Medicare pays out $3 for every $1 paid in (Page 3)

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2013-04-04 2:12 PM
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Subject: RE: Medicare pays out $3 for every $1 paid in
tuwood - 2013-04-04 12:35 PM

 

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I didn't read the underlying report the article referenced, so I'm not 100% sure.  I believe it's the private insurance industry rates they're talking about.  Also, I have to correct you, the private sector insurance is NOT what continues to drive up the cost of everything.  They're just the boogyman the politicians try to blame it on because they're the one's "raising the rates".  If you have a business that sells bottles of water and your supplier doubles the price per bottle are you the one driving up the cost of the bottle as the store or is it your supplier?  Your customers will blame you because that's who they buy it from, but it's not your fault.  Yes, you could make less profit to "help out" your customers, but then you as a business owner are contributing to the problem by masking the higher supply costs to the end consumer.

Now adding more "regulations" on the healthcare industry can force an insurance company to not charge you more, or force a hospital to charge less, but in America they still have the right to refuse the government program.  Hence with the reduction in payments through medicare you have a lot of doctors opting out and refusing to see medicare patients.

Assuming the government completely takes over healthcare 100% it doesn't change the laws of supply and demand.  The pay will likely be far less for doctors and nurses so you will have far less people going to school to be doctors and the supply will go down.  The demand however will go through the roof.  Something will have to give and I just can't see any scenario where it doesn't all spiral down hill quickly under full government control.

The problem with this idea is that it assumes "supply and demand" and pay are the primary motivators for health care providers. It is not so simple. People go into healthcare because they want to go into healthcare. There are easier ways to make a buck, and since we are talking about smart, driven people, they could be successful at anything else.

Sure if the pay goes down for docs, they/we will complain. My biggest complaint would be that I went into serious debt that I am still paying off (and BTW, I could have paid it off a lot sooner if I chose to go into a more lucrative specialty - but I did not - because I wanted to be a child psychiatrist and not, for example, a surgeon. Again, the whole "money is the basic motivator" argument does not hold in this area). If the government assumes my debt, or if they had paid for my education (something done in many other countries), I would have happily repaid that debt by working for the government as a doc.

The biggest thing that drives people out of medicine is not the pay. It is being expected to treat patients like widgets. My "15 minute med check" is actually seen by insurance companies as spending 7.5 minutes with the patient. If you are happy with seeing your doc for 7.5 minutes, regardless of the seriousness of your problems, then thank your insurance company. If you let docs spend the time they think a case warrants, then there will be a lot less complaints about the factory-style approach, and we will again be encouraging people to go into medicine.

Lest you think that the government approach is going to be worse, I have a friend who is a social worker who used to work with me in the hospital. He now works for the VA (which, last time I checked, is run by the fed). He gets more money, more autonomy, and provides more care than he could when he worked with me.

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