Texas Ebola patient dies

[theeedude]

Red staters would leave to leave your sorry ass, but you stupid fucking blue staters are so dumb you keep preventing it.

Well you won that argument, now bye

 

[Fern]

Not really. Like all other organizations, hospitals are free to not accept Medicare or Medicaid if it is unprofitable. They don't do this. So either they are really bad at accounting, or Medicare and Medicaid make them money.

That private clinics and doctors' offices don't accept Medicaid/Medicare demonstrates that many of the fees are insufficient.

And Medicare/Medicaid is an 'all in, or all out' type of program. If you enroll in the programs as a provider you must accept treatment and their fees for all you are able to professionally provide. I.e., you can't say we'll sell oxygen but we won't sell wheelchairs because those are money losers.

Hospitals are mostly nonprofit set up by local govt entities (counties etc.) so of course they're going to accept Medicare/Medicaid as many residents (voters) of that govt entity are on those programs. It would be politically impossible for such a hospital to not accept those programs. And I think very unfair and morally unacceptable as many on Medicare/Medicaid pay their real estate and sales taxes that support those hospitals.

Fern

 

[Fern]

You know what is funny, is how most people in the world couldn't be bothered to donate, a single penny to help with Ebola. There is no major donation drive for Ebola, because they couldn't get any donations from people in the west.

If this does manage to spread a significant amount beyond Africa, the people to blame will be much of the west, who just couldn't care.

Umm... There are Western programs, both governmental and private, with campaign drives to fight Ebola and help Western African countries: https://www.google.com/search?q=ebo...a:en-US:official&client=firefox-a&channel=nts

Fern

 

[fskimospy]

That private clinics and doctors' offices don't accept Medicaid/Medicare demonstrates that many of the fees are insufficient.

No it isn't?

And Medicare/Medicaid is an 'all in, or all out' type of program. If you enroll in the programs as a provider you must accept treatment and their fees for all you are able to professionally provide. I.e., you can't say we'll sell oxygen but we won't sell wheelchairs because those are money losers.

Right, but in the aggregate they make money. If they didn't, they wouldn't accept it. Business 101.

Hospitals are mostly nonprofit set up by local govt entities (counties etc.) so of course they're going to accept Medicare/Medicaid as many residents (voters) of that govt entity are on those programs. It would be politically impossible for such a hospital to not accept those programs. And I think very unfair and morally unacceptable as many on Medicare/Medicaid pay their real estate and sales taxes that support those hospitals.

Fern

Approximately 25% of hospitals are set up by governments and about 20% are private, for profit. The remainder are private, nonprofit hospitals. So no, they are not "mostly" that at all, and needless to say the overwhelming majority of hospitals of all types accept Medicare and Medicaid.

You may have gotten some bad info somewhere.

 

[Hayabusa Rider]

That private clinics and doctors' offices don't accept Medicaid/Medicare demonstrates that many of the fees are insufficient.

Yeah it's pretty bad. In my field we about break even with Medicaid, well almost. Medicare D is a loss, but not bleeding bad. Part B is robbery, especially with diabetic supplies where reimbursments are commonly 20 cents on the dollar of acquisition costs. Like you say it's suicide to not take those plans though so staffing gets cut to compensate creating a genuinely dangerous environment. I can't wait to retire.

 

[Victorian Gray]

Second patient in Dallas confirmed Ebola.

Again, thank you Rick Perry.
If Texas did not have so many uninsured, and Duncan could have had health insurance, Duncan would have been admitted to that hospital with the first visit.

Because of Obamacare reforms, governors of states now play a direct role in deciding if that state should accept and cooperate with ACA, or nay.
A direct role.
You can not hide the fact that Rick Perry would not and did not wish to cooperate with ACA.
Try as some may, the facts are the facts.

Duncan could have had affordable health insurance and his chances would have been greatly increased for admittance to any hospital, as well as his chances for survival.

[blah, blah, blah]

.

You know, when you discuss an issue it might help to actually know something about the issue.

DUNCAN WAS NOT AN AMERICAN CITIZEN! WHAT THE HELL DOES RICK PERRY'S STANCE ON THE ACA HAVE TO DO WITH THIS CASE?

