Hospitals Stand to Lose Billions Under ‘Medicare for All’

[ElChupacabra]

No. The trillions of dollars spent to maintain the insurance companies would go towards healthcare. The billions paid to the CEO's so they can afford penthouses, private jets, multimillion dollar bonuses and such would now actually be available to pay for health care. The billions of dollars going to all the insurance workers would now go directly to health care. The burden taken away from the employer would allow more money to be paid in wages and taxes to fund health care. Trade offs. But clearly eliminating all the middle men would free up plenty of money to pay health care cost instead. Plus all the dickering over who is responsible for bills and who will pay is cleared up stream lining billing and payment which is half the staff of a lot of medical facilities. Oh and a Tylenol would go from $10. back to 10cents.


There would be no devastation. All the people in the insurance industry would move to health care where they would provide health care instead of just syphoning away money needed for heath care.

The point you made, which I put in bold, is one which I'm not surprised gets more attention than it currently does. It's an odd system we have here expecting employers to pay employees healthcare. Having worked in a large corporation, it's been interesting to see the changes in coverage and premiums in a direction which places more of the cost on employees. Employer based healthcare is a much better subsidy than anything you're going to get from the Healthcare Exchange, but I think it's better to have the government manage this than employers. From a cost perspective, it also incentivizes hiring more freelance workers and eliminating staff employees. I know in my former industry many companies were moving in the direction of replacing staff personnel with freelances as a way of saving money.

 

[Moderate Right]

That's the best you can do? An article pointing out that drugs aren't free? Are drugs free in the USA?

Doesn't matter what province you live in, you're lucky to be a Canadian, and have access to our healthcare model, instead of the American model.

That's why the vast majority of Canadians love our healthcare system, and would never want to switch to an American model.


We had a vote a while back: Who was the greatest Canadian of all time?

We didn't choose Wayne Gretzky, or any hockey player. We didn't choose Terry Fox, my personal hero. Nope, we chose Tommy Douglas, the man who brought universal healthcare to Canada. That's what Canadians think of our healthcare system.

Most drugs in the US are cheaper than Canada because we have this thing called insurance, as most people in the US have insurance through their employers. If you don't then you often get screwed. In my particular case, just about every single medicine I am prescribed is totally and completely free. No copay, no notta because my insurance covers all generics at 100%. I only have one prescription I personally pay for and the US retail price on that is around $1500 per month. I pay $400 per year and my insurance pays the rest. I do know that in Canada it can be purchased for far less than $1500 per month but even at that I couldn't get it from Canada for $400 per year, not even close to that.

 

[Moderate Right]

I'm not surprised. Trump accurately reflects the morals and principles of a good chunk of America, doesn't he.

What? All of this was happening before Obamacare and got worse and worse every year since Obamacare, long before Trump even came into the picture.

 

[JMaximus]

You obviously do not have a clue how Medicare works. Do not fool yourself when the government writes the check it also makes the rules. Right now the government writes the rules and the checks for Medicare. To say that Medicare isn't government ran healthcare is laughable. Have you ever billed Medicare for anything? Have you ever had to follow Medicare's rules on anything? I have.

Making rules is not the same as running something.

When you see a doctor as a Medicare beneficiary, that doctor doesn't work for Medicare and you don't go see them at a special Medicare clinic.

Medicare pays private actors to provide goods and services - it doesn't provide the goods and services itself.

 

[prometeus]

What? There are literally tens of thousands of doctors who refuse to take Medicare and Medicaid patients. I have heard several of my doctor's offices over the years say they aren't accepting patients with those.

So you spout unsupported drivel. There are tens of thousands of doctors who do accept it.

 

[SLC]

Refuses?

Work?

Same food and lodging?

Works hard?

Is otherwise successful?

Feel free to clarify what any of that means.

But if you're arguing that food and lodging/shelter aren't a basic human right, we have nothing to discuss.

Are you arguing that the government owes food and lodging to those that refused to work and are you arguing that they deserve the same level of food and lodging that people that do want to work? If you don’t understand that then we have the thing else to discuss.

 

[manofknowledge]

This article and most articles opposing "Medicare for All" grossly oversimplify the trade offs that would happen changing to single payer.

