Medicare for all? Too expensive and too cheap. Serious discussion of cost controls through limits on end of life care? “DEATH PANELS!”

Well, I give up. Every other modern nation will continue to do better than we do at caring for our citizens' health and the right wingers and their sheep-like minions will shoot down every possible solution until they are all bankrupted by the very system they angrily and vociferously defend against ANY reform. Oh, except the rich. They'll be fine, and they just happen to include the executives of the insurance industry which the right apparently exists to protect.

Good luck with that. By the time your insurance rates double (in under 10 years, half of Americans will pay half their total income) and your employers all drop health benefits, I'll be on Medicare. Have fun feathering the nests of the rich and greedy on the backs of the sick and injured, and your families.

And unfortunately there haven't been any serious Republican plans.

And Santa will visit your home this Christmas

Also
http://stanford.wellsphere.com/healthcare-indus…

http://www.physicianspractice.com/index/fuseact…

Although it does not blame Medicare alone for the problem, HSC reports that in 2001 — before last year's cut — nearly 29 percent of physicians nationally were declining new Medicare patients, up from 25 percent four years prior. Some parts of the country are experiencing more dramatic access difficulties than others.

Even more recently, an American Medical Association survey found that about a quarter of physicians had limited their Medicare patients, or were planning to.

Added: Damn, GD, I should learn to read the other comments before making mine!

Actually, no — the problem is that of underpayment, something for which I'm not exactly agitating against, as a rule, when it comes to a government program, or government spending of any kind.

Even you conceded the Medicaid case, kinda sorta:

“probably should increase provider reimbursement rates”

Cram-downs on the providers after a federal takeover of health care isn't the easy or painless thing that cram-downs on lenders and GM-Chrysler bond holders were (for most other than those who suffered at the time).

No, it's not my ideal at all, nor do I consider Medicare and Medicaid ideal government programs.

“DLS, thanks for the links. Do you even READ them?”

Yep. The emphasis on Medicaid is not misplaced; that program is more notorious than Medicare.

“So the inability of insurance companies to negotiate better rates is the fault of those who do?”

You're assuming that lower rates should be demanded and negotiated by the insurers, when in fact the problem is that the government programs are underpaying.

Nobody has successfully answered, What happens when current underpayments become more widespread, the rule rather than (for now) still amounting to an exception? Note that reducing Medicare payments not only is a hot current issue, but there are expressions of desires for (threats of) more to come.

That's clever indeed. Let's see. WalMart is selling $4 prescriptions. My local pharmacy charges over $20. So WalMart is “cost-shifting” massively, and the ACTUAL cost of those drugs should be $12. Because if someone can get a better deal, they're “cost shifting” to those who don't.

Didn't we start a long time ago talking about REDUCING health care cost? Apparently, now we're debating how to keep costs high to suit the insurance industry.

http://gateway.nlm.nih.gov/MeetingAbstracts/ma?…

“Consumers and Employers Paying Almost $90 Billion Due to Under-Payments to Hospitals and Physicians by Medicare and Medicaid” [2008]

http://www.ahip.org/content/pressrelease.aspx?d…

http://www.bcbs.com/news/bluetvradio/cost-shift…

[California]

http://www.cfcepolicy.org/NR/rdonlyres/46C2B526…

[Vermont]

http://www.vtreform.com/d/volume3/20070131_THE_…

[Wisconsin]

http://www.wha.org/newsCenter/pdf/nr6-30-08pric…

[Maryland]

http://www.hcfo.net/pdf/chang.pdf

Et cetera

Seriously, other than knee-jerk (and very selective) fear of socialism, what is the case for keeping health insurance companies?

The proposals coming from Congress are neither fish nor fowl. They seek to impose mandates on individuals, but are extremely weak on cost containment. The Baucus option, for example, claims to control insurance premiums while capping them at $21,000 annually for family coverage. That's about 50% higher than average family coverage costs today. It also claims to attack fraud and waste in Medicare, but is very non-specific in its approach, as it is with health care cost containment generally. It continues to allow for insurance company pricing increases based on pre-existing conditions, age and family size. It continues the costly multi-regulatory scheme of state-by-state regulation of the industry; it is built on a tax credit scheme, rather than a service provision scheme. Whoever labelled this an “insurance company enrichment and enhancement plan” had it about right. This is legislation designed to be “gamed” by the insurance companies.

Congress is simply unwilling to take on the entrenched interests to bring about real reform, whether those interests are the trial lawyers, the AMA, the insurance industry, unions, the AHA, medical device manufacturers, or the drug industry. Until we get legalized bribery (special interest influence) out of our system, meaningful reform appears destined to either fail or be so watered down as to be ineffectual.

Of course. Cost-shifting has long been known to be happening, as well as underpayment by Medicare (and Medicaid), which results in losses (which are made up by what else, cost-shifting for recovery). What will happen if we have even more underpayment later (which is what many short-sighted or class-envy-ridden people want more of, with government health care, when not more naive or ignorant “magic” cost savings) and there's less (or no more) chance to recoup at least some of the losses in some way?

On the plus side, the Baucus bill and announcing the intention to proceed with it is Baucus's contribution to the attempt begun by Obama to bring order to the Dem silliness and to resume “progress” toward some kind of eventual plan and eventual legislation. On the minus side is that this bill apparently continues the same gimmickry that the House dopes' bill and Obama's own list of objectives features, which is to “pay” partially for this expansion of federal health care by simply taking $500 B or some other big amount from Medicare — without any kind of reconciliation of the loss to Medicare, which already is failing even without being looted like that. As for any non-profit co-op, it means government (federal) support of some kind, most likely, and could well be a public option but just renamed.

97% of doctors take new Medicare patients, same as private insurers. Nearly all hospitals and clinics take Medicare patients. These are tiresome excuses for keeping insurance company fat cats fat. I personally know doctors who have opted out of Medicare. They've opted out of every PPO, and finally stopped taking ANY third party payment. That however, is NOT the norm.

Don't forget Medicaid. While on the road today between Michigan and Indiana I got to listen to the latest description of how well things are going in Michigan, where only 64 per cent of providers (not the 99.99% that some might claim, for example) accept Medicaid. This has actually been known for years:

“Physician participation in the Michigan Medicaid program dwindled from 88 percent in 1999 to 64 percent in 2005, the last year physicians were surveyed, according to the medical society.”

http://www.wilx.com/news/headlines/44645077.html

Also this piece on doctors choosing to opt out of medicare
http://www.nytimes.com/2009/04/02/business/reti…