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Thread: Hospitals Stand to Lose Billions Under ‘Medicare for All’

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    Hospitals Stand to Lose Billions Under ‘Medicare for All’

    Looks like this time around we're getting to the level of seriousness where trade-offs and winners-and-losers will get explored. Which is good! But it underscore the risks that primary candidates run in hitching their wagons to a very speculative idea without fully exploring those trade-offs.

    Hospitals Stand to Lose Billions Under ‘Medicare for All’
    The yawning gap between payments to hospitals by Medicare and by private health insurers for the same medical services may prove the biggest obstacle for advocates of “Medicare for all,” a government-run system.

    If Medicare for all abolished private insurance and reduced rates to Medicare levels — at least 40 percent lower, by one estimate — there would most likely be significant changes throughout the health care industry, which makes up 18 percent of the nation’s economy and is one of the nation’s largest employers.

    Some hospitals, especially struggling rural centers, would close virtually overnight, according to policy experts. Others, they say, would try to offset the steep cuts by laying off hundreds of thousands of workers and abandoning lower-paying services like mental health.
    Dr. Adam Gaffney, the president of Physicians for a National Health Program, warned advocates of a single-payer system like Medicare for all not to seize this opportunity to extract huge savings from hospitals. “The line here can’t be and shouldn’t be soak the hospitals,” he said. “You don’t need insurance companies for Medicare for all,” Dr. Gaffney added. “You need hospitals.”
    The Stuart Altman quote is the crux of it:

    Whether hospitals would be able to adapt to sharply lower payments is unclear.

    “It would force health care systems to go on a very serious diet,” said Stuart Altman, a health policy professor at Brandeis University. “I have no idea what would happen. Nor does anyone else.”
    This would be uncharted territory.

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    Quote Originally Posted by Greenbeard View Post
    Looks like this time around we're getting to the level of seriousness where trade-offs and winners-and-losers will get explored. Which is good! But it underscore the risks that primary candidates run in hitching their wagons to a very speculative idea without fully exploring those trade-offs.

    Hospitals Stand to Lose Billions Under ‘Medicare for All’



    The Stuart Altman quote is the crux of it:



    This would be uncharted territory.
    Exactly. Medicare for all relies heavily on screwing providers. I have pre-existing conditions and have talked to many others in single payer countries. They wait excessively for appointments, wait excessively while at the appointment, see nurses instead of doctors, when having issues are told to go to the emergency room because there are no appointments for months, have to travel to metropolitan areas for providers because there aren't any in rural areas, and can't receive the latest expensive medicines. The only reason why they like their health care systems is because they are basically free so they have financial peace of mind. The cold hard fact is that millions in the US are better off with our current system of employer based health insurance than they would be if we went to medicare for all. What we need to concentrate on is the people who don't have employer based insurance, which is less than 20% of Americans.


    None of this even takes into account the economic devastation from basically eliminating an entire industry.

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    Quote Originally Posted by Greenbeard View Post
    This would be uncharted territory.
    We can't simply keep accepting ballooning doctor, hospital, procedure, and drug costs.

    This trajectory has to change or someday in our lifetimes, routine healthcare will only be available to the wealthy.


    If you are not a person strong of character, Donald Trump eats your soul in small bites. — James Comey

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    The prices of providers are overinflated to begin with. They have been feasting at a banquet for far too long, propped up by insurance companies who in turn charge high premiums. As we see in our western neighbors, cost of care is not that high. Most hospitals could benefit from price reform in management and administration.

    When government controls payout, providers have to start cutting costs, and so they should.

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    Hate to see hospitals' obscene profits diminish.

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    Quote Originally Posted by Moderate Right View Post
    Exactly. Medicare for all relies heavily on screwing providers.
    If it purports to offer substantial savings beyond administrative simplification. Which the PNHP president quoted surprisingly (to me) seems to oppose. Single-payer that inherits the costs of the current system (again, except for some of the administrative overhead) wouldn't face the capacity constraints you're talking about. That's the likeliest scenario.

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    Quote Originally Posted by Rogue Valley View Post
    We can't simply keep accepting ballooning doctor, hospital, procedure, and drug costs.
    That's not the alternative to saying we're going to suck double digit percentages out of every provider organization's budget.

    Quote Originally Posted by Northern Light View Post
    The prices of providers are overinflated to begin with. They have been feasting at a banquet for far too long, propped up by insurance companies who in turn charge high premiums. As we see in our western neighbors, cost of care is not that high. Most hospitals could benefit from price reform in management and administration.
    Cost of care isn't an absolute. Factors like local wage pressures play a substantial role in it.

    When government controls payout, providers have to start cutting costs, and so they should.
    That's certainly the theory, but again this is uncharted territory if we were to try this on the scale some have imagined. Cutting is very hard and we're past the point where we can hand wave past what that looks like in practice. Grappling with that is to treat this idea with the seriousness it deserves--which is actually a good sign for the maturity of the MFA concept, though I imagine it will make some defensive.

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    Quote Originally Posted by Greenbeard View Post
    Looks like this time around we're getting to the level of seriousness where trade-offs and winners-and-losers will get explored. Which is good! But it underscore the risks that primary candidates run in hitching their wagons to a very speculative idea without fully exploring those trade-offs.

    Hospitals Stand to Lose Billions Under ‘Medicare for All’



    The Stuart Altman quote is the crux of it:



    This would be uncharted territory.
    Yes, when we become more cost-effective and can negotiate better prices, some people won't be rolling in profits like they did before at the expensive of everyone else who has trouble affording healthcare. Other developed nations pay 2 1/2 times less for healthcare and still have great healthcare. When a product can be provided or created at a lower cost, that is the definition of technological progress. If products never got cheaper, then we wouldn't get any richer. Technological progress requires that corporations get less money for the exact same product over time. They have to produce better and better products for the same price, and if that isn't happening, then progress has stagnated. So healthcare providers getting less in profits for the same services because healthcare is more cost-effective is a very good thing.

    As for uncharted territory, every other 32 developed nations has successfully implemented universal healthcare systems that are far cheaper than the US and most are very good. This territory is at charted as it can get and all we have to do is copy.

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    As long as there are sick people there'll be hospitals. With medicare for all hospitals will have more patients, not just the insured.
    Now listen Donald, stay focused, hold it together. Put down the bucket of chicken. Stop tweeting. Go into the next bedroom. Get under the bed. Calm down. Now the next part is very important...

    They're going to hear Mueller's testimony

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    Re: Hospitals Stand to Lose Billions Under ‘Medicare for All’

    Quote Originally Posted by j brown's body View Post
    Hate to see hospitals' obscene profits diminish.
    Many hospitals are barely profitable.

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