Reply #25: Bad Analysis [View All]

The problem is that most Medicare payments underpay for the services rendered, so the more people you get underinsured this way, the higher the private insurance rates go.

This isn't going to work unless Medicare payment schedules are sharply adjusted upwards.

Over the next 9 years it looks like the percent of the population covered under Medicare will increase about 5% - going up to around 17.~% from the current 12.5% or so. Now add 5% insured under a public plan, and you are up to around 22%? Then you have Medicaid, and Medicaid reimburses even lower on average than Medicare.

This will push private insurance rates way higher, and make private insurance much less affordable, so what will happen next? You'll have way more people who can't afford private insurance.

Either go single payer all the way, or reform the whole system so that we pay out more for Medicare and Medicaid, but don't think you can game the system this way.

Every time a privately insured or uninsured person goes to a hospital or a doctor, part of their charge covers the Medicaid and Medicare patients. The more of them there are, the higher those costs go.

See, what Medicare pays out for a scan might be something like $200 or $300, but a privately insured patient will be charged $1,500 or so, because the Medicare payment doesn't come close to covering the cost of the scan. That is why private insurance now costs so much. And the reason the costs have been rising so much is that we keep adding more and more people to the public insurance rolls, so more and more costs are being shifted to the diminishing pool of privately insured patients.

You cannot fix the system this way. This is by far the stupidest proposal yet. The reason why the Blue Dogs are so against this is that most of them come from more rural areas in which the hospitals are already in desperate straits.

Most doctors already have to limit the share of Medicaid and Medicare patients in their practices, because the privately insured and uninsured patients' payments have to cover the costs of treating the Medicaid and Medicare patients. So once the doctors get above their M/M quotient, they stop accepting new patients on Medicare or Medicaid. However the hospitals can't refuse patients, so what happens is that every other patient is charged way more than the service cost to make up for it.

It would be way better to just go to national healthcare and slap on a payroll tax, but people need to realize that the payroll tax would be really high - somewhere between 17-20%. (Of which the employee would pay half and the company would pay half.) And there would be more rationing than there is now, too. A lot of things wouldn't be covered.

But still, you can't fix any system by doing more of what is already breaking the system down. In many rural areas hospitals simply can't afford to provide a lot of types of treatments, and people are dying or becoming disabled because of it. Medicare and Medicaid don't pay enough to fund the facilities, and if the percentage of Medicare/Medicaid recipients at these facilities rises too high, they simply have to forgo certain types of treatment and equipment.

About 40% of the people in the US don't even have access to a hospital that can offer clot-busting treatment, and this is one of the reasons. I know a woman who went to a regional medical center in SGA with an infant in respiratory distress, and there was not one pediatrician available to treat the baby. This is what you get. No doctors. Few nurses. Poor equipment. There's something way worse than being uninsured or underinsured and having to declare bankruptcy because of high medical bills - dying because the hospital and the doctors aren't even there. THAT'S WHAT THIS PROPOSAL WILL DO.