For example. Yes, Medicare pays less than insurance companies, but the fact is, there are very few hospitals in the country that could stay in business withouth Medicare.

First, elderly people are the sickest demographic and have much higher medical expenses than working folks. No private insurance covers them without the Medicare subsidy so a large part of a hospital's business won't change.

Second there are not enough insured patients not on Medicare to keep hospitals in business. Most hospitals rely on Medicare for around 20% of their revenue. They could not afford to lose that revenue and be supported by private insurance revenue alone.

Hospitals make money on Medicare.

With single-payer there are many areas where hospitals realize savings. There are no provider networks to maintain, no special pricing based on the insurer. Only one claim process to deal with. Only one insurer to deal with. Very few uninsured patients. Most hospital bills will get paid promptly and without excessive red tape.

Since patients have access to primary care, hospitals will be much less burdened with minor injuries and illnesses and will be more focused on major medical problems.

Supplemental insurance will likely be available to help cover what Medicare doesn't, because Medicare will not cover everything.

 

[apdst]

Collapsing the system, forcing a government takeover, is the objective.

Medicare for all is designed to fail, just like Obamacare was designed to fail.

 

[SLC]

Making rules is not the same as running something.

When you see a doctor as a Medicare beneficiary, that doctor doesn't work for Medicare and you don't go see them at a special Medicare clinic.

Medicare pays private actors to provide goods and services - it doesn't provide the goods and services itself.

Yes but Medicare tells that doctor how much they will be paid for a service and they tell patients what treatments they can and can’t have. They tell the doctor if they can or cannot work on Medicare patients. They tell hospitals if they can or cannot take care of Medicare patients the tell nursing homes if they can care for nursing patients. If you are a contractor but there is only one payer in the country you work for that payer and follow their rules or you do not work. That is how single payer works. I went to undergrad 6 years grad school 2 years 4 years medical school residency 4 years and fellowship for 2 years At my own expense. It takes a while to recoup those lost years of earning and years of tuition. VERY few physicians work a 40 hour week most work more than 60 hours a week on average and malpractice insurance is very expensive.

 

[Lovebug]

That is awesome. I know here in Canada there is a shortage of doctors in rural communities, which is not a good thing. Hopefully the government can correct that. I know they're working on it.

My family doctor retired a few years back. But I can still book an appointment the same day if it's for something that needs immediate attention, which I like. I'm getting on in years, and am starting to use our medical system more and more, and have really come to appreciate it.

This is just my experience, nothing statistically significant or anything like that, but I've had a few operations over the last few years, and everything has happened in a timely fashion imo. The nice thing is you go in and everything is arranged and booked for you. Your entire responsibility is to follow the medical instructions you're given, and to show up on time for your appointments. It's completely stress free, which is so nice when you're worried and feeling like a giant dung heap.

We hear and read a lot about "long waiting", but I am guessing that has more to do with elective procedures. Without further research one tends to believe such stories. However, having looked more into it, I am somewhat impressed with both the Canadian and Australian HC systems. Of course every system has problems, that is understood.

 

[Northern Light]

In reality, what happens is that providers have to do more with less. That translates into poor patient care and less-than-optimal outcomes.
Progressives seem to believe that healthcare providers should not be compensated for their education, time and skills which quite literally, keep human beings alive.

In the short term maybe, in the long term no. Providers raise costs to pay for patients who can't afford services, but are legally obligated to receive urgent care. With the government as the payer, everybody gets covered, and providers can reduce costs over time.

 

[Carjosse]

Most drugs in the US are cheaper than Canada because we have this thing called insurance, as most people in the US have insurance through their employers. If you don't then you often get screwed. In my particular case, just about every single medicine I am prescribed is totally and completely free. No copay, no notta because my insurance covers all generics at 100%. I only have one prescription I personally pay for and the US retail price on that is around $1500 per month. I pay $400 per year and my insurance pays the rest. I do know that in Canada it can be purchased for far less than $1500 per month but even at that I couldn't get it from Canada for $400 per year, not even close to that.

Quebec covers prescription medications. Outside of Quebec most employers here provide health insurance that includes drug coverage or there is also private insurance available for it.

You seem to believe that Canada has just one unified healthcare system and private insurance is outlawed, neither of which is true.