 

[Hayabusa Rider]

You know, when you discuss an issue it might help to actually know something about the issue.

DUNCAN WAS NOT AN AMERICAN CITIZEN! WHAT THE HELL DOES RICK PERRY'S STANCE ON THE ACA HAVE TO DO WITH THIS CASE?

I think he's just an auto script posting.

 

[theeedude]

Yeah it's pretty bad. In my field we about break even with Medicaid, well almost. Medicare D is a loss, but not bleeding bad. Part B is robbery, especially with diabetic supplies where reimbursments are commonly 20 cents on the dollar of acquisition costs. Like you say it's suicide to not take those plans though so staffing gets cut to compensate creating a genuinely dangerous environment. I can't wait to retire.

What about the uninsured?

 

[DCal430]

Umm... There are Western programs, both governmental and private, with campaign drives to fight Ebola and help Western African countries: https://www.google.com/search?q=ebo...a:en-US:official&client=firefox-a&channel=nts

Fern

Not really, there is Government, but there is no major private campaigns. The total of private donations is in the few millions only, almost all from major foundations. There is no major private group taking any money for ebola. The reason is people in the west do not care about africans dying from ebola.

 

[theeedude]

I am not a conservative by any means, and am all for universal health coverage. I can't tell you how strongly I feel about this. I can just go on and on about the cruelty of the current 'system'. And it is not just the poor who suffer. In fact due to Medicaid, they are often better off than the middle class in this respect.

There is absolutely no reason for a hospital to hold someone because of fever. Ebola was not suspected.

Secondly, we are talking about a hospital in a major major city of the country. Even if you have seen ERs of smallish town hospitals, you would not be making this claim. Please see the reality of how overcrowded and chaotic things often are in the medical system. There is no cause to suspect intentional malice / money factor in this case.

Smallish town red state hospitals are getting decimated by lack of Medicaid expansion. This is well documented. As far as Texas goes, it's not about malice, but money factor is always at play. People are more likely err on the side that makes them most money. If you are insured, they will more likely err on side of ordering too many tests so it's a two way street.

 

[Matt1970]

Smallish town red state hospitals are getting decimated by lack of Medicaid expansion. This is well documented.

Can I see some of that documentation?

 

[theeedude]

Can I see some of that documentation?

http://www.npr.org/blogs/health/201...r-fights-to-expand-medicaid-in-north-carolina

 

[Subyman]

That private clinics and doctors' offices don't accept Medicaid/Medicare demonstrates that many of the fees are insufficient.

And Medicare/Medicaid is an 'all in, or all out' type of program. If you enroll in the programs as a provider you must accept treatment and their fees for all you are able to professionally provide. I.e., you can't say we'll sell oxygen but we won't sell wheelchairs because those are money losers.

Hospitals are mostly nonprofit set up by local govt entities (counties etc.) so of course they're going to accept Medicare/Medicaid as many residents (voters) of that govt entity are on those programs. It would be politically impossible for such a hospital to not accept those programs. And I think very unfair and morally unacceptable as many on Medicare/Medicaid pay their real estate and sales taxes that support those hospitals.

Fern

The reason some places do not accept medicare or medicaid isn't due to the reimbursed amount, its about the length of time until payment.

 

[DCal430]

One problem with medicare is the reimbursement is tied to budget formula that doesn't take actual cost or inflation into account.

 

[Matt1970]

http://www.npr.org/blogs/health/201...r-fights-to-expand-medicaid-in-north-carolina

Here is a little history on why that hospital was in trouble.

In 2001, Pungo District Hospital filed Chapter 11 bankruptcy due to the severe financial crisis....

