Affordable Care Act Supreme Court Hearings this week

[Jim in CT]

Originally Posted by TheSpecialist

Good points but not what I am saying.

We would not use medicare rates, and the paperwork would go to the health insurance company. Rather than 100 different insurers haggling over rates you could average the rates and that would be the max that any hospital or doctor could charge for that procedure whether the person has health insurance or pays cash. This way everyone is paying the same.

Right now if I have insurance and you do not we pay different amounts for the same quality of care:

My insurance might pay 200 for a checkup, and I pay my 10 copay

You might see the same doctor, get the same care but with no insurance and paying cash you pay 395.

That is not a good way to control or keep health care costs down.

The fed could say to the doctor you can charge 265 for the check up no matter what insurance someone has or doesn't have, because that is the average rate the 10 best insurers would pay you.

First, if everyone is paying the average of what we all pay today, I don't see how that lowers the cost, except for people who currently pay as they go without insurance. Second, while your idea controls the amount that doctors get paid for services, it doesn't address the costs of the care that the doctors provide.

We need to somehow address the underlying cost of the healthcare that docs provide. One way to do that is tort reform. Unfortunately, the American Trial Lawyers lobby gives big $$ to democrats, who consequently won't allow that reform.

That's just a very small piece. I don't know that there is a solution. It's a staggering problem even in a simple environment, but when you throw on top of it the looming tsunami of the baby boomers, and we are in for a real reckoning. A real reckoning.

[PaulS]

Originally Posted by Jim in CT

We need to somehow address the underlying cost of the healthcare that docs provide. One way to do that is tort reform. Unfortunately, the American Trial Lawyers lobby gives big $$ to democrats, who consequently won't allow that reform.

That's just a very small piece. I don't know that there is a solution. It's a staggering problem even in a simple environment, but when you throw on top of it the looming tsunami of the baby boomers, and we are in for a real reckoning. A real reckoning.

As you said, a small piece - but a piece.

The NE journal of medicine says about 7.4% of Drs. are sued each year and by age 65, even Drs. in low risk specialties (like pediatrics and dermatology) face a 75% chance they will have been sued. In 2009, the Congressional budget office said that going to a 250K cap on noneconomic damages and 500K on punitive damages and a 1 year statute of limitation would save about 11B/year - 40% of from reduced malpractice prem. and the rest from fewer tests/procedures.

Total cost/year are about 2.6Trillion. Thus 11B, is not even 1/2 of 1% of total costs. Cost are incr. about 100B/year.



In 2010, the 5 largest medical insur. had about 11.7B in profit.

[TheSpecialist]

Originally Posted by Jim in CT

First, if everyone is paying the average of what we all pay today, I don't see how that lowers the cost, except for people who currently pay as they go without insurance. Second, while your idea controls the amount that doctors get paid for services, it doesn't address the costs of the care that the doctors provide.

We need to somehow address the underlying cost of the healthcare that docs provide. One way to do that is tort reform. Unfortunately, the American Trial Lawyers lobby gives big $$ to democrats, who consequently won't allow that reform.

That's just a very small piece. I don't know that there is a solution. It's a staggering problem even in a simple environment, but when you throw on top of it the looming tsunami of the baby boomers, and we are in for a real reckoning. A real reckoning.

Well just in time, a bill came from our Orthopedist for my wife's shoulder surgery:

$11,800.00 billed for the ortho part not including anesthesia.

Anyone care to venture a guess how much Bluecross Blue Shield payed?

[justplugit]

$3700 ?

[TheSpecialist]

Originally Posted by justplugit

$3700 ?

nope...

[JohnnyD]

Originally Posted by TheSpecialist

Well just in time, a bill came from our Orthopedist for my wife's shoulder surgery:

$11,800.00 billed for the ortho part not including anesthesia.

Anyone care to venture a guess how much Bluecross Blue Shield payed?

Probably about 65-75%, so about $8500. In the end, why does it matter? It still doesn't change the whole bit about leverage I discussed above.

Even with BCBS paying a reduced rate, health care costs are still increasing. With that in mind, even enacting your "government regulated pricing", how would it decrease costs? Like I said above, it seems like you want the government to regulate pricing because you don't think it's fair.

[scottw]

Originally Posted by JohnnyD

? Like I said above, it seems like you want the government to regulate pricing because you don't think it's fair.

Bingo!...wants the govt to make it fair(er) regardless of whether or not it is the proper role of the federal government....

interesting comparisons...

Why The Supreme Court Should Uphold the Health Care Law 9-0 | TIME Ideas | TIME.com

RealClearPolitics - Back to the Future?

also interesting that I've read proffered cause for all but Thomas* of "the 5" as having reason or potential to uphold Obamacare but on the other side there is absolutely no question apparently, that "the 4" will ignore the Constitution and vote in lock step to uphold it........

