http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=439x87463newtothegame (1000+ posts)
Wed Dec-29-10 11:16 AM
Original message
The problem with Medicare for all is the false assumption that Medicare is working now.
Edited on Wed Dec-29-10 11:23 AM by newtothegame
I work in a non-profit cancer center providing medical oncology and radiation oncology. We are reimbursed ~$.51 on the dollar for Medicare patients and ~$.38 on the dollar for Medicaid patients. Contrary to many DU'ers beliefs about healthcare, this is on our COSTS, NOT CHARGES. So we are losing $.49 for every dollar on Medicare patients (treatments usually costs tens of thousands of dollars) and $.62 for every dollar on Medicaid patients. Medicare and Medicaid make up 70% of our patients. We are the only cancer treatment option for 90 miles around, and being extremely rural, our average patient is over 60 years old.
As a non-profit, we don't need or want a profit. But we do need to cover costs to keep our doors open. Buy the medicines, pay the workers, etc. And covering costs would not cover purchasing of new medicines, or new technology, or expanding our space as we see more patients.
We also lose money on most commercial insurers, but it isn't nearly as bad. We get ~$.80 on the dollar for our costs for commercial payers.
The only reasons we're still open is because 1) we have a benefactor who passed away in the mid 90's but whose foundation still regularly donates and 2) we as staff take barebones pay and do everything we can to keep expenses to a minimum because we care so much about this place and our patients, and realize how devastating it would be to see it go.
So my question to the "Medicare for All" folks is, if our government can't afford to reimburse Medicare care at more than $.51 on the dollar NOW, how the HELL would we stay open to treat patients if ALL our patients were Medicare/Medicaid? Our doors would be closed within 60 days and the only provider of cancer care in 30 counties would be gone.
The ONLY reason Medicare seems like such a great and affordable program to so many is because Medicare isn't actually paying for care at all. It's affordable to you because it's BANKRUPTING hospitals and clinics. Medicare for All is not a realistic cry at this point unless the government decides to make Medicare a TRUE reimburser of care.
On edit: Sorry for the rant, but this issue really upsets me and I think there's a lot of misinformation amongst those who don't actually work in healthcare.
How is that post allowed to stay on the DU? Holy smoke. Talk about speaking truth to power.
NNN0LHI (1000+ posts)
Wed Dec-29-10 11:25 AM
Response to Reply #1
8. How is my memory on this?
When Dennis Kucinich and some others came out in favor of Medicare for all last year didn't everyone say, "Yea, buddy, sure sounds good to me.", until the costs for such a program were revealed?
As I recall, and I may be wrong, the price was between $600 and $800 per person per month, depending on the state. At that point everyone became unexcited about DK's idea?
Am I remembering this right? Or did I dream that?
Don
Recursion (1000+ posts)
Wed Dec-29-10 11:28 AM
Response to Reply #8
10. Yep. We worked that out several times on the board
And the $600 to $800 per person only gets the level of under-reimbursement that the OP is having to deal with.
But, at some point, supporting single payer as an idea became more important than finding a way that we could actually afford to pay for the healthcare of an obese, unhealthy, and economically unequal nation.
Who are these people?? Damn. This doesn't look like the DU.
tavalon (1000+ posts)
Wed Dec-29-10 11:20 AM
Response to Original message
3. Yeah, having just helped hubby give away his medicare in favor of an HMO
so he can actually get care, I've been rather appalled. I do want single payer but I also want the "healthcare system" to be government owned and controlled. But then, I'm not just a nurse, I'm a socialist. I really believe the biggest problem is the leeches upon the system.
Ahhh there's the DU we all know and love so much.
But wait .... what's THIS??
Ron Green (1000+ posts)
Wed Dec-29-10 11:26 AM
Response to Original message
9. It's simple, if not easy:
1) Everybody in, nobody, out. Medicare for all.
2) Quit subsidizing Big Corn, and Big Soy and make policy that truly builds the public health.
3) Have a realistic dialog about death and all the kinds of end-of-life issues that have been driven for decades by the AMA, Big Pharma and other corporate players. Look at "hospice" rather than "hospital" as a first choice.
I thought Sara Palin was the total idiot for mentioning Death Panels! What the ...?? You mean DUmmies are now mentioning it? Wow.
It's a small thread. Probably destined to stay that way.
KC
