Medicare-For-All

[esmith]

And this proves?

you made a statement and I responded with some facts. Don't you even remember what you wrote. Hint:

You think improper payments don't happen with private insurance? I find that very unlikely.

 

[Salvador]

You think improper payments don't happen with private insurance? I find that very unlikely.

"Without a doubt, there is much more fraud committed in Medicare/Medicaid than in private insurance plans. Medicare requires no preauthorization. A doctor, hospital, home care or medical supply company sends a bill electronically and a government check comes through the mail.

If the Medicare biller makes a keying error and charges 500% more, a check for 500% more is paid. With Medicare/Medicaid, no one is watching the store.This is why the so called "overhead" of Medicare is touted to be low. (Of course, that excludes the cost of HHS and the various federal agencies that participate in retroactive audits and investigations).

There are numerous estimates of Medicare fraud accounting for 5-10% of annual payments. That is a whole lot of money.

PolitiFact also found a study that restores a measure of credibility to Roskam’s estimate. Donald Berwick, a former head of the Centers of Medicare and Medicaid Services or CMS, the agency that runs Medicare, collaborated with an analyst at RAND to produce a landmark paper in 2012 inJAMA, the Journal of the American Medical Association.

That paper offers three estimates of fraud in the Medicare and Medicaid programs: a low of 3 percent, a medium of 6 percent and a high of 10 percent. CMS told us they have no official estimate of fraud but pointed us to this study, and they cited FBI figures that mirror the numbers in this paper.

Medicare fraud rate is 8 to 10 percent, says Roskam of Illinois

How much Medicare and Medicaid fraud is there? No one knows for sure. In 2010 the Government Accountability Office (GAO) released a report claiming to have identified $48 billion in what it termed as “improper payments.” That’s nearly 10 percent of the $500 billion in outlays for that year. However, others, including U.S. Attorney General Eric Holder, suggest that there is an estimated $60 to $90 billion in fraud in Medicare and a similar amount for Medicaid. Big money!
Medicare And Medicaid Fraud Is Costing Taxpayers Billions

Private insurance fraud undoubtedly occurs but it's much more difficult. Almost everything requires preauthorization. It's tedious and expensive for physicians offices but a diagnosis must be put down for every test and expensive blood tests, scans and procedures require an explanation of the rationale and often require a phone call to a reviewing physician. No pre-authorization, no payment.

A lot of the overhead involved in private insurance involves collecting premium payments (calculate the cost of comparable IRS work to collect taxes for Medicare) and measures to minimize fraud.

The claim that Medicare is more efficient than private insurance rests on flawed premises: it fails to account for rampant waste, fraud, and abuse in the Medicare program; it fails to account for the degree to which Medicare's administrative costs are borne by other government agencies; and it involves an arithmetically incorrect calculation of Medicare's administrative costs.

By assuming that low administrative costs are always better than higher ones, policy analysts ignore the value that health-insurance administration provides. Specifically, private insurers invest substantial sums in ensuring that their premium revenues are spent on legitimate health expenses rather than on fraudulent or wasteful ones.

In 2010, the Centers for Medicare & Medicaid Services estimated that the traditional, government-run, Fee-for-Service Medicare program spent $34.3 billion on improper payments—an error rate of 11 percent.[1]
Malcolm Sparrow, a Harvard expert on Medicare and Medicaid fraud, stated in a 2009 Senate testimony that in the Medicare and Medicaid programs, "[l]oss rates due to fraud and abuse could be 10 percent, 20 percent, or even 30 percent in some segments."[2] This fraud could be prevented, Sparrow said, "but to do that, one would have to spend 1 percent or maybe 2 percent (as opposed to the prevailing 0.1 percent), in order to check that the other 98 percent or 99 percent of the funds were well spent."

Private insurers have to hire employees and expend resources to collect premiums. Economist Benjamin Zycher has estimated that a full accounting for these administrative expenses would double Medicare's administrative cost ratio to 6 percent.[3]

(1) Building A Better Medicare Program: Lessons from the Private Sector

I'm not a big fan of either the government or private programs as they currently exist. Medicare waste is huge. With private plans, either I and someone in my office is spending hours a day arguing for preauthorization with an insurance hired gun on why my patient needs another PET scan. I get turned down about 2% of the time but it discourages ordering all but the necessary tests and procedures.

But the waste in Medicare/Medicaid is astounding and it's system of having the providers on an honor system with a very low risk of retrospective auditing just doesn't make sense when one considers the vast sums of money that could be better spent.

When the Mafia and Russian mob starts doing Medicare/Medicaid fraud, you know there's a whole lot of easy money to be made."

(2) Health Care Goodfellas: Mafia Turns to Medicare Fraud

(3) Medicare Fraud and the Russian Mob

https://www.quora.com/In-the-United...mitted-Medicare-Medicaid-or-private-insurance

 

[youknowme]

you made a statement and I responded with some facts. Don't you even remember what you wrote. Hint:

You gave me a link for fraud (btw, statistics are not facts); improper payments are not always a case of fraud, often they are just mistakes.

