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| Economy |
| Obama's budget sidesteps dramatic health reforms |
| 2010-02-02 |
| The health care system may as well be run by the mafia. It's a total scam. Insurance companies pay a fraction of what they are billed for, and the hospital writes the difference off. If the person needing treatment doesn't pay, they write the whole thing off. If they do pay, it's like they won the lottery. Central to this whole thing is grossly over-used and overpriced CT scans (whose results are often ignored) and ER visit costs. I don't see how a hospital could lose here because there is a bigger upside to every "loss" they pretend to suffer. It's no wonder the hospitals always look like they are scraping by. All we need is tort reform and someone to go over the hospitals financial practices with a not-so-fine-toothed comb and nail them to the wall for the fraud they are committing. The Obama administration's latest spending plan calls for modest changes to the U.S. healthcare system but does little to incorporate sweeping moves called for Democrats' larger plan to increase access and cuts costs. In releasing his fiscal 2011 budget on Monday, President Barack Obama said his proposal "includes funds to lay the groundwork for these reforms." Instead of dramatic action, the plan seeks to boost health information technology, cheaper generic drugs and certain Medicare payment changes. The budget plan comes as efforts to pass sweeping healthcare reforms in Congress have stalled with little sign from Democratic leaders on when final legislation will move forward. "This budget -- absent health reform -- will still leave a major gap in not only affordable coverage for many, many Americans, but makes very little change in the cost trajectory, which right now is just crushing families," as well as businesses and government, Department of Health and Human Services Secretary Kathleen Sebelius said. "We need both." Reforming the nation's swelling $2.5 trillion healthcare system has been a top priority for Democrats in the last year, but talk of imminent change has quickly faded amid rising anxiety about the U.S. economy and the stinging loss of a Senate seat that cost Democrats the supermajority needed to break procedural hurdles in the chamber. Democrats in the House of Representatives and the Senate have passed different versions of legislation that aims to expand access to health insurance for millions more Americans, but have so far been unable to agree on a final bill. Obama and other Democratic leaders have vowed to press ahead but have faced gridlock after Republicans won a crucial Senate seat in Massachusetts long held by Democrats and as public concern rose about unemployment levels. HEALTH SAVINGS Administration budget officials, speaking on background, said while the health budget does not include specific health reform spending, it overall includes $150 billion in anticipated net savings over 10 years from the overhaul. Senate Finance Committee Chairman Max Baucus, who helped shepherd a health reform bill through the Senate and whose committee oversees the massive Medicare and Medicaid government insurance programs, said he was "pleased to see that health reform is assumed to be part of" the budget. Some Wall Street analysts also said Obama's plan appears to reflect the budget impacts of Congress' healthcare bills. Shares of healthcare insurance companies -- the biggest target of Democrats' reforms -- closed lower than the overall market. The S&P Managed Health Care index of large health insurers closed nearly unchanged while the overall S&P index closed up 1.4 percent. Specifically, Obama's plan seeks to reduce health costs through cheaper, generic medicines as well as limited steps to reform payments under the massive Medicare insurance program. It also expands efforts to compare medical treatments to help doctors determine which therapies work best by another $286 million. Health insurers back such research, but drug and device makers worry it could be used to deny coverage for newer, more costly treatments. Additionally, the plan seeks $110 million to boost health information technology such as electronic medical records. Congress must still weigh Obama's plan before drafting its final spending plan for the next budget year starting October 1. The White House has said reform must pass to shore up the nation's long-term finances. But analyst Ethan Siegal of The Washington Exchange said the budget shed little light on the future of the administration's health reform bid "except their hope." |
| Posted by:gorb |
| #11 Doctor removes raisin from friend's kid's nose. about $1450, negotiated down to $150. Rest was written off. Hospital in area where some relatives live got pi$$ed off by stupid city they were located in. Bailed out of old hospital that covered several city blocks. Build brand new high-tech, shiny modern hospital outside city limits that sprawls over several acres. Sometimes, hospitals need to be replaced or upgraded, too. So much for all their whining about how poor they were despite higher illegal population. |
| Posted by: gorb 2010-02-02 22:26 |
| #10 Kidney stone in NH ER. $4800 "negotiated" down by carrier to $4300, of which I pay a $150 deductible and 20% of the balance. On top of the many thousands we pay a year in premiums. In nine out of ten years I don't even go above my $550 deductible. They treated me very well. But, as gorb says, $4800 for a quick CT with no contrast, some oxycodone, keterolac, morphine (latter did nothing!), 30 min of the ER doc, and using the space for four hours seems high. The bill was itemized, at least 20 items, but each description was "ER services", so I as a patient have no idea what they were charging for. I'd have to go down to the hospital and get them to run a detail. |
| Posted by: KBK 2010-02-02 22:19 |
| #9 Hospitals are closing in part because we don't need them as much. We do more and more care as outpatients. That's a trend that started in the early 1980s. |
| Posted by: Steve White 2010-02-02 15:10 |
