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

[Texashiker]

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?

You are comparing socialized medicines to the free market?

Of course the free market is going to get paid more.

Realize a lot of the money our doctors make goes to providing health insurance for their employees.

 

[fskimospy]

You are comparing socialized medicines to the free market?

Of course the free market is going to get paid more.

Realize a lot of the money our doctors make goes to providing health insurance for their employees.

I think it's been made abundantly clear that you have no clue what health services cost.

 

[OverVolt]

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.

Correct. Before you got healthcare. Now you get... "healthcare"

Kinda like when Walmart first came out, it sold clothes. Now they sell "clothes" from China.

Cutting medicare will probably lead to more overcharging of private insurance to make up the difference, if you have employer/private insurance wait for your 2015 premiums before putting up the democrat version of the mission accomplished banner.

 

[OverVolt]

I think it's been made abundantly clear that you have no clue what health services cost.

It varies wildly by state, Maryland already had some of the lowest charges. I know its $74 for an EKG here instead of like $500-$1000 for some of the worst offending healthcare systems by state. Stuff like that.

 

[fskimospy]

It varies wildly by state, Maryland already had some of the lowest charges. I know its $74 for an EKG here instead of like $500-$1000 for some of the worst offending healthcare systems by state. Stuff like that.

If the mean charge for something so commonplace and commodified as an office visit today is $70, given the health care inflation that happened over the last two decades, it beggars belief to think that his insurance company was paying more for an office visit in the 1990's than Medicare is paying in 2014.

My guess is he was looking at the billed charge, not what the company paid.

 

[OverVolt]

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.

They go back to their desk and write orders, check diagnoses, get calls back with questions, get calls back from the pharmacy, get calls back to check your labs, etc. etc. They have to keep all this straight for 100's of patients at a time if they see that many per hour. If they screw up an obvious diagnosis they're probably going to get sued. You don't want to go to a doctor who sees 5 patients an hour.

 

[senseamp]

They go back to their desk and write orders, check diagnoses, get calls back with questions, get calls back from the pharmacy, get calls back to check your labs, etc. etc. They have to keep all this straight for 100's of patients at a time if they see that many per hour. If they screw up an obvious diagnosis they're probably going to get sued. You don't want to go to a doctor who sees 5 patients an hour.

I know you think we should shower them with unlimited Medicare money while criticizing Medicare for spending too much. But you'll have to pick one or the other.
I think $74 per 15 minute consultation visit is plenty. My dentist and his assistant actually work on cleaning my teeth for an hour for $160, he has office and staff too. I am not inclined to feel bad for someone making 2x as much per hour for just offering his opinion, and orders of magnitude more for actually performing procedures.

If a doctor is not efficient with managing information, then he should join a medical group where this is handled by a shared staff, not expect Medicare to compensate him for his inefficiency.

 

[senseamp]

You are comparing socialized medicines to the free market?

Of course the free market is going to get paid more.

Thank you for being honest that the free market approach is the reason that medicine costs so much in the US.

 

[rudder]

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?

If you are going to mention doctor pay in other countries you should really provide more relevance. That is like saying the minimum wage in the U.S. is so much worse than Australia because the rate is $15 there. Even though in the U.S. there is earned income credit. Sam with doctors. A lot of different factors come into play to simply compare income statistics.

At any rate there are loads of articles out there on how medicare reimbursement rates are affected GPs. Congress has been passing yearly temp fixes to delay further cuts which would cause even more problems.

http://www.businessweek.com/articles/2014-04-10/doctors-shun-patients-who-pay-with-medicaid

 

[senseamp]

If you are going to mention doctor pay in other countries you should really provide more relevance. That is like saying the minimum wage in the U.S. is so much worse than Australia because the rate is $15 there. Even though in the U.S. there is earned income credit. Sam with doctors. A lot of different factors come into play to simply compare income statistics.

