...   
      
    RS>> A friend of mine's Mom works in accounts at a local hospital, the   
    RS>> "indigent" patients (meaning those who can't pay,) their bill ends up   
    RS>> getting eaten by the hospital.   
      
    RS>> The hospital then has to jack up their rates to cover those losses.   
      
    RS>> That's why an aspirin shows up on the bill costing $3.50.   
      
    BA> What the f*ck do you think I've been saying for the past 20   
    BA> years??? Now that you apparently understand that fact,   
    BA> would you mind explaining it to Klahn?   
      
    I understand it, I don't believe it. No hospital can charge you   
    $3.50 for an aspirin just because they have to cover another   
    patient's bills. No for profit hospital will charge any less   
    than they can get away with whether or not another patients   
    bills are covered.   
      
    RS>> Recently I've read about a major operation in Florida, hunting down   
    RS>> and arresting dozens of Medicare fraud crooks.   
      
    RS>> "60 Minutes" has a feature on how easy it was to commit fraud on   
    RS>> Medicare.   
      
    RS>> And how profitable Medicare fraud is.   
      
    BA> While it does exist, it's not nearly as rampant as the   
    BA> politicos would have us believe.  And yes, those who engage   
    BA> in it should be locked up for a nice long time.   
      
    I have been of that opinion for a long time. Crooks will defraud   
    private insurance just as much as medicare. And the medicare   
    frauds seem to tend to be doctors and medical providers, not the   
    patients.   
      
    BA> That said, the biggest Medicare fraud is the claim that   
    BA> Medicare pays the bills for   
    BA> the health care received by the nation's elderly.  It   
    BA> doesn't, and hasn't for probably   
    BA> thirty years.  What it pays is a *portion* of those bills.   
      
    My private sector insurance does exatly the same thing. What's   
    the difference?   
      
    BA> When Medicare started   
    BA> discounting its payments, providers started billing the   
    BA> patients for the unpaid balances.   
      
    That is what I do not believe. Those private for profit   
    hospitals will charge whatever they can get, regardless of what   
    other patients pay or don't pay.   
      
    In a truly competitive market they could not get away with that   
    at all. Some hospitals would just not take the medicare payments   
    and patients, then cut the bills of their regular patients and   
    the ones overcharging would lose business.   
      
    Believe it or not that is how a real free market works. The fact   
    that you don't see that at all is the proof there is no free   
    market. It is also the proof that the conservative mantra of   
    private sector competition is a fraud.   
      
    BA> Said patients screamed to their congresscrooks, who   
    BA> promptly made it illegal for providers   
    BA> to bill Medicare patitnts for any unpaid charges.   
      
    The providers can't bill me for the discounted part from my   
    private sector insurance. What's the difference?   
      
    BA> Medicare is also infamous for slow payment - 90 days is   
    BA> *early* to them.  Note that   
    ...   
    BA> and payments were made by EFT.  There's no reason on earth   
    BA> that an insuror should need   
    BA> more than *TEN* days to pay a claim (fraud investigations   
      
    True. So solve that problem. Oh and if the republicans have any   
    solutions at all, why didn't they fix that in the 6 years they   
    had complete control of the federal government?   
      
    BA> can come later).  Yet Medicare   
    BA> rarely takes ANY action on a claim for 90 days; then it   
    BA> disallows every charge it thinks it   
    BA> can get away with and writes itself a humongous discount on   
    BA> the remaining balance - only   
    BA> rearely does Medicare pay even half of the billed amount.   
      
    My private sector insurance typically pays about 36% or less.   
    What's the difference?   
      
    ...   
      
    BA> bill just shy of $50K for my angioplasty and stent back in   
    BA> 2004.  Tricare paid just shy of   
    BA> $9,000 of those charges.  MY share of those charges was a   
    BA> whopping $33.00.  The other   
    BA> forty grand - EIGHTY PERCENT of the billed amount - went   
    BA> where all the other unpaid   
    BA> charges go, onto other peoples' bills.  And it took Tricare   
      
    Again, I do not believe that. If the hospital and doctors found   
    the medicare payments insufficient they would simply refuse to   
    do business with them.   
      
    ...   
      
    BA> And unpaid charges - even those for 'uncompensated care'   
    BA> and 'charity care' - don't just   
    BA> go away because they don't get paid.  They get factored   
    BA> into everybody else's bills, just   
    BA> like shoplifting and employee theft are factored into the   
    BA> prices on retail merchants' shelves.   
      
    The big difference is, the hospitals can stop taking medicare,   
    store owners can try to stop theft, but they can't just refuse   
    to do business.   
      
    About 2/3rds of medical care in this country is paid for by the   
    government or insurance. Much of the rest is paid for by the   
    patients. Since, in many cases where bills have to be covered   
    before treatment will be provided, the patient does have to pay   
    the bills, those cover the bills that actually are paid.   
      
    So, about 2/3rds of medical bills are discounted, usually by   
    more than 50%. That tells me the other 1/3rd is overcharged. And   
    the hospitals can't double the bills of all other patients just   
    because of the 2/3rds that are discounted. Ok, That would mean   
    just more people who are not paying.   
      
    Oh, I just recently paid cash for a doctor bill that was not   
    covered by insurance. The bill was reduced by something like   
    40%. So, how can doctors cut bills for cash payments if they   
    have to make up for third party discounts?   
      
    My suspicion, the original bill is jacked up to allow for the   
    discounts.   
      
    And once everyone is covered by insurance I believe they won't   
    be able to do that anymore, since eveyone will know what will be   
    paid in advance.   
      
    So, Obamacare is the answer even to that.   
      
      
      
   BOB KLAHN bob.klahn@sev.org   http://home.toltbbs.com/bobklahn   
      
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