 

[SLC]

This article and most articles opposing "Medicare for All" grossly oversimplify the trade offs that would happen changing to single payer.

For example. Yes, Medicare pays less than insurance companies, but the fact is, there are very few hospitals in the country that could stay in business withouth Medicare.

Correct most rural small hospitals could not do without Medicare but most medium and larger sized urban hospitals lose money on Medicare patients. They take Medicare because their medical staff takes Medicare. The hospitals cost shift their loses onto insurance patients.

First, elderly people are the sickest demographic and have much higher medical expenses than working folks. No private insurance covers them without the Medicare subsidy so a large part of a hospital's business won't change.

Yes the elderly is also the most ill part of the population. Its not uncommand for a 65 year old with a fractured hip to have diabetes, heart disease, kidney disease, and hypertension and for their medical stay to be longer than the DRG for a fractured hip. In that case the hospital loses money.

Second there are not enough insured patients not on Medicare to keep hospitals in business. Most hospitals rely on Medicare for around 20% of their revenue. They could not afford to lose that revenue and be supported by private insurance revenue alone.

That simply isn't true for most urban hospitals. It is true for most rural small hospitals.

Hospitals make money on Medicare.

Rural hospitals frequently barely stay afloat on Medicare and larger urban hospitals would much rather to have all private insurance. The more Medicare the less profitable they become.

With single-payer there are many areas where hospitals realize savings. There are no provider networks to maintain, no special pricing based on the insurer.

I do not know of ANY private insurance that pays less than Medicare no matter what "special pricing" they have. The only insurance that I know of that pays less than Medicare is Medicaid and it is government controlled insurance also.

Only one claim process to deal with. Only one insurer to deal with. Very few uninsured patients. Most hospital bills will get paid promptly and without excessive red tape.

:lol: You have obviously never dealt with receiving payments from Medicare or Medicaid.

Since patients have access to primary care, hospitals will be much less burdened with minor injuries and illnesses and will be more focused on major medical problems.

Supplemental insurance will likely be available to help cover what Medicare doesn't, because Medicare will not cover everything.

People with Medicaid show up in the ER when they should be seeing a primary care doctor because the visit to the ER cost them nothing. Medicare won't pay for a non emergent emergency room visit and the hospital will still be on the hook because they cannot refuse care.

 

[manofknowledge]

Yes but Medicare tells that doctor how much they will be paid for a service and they tell patients what treatments they can and can’t have. They tell the doctor if they can or cannot work on Medicare patients. They tell hospitals if they can or cannot take care of Medicare patients the tell nursing homes if they can care for nursing patients. If you are a contractor but there is only one payer in the country you work for that payer and follow their rules or you do not work. That is how single payer works. I went to undergrad 6 years grad school 2 years 4 years medical school residency 4 years and fellowship for 2 years At my own expense. It takes a while to recoup those lost years of earning and years of tuition. VERY few physicians work a 40 hour week most work more than 60 hours a week on average and malpractice insurance is very expensive.

According to a recent survey 56% of physicians favor Medicare for All. Virtually all doctors and hospitals currently accept Medicare and follow their rules. In my experience insurance companies tend to follow the same rules as Medicare.

Doctors Warm To Single-Payer Health Care | Kaiser Health News

 

[JustHanging]

Most drugs in the US are cheaper than Canada because we have this thing called insurance,

Oh, you're including insurance? Then I pay virtually nothing for my drugs.

as most people in the US have insurance through their employers.

That's what I have.

If you don't then you often get screwed.

Here you still get your healthcare coverage. I like our system better.

In my particular case, just about every single medicine I am prescribed is totally and completely free. No copay, no notta because my insurance covers all generics at 100%. I only have one prescription I personally pay for and the US retail price on that is around $1500 per month. I pay $400 per year and my insurance pays the rest.

As I noted, if we're including insurance I get my scripts for free as well.

I do know that in Canada it can be purchased for far less than $1500 per month but even at that I couldn't get it from Canada for $400 per year, not even close to that.

Well sure, if you're trying to compare apples to oranges. If we're comparing oranges to oranges, then insurance can cover your entire script cost here as well.

So Canadian system still better. And honestly, there are supposed to be a lot better systems in other countries.

