient care is no longer the most important piece of what the health system delivers.

New models like ACOs are taking off as the amount of the nation's health care revenue in value-based or risk-based arrangements grows. Team-based care and new partnerships across various docs and hospitals are on the rise. Care is getting better, it's getting smarter, and for the first time in a long time the cost curve is starting to bend.

But in a sense you're right. The best is yet to come!
 
Where do you get such faith that the government will keep patching a broken system into perpetuity? At some point the whole house of cards will fall.



That's the tide being fought.

How many times does it have to be pointed out that it is fundamentally flawed, this 11 hundred page law that had to be amended 22 times? That right there should tell you this is a cannabalized junker with no clutch to start with, the only way to keep it running it to continue to fix it, like a Havana taxi cab.

I repeat, the bad news is only just beginning.
 
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