| #8 Health care may as well be run by the mafia. They have infiltrated it already: Feds ignored Medicare scam warnings for years The Centers for Medicare and Medicaid Services received roughly 30 warnings from inspectors over three years -- mostly under the Bush administration -- but didn't respond to half of them, even after repeated letters, according to records provided to The Associated Press by U.S. Sen. Charles Grassley's office. A July 2008 warning said organized crime had infiltrated the system and was costing more than $1 million dollars for each phony Medicare provider license the crooks obtained. The letter got no response, Grassley said. He and other critics said lack of oversight in the federally administered program is part of an estimated $60 billion a year in Medicare fraud. "There's no good answer for why the bureaucracy turned a blind eye, and it's a breach of the public trust," said Grassley, an Iowa Republican and ranking member of the Senate Finance Committee. |
| Posted by: Lumpy Elmoluck5091 2010-02-02 11:52 |
| #7 The insurance companies pay little more than incremental costs of products and services. The indigent pay nothing at all. Those without insurance but with some means to pay are stuck with carrying the indigent AND the (very substantial) overhead of the whole system. But raising the insurance payments to cover overhead will raise the cost of insurance, driving more people to have to go without insurance. The total cost of health care is unaffordable to society in general. Costs have to come down - either by decreasing demand (rationing), or by increasing supply (education, time). |
| Posted by: Glenmore 2010-02-02 11:50 |
| #6 On the other hand, greedy Americans have gleefully allowed personal injury lawsuits and awards against hospitals and doctors to balloon well beyond what is necessary to keep true malpractice in check. And the medical community supports the lawyers by failing to effectively and efficiently clean their ranks of practitioners who should not be in the 'profession'. The lawyers are simply making money because juries, the people, do not see that happening. Convince the people that you can clean your house [do a better job than others] and they'll let you alone. Tort is an ineffective and costly means in the absence of other functional corrective mechanisms. |
| Posted by: Procopius2k 2010-02-02 11:22 |
| #5 A 'total scam' until the life of you or your loved one is in danger, and the health care system has what you need. I don't mind them making a profit. But I would like to know how a kidney stone can cost $5,000 when all you get is a CT scan, flexeril, and vicadin. The doctor didn't even read the CT scan. I know. because I got a copy of it and there were three stones, not just the one he mentioned. It's BS. If it wasn't, someone would be able to explain it, and would have by now. On the one hand hospitals have been forced to accept patients without insurance - even those illegally in the country - and provide expensive services. The services are not as expensive as they make them out to be. On the other hand, greedy Americans have gleefully allowed personal injury lawsuits and awards against hospitals and doctors to balloon well beyond what is necessary to keep true malpractice in check. That's what I'm talking about when I say tort reform. At least it's what I think I'm talking about. :-) As a result, most hospitals are near bankruptcy and many have already closed. I'll bet the administration and doctors are paid well until then. And being on the verge of bankruptcy is right where they want to be. I just cannot accept the idea that they are charging what they do and are going bankrupt. A doctor's appointment used to cost me $30 or so in the '80s. Along come the HMOs and the price skyrocketed. A vial of insulin then was about $10. Now it's $150. WTF? Whatever is happening, we are doing it to ourselves, it is not true unfettered market dynamics. Something is broken, I don't know what. But it ought to be easy enough to find, because it seems all hospitals are onto it, and the government seems to be colluding with them. Are the HMOs a jobs program of some kind? What is so hard about finding fraud? It seems like they are spending four times as much as they used to just to make sure there isn't 10% fraud, and they aren't finding any more than they did before! Now fraud is legalized in the form of unnecessary and unread tests to cover the doctors' a$$es. Hospitals and doctors are referring patients to self-owned and very lucrative CT machines! When I see a doctor for 10 minutes, he charges me about $150 nowadays. So the doctor ends up pulling down about $600/hour. Shouldn't that be enough? Isn't it? I don't see doctors having to treat an inordinate number of illegals. Do they have to tithe 50% of what they get to the poor, struggling hospitals that charge me $5,000 for a total of about two or three man-hours of their time? For that $5,000, they could treat ten illegals and me and about break even, I feel. Something is wrong. I feel the government isn't fixing it so they can justify healthcare takeover, and then they will continue with the high prices so they can control that huge, over-inflated sector of the economy. |
| Posted by: gorb 2010-02-02 10:06 |
| #4 The bottom line is that "Political Correctness" is killing our health care system as it is. Hospitals ARE CLOSING. One closed several miles from where I live. Providing virtually FREE health care to non-citizens hear illegally in this country and then trying to recover those costs by over billing citizens, many who then cannot pay those bills due to the poor economy or the sky rocketing medical insurance premiums ends up putting hospitals between a rock and a hard place. |
| Posted by: wr 2010-02-02 09:44 |
| #3 Beware of self-referential comments. |
| Posted by: Nimble Spemble 2010-02-02 09:29 |
| #2 On the one hand hospitals have been forced to accept patients without insurance - even those illegally in the country - and provide expensive services. On the other hand, greedy Americans have gleefully allowed personal injury lawsuits and awards against hospitals and doctors to balloon well beyond what is necessary to keep true malpractice in check. As a result, most hospitals are near bankruptcy and many have already closed. All that "writing the difference off" might in fact have turned out to be, you know, bad for finances ... |
| Posted by: lotp 2010-02-02 08:41 |
| #1 A 'total scam' until the life of you or your loved one is in danger, and the health care system has what you need. Beware of generalities. |
| Posted by: Anguper Hupomosing9418 2010-02-02 01:51 |