Medicare no longer a budget buster as CBO shows reduction over the years

[Londo_Jowo]

Baby boomer retirements are built into the projections.

Projections are inherently imprecise, but it's comforting to see that the CBO has been consistently overestimating Medicare costs, not underestimating them.

Agreed.

 

[Texashiker]

http://www.nytimes.com/interactive/2014/04/09/health/medicare-doctor-database.html

Interesting website. Enter a local doctor, type of practice and zip code.

A local orthopedic surgeon near me gets reimbursed sometimes 20% of the amount he bills.

 

[zinfamous]

One of the reasons for that is a significant reduction in reimbursement rates to hospitals and other healthcare providers. Agree or not about the reimbursement rate but it is forcing healthcare organizations to become much more lean in their operations. Where I work, our health system has cut 400 staff this year (mainly thru attrition) and plans are for another 400 next year.

it's inevitable. The bulk of the healthcare industry in this nation is still dependent on archaic models: paper files--which are slow, inefficient, and extremely costly.

replacing that with a digital model has always been part of the overhaul, and it always meant layoffs.

 

[dphantom]

it's inevitable. The bulk of the healthcare industry in this nation is still dependent on archaic models: paper files--which are slow, inefficient, and extremely costly.

replacing that with a digital model has always been part of the overhaul, and it always meant layoffs.

we are not. we have been electronic for about 15 years. From patient intake, thru care stages to discharge is all electronic. Lab, radiology, cardiology cancer and more all electronic. delivery of our emr is available securely anywhere in the world. Medicare makes up roughly 60% of our income. Cuts in reimbursement means significant affect on our staff, capital outlays and services we can offer.

 

[senseamp]

I guess covering more Americans for the same price isn't a cost reduction, but it's certainly a huge improvement.

Per Medicare user, it's a cost reduction. What the savings are used for is a separate discussion, but seems like covering the uninsured is a better use than an unnecessary war or two.

 

[senseamp]

http://www.nytimes.com/interactive/2014/04/09/health/medicare-doctor-database.html

Interesting website. Enter a local doctor, type of practice and zip code.

A local orthopedic surgeon near me gets reimbursed sometimes 20% of the amount he bills.

You mean that hospital billing $10K for a bandage may only get paid $2K? There is a whole orchestra of tiny violins playing a sad song over that.

 

[Texashiker]

You mean that hospital billing $10K for a bandage may only get paid $2K? There is a whole orchestra of tiny violins playing a sad song over that.

Did you look up any providers? I did.

Do you think $74 for an office visit to your doctor is acceptable? That is less than what my insurance paid in the mid 1990s.

In the 1990s my health insurance provider was paying around $90 - $95 for an office visit.

But medicare only pays $74 today almost 20 years later?

 

[fskimospy]

Did you look up any providers? I did.

Do you think $74 for an office visit to your doctor is acceptable? That is less than what my insurance paid in the mid 1990s.

In the 1990s my health insurance provider was paying around $90 - $95 for an office visit.

But medicare only pays $74 today almost 20 years later?

According to this analysis private insurers pay $76 per visit and Medicare pays $70.

Apparently you had the world's stupidest insurance company in the 1990's.

 

[Texashiker]

Apparently you had the world's stupidest insurance company in the 1990's.

I am pretty sure you were on mommy and daddies insurance in the 1990s.

So you probably have no idea what you are talking about.

Why are doctors fleeing medicare? Because doctors lose money by taking it.

 

[fskimospy]

I am pretty sure you were on mommy and daddies insurance in the 1990s.

So you probably have no idea what you are talking about.

Why are doctors fleeing medicare? Because doctors lose money by taking it.

Either there has been flat or negative medical cost inflation since then or you're full of shit.

Guess which one it is.

http://money.cnn.com/2014/04/21/news/economy/medicare-doctors/

 

[Jhhnn]

According to this analysis private insurers pay $76 per visit and Medicare pays $70.

Apparently you had the world's stupidest insurance company in the 1990's.

Ring-a-ding-ding!

 

[Fern]

I'm not particularly interested in projections. I prefer the actual numbers.

From the chart the OP links I see what looks like a decrease staring in 2011 from $12,000 to about $11,100. How did Obamacare cause this? Obamacare just began this year.

If it's merely cuts in fees, that's not Obamacare. That's been going on long before Obamacare passed.

What about Medicaid?

Fern

 

[ivwshane]

I'm not particularly interested in projections. I prefer the actual numbers.

From the chart the OP links I see what looks like a decrease staring in 2011 from $12,000 to about $11,100. How did Obamacare cause this? Obamacare just began this year.

If it's merely cuts in fees, that's not Obamacare. That's been going on long before Obamacare passed.

What about Medicaid.

Fern

The ACA was passed in 2010, the mandate went into effect this year, a ton of other stuff happened immediately. The cuts to Medicare were also apart of the ACA.

Were you living in a cave in 2010?

 

[senseamp]

Did you look up any providers? I did.

Do you think $74 for an office visit to your doctor is acceptable? That is less than what my insurance paid in the mid 1990s.