 

[Born Free]

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.

And the first place to cut cost is to CUT QUALITY CARE for their patients. Less nurses, less Dr. rounds to check on their patients, hospitals and Dr offices will cut their time with you by half. Longer wait times. etc etc etc. The list goes on and on. Good luck with Medicare for all.

 

[JustHanging]

What? All of this was happening before Obamacare and got worse and worse every year since Obamacare, long before Trump even came into the picture.

I didn't say anything about when or what. Just noting that Trump accurately reflects the morals and values of a lot of Americans. I can see why you chose him as your leader.

 

[JustHanging]

And the first place to cut cost is to CUT QUALITY CARE for their patients. Less nurses, less Dr. rounds to check on their patients, hospitals and Dr offices will cut their time with you by half. Longer wait times. etc etc etc. The list goes on and on. Good luck with Medicare for all.

That's nonsense. At least in every other Western nation. Are Americans really that stupid and incompetent that they can't implement what every other Western nation has managed?

 

[Hypothetical]

about medical malpractice.. what do nations like canada, with universal healthcare, do about such things?

 

[manofknowledge]

Correct most rural small hospitals could not do without Medicare but most medium and larger sized urban hospitals lose money on Medicare patients. They take Medicare because their medical staff takes Medicare. The hospitals cost shift their loses onto insurance patients.

Hospitals do not have to accept Medicare. So why would a hospital or its staff accept Medicare if they are losing money on it. The fact is on average 40% of a hospital's paitents are on Medicare and 17% on Medicaid. So how would they stay in business on just private insurance?

I do not know of ANY private insurance that pays less than Medicare no matter what "special pricing" they have. The only insurance that I know of that pays less than Medicare is Medicaid and it is government controlled insurance also.

The savings hospitals would have by only having one insurance payer to deal with is that there is no need to deal with dozens of insurance payers and all of their different requirements and payment schedules. It reduces the cost of claims.

:lol: You have obviously never dealt with receiving payments from Medicare or Medicaid.

You obviously haven't dealt with insuance companies. They have loads of red tape and there are dozens of them each with different red tape.

People with Medicaid show up in the ER when they should be seeing a primary care doctor because the visit to the ER cost them nothing. Medicare won't pay for a non emergent emergency room visit and the hospital will still be on the hook because they cannot refuse care.

Note that under "Medicare for All" there would be no Medicaid and there would be a lot more than just the poor getting primary care.

 

[Moderate Right]

I didn't say anything about when or what. Just noting that Trump accurately reflects the morals and values of a lot of Americans. I can see why you chose him as your leader.

So, you're trying to deflect the thread to something else because you have no argument.

 

[Moderate Right]

Oh, you're including insurance? Then I pay virtually nothing for my drugs.



That's what I have.


Here you still get your healthcare coverage. I like our system better.



As I noted, if we're including insurance I get my scripts for free as well.


Well sure, if you're trying to compare apples to oranges. If we're comparing oranges to oranges, then insurance can cover your entire script cost here as well.

So Canadian system still better. And honestly, there are supposed to be a lot better systems in other countries.

The left are all about comparing apples to car tires in order to prove their point.

 

[Moderate Right]

Quebec covers prescription medications. Outside of Quebec most employers here provide health insurance that includes drug coverage or there is also private insurance available for it.

You seem to believe that Canada has just one unified healthcare system and private insurance is outlawed, neither of which is true.

I specifically said in one post that all provinces are different.

 

[JustHanging]

So, you're trying to deflect the thread to something else because you have no argument.

What? Why would need to deflect from anything? I'm the one with all the facts and evidence on my side.

 

[JustHanging]

The left are all about comparing apples to car tires in order to prove their point.

What does that have to do with my post? You just said I was trying to deflect, and here you are deflecting.

As I just pointed out, with private insurance Canadians can get free scripts as well. I do. So I get the same advantages you get, plus I get universal healthcare thrown in as a bonus.

And interestingly enough, appear to pay less taxes:

Canadians Now Paying Lower Income Taxes Than Americans, OECD Data Shows
And families with children are paying much, much less than Americans.


So I'm getting universal healthcare, and I'm paying less in taxes. Jesus, you guys must be getting ripped off blind.