So you don't think the 'single payer' would have any say in how healthcare
was run?

On Fri, May 1, 2009 at 7:46 PM, Judah McAuley <[email protected]> wrote:

>
> 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
>
> 

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