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ColbertWatcher Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 06:30 PM
Original message
Open up Medicare to all
From the Los Angeles Times
Opinion
Open up Medicare to all
Why should we have to be 65 to have access to public healthcare?
By Jamie Court
January 24, 2009
By almost every measure, Medicare is cheaper and more effective than private plans, according to government and academic research. Medicare spends 2% on overhead; private insurers typically spend 25% to 27% for overhead and profit.

(...)

Critics contend that Medicare pays doctors so little that most physicians won't accept the coverage, and that it is too bureaucratic and financially unstable. Medicare does use its size to drive down what doctors and hospitals are paid. However, the Medicare Payment Advisory Commission reports that 97% of physicians accept new Medicare patients, with 80% taking all or most patients, which is comparable to HMO acceptance rates. And with the massive consolidation of insurance companies and of HMOs, doctors and hospitals report to our group that Medicare payments are often as generous, if not more generous, than those of HMOs and private plans -- and received with less hassle and more consistency. Studies by AARP and the Commonwealth Fund also show that Medicare patients are more satisfied with every aspect of their care than patients with private plans.

(...)

Medicare's financial challenges are also real but solvable. Predictions of its impending bankruptcy mostly have to do with the fact that the program serves the sickest and neediest patients in the system without a proper revenue base and in an era of costly techno-medicine. There are a number of ways to help solve the funding problem. (more)

--Los Angeles Times

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CaliforniaPeggy Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 06:35 PM
Response to Original message
1. Ah, you beat me to it!
I was going to post it too...

Glad you did, though, still...

It's a great article!

K&R

:patriot:

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ColbertWatcher Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 07:09 PM
Response to Reply #1
7. Sorry.
I agree it is a great article.

I'd even take a mediocre article, just as long as we talk about healthcare everyday.

Even after we get universal, single-payer.

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Hieronymus Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 06:38 PM
Response to Original message
2. That's apt to be the solution that the new administration will chose.
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Jackpine Radical Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 06:46 PM
Response to Reply #2
4. That's certainly what I would do if I were them.
Offer a national Medicare-like program to employers for starters, then start writing new Medicare tax legislation.
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TheWraith Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 10:07 PM
Response to Reply #2
12. It's what my new Senator supports.
Go Gillibrand.
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Delphinus Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 06:14 AM
Response to Reply #2
16. Let us hope!
Medicare Part E - E for Everyone!
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Jackpine Radical Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 06:45 PM
Response to Original message
3. For outpatient psychotherapists, at least, the argument about how low
Medicare payments are is kinda bogus. A lot of HMOs and PPOs have been trying to negotiate rates with us that are actually under the Medicare rates--and then we still have to fight them for every payment. It would be cheaper for us to provide Medicare services because we wouldn't have to hire a full-time person just to fight the HMOs, and we would be more certain of payment. I do think there would have to be an overall adjustment of rates in Medicare in some areas, but that's no big deal.
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pinto Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 06:55 PM
Response to Reply #3
6. Great point. Thanks for a provider opinion. One real problem with reimbursement rates
is how outdated they are, as you probably know. Locally rates are still pegged to a time when we were a solidly rural county. Now, office space and all other ancillary costs are multiples of the picture when the reimbursement schedules were set.
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pinto Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 06:51 PM
Response to Original message
5. I second that opinion.
I'd love to see it expanded. Current premium for outpatient coverage is about $95/month, covers 80% of their "allowed" rates for care, which runs from 60 - 80% of billed charges. So, while the client is liable for co-pays, I have been able to find health care providers that accept "assignment", i.e. they accept Medicare as payment in full. And that includes an internist, GI specialist and oncologist/hematologist. The key is asking up front about assignment.

The only problem I've had on co-pays is any ER visit. They are expensive and the decision on assignment is often no or a we'll see sort of answer. Even then, I've been able to get their billing departments to back off to the assignment reimbursement, but it takes some persistence.



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WePurrsevere Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 07:52 PM
Response to Original message
8. Using Medicare as the base makes sense but I'd like to see...
Dental, Optical and Prescription all bundled in with it. Also Medicare needs to make more needed medical equipment for quality of life more readily available.

Medicaid might also make a good base, they'd just have to figure out how much to charge per month for those not low income.

Mind you my favorite idea is that all Americans get the SAME health care benefits as their Congressional and Senatorial reps. :D

The thing is we have the basics of "social" health care plans in place.. we just need to work out the kinks, expand and implement them. :)
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ColbertWatcher Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 08:19 PM
Response to Reply #8
9. "Dental, Optical and Prescription all bundled in with it"
That would be a great idea and I don't see why they wouldn't just add that in.

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WePurrsevere Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 05:27 AM
Response to Reply #9
14. I really hope they do. Dental tends to be all to often overlooked
as a real "health" issue when research has showed that dental problems can cause larger physical health problems even death.
http://dentistry.about.com/od/researchandstudies/Dental...

Optical is needed because if you can't see well it tends to put a major damper on the quality of your life. Medicare Part B covers an ophthalmologist but not glasses themselves even though for some of us they're as important as mobility aids are to some.

Prescriptions being covered should go without saying and should also be included. This nonsense they offer Medicare recipients now is a travesty and needs to be overhauled and included.... not a'la carte.

IMO if we're going to go with some sort of socialized medical plan that's available to all, it really needs to take a holistic approach to health. IME true good health comes when all of our health needs are addressed. We need to work towards not just quantity but quality of life. :)
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pinto Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 08:29 PM
Response to Reply #8
10. Yep, agree. I had expensive dental work this year and we tried hard to find an avenue for coverage.
One approach was admitting me to a hospital for the procedures. It was good on paper - I had a history of bleeding disorders, required numerous extractions and a full denture, but it didn't fly. Justifiably under the guidelines. My bleeding was under control and a hospital stay was unnecessary.

Simple inclusion of dental coverage under Medicare wold have been great. AS it was, MediCal (our Medicaid), covered the extractions, but the denture work was pay as you go.

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WePurrsevere Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 06:06 AM
Response to Reply #10
15. Medicare is a great program but there are areas, like with dental...
where it's lacking as you know.

When I met and married my DH he had a great job and benefits, then he was badly injured on the job, ended up not being able to work and losing those wonderful benefits. We're both on SSD/Medicare now (I've been disabled w/MS for almost 20 years) but like many other Americas who fall through the cracks, we make just a bit to much to qualify for Medicaid but not enough to afford the extra for dental care so ATM we're SOL and hoping like heck for a miracle and soon.
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Merlot Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Jan-24-09 08:45 PM
Response to Original message
11. Why not start with opening it up to the uninsured under 65?
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area51 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 03:02 AM
Response to Original message
13. Kick. (n/t)
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Vinca Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 07:24 AM
Response to Original message
17. Opening Medicare to everyone is the most logical way to solve
the uninsured problem, but Medicare cannot stay "as is." Some seniors pay as much as everyone else who can afford insurance because they must buy supplemental insurance to fill the gaps. My friend's father was paying out $900 (just for himself) a month and that was a few years ago. The program is in place, though, and with some changes it could be a relatively easy solution to a horrible problem.
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L0oniX Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 11:58 AM
Response to Original message
18. kick
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Jan-25-09 10:17 PM
Response to Original message
19. How to increase reimbursement levels
Eliminate private insurance and use the money they are wasting to do that.
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