So, hey, what about hospitals in the Democrats Single Payer, er, Medicare for All scheme?
This Is The Part Of ‘Medicare For All’ That You Never Hear About
Sen. Bernie Sanders (I-Vt.) and his allies talk a lot about how “Medicare for All†would take back money from insurers and drug companies, and use those savings to help make sure every American has generous health insurance. That is accurate.
But Sanders and his allies rarely mention that Medicare for All would also restrict the flow of money into the rest of the health care industry, including the parts that aren’t as easy to demonize in speeches.
At the top of that list are hospitals, which alone account for roughly one-third of the nation’s health care spending. No other sector, not even pharmaceuticals, rivals it. Under the Medicare for All proposals from Sanders as well as some other potential reforms getting attention these days, the federal government would limit payments to hospitals, quite possibly reducing their incomes significantly.
The case for squeezing hospitals is strong, given the available research on what they charge and why. Even some experts historically wary of government regulation are warming to the concept.
But actually crafting a policy that would cut hospital payments enough to free up big sums of money without adverse effects wouldn’t be easy and getting such a policy through Congress could be even tougher. The hospital industry is already pushing back and, as this debate moves forward, it’s only going to push harder.
There’s no doubt that hospitals probably get too much money, that they charge too much for the service they provide, especially when compared to hospitals around the world. And, I’m sure, many can make the argument that the costs are what they should be (an aspirin costing $30? No.) But, do we want to squeeze them so much that they cannot provide proper care?
The promise of simplicity is one reason price regulations are getting another look. If hospitals could send bills just to one place, instead of dozens, and if they could have just one list of prices, they wouldn’t have to maintain such complex electronic billing systems and hire so many people to run them.
More important, though, giving government the power to set prices would mean giving government the power to set those prices a lot lower than they are today.
So, um, yeah, putting the Central Government pretty much fully in charge of hospitals nationwide. If you control the money, you control the institution.
Not every hospital closure is a problem. The worry is that some hospitals might cut back on services like psychiatry that typically lose money but are already insufficient to meet current demand. Reducing hospital income crudely could make these sorts of problems worse, causing even longer waits for services ― or simply making it harder to deliver care effectively. (snip to end)
Adopting Medicare for All, Medicare for America, and other schemes that would regulate hospitals would require trade-offs of one sort or another. But so would doing nothing.
You could see hospitals closing, as well as reduced care and long wait lines. Surprise? Really, though, the Medicare for All crowd doesn’t care about costs or service, they just want the government in control of everything.
Medicare and Medicaid (and military retiree healthcare “TriCare”) all use the same negotiated price levels for services. In every case, those prices are “negotiated” by a government bureaucrat telling health services providers to “take it or take it”. In every case, the prices are less than the cost of delivery. Hospitals and health providers make up the difference by shifting costs to people with “real insurance”. This is the reason real insurance costs so much. They are paying for all those people who don’t pay, and all the people who don’t pay enough. Medicare can’t exist without the private insurance to pay the bills. Forcing it will result in closed hospitals and clinics, longer wait times, higher rates of death from previously treatable diseases and rationing… just like in every country that already has this.
The problem with health care in the USA is entirely caused by government meddling. The solution is NOT “more government meddling”. If the government wants to control health care, they should start by paying the real cost of Medicare/Medicaid/Tricare/ and VA services. After they prove how easy and efficient that is, then they can make claims about applying it to everyone.
Didn’t we already have this discussion ten years ago? Wasn’t this already supposed to be fixed by Obamacare? How can the same people who failed so spectacularly then make any credible claim that this time we should trust them to “fix it again”?
Prof,
Good analysis. From a physician standpoint, I can assure you that many of the hospitals in my area are in trouble and going out of business. One of the largest, employing 5000 people just shut down and in the 80’s it was the star hospital in my town drawing on an area radius of 150 miles. The fact is that Medicaid pays less than the real cost of any procedure, Medicare pays but very poorly and there is a 30% cost of doing Medicare that must be figured in. Then, private insurance will formulate contracts to give a percent of the Medicare reimbursement, usually about 150%. This does not go well for the fixed cost of hospitals. If you are in an area with illegals and high number of indigents, they get free care at the expense of the hospital. The cost of procedures has gone out the roof and this happened under Obama and his crap insurance scam. Some of the cost falls back on the people with private care, but a large amount is written off.
To be fair. This goes back much further than Obama. The Medicare reimbursement rates were not invented by him. Nor was the federal law that required emergency rooms to treat everyone regardless of ability to pay. That law alone turned emergency rooms into free clinics. And no one counts the costs of how many people die because of longer waiting room times and longer ambulance trips to hospitals that are further away. The hospitals were all on board for ACA because they saw it as a way finally to get reimbursed for all the services to people with no insurance. They didn’t realize that reimbursements would be paid at medicaid rates. Other countries get around this by simply refusing to treat people, by refusing to pay for really expensive procedures on old people, and by refusing to pay for gold plated life-long care on chronically sick people, like those with birth defects.
