...

 RS>> A friend of mine's Mom works in accounts at a local hospital, the
 RS>> "indigent" patients (meaning those who can't pay,) their bill ends up
 RS>> getting eaten by the hospital.

 RS>> The hospital then has to jack up their rates to cover those losses.

 RS>> That's why an aspirin shows up on the bill costing $3.50.

 BA> What the f*ck do you think I've been saying for the past 20
 BA> years??? Now that you apparently understand that fact,
 BA> would you mind explaining it to Klahn?

 I understand it, I don't believe it. No hospital can charge you
 $3.50 for an aspirin just because they have to cover another
 patient's bills. No for profit hospital will charge any less
 than they can get away with whether or not another patients
 bills are covered.

 RS>> Recently I've read about a major operation in Florida, hunting down
 RS>> and arresting dozens of Medicare fraud crooks.

 RS>> "60 Minutes" has a feature on how easy it was to commit fraud on
 RS>> Medicare.

 RS>> And how profitable Medicare fraud is.

 BA> While it does exist, it's not nearly as rampant as the
 BA> politicos would have us believe.  And yes, those who engage
 BA> in it should be locked up for a nice long time.

 I have been of that opinion for a long time. Crooks will defraud
 private insurance just as much as medicare. And the medicare
 frauds seem to tend to be doctors and medical providers, not the
 patients.

 BA> That said, the biggest Medicare fraud is the claim that
 BA> Medicare pays the bills for
 BA> the health care received by the nation's elderly.  It
 BA> doesn't, and hasn't for probably
 BA> thirty years.  What it pays is a *portion* of those bills.

 My private sector insurance does exatly the same thing. What's
 the difference?

 BA> When Medicare started
 BA> discounting its payments, providers started billing the
 BA> patients for the unpaid balances.

 That is what I do not believe. Those private for profit
 hospitals will charge whatever they can get, regardless of what
 other patients pay or don't pay.

 In a truly competitive market they could not get away with that
 at all. Some hospitals would just not take the medicare payments
 and patients, then cut the bills of their regular patients and
 the ones overcharging would lose business.

 Believe it or not that is how a real free market works. The fact
 that you don't see that at all is the proof there is no free
 market. It is also the proof that the conservative mantra of
 private sector competition is a fraud.

 BA> Said patients screamed to their congresscrooks, who
 BA> promptly made it illegal for providers
 BA> to bill Medicare patitnts for any unpaid charges.

 The providers can't bill me for the discounted part from my
 private sector insurance. What's the difference?

 BA> Medicare is also infamous for slow payment - 90 days is
 BA> *early* to them.  Note that
 ...
 BA> and payments were made by EFT.  There's no reason on earth
 BA> that an insuror should need
 BA> more than *TEN* days to pay a claim (fraud investigations

 True. So solve that problem. Oh and if the republicans have any
 solutions at all, why didn't they fix that in the 6 years they
 had complete control of the federal government?

 BA> can come later).  Yet Medicare
 BA> rarely takes ANY action on a claim for 90 days; then it
 BA> disallows every charge it thinks it
 BA> can get away with and writes itself a humongous discount on
 BA> the remaining balance - only
 BA> rearely does Medicare pay even half of the billed amount.

 My private sector insurance typically pays about 36% or less.
 What's the difference?

 ...

 BA> bill just shy of $50K for my angioplasty and stent back in
 BA> 2004.  Tricare paid just shy of
 BA> $9,000 of those charges.  MY share of those charges was a
 BA> whopping $33.00.  The other
 BA> forty grand - EIGHTY PERCENT of the billed amount - went
 BA> where all the other unpaid
 BA> charges go, onto other peoples' bills.  And it took Tricare

 Again, I do not believe that. If the hospital and doctors found
 the medicare payments insufficient they would simply refuse to
 do business with them.

 ...

 BA> And unpaid charges - even those for 'uncompensated care'
 BA> and 'charity care' - don't just
 BA> go away because they don't get paid.  They get factored
 BA> into everybody else's bills, just
 BA> like shoplifting and employee theft are factored into the
 BA> prices on retail merchants' shelves.

 The big difference is, the hospitals can stop taking medicare,
 store owners can try to stop theft, but they can't just refuse
 to do business.

 About 2/3rds of medical care in this country is paid for by the
 government or insurance. Much of the rest is paid for by the
 patients. Since, in many cases where bills have to be covered
 before treatment will be provided, the patient does have to pay
 the bills, those cover the bills that actually are paid.

 So, about 2/3rds of medical bills are discounted, usually by
 more than 50%. That tells me the other 1/3rd is overcharged. And
 the hospitals can't double the bills of all other patients just
 because of the 2/3rds that are discounted. Ok, That would mean
 just more people who are not paying.

 Oh, I just recently paid cash for a doctor bill that was not
 covered by insurance. The bill was reduced by something like
 40%. So, how can doctors cut bills for cash payments if they
 have to make up for third party discounts?

 My suspicion, the original bill is jacked up to allow for the
 discounts.

 And once everyone is covered by insurance I believe they won't
 be able to do that anymore, since eveyone will know what will be
 paid in advance.

 So, Obamacare is the answer even to that.



BOB KLAHN bob.klahn@sev.org   http://home.toltbbs.com/bobklahn

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