What do you know about the American Medical Association/Specialty Society Relative Value Scale Update Committee, or RUC and how DOCTORS decide Medicare reimbursement?
I am aware of how this effective Union for health care practitioners has helped to increase cost. That is exactly the reason why we need to move back toward a free market system of competition. Unions when faced with competition, end up ruining themselves and going into irrelevance.
I assume you already know about how the AMA applied pressure on government to restrict medical schools, intentionally to inhibit new doctors in the field, thus increasing price?
How Much do Hospitals Cost Shift? A Review of the Evidence
Abstract:
Context: Hospital cost shifting - that private payers are charged more in response to shortfalls in public payments - has long played a role in debate over health care policy.
Findings: Analyses and commentary based on descriptive, industry-wide hospital payment-to-cost margins by payer provides a false impression that cost shifting is a large and pervasive phenomenon. More careful
theoretical and empirical examinations suggest that cost shifting can and
has occurred, but usually at a relatively low rate. Margin changes are also strongly influenced by the evolution of hospital and health plan market structures and changes in underlying costs.
Isn't it interesting how just changing the focus, seems to call into question the entire premise?
It "HAS OCCURRED".... PERIOD. IT *HAS* OCCURRED. PERIOD.
Your own link.... the very link you posted on this forum, make it absolutely, undeniably clear, that cost shifting
HAS OCCURRED.... PERIOD.
The only question is to the degree. Which honestly, just look at evidence they used....
"More careful
theoretical (?!?) and empirical examinations..."
Theoretical.... oh yes, and empirical!.... examinations.... Theory? Part of their 'evidence' that cost shifting is fairly um... you know minor and unimportant..... is based on 'theoretical'.... examinations. AND some empirical stuff too.
Now this is great, because I actually downloaded the whole report, and started reading..... then laughing.....
Do you have any idea where this graph that I posted several days ago, came from? It's from YOUR LINK. LOL
The graph clearly showing and proving that cost shifting
HAS OCCURRED, came from the very report that you yourself, just posted a link too.
How poetic is that. The more arrogant people act on here, the faster they shove their own foot into their mouth.
So I kept reading.... and laugh again, when I got to page 15.
If this isn't hilarious, I don't know what is.
The claim "hospitals are out to maximize profits".... therefore prices are already as high as they can be. Thus, they can't possibly cost shift from under paying Medicare to Private payers, because their prices are already maxed out.
The only reason why anyone can't increase their prices, is because of competition. The less competition, and the more regulated the competition, the higher the prices can go, but it's still limited. Eventually people will go to a different hospital.
The theory that a hospital can't raise prices to cost shift, is based on that idea.
But there is a fundamental flaw this paper doesn't cover. That argument would be true..... if other hospitals didn't raise their prices.
But Medicare effects ALL hospitals. So ALL hospitals would raise their price together.
It's the same thing as the minimum wage. Yeah, if the minimum wage only effected McDonald's, they would not have been able to increase costs, because Burger King and Wendy's would have slaughtered them.
But since it effect all of them, prices have increased by 50% to 75% after the minimum wage went from $5.25 to $7.25.
Price Increases at Fast Food Restaurants from 2002 to 2013
This guy did a simple before and after comparison of Wendy's Burger King, McDonald's, Taco Bell, from 2002 to 2012.
Same thing with Hospitals. If you increase costs, through Medicare and Medicaid losses.... those losses are going to effect all hospitals, and thus the "theoretical evidence" that suggests they can't increase costs, is idiotic.
This report you linked to is a joke. All the rest of their arguments are the same. Lots of theory, let's of claims, zero empirical evidence. The graph, that clearly shows cost shift, *IS* the empirical evidence.
And BTW, I also had to laugh when they concluded that Medicare paying only 90% of the cost of treatment can't possibly be to blame for private care charged 25% over. Dur.... the people who wrote this report, not even look at their own published graph? Um.... Medicaid? Which pays even less than Medicare? Ya think that might make up a significant portion of that rest?
Of course I highly doubt you read any of this report you linked too. So typical.
Hey Einstein, you STILL haven't gotten to 50%... even the chart that you claim is PROOF doesn't show a 50% difference at any point. If you had actually READ the study, you would know that chart is from a previous study.
But lets take a look at REAL payments.