Also, I am not gonna dig though a link with no explanation for whatever you might be thinking. I am not a mind reader and I have better things to do than play 20 questions.

 

[youknowme]

"Without a doubt, there is much more fraud committed in Medicare/Medicaid than in private insurance plans. Medicare requires no preauthorization. A doctor, hospital, home care or medical supply company sends a bill electronically and a government check comes through the mail.

If the Medicare biller makes a keying error and charges 500% more, a check for 500% more is paid. With Medicare/Medicaid, no one is watching the store.This is why the so called "overhead" of Medicare is touted to be low. (Of course, that excludes the cost of HHS and the various federal agencies that participate in retroactive audits and investigations).

There are numerous estimates of Medicare fraud accounting for 5-10% of annual payments. That is a whole lot of money.

PolitiFact also found a study that restores a measure of credibility to Roskam’s estimate. Donald Berwick, a former head of the Centers of Medicare and Medicaid Services or CMS, the agency that runs Medicare, collaborated with an analyst at RAND to produce a landmark paper in 2012 inJAMA, the Journal of the American Medical Association.

That paper offers three estimates of fraud in the Medicare and Medicaid programs: a low of 3 percent, a medium of 6 percent and a high of 10 percent. CMS told us they have no official estimate of fraud but pointed us to this study, and they cited FBI figures that mirror the numbers in this paper.

Medicare fraud rate is 8 to 10 percent, says Roskam of Illinois

How much Medicare and Medicaid fraud is there? No one knows for sure. In 2010 the Government Accountability Office (GAO) released a report claiming to have identified $48 billion in what it termed as “improper payments.” That’s nearly 10 percent of the $500 billion in outlays for that year. However, others, including U.S. Attorney General Eric Holder, suggest that there is an estimated $60 to $90 billion in fraud in Medicare and a similar amount for Medicaid. Big money!
Medicare And Medicaid Fraud Is Costing Taxpayers Billions

Private insurance fraud undoubtedly occurs but it's much more difficult. Almost everything requires preauthorization. It's tedious and expensive for physicians offices but a diagnosis must be put down for every test and expensive blood tests, scans and procedures require an explanation of the rationale and often require a phone call to a reviewing physician. No pre-authorization, no payment.

A lot of the overhead involved in private insurance involves collecting premium payments (calculate the cost of comparable IRS work to collect taxes for Medicare) and measures to minimize fraud.

The claim that Medicare is more efficient than private insurance rests on flawed premises: it fails to account for rampant waste, fraud, and abuse in the Medicare program; it fails to account for the degree to which Medicare's administrative costs are borne by other government agencies; and it involves an arithmetically incorrect calculation of Medicare's administrative costs.

By assuming that low administrative costs are always better than higher ones, policy analysts ignore the value that health-insurance administration provides. Specifically, private insurers invest substantial sums in ensuring that their premium revenues are spent on legitimate health expenses rather than on fraudulent or wasteful ones.

In 2010, the Centers for Medicare & Medicaid Services estimated that the traditional, government-run, Fee-for-Service Medicare program spent $34.3 billion on improper payments—an error rate of 11 percent.[1]
Malcolm Sparrow, a Harvard expert on Medicare and Medicaid fraud, stated in a 2009 Senate testimony that in the Medicare and Medicaid programs, "[l]oss rates due to fraud and abuse could be 10 percent, 20 percent, or even 30 percent in some segments."[2] This fraud could be prevented, Sparrow said, "but to do that, one would have to spend 1 percent or maybe 2 percent (as opposed to the prevailing 0.1 percent), in order to check that the other 98 percent or 99 percent of the funds were well spent."

Private insurers have to hire employees and expend resources to collect premiums. Economist Benjamin Zycher has estimated that a full accounting for these administrative expenses would double Medicare's administrative cost ratio to 6 percent.[3]

(1) Building A Better Medicare Program: Lessons from the Private Sector

I'm not a big fan of either the government or private programs as they currently exist. Medicare waste is huge. With private plans, either I and someone in my office is spending hours a day arguing for preauthorization with an insurance hired gun on why my patient needs another PET scan. I get turned down about 2% of the time but it discourages ordering all but the necessary tests and procedures.

But the waste in Medicare/Medicaid is astounding and it's system of having the providers on an honor system with a very low risk of retrospective auditing just doesn't make sense when one considers the vast sums of money that could be better spent.

When the Mafia and Russian mob starts doing Medicare/Medicaid fraud, you know there's a whole lot of easy money to be made."

(2) Health Care Goodfellas: Mafia Turns to Medicare Fraud

(3) Medicare Fraud and the Russian Mob

https://www.quora.com/In-the-United...mitted-Medicare-Medicaid-or-private-insurance

Not interested, my mind about this was made up decades ago. You are talking to a lost cause.

 

[esmith]

Not interested, my mind about this was made up decades ago. You are talking to a lost cause.

