What we may end up with is

[Oddball]

The other countries made no pretense about it and went all in for socialized medical services, rather than this idiotic cramdown, not-at-all cleverly disguised as "insurance reform".

In socialized medical scams, gubmint pays less through rationing...."The people" couldn't pay for it if they wanted to.

Foo.

 

[Mr.Fitnah]

How it works - very roughly - is that I go to see my doctor and he gives me a bill. My doctor is in a private clinic and the business doesn't "bulk bill", that is, it charges the AMA rate and not the Medicare rate. I pay at the clinic and then I electronically claim on Medicare and the reimbursement goes into my bank account. If I have a Health Card and am on concessions then I don't pay anything. Some doctors will only charge the Medicare rate so people don't have to pay anything.

I don't know about doctors refusing to treat patients in the manner you assert.

We can get to the things you dont know later lets deal wtih, if you dont have the scratch to pay the bill?

I do know that the previous federal government - conservative Howard government - fucked with Medicare here. Just another reason I'm so glad they're not in power. But even that ideologically driven fool didn't try to dismantle it.

So, the evidence for non-treatment?

Thats a straw man I said

Something that is not unlike what is evolving in Australia.
The person in need of care will have to pay out of pocket and have to file for reimbursement from the government.
Many Doctors in Australia will no longer treat patients under government care programs due to low and slow payments.

How is that for a health care solution?

What is happening is the Doctors are dropping the bulk billing and demanding full payment up front leaving the patients to seek reimbursement according to there insurance schedule .

Now what happens when you dont have the money to pay up front?

 

[Diuretic]

We can get to the things you dont know later lets deal wtih, if you dont have the scratch to pay the bill?

I do know that the previous federal government - conservative Howard government - fucked with Medicare here. Just another reason I'm so glad they're not in power. But even that ideologically driven fool didn't try to dismantle it.

So, the evidence for non-treatment?

Thats a straw man I said

Something that is not unlike what is evolving in Australia.
The person in need of care will have to pay out of pocket and have to file for reimbursement from the government.
Many Doctors in Australia will no longer treat patients under government care programs due to low and slow payments.

How is that for a health care solution?

What is happening is the Doctors are dropping the bulk billing and demanding full payment up front leaving the patients to seek reimbursement according to there insurance schedule .

Now what happens when you dont have the money to pay up front?

The AMA is advising its members to charge the AMA fee. Medicare, the agency funded by the federal government, is prepared to pay a fee less than the AMA fee.

Let me use some information from the Medicare site to make some points. It's actually worth poking around in the site, it's got a lot of info.

Anyway:

What does Medicare cover?

The benefits you receive from Medicare are based on a Schedule of fees set by the Australian Government. Doctors may choose to charge more than the Schedule fee. The Medicare Benefits Schedule (MBS) lists all the Medicare item numbers.

Out-of-hospital services

Medicare provides benefits for:
consultation fees for doctors, including specialists
tests and examinations by doctors needed to treat illnesses, including X-rays and pathology tests
eye tests performed by optometrists
most surgical and other therapeutic procedures performed by doctors
some surgical procedures performed by approved dentists
specified items under the Cleft Lip and Palate Scheme
specified items for allied health services as part of the Enhanced Primary Care (EPC) program—contact Medicare on 132 011 for more information

You can choose the doctor who treats you for out-of-hospital services.

In-hospital services
Public Patient

If you choose to be admitted as a public (Medicare) patient in a public hospital, you will receive treatment by doctors and specialists nominated by the hospital. You will not be charged for care and treatment, or after-care by the treating doctor.
Private Patient

If you are a private patient in a public or private hospital, you will have a choice of doctor to treat you. Medicare will pay 75 per cent of the Medicare Schedule fee for services and procedures provided by the treating doctor. If you have private health insurance some or all of the outstanding balance can be covered.

You will be charged for hospital accommodation and items such as theatre fees and medicines. These costs can also be covered by private health insurance.

What's not covered by Medicare?