Reimbursement rates
Blood tests:
Comprehensive metabolic panel: A blood test that assesses liver and kidney function as well as electrolytes
Hospital charge: $179 Private insurance: $15 Medicare: $15
Lipid Panel: A blood test that checks total cholesterol and breaks it down to good and bad components.
Hospital charge: $68 Private insurance: $19 Medicare: $19
Complete Blood Count: A blood test that checks your hemoglobin, hematocrit, white blood counts.
Hospital charge: $51 Private insurance: $11 Medicare: $11
Urine Analysis: Looks for blood, signs of infection or protein in your urine.
Hospital charge: $92 Private insurance: $5 Medicare: $4
Hemoglobin A1C: A single blood test that checks your average blood sugar for the last 3 months.
Hospital charge: $61 Private insurance: $14 Medicare: $13
Thyroid Stimulating Hormone: A blood test that evaluates your thyroid function.
Hospital charge: $108 Private insurance: $24 Medicare: $23
Prothrombin Time: A blood test to check Coumadin level and your bloods ability to clot
Hospital charge: $36 Private insurance: $6 Medicare: $6
PSA: A blood test that helps to check for prostate cancer.
Hospital charge: $117 Private insurance: $26 Medicare: $22
HIV: Tests for HIV (obviously).
Hospital charge: $92 Private insurance: $20 Medicare: $19
Cardiology:
EKG: A screening test for abnormal heart rhythms and other signs of heart disease.
Hospital charge: $367 Private insurance: $26 Medicare: $26
Echocardiogram: An ultrasound of the heart to look at valves and assess function.
Hospital charge: $4,361 Private insurance: $317 Medicare: $291
Exercise Stress Test: This test is good for evaluating chest pain to see if your heart is the cause.
Hospital charge: $1,182 Private insurance: $123 Medicare: $123
Radiology: (Price includes fee for Radiologist)
Chest X-Ray: To check for lung disease and some forms of heart disease.
Hospital charge: $375 Private insurance: $42 Medicare: $41
Mammogram: Screening test for breast cancer
Hospital charge: $336 Private insurance: $191 Medicare: $146
Ultrasound of the Abdomen: Can assess Kidneys, Liver, Gall Bladder and other organs.
Hospital charge: $1,440 Private insurance: $184 Medicare: $181
Ultrasound of the Pelvis: Images the Uterus and Ovaries
Hospital charge: $1,106 Private insurance: $170 Medicare: $169
CT of Head: Often used to look for lesions in the Brain.
Hospital charge: $2,621 Private insurance: $344 Medicare: $269
CT of Chest with IV Contrast: Can accurately evaluate lung disease and other problem in the chest.
Hospital charge: $5,295 Private insurance: $431 Medicare: $426
CT of Abdomen with IV Contrast: Accurately images the abdomen for tumors or other disease
Hospital charge: $5,680 Private insurance: $463 Medicare: $458
CT of Pelvis with IV Contrast: Often done at the same time as the abdominal CT.
Hospital charge: $5,030 Private insurance: $408 Medicare: $403
MRI of the Brain: A more accurate way to image the brain than a CT scan but its more expensive and cant be done as quickly or easily.
Hospital charge: $3,422 Private insurance: $578 Medicare: $654
MRI of the Cervical Spine: Accurately images the neck
Hospital charge: $3,041 Private insurance: $584 Medicare: $587
MRI of the Thoracic Spine: Accurately images the upper back
Hospital charge: $3,422 Private insurance: $584 Medicare: $596
MRI of the Lumbar Spine: Accurately images the lower back.
Hospital charge: $3,535 Private insurance: $577 Medicare: $588
Procedures: (Usually these procedures are done in an office not a hospital. The amount billed varies substantially for different medical groups but it usually ranges from $1,000 to $8,000 for each).
Colonoscopy, Diagnostic: A screening test for colon cancer where the entire colon is examined through a fiber optic tube.
Private insurance: $504 Medicare: $464
Colonoscopy with Biopsy: If a lesion is found on screening colonoscopy a biopsy is needed.
Private insurance: $603 Medicare: $555
Upper endoscopy with Biopsy: Evaluates problems in the esophagus and stomach, again through a fiber optic tube.
Private insurance: $447 Medicare: $410