Emergency Action Alert--Stop biggest expansion of govt. (Medicare drug plan) since LBJ

Wall Street Journal/Stephen Moore | November 20, 2003 | Wall Street Journal/Stephen Moore

[bonesmccoy]

The bill returns competitive forces to healthcare in our nation.

Under Clinton Admin momentum, the health care system of our nation has been converted to a socialistic one.

Hospitals in most major metropolitan areas receive the lionshare of funding under "risk pools" which make massive allocations of tax payer dollars to hospitals. These allocations have little to do with services because the payments do not correlate to amount of service rendered.

This new legislation specifically creates "FEE FOR SERVICE" models where the physician and hospital are paid ONLY when services are rendered.

In our county nearly 99% of current Medi-Care/Caid funding is tunneled through liberal hospitals (some lead by execs who publicly profess commitment to socialistic models).

These hospitals then dump the funds to foreign bank accounts.

Meanwhile, the primary care physician site only receives about 1% of the total premium paid by the fed to states.

[4CJ]

The bill returns competitive forces to healthcare in our nation.

Granted. But it still leaves the taxpayers to fund it. When the government purchases goods & services, private entities will reduce rates to obtain the business - guaranteed customers/profits on the voulume of business. But the companies shift costs to their remaining customers. The medical practices basically have a medicaid/medicare rate, a state-insurance rate, and uninsured rate, an insured rate, and a rate for cash services. Our taxes pay for the 1st two, the second pair are still paid by us in the form of higher premiums and charges, and cash customers are almost non-existant. Even then, low-income recipients of services can usually have their charges reduced or wiped out by simply placing a phone call - it happened at my wife's office for years, and our local hospital has an entire office devoted to such. The practices have to make that lost revenue up somewhere.

This new legislation specifically creates "FEE FOR SERVICE" models where the physician and hospital are paid ONLY when services are rendered.

A step in the right direction. Just as Medical Savings Accounts are a step, but only add to the bureacracy..

Meanwhile, the primary care physician site only receives about 1% of the total premium paid by the fed to states.

If that happended in a third-world country, we'd go ballistic. Just more proof that the government should remain out of the medical field, and end the socialist program altogether.

[BureaucratusMaximus]

Americans will be waiting in line behind them in the ERs. The illegals get everything for free.

(snicker)...I've already realized that if you whine and complain about the ER waitime in broken English...you have a better chance to get pushed up in line. It happened to my wife last week. A woman speaking spanglish was carrying on and on and on...and not 5 minutes after...got called in. My wife is pregnant and was having severe abdominal pains. (she and baby are fine now but thats not the point) You'd think a pregnant woman would get top priority at an ER...no matter...after a 3 hour wait, we went to different hospital where speaking broken English was not a prerequiste to get looked at. I guess this is what we have to look forward to unless you live in an area where the majority of people do not depend on the welfare state, don't speak spanish, and don't expect the silver spoon because of their "minority" status.

[bonesmccoy]

Hearing you lecture me about physician fees is funny. You haven't a clue how the medical billing systems work and have failed to disclose how HMO plans reimburse contracted physicians.

PPO, POS, and HMO plans are handled in totally separate fashion.

The reform contained in this bill reinforces fee-for-service systems where physicians and hospitals get paid for delivering care, not for political shenanigans that busts-out on medical networks.

HMO networks are the cause of the problem. Privatization of medi-care will NOT resolve the problem because legislation is needed to bans the transfer of financial risk from insurers to physicians.

HMO's function on false pretenses that do not reflect economic realities nor on medical reality.

But, if you are so committed to HMO's and privatization, I suggest that you tell that the families in our practice who have suffered from delays and injuries CREATED BY the delays of the HMO medical groups in this area.

[4CJ]

Hearing you lecture me about physician fees is funny. You haven't a clue how the medical billing systems work and have failed to disclose how HMO plans reimburse contracted physicians.

If you think I'm LECTURING you, then you're sadly mistaken. I certainly know how medical billing works, my wife worked for a family practice, I know the doctors well, and have discussed this exact issue. We also work with the local hospital, and was there just last week discussing this issue again. Participating HMO physicians are paid a monthly fee based on the number of members selecting them as their primary care provider. If the doctor/facility can reduce expenses they can increase profits, some plans pay bonuses to providers based on their not exceeding a cost threshold.

But I'm not arguing for HMO's, PPO's or any other plan - privatization is great - get the government out of insurance period.

[bonesmccoy]

OK... somehow you've left out the fact that HMO's send a cap check to the hospital for each patient being cared for by the medical group.

So, basically, the hospital gets paid for rendering no service and the medical group gets paid when rendering no service.

Your analysis is flawed because you are not privy to the cap rates paid to physician offices under medicare HMO plans.

These plans send only $5.00 per month to most physicians.

You can't render ANY care at that rate.

[4CJ]

Your analysis is flawed because you are not privy to the cap rates paid to physician offices under medicare HMO plans.

If you'll go back through all my posts on this subject, the one constant is that I advocate that the government leave this issue to the citizens, not that I support HMO's or any other plan with government funding.

These plans send only $5.00 per month to most physicians.

Why were HMO's, PPO's formed in the first place? To offer a low cost alternative. With that low-cost is low service.

[bonesmccoy]

Sir,

The appearance of HMO's correlates to the appearance of Hillary Clinton and her healthcare agenda.

HMO's are NOT a cost cutting technique. That was only the PR rationale.

IMHO, HMO's were created to:
1. Socialize healthcare
2. Corrale medical information into massive databases for data mining
3. Redlining of particular communities (ethnic or religious) to kill growth there
4. Greed- shift healthcare dollars out of the nation into off shore bank accounts

[texastoo]

I am sure what you said is true. It is sad about what is happening to our hospitals. The reason more people are not concerned with this issue is it has not happened to them. The percentage of people using a hospital every year is probably less than 10% of the population.