On Fri, May 1, 2009 at 4:34 PM, Scott Stroz <[email protected]> wrote: > > Dammit...hit send too fast... > > I have worked in several government agencies and the waste and > bueracracy was pathetic. Sorry, but I can't imagine it would get any > better if the gov't started running all healthcare.
First off, under a single payer healthcare plan, the government wouldn't run healthcare. They would run an insurance plan, just like BCBS does now, rather than like Kaiser that runs insurance and provides care. That's a big difference. As for reimbursement rates on Medicare, that is a point of contention, for sure and something that needs to be addressed. Medicare reimbursement works fine in several places, routine care seems to be fine. But there are a number of areas where it definitely falls short. Of course that is true with other insurance plans too, it is by no means a problem confined to Medicare. It brings up one issue that does concern me about a single payer plan though. If you have one payer that is so much larger than everyone else you run the risk of having it set terms so low that no one could survive on the medical side. I've seen that happen with providers and private insurance, where BCBS and the like try to beat providers into submission by threatening to take them off the preferred provider list and making visits to them cost 30% more for patients as a result. Then the providers have to take a lower payout from BCBS than they want and have to try to make it up in volume instead and quality of care decreases. In that regard though I'd prefer to have Medicare (or some government agency) be the 800 lbs gorilla as there are better mechanisms in place to lobby the government and the government doesn't have a profit number they have to hit. Medicare has led the way on higher reimbursements for meeting quality of care metrics, EMR adoption, etc. The issue of payment rates for providers in a field where costs are rising is going to have to be tackled no matter what kind of health care reform we have. I don't see that a single payer solution is going to make that issue more difficult to solve, but perhaps you're right. Thanks for the input, Judah ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| Adobe® ColdFusion® 8 software 8 is the most important and dramatic release to date Get the Free Trial http://ad.doubleclick.net/clk;207172674;29440083;f Archive: http://www.houseoffusion.com/groups/cf-community/message.cfm/messageid:296606 Subscription: http://www.houseoffusion.com/groups/cf-community/subscribe.cfm Unsubscribe: http://www.houseoffusion.com/cf_lists/unsubscribe.cfm?user=89.70.5