Medicare does not cover such things as:
- private patient hospital costs (for example, theatre fees or accommodation)
- dental examinations and treatment (except specified items introduced for allied health services as part of the Enhanced Primary Care (EPC) program)—contact Medicare for more information
- ambulance services
- home nursing
- physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology (except specified items introduced for allied health services as part of the Enhanced Primary Care (EPC) program)—contact Medicare for more information)
- acupuncture (unless part of a doctor's consultation)
- glasses and contact lenses
- hearing aids and other appliances
- the cost of prostheses (except External Breast Prostheses covered by the External Breast Prostheses Reimbursement Program)
- medicines (except for the subsidy on medicines covered by the Pharmaceutical Benefits Scheme)
- medical and hospital costs incurred overseas
- medical costs for which someone else is responsible (for example a compensation insurer, an employer, a government or government authority)
- medical services which are not clinically necessary
- surgery solely for cosmetic reasons
- examinations for life insurance, superannuation or membership of a friendly society
- eye therapy

You can arrange private health insurance to cover many of these services.

How do I pay my doctor?

Bulk billing

Bulk billing is when your doctor bills Medicare directly, accepting the Medicare benefits as full payment for a service. This means if your doctor bulk bills, you cannot be charged a booking fee, administration fee, a charge for bandages, record keeping or a charge by your doctor’s company.

Many doctors bulk bill some of their patients such as pensioners or health care cardholders. If your doctor bulk bills you will be asked to sign a completed form after the service and will be given a copy.

There are circumstances where more than one service can be provided at the same visit and your doctor is not required to bulk bill each service.

Accounts

If your doctor charges you a fee, you can:
- pay the account and then claim the benefit from Medicare
- claim your unpaid account from Medicare and receive a cheque made out in the doctor’s name which you give to your doctor along with any outstanding balance

Medicare usually pays:
- the full Schedule fee for GP services
- 85 per cent of the Schedule fee for other out-of-hospital services
- 75 per cent of the Schedule fee for in-hospital services

The Schedule fee is a fee for service set by the Australian Government and not what your doctor charges you.

We have to pay the gap between the AMA fee and the Schedule fee. Private insurance doesn't cover it. But as the excerpt points out, people who are on low incomes are usually bulk-billed. If a medical business doesn't bulk bill then low income earners are free to find one that does

All info available here - Medicare Australia

 

[Mr.Fitnah]

Has Dr reimbursement faced any cuts?
At what % point do all the doctor quit that system?

 

[JakeStarkey]

The other countries made no pretense about it and went all in for socialized medical services, rather than this idiotic cramdown, not-at-all cleverly disguised as "insurance reform".

In socialized medical scams, gubmint pays less through rationing...."The people" couldn't pay for it if they wanted to.

Foo.

Dude, you are talking through your butt. Where is the empirical data that supports your conclusion? There isn't any such proof.

 

[Diuretic]

Has Dr reimbursement faced any cuts?
At what % point do all the doctor quit that system?

Usually the AMA ramps up the fees and the government and the AMA have a big blue about it and it settles down again and we all get on with it. Doctors can stop public practice any time but they tend not to. Even specialists such as surgeons will practice in both the public and the private sector. One of our best plastic surgeons where I am works in public practice on cranio-maxillo whatever it's called and has a big private practice in purely cosmetic surgery which is not covered by Medicare.

Don't get me wrong, the system isn't perfect and there are always problems with underfunding by governments who don't want to raise taxes but by and large the system is supported by the electorate.

 

[jeffrockit]

Then, Some Guy, you do not believe in free market competition for customers that will inevitably drive down costs.

It will not be "free market competition" as the govt will control what they insurance companies can charge which will put them with a deficit that will cripple them. That added with the fact that 30+ million more getting HC benefits, the private run insurance companies are done for. When people think that something is free, studies show they use more of that something.
When the private insurance companies fail, the govt will say "we gave them a chance and they just were greedy and failed", then the govt steps in with the public (govt) option. If you think that they can co-exist, consider this; the govt HC will not have to make a profit to survive as they will have our seemingly endless tax dollars and the private HC companies will not. This surely can not be considered "free market competition" by anyone.
What I can't understand is that with all the success stories of the free market working for many decades, granted their have been some failures, but for the most part successes, why would we opt for the govt to run something as important and our healthcare. An overwhelming majority of all govt run programs are soon to be broke and totally inefficient in administering services compared to free market businesses. Why so many think this will be different is beyond comprehension.

 

[Diuretic]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

 

[saveliberty]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

Don't know what jeffr thinks, but for me its not wanting the government to make decisions for me and my family AND that they are not very good at running anything.