After bankruptcy, we were fortunate to receive various grants that helped us to keep operating in spite of an ongoing difficult financial situation. Managing the hospital continued to be very challenging as we emerged from the bankruptcy. There were many challenges including:
• Grant money was decreasing.
• The hospital continued to lose money on operations.
• The cost of providing care continued to rise.
• Our building was now in need of major, critical repairs.
• The expense of providing uncompensated care continued to rise.
• New rules and regulations of the 2010 Affordable Care Act were coming our way including reductions in
Medicare and Medicaid reimbursements and the requirement that all hospitals have electronic health
records, a cost that would exceed $2 million.
• Concerns about the ability to recruit and retain doctors and other health care workers to our community, a
problem that many rural communities all across the country were facing.

http://www.wnct.com/story/24387311/pantego-creek-llc-votes-against-saving-vidant-pungo-hospital

 

[Engineer]

*snip*

What about the other 13 hospitals that have closed down (out of 18)?

Holmes says that 14 of the 16 rural hospitals that have closed in the last 18 months are in Southern states that chose to not expand Medicaid.

 

[Matt1970]

What about the other 13 hospitals that have closed down (out of 18)?

I really don't have time to dig into all of them but the Medicaid expansions have only been going on since Jan 1, or 10 months? They are associating closures for the last 18 months so I assume there is a lot more to their situations other than just lack of Medicaid expansions. Remember, even as cited in that article the ACA put a lot of reductions in Medicare and Medicaid reimbursements.

 

[theeedude]

I really don't have time to dig into all of them but the Medicaid expansions have only been going on since Jan 1, or 10 months? They are associating closures for the last 18 months so I assume there is a lot more to their situations other than just lack of Medicaid expansions. Remember, even as cited in that article the ACA put a lot of reductions in Medicare and Medicaid reimbursements.

Reimbursements to hospitals for uninsured patients were replaced by expanding Medicaid to those patients instead. Except in the states whose genius Republican elected officials locked that expansion. They got stuck with lower reimbursement, but are too dumb to accept coverage through Medicaid. Classic case of cutting off the nose to spite the face

 

[Matt1970]

Reimbursements to hospitals for uninsured patients were replaced by expanding Medicaid to those patients instead. Except in the states whose genius Republican elected officials locked that expansion. They got stuck with lower reimbursement, but are too dumb to accept coverage through Medicaid. Classic case of cutting off the nose to spite the face

Correct me if I am wrong but reimbursements to hospitals for uninsured patients wasn't reduced, that was never paid by Medicaid to begin with.

 

[theeedude]

Correct me if I am wrong but reimbursements to hospitals for uninsured patients wasn't reduced, that was never paid by Medicaid to begin with.

Lucky for you, you live in NY, so more informed people decided to expand Medicaid in your state.

 

[Matt1970]

Lucky for you, you live in NY, so more informed people decided to expand Medicaid in your state.

You mean like the 'informed' people like you who think hospitals get reimbursed for the uninsured?

 

[theeedude]

You mean like the 'informed' people like you who think hospitals get reimbursed for the uninsured?

http://en.wikipedia.org/wiki/Disproportionate_share_hospital

The United States government provides funding to hospitals that treat indigent patients through the Disproportionate Share Hospital (DSH) programs, under which facilities are able to receive at least partial compensation.[1]

Enjoy.

 

[doubledeluxe]

I've lived in multiple countries on 3 continents and can honestly say that out health care system is not just bad, it's terrible.

Hopefully we get no more Ebola cases. The silver lining would be if we took a serious look at our for system and brought it up to modern standards like the rest of the developed world. Universal health care is the way to go.

 

[squarecut1]

I've lived in multiple countries on 3 continents and can honestly say that out health care system is not just bad, it's terrible.

Hopefully we get no more Ebola cases. The silver lining would be if we took a serious look at our for system and brought it up to modern standards like the rest of the developed world. Universal health care is the way to go.

And to top it off, it is most expensive health care system as well.

 

[Matt1970]

http://en.wikipedia.org/wiki/Disproportionate_share_hospital



Enjoy.

"Although 3,109 hospitals receive this adjustment, Medicare DSH payments are highly concentrated. Ninety three percent of total DSH payments go to large hospitals in urban areas and teaching hospitals receive about 65 percent of all DSH payments."

So much for your theory that Medicaid expansions in rural areas were going to offset uninsured reimbursements. Doesn't look like they were getting any of the reimbursements to begin with. I also cannot find how much partial compensation amounts to.