Healthcare Education and Q&A Thread

[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.

[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.

[GMScud]

Great post Schneed. I sincerely hope your last line is correct. Obama Care is a train wreck. My father is Cheif Legal Officer and Executive VP of Children's National Medical Center here in DC, and he's beside himself with the idiocy of this plan. I wasn't aware of the Disproportionate Share aspect. I'm having dinner with him on Sunday- I'll find out if his hospital has a lot of Medicaid patients and how this wrinkle will affect them. These individual case studies are a great way to look at the impact on the ground level.

And the fact that Obama wants to force this thing through before the August recess is pretty shortsighted IMO.

[saden1]

LOL...I find it super hilarious the same people against universal healthcare are against it because it would mess with government payments to hospitals. I wonder Mr. S10, how many of your hospital's Medicaid patients are emergency care patients.

I say do it right, raise taxes, insure everyone and keep rural hospitals open but weak-ass Obama isn't going to do that. What kind of a public plan is it anyways if there aren't even government hospitals? Perhaps it's time to let those rural hospitals be taken over by the government? If they can't survive on their on to begin with why not turn them into government hospitals? Alternatively we can let them people go ahead and just die.

[GMScud]

Originally Posted by saden1

LOL...I find is super hilarious the same people against universal healthcare are against it because it would mess with government payments to hospitals. I wonder Mr. S10, how many of your hospital's Medicaid patients are emergency care patients.

I say do it right, raise taxes, insure everyone and keep rural hospitals open but weak-ass Obama isn't going to do that. What kind of a public plan is it if there aren't even government hospitals anyways? Perhaps it's time to let those rural hospitals be taken over by the government? If they can't survive on their on to begin with why not turn them into government hospitals? Alternatively we can let them people go ahead and just die.

Kind of like the way you scoff at American history and advocate gigantic government in the same breath??

We've got a big enough shortage of healthcare professionals as it is. Where are we going to find the bureaucracy (qualified) to create and staff government hospitals?

[saden1]

Originally Posted by GMScud

Kind of like the way you scoff at American history and advocate gigantic government in same breath??

We've got a big enough shortage of healthcare professionals as it is. Where are we going to find the bureaucracy (qualified) to create and staff government hospitals?

I'm flexible and acrobatic enough to point out the hypocrisy of American's history, adore America, and advocate for spending more money caring for our people instead of some of our people all in the same breath. I pray I do not offend your sensibility with my views good sir for I have put quite a bit of effort in formulating my thoughts.

As articulated in my previous post the government can buyout these fledgling private hospitals if they can not stand on their own...and I am sure the current hospitals have somewhat enough staff to care for their current patients.

No one said this is was all going to be a cakewalk. One can not possibly expect to enact universal heathcare without some serious ramification to the current system. Unfortunately we have people wanting the balancing act to go on when the elephant needs to be shot before his handlers gets trampled.

[GMScud]

Originally Posted by saden1

I'm flexible and acrobatic enough to point out the hypocrisy of American's history, adore America, and advocate for spending more money caring for our people instead of some of our people all in the same breath. I pray I do not offend your sensibility with my views good sir for I have put quite a bit of effort in formulating my thoughts.

As articulated in my previous post the government can buyout these fledgling private hospitals if they can not stand on their own...and I am sure the current hospitals have somewhat enough staff to care for their current patients.

No one said this is was all going to be a cakewalk. One can not possibly expect to enact universal heathcare without some serious ramification to the current system. Unfortunately we have people wanting the balancing act to go on when the elephant needs to be shot before his handlers gets trampled.

I'm not too easily offended, especially on a site where we're all basically anonymous.

I know you put plenty of thought into your opinions, and I respect how well developed they are, no matter how much I may disagree.

[Schneed10]

Originally Posted by saden1

LOL...I find it super hilarious the same people against universal healthcare are against it because it would mess with government payments to hospitals. I wonder Mr. S10, how many of your hospital's Medicaid patients are emergency care patients.