At any rate there are loads of articles out there on how medicare reimbursement rates are affected GPs. Congress has been passing yearly temp fixes to delay further cuts which would cause even more problems.

http://www.businessweek.com/articles/2014-04-10/doctors-shun-patients-who-pay-with-medicaid

Sounds like an incentive to improve efficiency. The money is right there, just reduce your costs an you will make a profit.

 

[Slew Foot]

If the mean charge for something so commonplace and commodified as an office visit today is $70, given the health care inflation that happened over the last two decades, it beggars belief to think that his insurance company was paying more for an office visit in the 1990's than Medicare is paying in 2014.

My guess is he was looking at the billed charge, not what the company paid.

not necessarily, in 1996 medicare was paying $300 for an appendectomy, this year its around $100.

an epidural steroid injection was reimbursed at $300 in 2004, next year it $40. in real $, reimbursement goes down pretty much every year, and as it progressively gets lower, less places are willing to accept it.

 

[Slew Foot]

They are overpaid compared to other doctorates with similar experience.

no one cares about a guy with a phd in anthropology.

 

[fskimospy]

not necessarily, in 1996 medicare was paying $300 for an appendectomy, this year its around $100.

an epidural steroid injection was reimbursed at $300 in 2004, next year it $40. in real $, reimbursement goes down pretty much every year, and as it progressively gets lower, less places are willing to accept it.

Medicare has a searchable tool that allows you to look at codes and see relative billing over years. (although it only goes back to 2000). There are multiple different areas and billing codes, but for the sake of simplicity you can look at the first one.

Apparently the most common Medicare billing code for an office visit is 99213. The price paid by Medicare at a non-facility for 99213 in 2000 varies somewhat by location, but is about $45. The same office billing code price today is around $80 or more. (facility prices show a similar ratio)

Play with it yourself if you want to: http://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx

So seriously, for the last time, TH is full of shit.

 

[rudder]

Sounds like an incentive to improve efficiency. The money is right there, just reduce your costs an you will make a profit.

Or double the number of medicare patients the doctor sees. After the buzzer goes off after 4 minutes the patient then has 30 seconds to finish telling the doctor what ails him.

Or maybe get some rent-a-doctors from Cuba. Lots of options.

 

[piasabird]

I will never trust anything that the CBO says. They do not have a crystal ball. I see no reason to believe that they can reduce the cost of health care. The only way that can happen is if we have death panels.

It is hard enough to find a good doctor now.

 

[senseamp]

Or double the number of medicare patients the doctor sees. After the buzzer goes off after 4 minutes the patient then has 30 seconds to finish telling the doctor what ails him.

Or maybe get some rent-a-doctors from Cuba. Lots of options.

Sure, or you can make $73 per 10-15 minutes of medical advice.
The efficient operations will figure out how to make that profitable and grow, and the inefficient ones will disappear. You can cry for them, but I won't. Every other industry has figured out how to be more efficient and productive, it's time for Medicine to do the same and the government to stop subsidizing their inefficiency.

 

[Victorian Gray]

You are comparing socialized medicines to the free market?

Of course the free market is going to get paid more.

Realize a lot of the money our doctors make goes to providing health insurance for their employees.

A lot of those countries don't have socialized medicine. Like Canada, most, I believe, have socialized health insurance systems (or a combo of private and public insurance. Not even close to being the same thing.

here's a nice chart of who has what type of system:

http://truecostblog.com/2009/08/09/countries-with-universal-healthcare-by-date/

 

[Fern]

ACA Medicare changes took place before the individual mandate.

Perhaps I wasn't clear enough. I'm not asking about dates etc. I'm asking what specific changes did Obamacare make that directly caused the cost reduction.

Fern

 

[fskimospy]

Perhaps I wasn't clear enough. I'm not asking about dates etc. I'm asking what specific changes did Obamacare make that directly caused the cost reduction.

Fern

As I said, reductions in rates paid by Medicare, for starters. Reductions in Medicare overpayments to Advantage plans, payment penalties to hospitals with high rates of preventable readmissions, etc.

 

[Texashiker]

I think it's been made abundantly clear that you have no clue what health services cost.