Charging Medicare was not that bad of an experience until the mid 80s. About that time the government stated rumbling about how expensive medical charges were. So a graduate student, I think it was Jindal, came up with a system of DRGs. 0490894 to DRY we were charging about $30 for a day in the hospital, doctor fee. On looking at what we were required to charge, the price went to well over $100 per day. Other changes occurred shortly which were crazy things like not being able to give free care and not able to consistently charge low fees. But with Obama care the charging and prices for real crazy. An ECHO went from $200 or less to $1000 or more. No one knows who is getting this money as it is not going to doctors or techs. In short the government screwed the goose, again.
This article reads like a press-release for the hospital industry. It’s so one-sided that it doesn’t even qualify as an article. It’s just propaganda intended to protect the huge amounts of money that hospitals charge.
At issue here is what the author calls “proper care”. Right now, just about every quack treatment that you can think of is covered by Medicare. The first thing to do is narrow-down the list of covered treatments to actual physical care. No more talk therapy, or guitar therapy, or brain-wave therapy. Further, the list of approved medications should be narrowed down to about fifty.
Then, the number of covered procedures needs to be reduced. No more heart surgery, or joint replacements. As I’m sure readers will understand, the politically powerful lobby of elderly people will never allow this to happen. They will take advantage of the system, until there is not one single penny left.
As I said… this always leads to rationing. People getting the benefits don’t want to pay the costs. People paying the costs don’t want anyone getting the benefits. It’s a shame that the people who get the benefits aren’t the same people paying the cost.
Why on earth would you eliminate heart surgery and joint replacements? The first is a matter of life and death and the latter is a case of excruciating pain and immobility. These things are exactly what the practice of medicine is all about.
…Because they are expensive, and old people aren’t worth it. That’s the sort of logic you get when other people decide how valuable you are.
With sterling success of all the government run hospitals perhaps the Dems should rebrand their argument.
Veteran’s Administration For All
Yep, go with that.
Exactly. I’m a vet and I’ve never set foot in a VA except to visit someone else. I use my own insurance.
If you like your own insurance… you can keep your own insurance. Really, this time. We swear.
I am also a Vet. Retired Army. When I retired, I had to go to the VA for examining service connected disabilities. The Dr examined by knees, concluded that i had arthritis and prescribed a lifetime supply of Motrin. Several years later, i saw a real doctor who actually used X-rays and MRI scans to determine I had a torn meniscus. Easily repaired. Total cost billed: $30K. Total paid by me: $3K. Total paid by the government: $1 K. Total that the providers never got, $26K. That is the cost they had to shift to other insurers. That repair was outstanding and greatly improved my quality of life, including making me healthy enough to do another tour in Iraq.
Somehow, other advanced nations such as Australia, Belgium, Canada, Denmark, England, Finland, Germany, Holland, Israel, Japan, Korea etc, make their healthcare systems function for ALL their residents for about 1/2 of what we pay in the US. If we squeezed just 33% out of our system it would save our stressed working classes $1 Trillion. Every year. That’s about $3000 less per person per year.
You would think the US, with more resources than any other nation, could figure it out. Granted, we Americans have lower IQs than Asians, so we might have to copy them… but still…
Jeff,
you keep posting that tired old crap and don’t even update it or know what you are talking about. All countries with socialized systems are trying to get out and are going broke. Those that are doing well are getting money from North Sea oil. Basically your posting this says you know nothing.
Ernest,
That tired old crap has the advantage of being true.
Our health care system is very expensive compared to other rich nations – and doesn’t deliver better results. We can do better.
No, all countries with universal healthcare systems are NOT “trying to get out and going broke”.
I may not know everything but it’s certainly a lie that I know nothing.
No you are wrong.
A comparison:
Problem: poor people can’t afford to get medical treatment.
Free market solution: Charities build hospitals that treat patients for free and raise money on a voluntary basis.
Government solution: Pass a law forcing hospital emergency rooms to treat everyone regardless of ability to pay and pay for the treatment themselves.
Inevitable response: ER’s close and hospitals that stay in business operate as business hours only clinics. People with time sensitive illnesses and injuries die instead of surviving treatable conditions. Higher prices for emergency room treatments and the ubiquitous “$30 aspirin”.
Free market response: Urgent care facilities. Much lower costs than an ER. Not “technically” an ER do doesn’t have to accept everyone.
As we’ve proven before, this is yet another lie.
Income taxes, sales taxes, and fees are demonstrably higher. US income tax is 37%, sales is 0 (by state)
Income Sales or VAT
Sweden 61.85 25.00
Denmark 55.80 25.00
Austria 55.00 20.00
Belgium 53.70 21.00
Netherlands 52.00 21.00
Finland 51.60 20.00
Slovenia 50.00 22.00
Luxembourg 48.78 17.00
Ireland 48.00 23.00
Portugal 48.00 23.00
Germany 47.50 19.00
Iceland 46.30 24.00
France 45.00 20.00
Greece 45.00 24.00
Spain 45.00 24.00
United Kingdom 45.00 20.00
Italy 43.00 22.00
Switzerland 40.00 7.70
Norway 38.52 25.00
But they get all that free stuff.
Actually in all those countries they still have to BUY INSURANCE.
