atomic_fungus (atomic_fungus) wrote,

#1990: ARRRRRRGHHH!!!!


The damn coughing! I can't sleep for more than a few hours at a time, and I constantly have a sinus headache because of the coughing! My nose WILL NOT STOP RUNNING!

* * *

One of the dirty secrets of our health care system is Medicare. Medicare doesn't pay the going rate for any medical procedure or supplies; it pays less. It always has.

Witness please this Anchoress post.
Medicare and Medicaid, the current government paid ‘insurer’ – pays approximately 70% of the cost of care. ie its more expensive for doctors to care for these patients than we get reimbursed for. Say you are a contractor. Imagine the government mandating a significant number of your jobs whereby your out of pocket costs are ~ 30% + greater than your income.
Let me help you understand what that means.

Let's say that I run a pharmacy. Let's say that I have ten customers, half of whom have private insurance; the other half are on Medicare/Medicaid. Let's further say that all my products--regardless of what they are or do--are priced at $1 per unit. This price reflects my total cost of stocking my shelves and paying my staff, and ensures a modest profit to keep the store in business. (Let's go with a total profit of 4%, which is typical for the health insurance industry.)

If everything goes right and I sell ten units of health products a month, everything's paid for and the store makes a modest profit of $0.20.

We start with January.

Customer A, who is on Medicare, requires a unit of Product X and presents his Medicare information to me. After all the paperwork is done, the federal government gives me $0.70 for that unit of Product X.

Customers B, C, D, and E also require a unit of Product X (popular stuff, that X) and they, too, present Medicare paperwork. I've sold five units of Product X, at $0.70 each.

I've sold $5 worth of product for $3.50. Excluding my profit margin--4% of $5 is $0.20--I am still $1.30 in the hole. I'm not meeting my expenses; this way lies bankruptcy. Somehow I have to recoup that $1.30 if I am to escape January with the clothes on my back.

I raise prices. Now Customer F comes in to buy some Product Y. His private health plan pays half of the price of Y, which is now $1.26 per unit. (Everything in the store now costs $1.26 per unit.) Customer F pays $0.66 out of pocket.

Customers G, H, and J end up paying the $1.26 cost for their units of Product Y using various mixes of insurance and out-of-pocket expenses. When K comes in on January 31st and buys a unit of Product Z, at $1.26, I am saved: I have just barely broken even in January. The store didn't earn any profit, but the lights stayed on and the paychecks didn't bounce. If it hadn't been for Customer K coming in at the last minute, I would have been $1.26 in the hole.


Customers A-E come in and get their Product X again. Medicare again pays 70% of the price. But the price is $1.26, leaving me onluy $0.12 in the hole per unit instead of $0.30. And my non-Medicare customers come in for things, too. No sign of Mr. K this month, but the other guys got their Product Y, and at $1.26 each, that leaves me at a gross of...$9.44.

I need $9.80 per month to break even. Where am I going to get that other $0.36 from? I own the store, so I'll cut my own pay this month...I'll raise the prices on everything to $1.40.


Four Medicare customers--what happened to Ms. C?--net me $3.92. But I get five private insurance customers, and that nets me $7. Hooray! I made up for February's loss! Let me see, I made $10.92 gross in March, which even makes up for breaking even in January! I can even give myself the back pay I had to forego last month.


Citing excessive health industry profits, Medicare cuts the reimbursement rate to 66%.

I quit.

* * *

The whole health care debate was supposed to be on C-SPAN, but now the President is keeping it all as secret as possible.

* * *

The White House is spamming federal employees with liberal propaganda.

* * *

"Democrats are on the cusp of a profound and historic mistake, comparable in our view to the Smoot-Hawley tariff and FDR's National Industrial Recovery Act." And they'll be just as big a mistake economically, too.

More taxes, more spending, more debt, more economic malaise that'll make the Carter years look like a birthday party.

Thanks, Democrats.

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