Kid, I was paying medical bills while you were still sucking on your mommas tit.

Thank you for being honest that the free market approach is the reason that medicine costs so much in the US.

Exactly.

Capitalism and the free market does not work with necessities such as healthcare, food, water,,, etc.

 

[OverVolt]

Medicare has a searchable tool that allows you to look at codes and see relative billing over years. (although it only goes back to 2000). There are multiple different areas and billing codes, but for the sake of simplicity you can look at the first one.

Apparently the most common Medicare billing code for an office visit is 99213. The price paid by Medicare at a non-facility for 99213 in 2000 varies somewhat by location, but is about $45. The same office billing code price today is around $80 or more. (facility prices show a similar ratio)

Play with it yourself if you want to: http://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx

So seriously, for the last time, TH is full of shit.

I'm not on medicare and likely neither is he. :/ As the government cuts spending on medicare they try and offset that by charging insurance exorbitant prices and the insurance companies try and haggle it down. The government got confused with saving itself money as being "saving us money" but the opposite will likely happen, it'll cost anyone with actual insurance. My family has worked in healthcare for 3 generations now. Medical billing has always been stupid and set more or less arbitrarily. You can't say you're going to expand medicare-like reimbursement to cut costs as slack in medicare reimbursement is picked up for by insurance and a dwindling number of people have good employer insurance. America isn't Europe or Canada and the ACA sure isn't single payer. Thats just the reality of it. Healthcare is crumbling under the ACA at the hospital/doctors office level.

 

[Texashiker]

I'm not on medicare and likely neither is he. :/

Nope, and never have been on medicare.

eskimospy claims a doctors visit today is reimbursed at around $80. That is for new patients. Once again liberal democrats flat out lying.

Existing patients are remimbursed at a much lower rate than new patients.

Go to this page.

http://www.nytimes.com/interactive/2014/04/09/health/medicare-doctor-database.html?_r=0

Type in your doctors name, practice, and zip code.

One of my doctors is reimbursed at $51 per visit for existing patients.

eskimospy is twisting the truth and leaving out important facts. Doctors today are being reimbursed at barely above what they were making in 2000.

 

[senseamp]

Kid, I was paying medical bills while you were still sucking on your mommas tit.




Exactly.

Capitalism and the free market does not work with necessities such as healthcare, food, water,,, etc.

Yep, those are utilities, and need to be regulated as such.

 

[fskimospy]

I'm not on medicare and likely neither is he. :/ As the government cuts spending on medicare they try and offset that by charging insurance exorbitant prices and the insurance companies try and haggle it down. The government got confused with saving itself money as being "saving us money" but the opposite will likely happen, it'll cost anyone with actual insurance. My family has worked in healthcare for 3 generations now. Medical billing has always been stupid and set more or less arbitrarily. You can't say you're going to expand medicare-like reimbursement to cut costs as slack in medicare reimbursement is picked up for by insurance and a dwindling number of people have good employer insurance. America isn't Europe or Canada and the ACA sure isn't single payer. Thats just the reality of it. Healthcare is crumbling under the ACA at the hospital/doctors office level.

Have any empirical basis for this whatsoever?

 

[fskimospy]

Nope, and never have been on medicare.

eskimospy claims a doctors visit today is reimbursed at around $80. That is for new patients. Once again liberal democrats flat out lying.

Existing patients are remimbursed at a much lower rate than new patients.

Go to this page.

http://www.nytimes.com/interactive/2014/04/09/health/medicare-doctor-database.html?_r=0

Type in your doctors name, practice, and zip code.

One of my doctors is reimbursed at $51 per visit for existing patients.

eskimospy is twisting the truth and leaving out important facts. Doctors today are being reimbursed at barely above what they were making in 2000.

New patients frequently have a more extensive visit than existing ones, which is billed under a different Medicare code.

Texashiker is, as usual, either exceptionally stupid or lying.

You said doctors were paid more in the 90s than now, now you're claiming that doctors are making more than they used to. I keep asking you to put up or shut up, but you can't. Because you're a liar.