I say do it right, raise taxes, insure everyone and keep rural hospitals open but weak-ass Obama isn't going to do that. What kind of a public plan is it anyways if there aren't even government hospitals? Perhaps it's time to let those rural hospitals be taken over by the government? If they can't survive on their on to begin with why not turn them into government hospitals? Alternatively we can let them people go ahead and just die.

I'm not sure why you're talking about rural hospitals? Ours are inner city Philadelphia, in the poorest section of town.

To answer your question, about 55% of our Medicaid patients are emergency, 30% are maternity, and the rest elective.

The point isn't that we shouldn't have to take care of them. The point is without the Disproportionate Share payments, there won't be a hospital anymore. Our University can't afford to subsidize losses as massive as this would generate.

Based on your response, which was pretty confusing, I'm not sure you fully understand. My point is we're already a government hospital in a lot of respects. We get an $80 million lump sum payment annually from the government just to keep us in business. We need to keep getting that government payment or we'll go out of business.

Being run by the government won't solve anything. Believe me, our management has us running lean and mean, our staffing levels are low. A takeover by government management would not yield any expense reductions. We don't need to be run by the government, we just need to be propped up by the government.

That is if you want poor people to have any healthcare at all. That's reality.

[firstdown]

Originally Posted by saden1

I'm flexible and acrobatic enough to point out the hypocrisy of American's history, adore America, and advocate for spending more money caring for our people instead of some of our people all in the same breath. I pray I do not offend your sensibility with my views good sir for I have put quite a bit of effort in formulating my thoughts.

As articulated in my previous post the government can buyout these fledgling private hospitals if they can not stand on their own...and I am sure the current hospitals have somewhat enough staff to care for their current patients.

No one said this is was all going to be a cakewalk. One can not possibly expect to enact universal heathcare without some serious ramification to the current system. Unfortunately we have people wanting the balancing act to go on when the elephant needs to be shot before his handlers gets trampled.

Why not your and all that support Obama care fork up the money and go for it. I'm sure with the cost savings you guys will actually save money.

[dmek25]

schneed, what happens at your hospital right now, if and uninsured person comes in that desperately needs help?

[saden1]

Originally Posted by Schneed10

I'm not sure why you're talking about rural hospitals? Ours are inner city Philadelphia, in the poorest section of town.

To answer your question, about 55% of our Medicaid patients are emergency, 30% are maternity, and the rest elective.

The point isn't that we shouldn't have to take care of them. The point is without the Disproportionate Share payments, there won't be a hospital anymore. Our University can't afford to subsidize losses as massive as this would generate.

Based on your response, which was pretty confusing, I'm not sure you fully understand. My point is we're already a government hospital in a lot of respects. We get an $80 million lump sum payment annually from the government just to keep us in business. We need to keep getting that government payment or we'll go out of business.

Being run by the government won't solve anything. Believe me, our management has us running lean and mean, our staffing levels are low. A takeover by government management would not yield any expense reductions. We don't need to be run by the government, we just need to be propped up by the government.

That is if you want poor people to have any healthcare at all. That's reality.

My sentiments also applies to urban hospitals. I understand the problem fully, we have this bastardized hybrid system where hospitals are "basically government hospitals" when they aught to be "fully taxpayer funded government hospitals."


Let me ask you this, are there any type of savings having universal healthcare would yield? I know the AHA was all for saving taxpayers 155 billion no too long ago if 95% of Americans were coverage.

[firstdown]

Originally Posted by saden1

My sentiments also applies to urban hospitals. I understand the problem fully, we have this bastardized hybrid system where hospitals are "basically government hospitals" when they aught to be "fully taxpayer funded government hospitals."


Let me ask you this, are there any type of savings having universal healthcare would yield? I know the AHA was all for saving taxpayers 155 billion no too long ago if 95% of Americans were coverage.

I can answer that. NO, there has never been a goverment programe that has reduced cost.

[Slingin Sammy 33]

Originally Posted by saden1

I understand the problem fully, we have this bastardized hybrid system where hospitals are "basically government hospitals" when they aught to be "fully taxpayer funded government hospitals."

You have gone over the cliff my friend.