Who said Obamacare didn't have...

[Winehole23]

I suppose you think such recommendations get put in the circular file?

Some will be taken up, others will be considered politically imprudent. What the final regs will look like isn't an easy call.

[ploto]

We are seeing it already. 50% of doctors in Texas no longer accept medicare because they can't afford to lose money on every medicare patient they see.

Actually, medicare pays BETTER than some of the private insurance companies. I know of some whose rates are set at 90% of the medicare rate.

[Yonivore]

Actually, medicare pays BETTER than some of the private insurance companies. I know of some whose rates are set at 90% of the medicare rate.

Doesn't seem to be stopping doctors from abandoning Medicare patients.

[ElNono]

Doesn't seem to be stopping doctors from abandoning Medicare patients.

You mean Texas doctors? And they threatened to drop out, they haven't. We'll see if they go through with it. I suspect they won't. Most repeat patients are old patients and thus Medicare patients.

[xrayzebra]

You mean Texas doctors? And they threatened to drop out, they haven't. We'll see if they go through with it. I suspect they won't. Most repeat patients are old patients and thus Medicare patients.

There are lots of doctor's who will no longer accept Medicare. I am
speaking of Primary Care doctors. Specialist, it seems, still accept you.
But maybe, I don't know, they get a higher fee from Medicare.

But I do know of a couple of people who have had a real problem in
finding a Primary Care doc to take them on.

Price controls. Nixon started them during his administration, including
pay. I don't believe Carter inherited them. I think Nixon had already
learned his lesson. Price Controls don't work, during peacetime.

[ElNono]

There are lots of doctor's who will no longer accept Medicare. I am
speaking of Primary Care doctors. Specialist, it seems, still accept you.
But maybe, I don't know, they get a higher fee from Medicare.

But I do know of a couple of people who have had a real problem in
finding a Primary Care doc to take them on.

Maybe in Texas, and honestly, I have family in Texas under Medicare, and all it took is a cursory search over the net to find a damn good doctor within 10 mins where they live.

I'm sure some doctors are opting out. Some might try being out and then come back in. 50% sounds like a lot of BS though. Punisher is also right Medicare sometimes pays more than quite a few private insurances.

Price controls. Nixon started them during his administration, including pay. I don't believe Carter inherited them. I think Nixon had already learned his lesson. Price Controls don't work, during peacetime.

There just isn't a lot of options when you want to forcefully bring costs down. Removing middle-men and things like tort-reform (as seen in Texas) only get you meager savings. Actual tangible savings have come from price controls.

It's funny too you say they don't work, because the VA has been operating under price controls for a long time now. When it comes to healthcare, it has been working worldwide too.

I actually lean more towards a single payor with price controls (like the VA) for basic care only, and catastrophic under private insurance, a hybrid system. Much like it exists in countries like France, Italy, Germany, Canada, etc where they get a lot more bang for the buck.

Aglioco might hate me for this proposal (), but we can dance around the healthcare problem all day, and if you don't tackle cost/prices, you're not going anywhere. Obamacare didn't tackle it, and it's going nowhere (long term).

[boutons_deux]

Even without the govt holding down Medicare payment schedules, there is already huge lack of primary care doctors. The may start in general practice, but payback their education loans, take out more for specialty training, and drop GP work.

"There was a study" last year or so that showed the average overhead for a Canadian GP were was about $25K, vs about $80K for US GP. The US GP's principal overhead is in hiring people to fight with Medicare and all the other insurers. A US hard-core public option (Medicare for all, with premiums as universal income levy) would simplify overheads with Medicare as "single payer" (and as aggressive "single buyer").

Also, when Medicare came in, a lot of US GPs starting charging Medicare for treatments of impoverished patients that they had done pro bono.

When adults talk about reducing Medicare/Medicaid costs, it's about lowering reimbursements.

When sociopathic Repugs/conservatives talk about reducing Medicare/Medicaid costs, it's about denying care, aka, "death/sickness panels" and shoving Medicare customers into the greedy, care-denying, gouging clutches of for-profit insurers.