I see, you are one of those:
Don't confuse me with facts, my mind is already made-up.

 

[youknowme]

oh, I understand.
Don't confuse me with facts, my mind is already made-up.

Statistics are not facts and clearly open to interpretation. Look it up.

 

[youknowme]

I see, you are one of those:
Don't confuse me with facts, my mind is already made-up.

Although, once I again, I do like how you turn to Statistics when you think it supports your position, but in all other cases you rail on it as being fake.

 

[youknowme]

I have no plan to spend an exorbitant amount of time arguing over the interpretation of statistics with one person who thinks they are fake except when he thinks it supports his claims, and the other that has a history of misrepresenting statistical information. Both have shown considerable disrespect to the science in the past and I have no reason to believe either will engage it honestly.

 

[Salvador]

Not interested, my mind about this was made up decades ago. You are talking to a lost cause.

Ok...let's make health care more affordable by way of taxpayer assistance along with insured cost sharing for universal catastrophic health insurance; but a Bernie Sander's version of single payer healthcare where taxpayer funds pay every dollar of everybody's medical bills would be totally non-affordable.

 

[esmith]

Statistics are not facts and clearly open to interpretation. Look it up.

Guess all you did was look at the title and not read the article....typical
The article had "facts" and "statistics" in it but I guess you couldn't bother to take the time to look......just made an assumption..
So according to you, if new facts are presented you will not be interested because your mind is already made up. Typical.

Not interested, my mind about this was made up decades ago. You are talking to a lost cause.

 

[youknowme]

Guess all you did was look at the title and not read the article....typical
The article had "facts" and "statistics" in it but I guess you couldn't bother to take the time to look......just made an assumption..
So according to you, if new facts are presented you will not be interested because your mind is already made up. Typical.

You didn't give me any facts, you gave me a link with no explanation and expected me to read your mind.

 

[esmith]

You didn't give me any facts, you gave me a link with no explanation and expected me to read your mind.

No I expected you to at least look at the article then make a educated decision on it's value

 

[youknowme]

No I expected you to at least look at the article then make a educated decision on it's value

I think you were just being lazy.

 

[esmith]

I think you were just being lazy.

No the facts were in excess of the allowed characters on this forum.

 

[youknowme]

No the facts were in excess of the allowed characters on this forum.

A link without any explanation at all is just someone being lazy.

 

[esmith]

A link without any explanation at all is just someone being lazy.

Fine, I'm done with any discussion with you concerning this thread.

 

[youknowme]

Fine, I'm done with any discussion with you concerning this thread.

OK.

 

[Shadow Wolf]

I see you haven't really talked to a doctor in a long time about things other that your health.

I'm not a doctor, but have schooling and experience as a provider. Across the board, do you think we want to do more than we have to when we already have so much to squeeze into what little time there is? The concern is actually overlooking things because so many providers are so overworked. And it's easy to do when you have clients to see and meetings to attend and people to meet and notes to write and papers to file. You think there is a desire to be bothered with more? Self-inflicted and willingly? Are you aware being on call 24/7 is pretty common?

I had a small growth (non-cancerous) removed from the back of my neck. It took 3 or 4 stitches to close the very small incision. I told him he didn't need to do it, just put a band-aid over it. His response was along the lines of "if I did that it will leave a scar" I told him I could care less he said something like maybe now but you might change your mind in the future and I would be liable. So it was basically a CYA procedure.

So, you're complaining about procedures and caution? You think a started job shouldn't be completed? There's nothing wrong with him following procedure to close a wound in order to prevent scaring. It's pretty routine.

 

[GoodbyeDave]

If doctors were to be paid less in the U.S., then there would be fewer of them; hence, there would be a shortage of health care providers here. Long waits for seeing a doctor or extreme health care rationing might be acceptable to socialist Europeans, but this would be totally unacceptable to most of us free-market capitalistic Americans.

And where is your evidence for a shortage of doctors in, say, France? Where is your evidence for delays and rationing in Germany? Like all too many USians, you are clearly ignorant about the rest of the world. As to what's acceptable to your compatriots, perhaps you should consider those who have difficulty in paying for the care of chronic illness, like type-1 diabetics. It's easy to be a "free-market capitalist" when you are healthy, in work, and well paid!

 

[Valjean]

Oh, I absolutely agree.

Just as soon as everybody ELSE does. History has shown us that every single time a powerful nation cuts back military spending...for very good reasons...other nations get greedy and 'go after." WWII and what both the UK and the US did should be a pretty good case in point.

but you are absolutely right. The problem isn't about getting US to cut back. It's about getting the Germany's and the Japans.....(though they have since joined the 'good guys,' of course) to not take advantage. What you are proposing is a fundamental sea change in human thinking. Wonderful if you could pull it off, but, er.....I don't see that happening.

So who the heck is going to invade the US if we cut back on our military a little? We could cut back 90% and still have a powerful military.
Plenty of rich, juicy countries have much smaller militaries than the US, yet manage to survive without the existential paranoia the US seems to exhibit.