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tazzygirl -> Costs of the uninsured/underinsured (9/18/2009 10:35:39 AM)
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Sanity posted on another thread the following...
quote:
Your idea is single payer, Orion. That's exactly what I was discussing... and partisan politics will always be a part of these discussions. Maybe there's some magical La La land somewhere in which everyone is perfectly nonpartisan and things happen as if by magic, but that's not where we're at. Not even close.
More specifically, your "simple" idea is naive. Medicare is breaking us now, Obama even admits that. And so any efforts at this point towards expanding it to cover everyone is just ludicrous.
Fix medicare first, then we can talk. Show us the cuts, show us the new efficiency. Because all I'm hearing right now are dreams.
http://www.collarchat.com/fb.asp?m=2809955
I would like to take this thread to discuss what is actually affecting the costs of Medicare/Medicaid/Private Insurance, beyond the politics.
I think there is a huge misconception that people who cannot pay their bills have no effect on the costs.. to both the insurance company, regardless of who it is, and the out of pocket expences.
Here is a tidbit for consideration...
quote:
Q7: Will Medicare pay a hospital’s bad debts for non-Medicare patients who don’t
pay their bills?
A7: No. Medicare does not pay the bad debts of non-Medicare patients.
Q8: Does Medicare provide any special compensation to hospitals that treat a large
number of uninsured patients – especially those hospitals that have to write off a
large number of bills for the uninsured?
A8: Yes. CMS makes payments – significant payments – to hospitals that treat a large
number of low-income and uninsured patients. For example, the Medicare and Medicaid
disproportionate share provisions paid $22 billion to hospitals last year. And under the
rules we explain in Question 9, Medicare pays over $1 billion per year to hospitals for the
bad debts of Medicare patients.
Q9: Can a hospital be reimbursed by Medicare for a Medicare patient’s unpaid
deductibles or coinsurance? Are there special rules for this “bad debt” if the patient
meets the hospital’s indigency guidelines?
A9: Yes. In the case of Medicare patients generally, the program reimburses a hospital
for a percentage of the “bad debt” of a Medicare beneficiary (i.e., unpaid deductibles or
coinsurance) as long as the hospital sends a bill to a patient and engages in reasonable,
consistent collection efforts.
However, if a hospital, using its customary methods, can document that a Medicare
patient is indigent or medically indigent (as we used that term in question 1), the hospital
can then forgo any collection effort aimed at the patient. And, if the hospital also
determines that no source other than the patient is legally responsible for the unpaid
deductibles and coinsurance, the hospital may claim the amounts as Medicare bad debts.
Hospitals may, but are not required to, determine a patient’s indigency using a sliding
scale. In this type of arrangement, the provider would agree to deem the patient indigent
with respect to a portion of the patient’s account (e.g., a flat percentage of the debt based
on the patient’s income, assets, or the size of the patient’s liability relative to their
income). In the case of a Medicare patient that is determined to be indigent using this
method, the amount the hospital decides, pursuant to its policy, not to collect from the
patient can be claimed by the provider as Medicare bad debt. The provider must,
however, engage in a reasonable collection effort to collect the remaining balance
http://www.cms.hhs.gov/AcuteInpatientPPS/downloads/FAQ_Uninsured.pdf
Each time we visit a Dr or Hospital, we pay a small portion of the bills incurred by those who cannot. By giving all at least minimal insurance, some of this cost will be removed from those who are paying it now, such as Medicare and Private Insurance, and given back to those who now have insurance.
To me, its truly a process of simple mathematics. Medicare and Medicaid are a drain on our system. Remove some of the drain.. and their cost will decrease.
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