What would Medicare-For-All look like?

[newtothegame]

I see these posts maybe once a week renewing the call for Medicare-for-All.

I am now the director of a pediatric cancer organization, but before this, I was head of our hospital foundation. The reason I ask the question about Medicare-for-All is because government payers comprised 75% of our patients. Medicare reimbursed us 51% of our cost to provide care, and Medicaid was even worse. And when I say costs, I don't mean our charges, but our actual COSTS of providing care. And that cost was just to provide current care, not to fund future technology, outreach clinics, etc. Meeting those costs would be just to keep our doors open this year, and the government could barely get halfway there. Commercial payers, greedy bastards that they are, were actually our BEST payers in terms of %, but we had to bilk them and upscale charges even more to them to make up for the ENORMOUS shortfall from government payers.

So my question is, if the government can only pay providers $.51 on the dollar for care now, what the HELL would reimbursement rates be if the government had to reimburse for EVERY patient? I'm all for a single payer system, but the government can't even afford to reimburse providers for the patients it has now...

[GreenPartyVoter]

1. What about Medi-care for all with buy-ins at progressively higher rates as income levels rise?

[jpak]

2. French/Swedish Socialized Medicine Death Panels

or so we would be told by Mama Grizzly

:D

[Tony_FLADEM]

3. I think part of the reason government reimbursement is low relative to commercial payers

is because Medicare and Medicaid deal with people who have greater health needs than people in private insurance. Many of the people in private insurance system do not require a high amount of health care and private insurers are able to make bigger reimbursements overall.

I don't support single payer, but if you did have single payer, healthy and non-healthy people would be in the same insurance pool and this would help the reimbursement issue.

[dflprincess]

4. I would imagine if we went to a Medicare for all system

we would see an increase in the Medicare tax - though by rights the increase would be less than what we're currently paying in premiums as we would be rid of the for profit middle man currently taking such a big chunk of our money. As the pool would now include age groups that tend to be healthier there would be more money in the pool so there might indeed be an increase in reimbursement.

Though, a couple years ago I ran up what was (for me) a fairly large bill. The total billed by the doctors & hospital listed on the EOBs was nearly $13,000. The negotiated price my private insurer paid was about 52% of what was billed - not a whole lot more than Medicare.

[zipplewrath]

5. They would control your costs

Many of the costs you would bear would be controlled by the feds, single payer gives them that clout. Of course, they'll control what you charge as well, by controlling what you pay your staff, and what equipment you're allowed to own. You might see your salary approach what teachers make.

[Greyhound]

6. Just read through HR626, all of your concerns, including the displaced workers

that an efficient system will create. Between your lowered costs and universal buy-in, the delivery system be fine. Of course, your salary might well have to come down, but that also serves to weed out those that are in it for the $.

[bluethruandthru]

7. According to PNHP, a single payer system would

be funded through an approximately 7percent payroll tax for businesses and a 2percent income tax for individuals...plus public money already being used to fund Medicare and Medicaid.

http://www.pnhp.org/facts/single-payer-faq#raise_taxes