Leaks reveal the health care industry's playbook for smearing and spinning Medicare for All out of existence by 2020

[Wanderfound]

[AnthonyC]

@docosc

If you work for large groups or hospitals, you can charge “facility fees” which can double the billing for a visit. Those are not allowed for independents, though.

This is an aspect of the relevant economics I never knew about the trend towards larger groups and facilities. Thanks!

@anon81034786

@docosc I would be called into the ED at 3:00 am to deal with a critically ill child and be paid $20. No thank you.

I know everyone’s time is valuable and I’m sure you didn’t mean it this way, but the words you wrote out sure sound heartless.

I see what you mean but completely disagree. The only thing that seems heartless to me is the fact that the medical system thinks a child’s life is only worth $20 (In some contexts. In other contexts it is deemed to be worth millions. It’s amazing how much less suffering there would be if we were willing to put a fixed number on how much we were willing to spend to save and improves lives, do the relevant analyses, and then stick to it). Depending on the location, the commute, and the specific care required, this quite likely means paying the doctor less than minimum wage.

[anon81034786]

@AnthonyC

The only thing that seems heartless to me is the fact that the medical system thinks a child’s life is only worth $20

That was exactly my point

[Sludge]

Even if it came from Democrats, I’d be wary of any move couched as “improving” Obamacare.

[HMSGoose]

I’m of two mind on these leaks. On the one hand, it sucks how many Democrats are on the anti-single-payer payrolls. On the other hand, this is all the same old shit, I don’t see any innovation or silver bullets in here, we’ve heard it all before, and still got to 70% support…

[AnthonyC]

Got it, sorry, I thought you were saying the doctor sounded heartless for not being happy to work at that rate. My mistake.

[Vicq_Ruiz]

@AnthonyC

the medical system thinks a child’s life is only worth $20

Medicaid is predicated on the model that there will be enough children with private insurance who can be billed $2000 so as to make up the difference.

[docosc]

And that is (was) the truth. Private insurance has been turning the screws on that system for years, though. Once you introduce the profit motive, they realized that subsidizing Medicaid patients was not good for their bottom line, and the “excess billing” began to dry up. Also, at the time I started on this business Medicaid was a tiny portion of the patient population, so losing money on seeing Medicaid was supportable. In my area, Medicaid is now 50% and rising. You just cannot support a business in those conditions. The ACA act actually did slow the rush to insolvency of our medical system, but that is still where we are headed. Like the fossil fuel industry, the insurance companies seem to realize this and take the attitude of “How can we maximize our profit before the whole thing falls apart” instead of “How do we fix this.” Disappointing but not surprising.