To wit: Learn More Traveling to Europe? Schengen countries require most non-US citizens to purchase Schengen visa insurance. If you wish to travel Europe you are required to purchase health insurance before you do.
Insurance Europe is the European insurance and reinsurance federation. Through its member bodies comprising of national insurance associations, Insurance Europe represents all types of insurance and reinsurance undertakings, including pan-European companies, monoliners, mutuals or SMEs
EU Insurance offers several Private Health Plans options to suit all budgets. From health insurance cover limited to Spain or to the whole of Europe or Worldwide. So whatever your health insurance Spain needs contact us today
I could go on and on. Many people of any means buy additional insurance in these countries because the regular Universal health care puts them at a severe disadvantage. Travel insurance is DEMANDED because the nations dont want YOU showing up at their hospitals for FREE.
There is no free lunch and that includes in the EU and health insurance in particular.
Well of course they buy insurance. Health care isn’t free. But those nations spend less per capita than we do in the US, about 1/2 on average.
The Wiz typed: As we’ve proven before, this is yet another lie. (referring to other nations paying less for health care(?)).
He then inexplicably types a list of tax rates throughout Europe.
Why not post the average high in August for each nation, as that is just as relevant as the federal tax rates of each?
Wiz attempts to prove someone a liar by being a liar. Do you have a point? If so, make it.
FUN FACT”
The left claims they are all about the middle class.
Guess who is smack dab in the middle class? YEP that would be hospital workers, staff, nurses and even many janitorial types make 50k a year in a lot of hospitals around the country.
NOPE NIX all those health care workers. To make medicare for all work they have to fire people. Then privitize all those hospitals that will go broke in the first year because they will be getting paid pennies on the dollar and cant afford to buy new medical equiptment pay good wages to their workers and of course let us not forget.
HOW ARE THEY going to power the equiptment. the LUNATIC LEFT wants to get rid of fossil fuels in 12 years.
By the time 12 years are up with the democrats in control IF they were allowed to do everything they campaign on, the country would be full of radical muslims blowing everyone the hell up. The streets of every town would look like a junk yard of homeless. highways would be empty. Factories would be shuttered and the people would be starving. But by god they would have FREE health care and a free education which did them no good since there are no jobs because their is no power.
A VOTE FOR ANY DEMOCRAT EVER AGAIN IS A VOTE TO END AMERICA. NOT AS YOU KNOW IT BUT TO END AMERICA. PERIOD.
Fun Fact: M is nutz.
So US health care is a jobs program costing the working classes an extra $1 trillion a year?
Why do they have to fire people to expand healthcare coverage to all Americans?
Why do they have to fire people, because the insurance does not cover expenses. Proof the number of people losing their jobs z free Obamacare. It is funny that Jeff thinks he cares about working people.p
I find it even funnier that anyone cares what Jeff thinks after his long history of comments here.
I’m with you Prof. I will no longer respond to the immature and untruthful rantings of that ignorant angry little black child from st. louis.
I really wish people would ignore him. Then comments would be more intellectual and lack the hate.
And yet… here you are, obsessed with me – Not discussing issues, making arguments or adding relevant information. If not for me, you wouldn’t exist!
Our esteemed host wrote:
You can blame the lawyers for that! Everything that is given to a patient has to be specifically ordered, and is handled multiple times, by multiple people, before it gets to the patient. If hospitals did not have these measures in place, they’d be in even greater risk for malpractice lawsuits.
The procedures for securing narcotics are stringent, and many — not all — hospitals require two RNs, not one, to draw a narcotic dose, as a security precaution. At $40 an hour or more per nurse, this simple procedure costs a lot of money. If the narc count is off, every nurse on the floor gets a whiz quiz.
Hospitals charge a LOT for TWO very good reasons. One is they get sued….A LOT. And seldom for actual negligent actions. Lawsuits generally arise from outcomes that the petitioner didn’t like….even if they were informed early and explicitly that the outcome would be unpleasant.
The second reason is the EIGHT THOUSAND POUND gorilla nobody wants to talk about. That gorilla
is the EMTALA law….signed by Reagan in 1986. That law REQUIRES under massive legal penalties for ALL hospitals that receive even ONE THIN DIME from Medicare to accept and treat ANYONE AND EVERYONE
that walks in the door of their Emergency Room. NO EXCEPTIONS. In some hospitals the Emergency Department is lucky to collect 12 cents for every dollar billed. In order to keep the doors open they must bill the people who DO pay TEN TIMES AS MUCH to pay the costs of treating MILLIONS of homeless bums and illegal invaders each and every goddam day. And if said parasite needs to be admitted to the hospital????? Then the UNPAID BILL literally skyrockets. It can cost A HUNDRED THOUSAND DOLLARS A DAY for someone in ICU. And we can’t even ASK if the person sucking up those resources is a citizen….or a criminal invader. So don’t call hospitals greedy….they are doing what they MUST DO to keep the doors open.
And yet every advanced nation on this Earth finds a way to deliver healthcare to all their residents for about half of we Americans. Is your argument that Americans just aren’t smart enough or courageous enough to figure this out?
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