Healthcare Education and Q&A Thread

[JoeRedskin]

Originally Posted by Schneed10

It's really tough to say without knowing what the reimbursement to hospitals would be under the government plan. My instinct says covering all 45 million under Medicaid would be cheaper.

However to cover the 45 million you'd have to raise the limit on the income level that qualifies people for Medicaid. In doing so, you'd end up covering a lot more than 45 million people, which would get exceedingly expensive.

But in a vacuum, if you covered the 45 million under Medicaid, I think it would be cheaper for the government. However, as discussed in previous posts in this thread, Medicaid reimbursement to hospitals blows, and commercial insurance companies are asked to pay rates to hospitals high enough to cover the losses on Medicaid patients. Adding Medicaid patients (without boosting Medicaid reimbursement rates) would mean an even greater burden would be placed on commercial insurance companies.

Those of us who are insured through the Blue Crosses of the world would pay even higher premiums to make up for even more horrendous Medicaid reimbursement. So while the federal government saves money by covering the 45 million through Medicaid, the ultimate cost on the citizenship is the same.

That's the thing, no matter how you configure the reimbursement and coverage part of the equation, healthcare costs what it costs. You're just debating over who pays for it, and how much. The only way we can make the system better is by actually attacking the cost of delivering care.

First, and again, thanks for the info. As, to the bolded part, I wholeheartedly agree.

[JoeRedskin]

Excellent points. Thank you.

[Schneed10]

Also, it should be noted that the geography of the United States lends itself to an expensive healthcare system. We're spread out across a lot of square miles.

Conversely, Europe and Japan are tightly packed. When tightly packed, you gain economies of scale by having fewer access points to care. It makes for fewer locations to staff up. However when spread out geographically like the US, you can't just have a number of hospitals in Chicago and then a number of hospitals in St. Louis, you need a number of centers in between to accomodate emergency care.

While building costs wouldn't vary between countries (you'd simply scale the size of the building to the population density in the area), you still have to staff each facility adequately to handle patient needs. The more facilities you have to staff, the more costly it gets.

[BaltimoreSkins]

Schneed,

I agree with your statement about attacking the cost of the delivery of care. My question is does that include a stronger regulation of the pharmaceutical industry and its relationship with doctors? What about the relationship between insurance companies and doctors?

[dmek25]

i like to see the numbers of company insured/ versus privately insured? anyone?