In the 1990s my health insurance provider was paying around $90 - $95 for an office visit.

But medicare only pays $74 today almost 20 years later?

Sure, a doctor usually sees 4-5 patients an hour. That's $300+ per hour, for just seeing him, and that's before he does any tests and procedures. Just because your insurance paid more before, doesn't mean he is not adequately paid now.

 

[fskimospy]

I'm not particularly interested in projections. I prefer the actual numbers.

From the chart the OP links I see what looks like a decrease staring in 2011 from $12,000 to about $11,100. How did Obamacare cause this? Obamacare just began this year.

If it's merely cuts in fees, that's not Obamacare. That's been going on long before Obamacare passed.

What about Medicaid?

Fern

Obamacare didn't just start this year. Don't confuse the individual mandate with obamacare.

 

[Fern]

Obamacare didn't just start this year. Don't confuse the individual mandate with obamacare.

Can you explain how Obamacare helped reduce Medicare costs? (Honest question)

TIA

Fern

 

[senseamp]

PA is accepting Medicaid expansion now.
Game Over, GOP.

 

[fskimospy]

Can you explain how Obamacare helped reduce Medicare costs? (Honest question)

TIA

Fern

ACA Medicare changes took place before the individual mandate.

 

[IronWing]

Force medicare to pay fair market value for doctor serves and see what happens.

I'm game. What is fair market value for medical care?

 

[rudder]

You mean that hospital billing $10K for a bandage may only get paid $2K? There is a whole orchestra of tiny violins playing a sad song over that.

Many doctors run their own business. Collecting $74 for something that cost them $100 is not the best way to stay in business. Doctors have to cover salaries (nurses, office staff), rent, supplies, insurance, etc etc.

So when you are on medicare have a hard time finding a general practitioner... remember that tiny violin playing.

 

[Victorian Gray]

Many doctors run their own business. Collecting $74 for something that cost them $100 is not the best way to stay in business. Doctors have to cover salaries (nurses, office staff), rent, supplies, insurance, etc etc.

So when you are on medicare have a hard time finding a general practitioner... remember that tiny violin playing.

Average GP sees around 24 patients per day. If all of them were medicare patients, 24x$74= $1776.00/day. Work 5 days per week, $8880.00/week. Work 4 weeks per month, $35,520.00/month. Work 10 months per year, $355,200.00/year. note: I used 10 months per year because my family doctor takes about 2 months per year off but he also works in a combined practice with 6 other doctors. I suspect a single physician practice would take less time off per year.

And that is if the doctor only takes in medicare patients.

Average yearly salary for a GP in the US is a bit over $150,000.00 so that leaves our hypothetical 'see only medicare patients' family doctor with $200,000 to cover his/her expenses.

How many family doctors in the US do you think there are who only see medicare patients?

 

[shira]

Many doctors run their own business. Collecting $74 for something that cost them $100 is not the best way to stay in business. Doctors have to cover salaries (nurses, office staff), rent, supplies, insurance, etc etc.

So when you are on medicare have a hard time finding a general practitioner... remember that tiny violin playing.

Somehow, doctors in most other first-world countries make considerably less than U.S. doctors, yet they're not all folding up their practices. Does that suggest, possibly, that U.S. doctors are currently OVERpaid relative to doctors in other countries?

Notice that US GPs - you know, the doctors you go to the most - are by far the highest paid in the world. And American specialists are very close to being the highest paid in the world. (Note: Yes, this is 2007 data, but it's the most recent comparison data that's out there. And there's no reason to suspect that the rankings are significantly different now than they were seven years ago.)

Given this data, how - by any measures - can American doctors be considered to be "suffering" because of low Medicare payments?

 

[Slew Foot]

Somehow, doctors in most other first-world countries make considerably less than U.S. doctors, yet they're not all folding up their practices. Does that suggest, possibly, that U.S. doctors are currently OVERpaid relative to doctors in other countries?

Notice that US GPs - you know, the doctors you go to the most - are by far the highest paid in the world. And American specialists are very close to being the highest paid in the world. (Note: Yes, this is 2007 data, but it's the most recent comparison data that's out there. And there's no reason to suspect that the rankings are significantly different now than they were seven years ago.)

Given this data, how - by any measures - can American doctors be considered to be "suffering" because of low Medicare payments?

Physicians compared to others in the US of similar intellect and training (law partners, accountants, MBAs) are underpaid.

 

[senseamp]

Many doctors run their own business. Collecting $74 for something that cost them $100 is not the best way to stay in business. Doctors have to cover salaries (nurses, office staff), rent, supplies, insurance, etc etc.

So when you are on medicare have a hard time finding a general practitioner... remember that tiny violin playing.

They are getting paid $74 for 15 minutes of consulatation before they do anything like a procedure or a test. Enough is enough. If you can't make your business work getting paid $300 per hour for offering your professional opinion, then you suck at business. Go work for Kaiser and let someone else handle the business side.

 

[senseamp]

Physicians compared to others in the US of similar intellect and training (law partners, accountants, MBAs) are underpaid.

They are overpaid compared to other doctorates with similar experience.