 

[Mr.Fitnah]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

For the same reason we dont have government run breweries ,Its to important.

 

[Foxfyre]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

As I failed to get back to your last excellently argued post directed to me, let me address it here within this context.

It has been proved time and time again that nations are most likely to prosper who 1) respect human rights and 2) embrace a free market system.

Further the USA is nation founded on an ideal that had never before been put into practice on a large scale anywhere in the world. That principle is that the people, not the government, would look to their own interests better than any government ever could. The role of the government was to secure our rights, which would include access to free markets, and then leave the people alone to work out what sort of society they wished to live in. Most Americans have a deep seated passion and instinct for freedom, and resent others presuming to govern them, especially on a scale as large as the USA.

Even if we don't look at Canada's population being 1/10th of the USA--that is not an insignificant consideration--we can include Canada with many other experiments in socializatin of some or all government services.

Without exception socialism in part or in total has seemed to make things better for awhile. Sometimes the people really like it. Often they get thoroughly hooked on it and are unwilling to give up security for freedom. But invariably socialism bogs down. It cannot sustain itself. As Maggie Thatcher once said, "Sooner or later you run out of other people's money." So the people lose more and more control of their own destiny and eventually economies bog down and stagnate as we see in much of Europe.

Canada may be getting there too re their universal healthcare if the rumors are accurate.

It calculates that at present rates, Ontario will be spending 85 percent of its budget on health care by 2035. “We can’t afford a state monopoly on health care anymore,” says Tasha Kheiriddin, Ontario director of the (Canadian Taxpayers) federation. “We have to examine private alternatives as well.”

Canada: Socialized Medicine Going Broke? | America's North Shore Journal

Here in the USA Medicare, Medicaid, and Social Security are all many hundreds of billions of dollars in debt. With a track record like that, on what planet would informed people then think the government would do a better job with the rest of the healthcare system?

 

[Diuretic]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

Don't know what jeffr thinks, but for me its not wanting the government to make decisions for me and my family AND that they are not very good at running anything.

Government makes decisions for us all the time, you just don't realise it. It's fine to have a personal ideology but I'm afraid it's irrelevant.

 

[Diuretic]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

For the same reason we dont have government run breweries ,Its to important.

I could almost concede just on that

But my point is that - sorry, broken record (young 'uns that refers to the old vinyl discs we used to play to make music) time again - health care shouldn't be a commodity in the free market, it's not like..................beer

 

[Diuretic]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

As I failed to get back to your last excellently argued post directed to me, let me address it here within this context.

It has been proved time and time again that nations are most likely to prosper who 1) respect human rights and 2) embrace a free market system.

Further the USA is nation founded on an ideal that had never before been put into practice on a large scale anywhere in the world. That principle is that the people, not the government, would look to their own interests better than any government ever could. The role of the government was to secure our rights, which would include access to free markets, and then leave the people alone to work out what sort of society they wished to live in. Most Americans have a deep seated passion and instinct for freedom, and resent others presuming to govern them, especially on a scale as large as the USA.

Even if we don't look at Canada's population being 1/10th of the USA--that is not an insignificant consideration--we can include Canada with many other experiments in socializatin of some or all government services.

Without exception socialism in part or in total has seemed to make things better for awhile. Sometimes the people really like it. Often they get thoroughly hooked on it and are unwilling to give up security for freedom. But invariably socialism bogs down. It cannot sustain itself. As Maggie Thatcher once said, "Sooner or later you run out of other people's money." So the people lose more and more control of their own destiny and eventually economies bog down and stagnate as we see in much of Europe.

Canada may be getting there too re their universal healthcare if the rumors are accurate.

It calculates that at present rates, Ontario will be spending 85 percent of its budget on health care by 2035. “We can’t afford a state monopoly on health care anymore,” says Tasha Kheiriddin, Ontario director of the (Canadian Taxpayers) federation. “We have to examine private alternatives as well.”

Canada: Socialized Medicine Going Broke? | America's North Shore Journal

Here in the USA Medicare, Medicaid, and Social Security are all many hundreds of billions of dollars in debt. With a track record like that, on what planet would informed people then think the government would do a better job with the rest of the healthcare system?

My turn to express appreciation of your post.