*despite his obvious distaste for Justice Thomas’s views, Jeffrey Toobin takes him seriously as a judicial thinker and pathfinder.
“In several of the most important areas of constitutional law, Thomas has emerged as an intellectual leader of the Supreme Court,” Toobin writes. “Rarely has a Supreme Court Justice enjoyed such broad or significant vindication.”

[TheSpecialist]

Originally Posted by JohnnyD

Probably about 65-75%, so about $8500. In the end, why does it matter? It still doesn't change the whole bit about leverage I discussed above.

Even with BCBS paying a reduced rate, health care costs are still increasing. With that in mind, even enacting your "government regulated pricing", how would it decrease costs? Like I said above, it seems like you want the government to regulate pricing because you don't think it's fair.

nope

[TheSpecialist]

It would decrease costs because the American public is being price gouged.

BCBS payed a grand total of 2159.14 The rest was written off, and they still had room for a profit.


So tell me they are not price gouging, and if there was a commission that set rates at this point healthcare cost would be no cheaper across the board?
It's not about fairness as much as about being price gouged.

[JohnnyD]

Originally Posted by TheSpecialist

It would decrease costs because the American public is being price gouged.

BCBS payed a grand total of 2159.14 The rest was written off, and they still had room for a profit.


So tell me they are not price gouging, and if there was a commission that set rates at this point healthcare cost would be no cheaper across the board?
It's not about fairness as much as about being price gouged.

The above post re-emphasizes that your position is about fairness. You keep saying "if the government set prices, health care would be cheaper". When asked How? health care would be cheaper, your reply is "because the government would be setting the prices."

If it's that easy, maybe the government should tell gas stations how much they can charge for a gallon of gas. How about having them regulate the price of a fishing reel? I'm sure Van Staal would still have room for profit if they sold their reels for half the price.

As I have said above, how about the government stay out of telling businesses what they can and cannot do and take action in the areas the government actual should have a roll in.
For instance:
- It is ridiculous that I cannot purchase medical (or vehicle) insurance from a company outside of Massachusetts. Nothing is more effective on creating competitive pricing than competition. Yet the government requires me to purchase through a company registered in Massachusetts.
- How about developing tort reform? Did you know an Obstetrician is potentially on the hook for every child they deliver until the kid turns 18? That's why many OBs have malpractice insurance rates far exceeding 6 figures. Maybe that has some effect on the cost of medical care.
- Drug companies and medical supply companies are allowed to distort the spirit of trademark laws in order to keep drug costs astronomically high. Yes, they need to earn back money and profit from their R&D but the exploitation is ridiculous.

Let's not allow for the further unnecessary expansion of the government's power and will over corporations and the people. The government holds enough power already to effect change without further regulating the free market.

[TheSpecialist]

Originally Posted by JohnnyD

The above post re-emphasizes that your position is about fairness. You keep saying "if the government set prices, health care would be cheaper". When asked How? health care would be cheaper, your reply is "because the government would be setting the prices."

If it's that easy, maybe the government should tell gas stations how much they can charge for a gallon of gas. How about having them regulate the price of a fishing reel? I'm sure Van Staal would still have room for profit if they sold their reels for half the price.

As I have said above, how about the government stay out of telling businesses what they can and cannot do and take action in the areas the government actual should have a roll in.
For instance:
- It is ridiculous that I cannot purchase medical (or vehicle) insurance from a company outside of Massachusetts. Nothing is more effective on creating competitive pricing than competition. Yet the government requires me to purchase through a company registered in Massachusetts.
- How about developing tort reform? Did you know an Obstetrician is potentially on the hook for every child they deliver until the kid turns 18? That's why many OBs have malpractice insurance rates far exceeding 6 figures. Maybe that has some effect on the cost of medical care.
- Drug companies and medical supply companies are allowed to distort the spirit of trademark laws in order to keep drug costs astronomically high. Yes, they need to earn back money and profit from their R&D but the exploitation is ridiculous.

Let's not allow for the further unnecessary expansion of the government's power and will over corporations and the people. The government holds enough power already to effect change without further regulating the free market.

The government regulates Electric, telephone, and natural rates. IN Mass they regulate car insurance cost, so what difference does it make if they regulate HealthCare cost nationally.


Do you think Obamacare is going to reign in the cost of healthcare?


There were 3 specialties that were over 100,000 for average cost
of premium. Orthopedist was around 89,000 and the other 21 specialties were less than 60,000 in 2010. But Massachusetts has one of the highest in the nation rates There are other states where every specialty is under 100,000, and according to Mass Div of insurance rates seem to have stabilized.

I definitely think that tort reform is needed, drug companies need to be regulated better, but bottom line is if you are charging X dollars 20% of X dollars as payment, and making your nut, then there is something wrong with your prices.

That is price gouging at it's finest.