How would vouchers reduce Medicare costs?

[Vette73]

http://biggovernment.com/ptuohe/2009/10/05/ama-endorses-largest-denier-of-health-care-claims/

Ha ha really, thats what pass's for objective facts in your book.

They only looked at 8 total plans and Medicare had OVER 6 million claims while 2 of the others had less then 25k in claims.
Thats like saying McDoanlds makes more people sick every year then my grandmothers kitchen. We should shut down McDonalds till they can keep up with my BooBoo. :biggrin:

Let me guess, you watch fox.

 

[Hayabusa Rider]

Ha ha really, thats what pass's for objective facts in your book.

They only looked at 8 total plans and Medicare had OVER 6 million claims while 2 of the others had less then 25k in claims.
Thats like saying McDoanlds makes more people sick every year then my grandmothers kitchen. We should shut down McDonalds till they can keep up with my BooBoo. :biggrin:

Let me guess, you watch fox.

Let me guess you have no clue about health care or insurance. Those other plans are among the largest private carriers out there. Medicare has more rejections AND a higher percentage.

 

[Tom]

No I do not expect consumers to be smarter than doctors, but I dont think it is a significant problem to have a consumer shop around for common tests either.

I think we could agree on something, the current system doesn't function correctly as a market because the suppliers and consumers don't have true market pressures applied to them.

However, vouchers don't change that, All they do is limit the amount the 3rd party will pay; that doesn't give the consumer any more power thsn they have now.

I don't think true market pressure is achievable in some kinds of healthcare, in order for there to be a market there has to be an upper limit, which means in the case of healthcare it's acceptable to let people die if they can't or won't pay. That's not a principal that is accptable to me or to most Americans.

 

[Zebo]

That is not correct. It would force everyone with a voucher to make better decisions about how their money gets spent. You will find that doctors will bill services for less when they are paid for in cash, rather billed though insurance.

Not true at all. Insurance is a huge reason doctors and other HC pros are leaving the profession. They dictate what is paid often not covering costs. Medicare is famous for that but other insurances do it too. You think a Doctor is going to bill you even less than sorry insurance remuneration they are unhappy with in the first place? I don't think so.

I had an MRI done before my surgery a couple months ago and Doctor billed over $4000 and was paid about $800 by my insurance (Celtic sends me statements to let me know my share). I am going to call and see what it would have cost if I said I want to pay cash.

 

[Engineer]

I had an MRI done before my surgery a couple months ago and Doctor billed over $4000 and was paid about $800 by my insurance (Celtic sends me statements to let me know my share). I am going to call and see what it would have cost if I said I want to pay cash.

Not a medical doctor, but I asked my dentist office if there were any discounts for paying cash vs insurance and they said that there were no discounts for cash at all. I told them that insurance adjust their prices down and pays them after the adjusted prices. I asked them if they adjusted the prices down for cash or if they charged the same full "initial" price that they submitted to insurance. They told me that they charge FULL initial insurance prices for cash.

I would think that paying cash (up front even) and having the office not have to deal with insurance would be worth discounts of AT LEAST what the insurance company forced discounts would be. I was surprised to hear this.

This was my first attempt to negotiate with any type of doctor/dentist and I was terribly disappointed. When I lose insurance in a few weeks, I guess it's off to the college of dentistry at UK or I'll be negotiating with a few new dentists around to see if they are more willing to negotiate lower cash price rates.

 

[Vette73]

Let me guess you have no clue about health care or insurance. Those other plans are among the largest private carriers out there. Medicare has more rejections AND a higher percentage.

You mean like Aetna with its 600k to medicares 6million, yet they both had in the same 6% reject rate. Like that. :biggrin:

EDIT: Actually medicare and aetna look good when you look at MORE then just a few hand picked plans...

"In the first six months of this year, the group found denial rates ranged from 6.4 percent for Aetna to 39.6 percent for PacifiCare. According to the analysis, Cigna rejected 32.7 percent of medical claims, Health Net denied 30 percent of the time and Kaiser Permanente and Anthem Blue Cross each rejected about 28 percent of their claims."

Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/09/04/BUFB19ICL2.DTL#ixzz10G0920Dn

Makes 6% look great.
Damm FACTS!!! getting in the way of faux outrage again.

 

[Vette73]

Not a medical doctor, but I asked my dentist office if there were any discounts for paying cash vs insurance and they said that there were no discounts for cash at all. I told them that insurance adjust their prices down and pays them after the adjusted prices. I asked them if they adjusted the prices down for cash or if they charged the same full "initial" price that they submitted to insurance. They told me that they charge FULL initial insurance prices for cash.

I would think that paying cash (up front even) and having the office not have to deal with insurance would be worth discounts of AT LEAST what the insurance company forced discounts would be. I was surprised to hear this.

This was my first attempt to negotiate with any type of doctor/dentist and I was terribly disappointed. When I lose insurance in a few weeks, I guess it's off to the college of dentistry at UK or I'll be negotiating with a few new dentists around to see if they are more willing to negotiate lower cash price rates.

