Healthcare Education and Q&A Thread

[Schneed10]

Originally Posted by saden1

For those interested where the overall national healthcare expenditure went and where it came from you might be interested in this chart produced by the United States Department of Health and Human Services.

This is actually very helpful for illustrating a point, thanks for posting.

You'll see on slide 2 of saden's link, it shows that 19% of healthcare spending was paid for through Medicare, and 15% through state Medicaid programs. Combined, that's 34% of the nation's healthcare spending from government programs.

Government budgets are suffering right now, and Obama's budget includes minimal increases in reimbursement from Medicare. State budgets are even worse off, and most aren't increasing reimbursement at all.

Overall, healthcare expenses are growing 7% per year. But, as noted, no increases are expected to come from the government. This means the rest of the payers need to fund the entire nation's 7% increase in expenses.

So for those of us not covered by government programs, the increase will feel like a 10.6% increase. We have to carry the government's share of the increase (7% / [1-.34] ) = 10.6%.

[saden1]

Originally Posted by Schneed10

This is actually very helpful for illustrating a point, thanks for posting.

You'll see on slide 2 of saden's link, it shows that 19% of healthcare spending was paid for through Medicare, and 15% through state Medicaid programs. Combined, that's 34% of the nation's healthcare spending from government programs.

Government budgets are suffering right now, and Obama's budget includes minimal increases in reimbursement from Medicare. State budgets are even worse off, and most aren't increasing reimbursement at all.

Overall, healthcare expenses are growing 7% per year. But, as noted, no increases are expected to come from the government. This means the rest of the payers need to fund the entire nation's 7% increase in expenses.

So for those of us not covered by government programs, the increase will feel like a 10.6% increase. We have to carry the government's share of the increase (7% / [1-.34] ) = 10.6%.

The 2009 budget allocated 262 billion for Medicaid and 425 billion Medicare. The 2010 Obama budget requests 290 billion for Medicaid (+11% from previous year) and 452 billion for Medicare (+6% from previous year) be allocated.

BTW Bush's original 2009 budget for Medicaid and Medicare had to be supplemented. My 2009 Death and Taxes poster says he originally budgeted 215 billion for Medicaid and 409 billion for Medicare.

[Schneed10]

Originally Posted by saden1

The 2009 budget allocated 262 billion for Medicaid and 425 billion Medicare. The 2010 Obama budget requests 290 billion for Medicaid (+11% from previous year) and 452 billion for Medicare (+6% from previous year) be allocated.

BTW Bush's original 2009 budget for Medicaid and Medicare had to be supplemented. My 2009 Death and Taxes poster says he originally budgeted 215 billion for Medicaid and 409 billion for Medicare.

You're right and I misspoke. He's proposing an increase for 2010, but the budget in place now (calendar year 2009) includes no increase.

Healthcare's fiscal year (including Medicare and Medicaid) runs July - June. As we just now enter FY 2010, there is no increase for either Medicare or Medicaid. But I suppose that stems from Bush's final budget, not Obama's.

There may be increases in FY 2011 thanks to Obama's 2010 budget. Of course to pay for it, an income tax increase will be required. And it's not that reimbursement will go up, it's more likely that more people will covered, resulting in the expected increase.

[firstdown]

Sneed we currently have an HMO or maybe its called a PPO and the rates have jumped to over $700 per month for a family of three. Me and my wife both have a Life/Health ins lic. but we do not sell any health ins. I have been bugging my wife for the past 2 years to switch over to a health savings plan and after taking a course (she had to take something for continued education requirments) she took a course on HSP and has now agreed to switch. We all have appointments to have everything checked out before we switch over so we will know we are all in good health. Besides having a higher ded. is there anything we should look for in a HSP that we may or may not want? I'd also like your opinion on these plans. My figures show we will save almost $400 a month which we can put into the savings sides which I no are tax defered if used for med. bills. I read something that we may want to work out something with our doctor on billing so we don't pay top dollar for every visit and get billed closer to what they bill ins. co's.

[Schneed10]

Originally Posted by firstdown

Sneed we currently have an HMO or maybe its called a PPO and the rates have jumped to over $700 per month for a family of three. Me and my wife both have a Life/Health ins lic. but we do not sell any health ins. I have been bugging my wife for the past 2 years to switch over to a health savings plan and after taking a course (she had to take something for continued education requirments) she took a course on HSP and has now agreed to switch. We all have appointments to have everything checked out before we switch over so we will know we are all in good health. Besides having a higher ded. is there anything we should look for in a HSP that we may or may not want? I'd also like your opinion on these plans. My figures show we will save almost $400 a month which we can put into the savings sides which I no are tax defered if used for med. bills. I read something that we may want to work out something with our doctor on billing so we don't pay top dollar for every visit and get billed closer to what they bill ins. co's.

Health saving plans, and other plans with higher deductibles, give you the nice benefit of charging you much less on a weekly/biweekly premium basis than a PPO or HMO program. The catch of course is you have the higher deductible.

Generally, the healthier you are the more a HSP (or any plan with a deductible) will financially benefit you. The sicker you are, the more a HSP will hurt you.

The nice thing with the HSP is any money you don't use on healthcare that year gets socked away to personal savings for you.

