A public option would provide a baseline in pricing that would lower costs for everyone

Medicare and Medicaid pay a fixed fee for services. This in turn creates a reference point from which other parties in the health care system negotiate pricing. If you did not have this, medical inflation would be even higher than it is today. The reason is that in most instances medical care is a necessity and patients are willing to pay whatever is required.

A public option would work even better to control costs because it would be more Representative of the population of health care consumers. This is why a public option is needed. Not because it would create competition with the free market, but because it would create a reference point from which health care costs would be transparent and contained.

is that they underpay -- the cost of services is higher than the reimbursement, leading providers to make it up with the private (self insured and ins. co.) payors. Medicare and medicaid also are very tough when it comes to reimbursement, they deny paying if every t or i is not crossed or dotted in the overwhelming documentation that is required (at least in home care). The documentation I do at point of care takes much longer than my actual patient visit/care; I am actually staring more at my computer than actually looking at my patient. It really really sucks. In addition, our state has issued what's called a "gross receipts tax" on medicaid payments. So even though what our agency is paid by medicaid is below costs, they take another percentage out once its paid.

I'd like to deliver better health care but the reimbursement hoops we have to jump through hinder my ability to do so. My teaching time is limited to about 5 minutes because of this. On top of that, the agency has to employ a whole level or contingent of people to double check my documenting and enter the data and then pay a big fee to subscribe to a service to scan every OASIS in search of error or inconsistency to reduce rejection or penalty d/t an error of a mouse click (say I make someone a 3 instead of a 2 in a functional rating).

While I support single payor, the top heaviness of the administration of this and the struggle to stay in the black as a provider is not much better than dealing with insurance companies.

edited to add that I work for a not for profit agency.