A lot of places give very big cash discounts. But many don't as they just make more money. Its cheaper for me to pay cash to have my teeth cleaned then use insurance after I called around.
The office my mom works at 1 persons job is about 75% of the time spent just doing paper work for insurance claims. There have also been stories how some offices are cash only and if you have insurance YOU bill them not the doctors office.

 

[Hayabusa Rider]

You mean like Aetna with its 600k to medicares 6million, yet they both had in the same 6% reject rate. Like that. :biggrin:

EDIT: Actually medicare and aetna look good when you look at MORE then just a few hand picked plans...

"In the first six months of this year, the group found denial rates ranged from 6.4 percent for Aetna to 39.6 percent for PacifiCare. According to the analysis, Cigna rejected 32.7 percent of medical claims, Health Net denied 30 percent of the time and Kaiser Permanente and Anthem Blue Cross each rejected about 28 percent of their claims."

Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/09/04/BUFB19ICL2.DTL#ixzz10G0920Dn

Makes 6% look great.
Damm FACTS!!! getting in the way of faux outrage again.

Nice

I forgot California is a nation to it's own. The other companies are all represented in the east. Now Anthem I'm familiar with, and the question is are these final rejections or initial? I've never heard of docs not being paid a third of the time, because they would drop them, but I have heard from the horses mouth that they are frustrated because they often don't get paid by medicare.

 

[Hayabusa Rider]

Also note that UHC now owns PacifiCare.

 

[Hayabusa Rider]

Ahh, found it from your article.

The trade group representing the state's health insurers said the nurses' numbers fail to reflect the reasons behind the denials, which may include requests for more information, paperwork errors and duplicate claims, as well as claims submitted to the wrong health insurer.
"It appears that a good deal of the so-called denials are merely paperwork issues between providers and plans and have little financial impact on consumers or impact the care received," said Nicole Kasabian Evans, spokeswoman for the California Association of Health Plans.


​

I get rejections all the time because of paperwork problems, with which your mother apparently quite familiar. We get paid, but it's a PIA.

 

[Vette73]

Ahh, found it from your article.




I get rejections all the time because of paperwork problems, with which your mother apparently quite familiar. We get paid, but it's a PIA.

Medicare also does the same. The dentist office my mom works at also takes Gov insurance and gets the same request from them.
Medicare is no differant then any other and usually the complints are they are to easy to get a bill paid, fraud, then turned down. You piss off someone and they call their Congress man on medicare. A private group just says policy bla bla then you have to sue or call the news and hope its enough heat to get your claim.

Just funny that as much heat as Medicare takes for paying claims that should be turned down now right wingers are now trying to say they turn down to many. Can;t win either way.

 

[Turin39789]

Nice

I forgot California is a nation to it's own. The other companies are all represented in the east. Now Anthem I'm familiar with, and the question is are these final rejections or initial? I've never heard of docs not being paid a third of the time, because they would drop them, but I have heard from the horses mouth that they are frustrated because they often don't get paid by medicare.

Yea I can't imagine the study linked is any good at all, because of the myriad of reasons for denials, the limited scope and question itself.

I don't know why they would have trouble getting paid from medicare, medicare is nice in that all of their rules are clearly posted on cms.gov and the local plan administrators websites. You should be able to figure up your reimbursement before you even submit the claim.

 

[Anarchist420]

What they ought to do is just make all medical costs tax-deductable.

Anyways, I'm kind of torn on the vouchers thing, although quantumpion makes a pretty good logical argument as to why they would be cheaper to the tax payer.

They should also start by repealing Part D or like importing canadian drugs and only paying for 3/5 of those. We're bankrupt, and we can't keep paying for welfare/ warfare.

 

[IronWing]

What they ought to do is just make all medical costs tax-deductable.

Like they are now? Okay.

Also, more importantly: YOU REPLIED IN ONE OF YOUR OWN THREADS! HOLY SHIT!

 

[Turin39789]

If the grocery store offered an all-you-can-eat plan to let you buy whatever you wanted with no limit for $500 a month, would you be inclined to buy more than $500 a month worth of groceries? How long do you think they would last before they would have to raise the price of their plan?

What they ought to do is just make all medical costs tax-deductable.

Anyways, I'm kind of torn on the vouchers thing, although quantumpion makes a pretty good logical argument as to why they would be cheaper to the tax payer.

They should also start by repealing Part D or like importing canadian drugs and only paying for 3/5 of those. We're bankrupt, and we can't keep paying for welfare/ warfare.

Anyone who thinks medicare is an all-you-can-eat plan is crazy. It has many limitations, has pretty strict cost controls as well. Many providers do complain that medicare underpays them, they then try go get even more out of their commercial payors to make up for what they feel they should get, since getting medicare reimbursement rates to increase is like getting blood from a turnip, and if all else fails the billed charges by most(but not all) providers are hugely excessive compared to the rates that they negotiate with health plans and they have a chance of pursuing these fanciful charges from health plans who they are not contracted with or from uninsured individuals.

 

[Throckmorton]

That is not correct. It would force everyone with a voucher to make better decisions about how their money gets spent. You will find that doctors will bill services for less when they are paid for in cash, rather billed though insurance.

Go and research the costs of individual health insurance, and come back with your findings.