I have a PPO plan through my employer which contains a higher deductible & higher copays than traditional PPO/HMO plans. It costs me $61 per paycheck to cover my family, compared to $169 per paycheck under the traditional PPO plan. On my plan, inpatient hospital admissions come with a $2000 copay. That's separate from my deductible, which is $500 per person and $1500 for the family. So if I get admitted to the hospital, first I drop $2000 out of pocket and then up to $500 to cover the admission.

26 paychecks times $61 = $1586 per year for my plan.

26 paychecks times $169 = $4394 per year for the traditional PPO.

The difference between those plans is $2808 deducted from the paycheck on an annual basis. So if one person gets admitted to the hospital, plus we have the typical complement of doctor's visits, they would both work out to about the same total cost after paycheck deductions & out of pocket costs.

Where we'd get crushed is if the whole family got in a car accident or something, and I had to drop the $2000 copay for each family member. So there's more risk there, but I'm an odds guy, and I play the odds that I think are in my favor.

So, key things to look for in your HSP plan:

- Are the hospitals and doctors you anticipate using "in network". If they're not in the plan's network, it could make the plan a bad deal.

- Understand what the annual out of pocket max is for your family. You want to know what is the max you could pay in the disaster scenario I mentioned where the whole family gets in a car accident.

- Going into it, know that you have a cash management issue to deal with. Whatever your deductible is, you need to make sure you have that amount of cash laying around in order to cover deductibles and copays. In my situation, I need to have at least $3000 laying around at all times in order to cover out of pocket costs for a hospital admission & typical doctor visits.

A lot of people forget this, and end up unable to pay out of pocket costs because they failed to manage their weekly budget and wound up in debt.

[MTK]

Drunk posting again?

[GhettoDogAllStars]

^^ ... and for stuff you don't use

[BleedBurgundy]

Originally Posted by GhettoDogAllStars

^^ ... and for stuff you don't use

Never know, maybe he uses skank abortions.

[firstdown]

Originally Posted by BleedBurgundy

Never know, maybe he uses skank abortions.

I heard you go there to find a date.LOL

[SmootSmack]

Originally Posted by firstdown

I heard you go there to find a date.LOL

???...really?

[Slingin Sammy 33]

Originally Posted by firstdown

I heard you go there to find a date.LOL

When I was single I was hitting the bars.....what was I thinking?

[firstdown]

Originally Posted by Slingin Sammy 33

When I was single I was hitting the bars.....what was I thinking?

You Va beach boys were probably to snobby to hang out infront of one of those places and hit on the chicks as they leave. LOL

This thread has gotton a little off topic.

[firstdown]

Originally Posted by GhettoDogAllStars

^^ ... and for stuff you don't use

The only reason we pay for coverages we don't need is because they are mandated by the federal goverment and drive up our cost.

[GhettoDogAllStars]

bb +1
fd -1

[Schneed10]

Today at work we started looking into the effects the current health care bill, as written, will have on our hospitals. This was a narrow view of course, our job is to look out for ourselves. But hospitals in similar situations to us (in poor neighborhoods with high concentrations of underinsured) all throughout the country would feel the same effects.

As discussed in the opening post in this thread, reimbursement from state medicaid programs on behalf of Medicaid patients is terrible. We lose 25 cents on the dollar on this reimbursement alone. Currently, the healthcare system is set up such that hospitals with higher concentrations of Medicaid patients receive an extra lump sum payment from the government to help assuage the massive losses felt on Medicaid patients. This payment is referred to Disproportionate Share.

The current plan being discussed in congress would establish a universal healthcare program, allowing nearly everyone in the country to acquire affordable coverage. This of course is costly and to fund this the bill proposes to increase taxes on the wealthy. But that wouldn't even be enough. Also to help fund it, the bill proposes pulling the Disproportionate Share payments and reallocating the funds to Universal Healthcare. This is a detail overlooked by the media.

This will effectively rob my health system of approximately $80 million per year, that's how much we get in Disproportionate Share currently. Given that last year we lost $40 million on operations, even with receiving the $80 million from the government, this puts one of the biggest Medicaid hospital providers in the nation at risk of going out of business.

See, Universal Healthcare helps the working class. It does not help the poor. The poor don't have 2 cents to rub together. The working class could actually afford healthcare coverage of $150-$400 per month. But those currently on Medicaid will not suddenly be covered by a government plan, those currently on Medicaid can't afford ANY plan because frankly they can barely afford to eat.

Our hospitals will still have tons of Medicaid patients. Some of our working class patients will now get covered by Universal Healthcare, and we'll get reimbursed for them instead of writing the cost of their care off to charity. But the improvement in revenues from working class patients will nowhere near offset the losses in Disproportionate Share payments.

So the result:

- Money gets taken away from hospitals with the highest concentration of Medicaid patients.

- Those hospitals won't recoup those losses because they don't see enough working class patients who will gain coverage under the government plan.

- Hospitals in the poorest communities will be forced to shut down, creating a political nightmare. Meanwhile those patients will have to go somewhere, and nearby hospitals will be overcrowded thanks to shifting patient populations.

It's a horrible solution, and it's as if the bill's creators have absolutely no understanding of the current healthcare system. The bill's creators seem to have good intentions, to help make healthcare more affordable. However they have no idea how to do it, and left to their own devices they would leave the poorest and most vulnerable in the country without care at all. Lobbyists are fighting hard to get the hospitals in poorest areas carved out of the current proposal so they can continue to operate with Disproportionate Share payments.

I suspect we'll succeed in convincing Washington that they're morons.