Subj : OBAMACARE To : BOB ACKLEY From : BOB KLAHN Date : Sun Feb 06 2011 13:54:54 ... RS>> A friend of mine's Mom works in accounts at a local hospital, the RS>> "indigent" patients (meaning those who can't pay,) their bill ends up RS>> getting eaten by the hospital. RS>> The hospital then has to jack up their rates to cover those losses. RS>> That's why an aspirin shows up on the bill costing $3.50. BA> What the f*ck do you think I've been saying for the past 20 BA> years??? Now that you apparently understand that fact, BA> would you mind explaining it to Klahn? I understand it, I don't believe it. No hospital can charge you $3.50 for an aspirin just because they have to cover another patient's bills. No for profit hospital will charge any less than they can get away with whether or not another patients bills are covered. RS>> Recently I've read about a major operation in Florida, hunting down RS>> and arresting dozens of Medicare fraud crooks. RS>> "60 Minutes" has a feature on how easy it was to commit fraud on RS>> Medicare. RS>> And how profitable Medicare fraud is. BA> While it does exist, it's not nearly as rampant as the BA> politicos would have us believe. And yes, those who engage BA> in it should be locked up for a nice long time. I have been of that opinion for a long time. Crooks will defraud private insurance just as much as medicare. And the medicare frauds seem to tend to be doctors and medical providers, not the patients. BA> That said, the biggest Medicare fraud is the claim that BA> Medicare pays the bills for BA> the health care received by the nation's elderly. It BA> doesn't, and hasn't for probably BA> thirty years. What it pays is a *portion* of those bills. My private sector insurance does exatly the same thing. What's the difference? BA> When Medicare started BA> discounting its payments, providers started billing the BA> patients for the unpaid balances. That is what I do not believe. Those private for profit hospitals will charge whatever they can get, regardless of what other patients pay or don't pay. In a truly competitive market they could not get away with that at all. Some hospitals would just not take the medicare payments and patients, then cut the bills of their regular patients and the ones overcharging would lose business. Believe it or not that is how a real free market works. The fact that you don't see that at all is the proof there is no free market. It is also the proof that the conservative mantra of private sector competition is a fraud. BA> Said patients screamed to their congresscrooks, who BA> promptly made it illegal for providers BA> to bill Medicare patitnts for any unpaid charges. The providers can't bill me for the discounted part from my private sector insurance. What's the difference? BA> Medicare is also infamous for slow payment - 90 days is BA> *early* to them. Note that ... BA> and payments were made by EFT. There's no reason on earth BA> that an insuror should need BA> more than *TEN* days to pay a claim (fraud investigations True. So solve that problem. Oh and if the republicans have any solutions at all, why didn't they fix that in the 6 years they had complete control of the federal government? BA> can come later). Yet Medicare BA> rarely takes ANY action on a claim for 90 days; then it BA> disallows every charge it thinks it BA> can get away with and writes itself a humongous discount on BA> the remaining balance - only BA> rearely does Medicare pay even half of the billed amount. My private sector insurance typically pays about 36% or less. What's the difference? ... BA> bill just shy of $50K for my angioplasty and stent back in BA> 2004. Tricare paid just shy of BA> $9,000 of those charges. MY share of those charges was a BA> whopping $33.00. The other BA> forty grand - EIGHTY PERCENT of the billed amount - went BA> where all the other unpaid BA> charges go, onto other peoples' bills. And it took Tricare Again, I do not believe that. If the hospital and doctors found the medicare payments insufficient they would simply refuse to do business with them. ... BA> And unpaid charges - even those for 'uncompensated care' BA> and 'charity care' - don't just BA> go away because they don't get paid. They get factored BA> into everybody else's bills, just BA> like shoplifting and employee theft are factored into the BA> prices on retail merchants' shelves. The big difference is, the hospitals can stop taking medicare, store owners can try to stop theft, but they can't just refuse to do business. About 2/3rds of medical care in this country is paid for by the government or insurance. Much of the rest is paid for by the patients. Since, in many cases where bills have to be covered before treatment will be provided, the patient does have to pay the bills, those cover the bills that actually are paid. So, about 2/3rds of medical bills are discounted, usually by more than 50%. That tells me the other 1/3rd is overcharged. And the hospitals can't double the bills of all other patients just because of the 2/3rds that are discounted. Ok, That would mean just more people who are not paying. Oh, I just recently paid cash for a doctor bill that was not covered by insurance. The bill was reduced by something like 40%. So, how can doctors cut bills for cash payments if they have to make up for third party discounts? My suspicion, the original bill is jacked up to allow for the discounts. And once everyone is covered by insurance I believe they won't be able to do that anymore, since eveyone will know what will be paid in advance. So, Obamacare is the answer even to that. BOB KLAHN bob.klahn@sev.org http://home.toltbbs.com/bobklahn .... DOOR:(n). Something you throw Windows out of. --- Via Silver Xpress V4.5/P [Reg] * Origin: Doc's Place BBS Fido Since 1991 docsplace.tzo.com (1:123/140) .