Further the USA is nation founded on an ideal that had never before been put into practice on a large scale anywhere in the world. That principle is that the people, not the government, would look to their own interests better than any government ever could. The role of the government was to secure our rights, which would include access to free markets, and then leave the people alone to work out what sort of society they wished to live in. Most Americans have a deep seated passion and instinct for freedom, and resent others presuming to govern them, especially on a scale as large as the USA.


I'm a bit tentative here in taking on these points. But let me say that when an American informs me about American values I won't argue with them, logically it's uncontestable. But that doesn't mean that the claims are valid of themselves, just that those values are held.

The USA's founding out of the British colonies was a first in so many ways and again I can't contest those claims because I agree with them. While Europe was by far and away the most advanced society (if I can allege a continent has a “society&#8221 it's true that in governmental terms it was a bit patchy and hardly democratic. But I need to make the point that many of the principles on which the Founding Fathers rested were know well before their implementation in the new nation. The doctrine of the separation of powers is one of them. But the new nation took those various ideas which appealed to its founders and implemented them and that is progress indeed. And leaving folks alone was also a great idea. I'm not sure but I would think until then the idea that people lived for the government was probably still strong in Europe, given its history of feudalism and near slavery of its peoples in that system.

But sometimes ancient values get in the way of common sense public policy. In this particular instance we're discussing public health policy. I don't think that any of us are arguing that people should be denied access to health care – the argument is about the appropriate mechanism(s) to ensure that happens. However when someone advocates DIY surgery at home I'll concede.

It has been a tendency for one side of the discussion to point to failings in health care systems. The Daily Mail in the UK is a great source of stories about the horrors of the NHS. And the distal cause of most of these incidents? Underfunding.

Yes, that's it, underfunding. The mechanism is fine, the fuel to drive the mechanism is the problem behind these incidents. Sometimes someone will argue that a surgeon taking out the wrong lung is due to “socialised health care”. No it isn't, it's called incompetence and it occurs regardless of the provision mechanism.

You have pointed to failings in the Canadian system (actually it's not a national system, it's provincially based and that might he one of the problems). Some provincial governments are stubbornly opposed to a two-tier system. I dsiagree with that.

It's good policy to have a two-tier system where those with cash or those who can afford insurance can get preferential treatment. This is a good thing because it's the case that more people can afford to pay directly or via insurance than there are those who can't afford to do either. That's a sort of crude utilitarian view but there is a benefit in that it reduces the load on the public system which allows the public system to be used by those who can't afford the private system.

In Canada some of the provinces have outlawed a two-tier system, I think Ontario is one of them. That's short-sighted, even here in notoriously (well we think we are) egalitarian Australia we have a two-tier system – sometimes pragmatism beats principle.

I'm addressing the general expression of disagreement now, not your points specifically Foxfyre.

Much of the popular opposition to Obama's healthcare reforms has been based on the values that have been discussed. I'm afraid though it seems to me that those opponents have been blinded by mythology. Now they are not alone, we all love to think of ourselves, our societies, in positive terms, expressing the social values that we learned as children, but sometimes they have to be set aside and we have to take a good hard look at our society without the comforting mythologies. The US has a failed health care system when it's examined objectively. If you're wealthy or insured you're okay, if you're neither than you're not okay. But you should be. No-one in a civilised society should be denied health care simply because they can't afford to pay for it. That's the sentiment that underpins my position that a form of universal health care - hybrid models included - is necessary for any society. I keep making the point that the free market is fine for commodities but not for essentials such as health care but the ideology of the free market is strongly held in the US and that ideology is what drives opposition to the reforms. I'm arguing to dump the ideology, it doesn't make sense in terms of public health policy.

The vested interests have marshalled opposition to the reforms by playing on Americans' basic values. To me that's tantamount to propagandising of the worst type. I'm always a bit annoyed when, in a political discussion the Trots bang on about the "false consciousness of the working class". I agree with them that it does exist but I hate the bloody patronising attitude they evince about it. But at the risk of being accused of patronising the opposition in this discussion there is a false consciousness at work where the vested interests have disguised their real motives for opposing the reforms. Instead of admitting naked economic self-interest they have grabbed the flag to cover up those real motives and many Americans have been conned.

 

[saveliberty]

When it comes to understanding people. I'm inclined to think the rich and powerful have a better view of the whole picture than the poor and unempowered. Many people have struggled and met challenges while rising to the heights of power and money. Few of the poor can truly say the same about how to deal with having power and money.

 

[jeffrockit]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

Because the free market works when it is actually free and not govt mandated or govt interfered. Do you really have confidence in the govt to run your healthcare? Do you truly believe the politicians have your best interest in mind; I know you don't think the free market does but want to know your opinion on politicians taking control.

 

[Diuretic]

When it comes to understanding people. I'm inclined to think the rich and powerful have a better view of the whole picture than the poor and unempowered. Many people have struggled and met challenges while rising to the heights of power and money. Few of the poor can truly say the same about how to deal with having power and money.

You really have swallowed it haven't you?

Think about it. How did people first get wealthy? Then think about how their children got wealthy? Then think how THEIR children got wealthy.

You know the problem here? Americans, bless 'em, don't understand how the class system works. The Brits know because they've lived with it for thousands of years. Americans with the facade of an egalitarian society getting in the way simply don't understand how social stratification works.

The rich and powerful only give a fuck about the rich and powerful. Remember Bush and his base of the "haves and have-mores"? The rich and powerful - throughout history - have worked hard to ensure they remain rich and powerful.

Now I'll wait for the usual nyah-nyah attacks of, "you're just envious".

Be my guest.

 

[Diuretic]

jeffr why would you allow something as important as health care to be subjected to free market mechanism?

Because the free market works when it is actually free and not govt mandated or govt interfered. Do you really have confidence in the govt to run your healthcare? Do you truly believe the politicians have your best interest in mind; I know you don't think the free market does but want to know your opinion on politicians taking control.

The free market is fine where it is appropriate. And where it is appropriate is where the twin laws of demand and supply can work to ensure that there is equilibrium. My contention is that the mechanism of demand and supply should not be used in the provision of health care because while health care has a cost, it shouldn't have a price. Having a price means that it must be purchased, if someone can't purchase it then they don't get it. And I don't think that should be the case.

Do I have confidence in the government to run health care? Yes I do. Why? Because they run everything else pretty well. I know that will be anathema to those who fondly cling to the idea that government is bad or incompetent or to be feared but really there's no evidence for that, it's a form of mythology that must be dispensed with.

Politicians, like everyone else, have their own best interests in mind at any time. Why do you think so many of them are trying to bring down the Obama health reforms?

 

[saveliberty]

When it comes to understanding people. I'm inclined to think the rich and powerful have a better view of the whole picture than the poor and unempowered. Many people have struggled and met challenges while rising to the heights of power and money. Few of the poor can truly say the same about how to deal with having power and money.

You really have swallowed it haven't you?

Think about it. How did people first get wealthy? Then think about how their children got wealthy? Then think how THEIR children got wealthy.

You know the problem here? Americans, bless 'em, don't understand how the class system works. The Brits know because they've lived with it for thousands of years. Americans with the facade of an egalitarian society getting in the way simply don't understand how social stratification works.

The rich and powerful only give a fuck about the rich and powerful. Remember Bush and his base of the "haves and have-mores"? The rich and powerful - throughout history - have worked hard to ensure they remain rich and powerful.

Now I'll wait for the usual nyah-nyah attacks of, "you're just envious".

Be my guest.

Since I'm your "guest". Americans have the equalizer of the voting booth. Fortunes have been made and lost here. There is no guarantee of future wealth just because a prior generation did so. An interesting point here is Democrats seem to have families like the Rockefellers and Kennedys which fit your profile.

 

[Diuretic]

When it comes to understanding people. I'm inclined to think the rich and powerful have a better view of the whole picture than the poor and unempowered. Many people have struggled and met challenges while rising to the heights of power and money. Few of the poor can truly say the same about how to deal with having power and money.

You really have swallowed it haven't you?

Think about it. How did people first get wealthy? Then think about how their children got wealthy? Then think how THEIR children got wealthy.

You know the problem here? Americans, bless 'em, don't understand how the class system works. The Brits know because they've lived with it for thousands of years. Americans with the facade of an egalitarian society getting in the way simply don't understand how social stratification works.

The rich and powerful only give a fuck about the rich and powerful. Remember Bush and his base of the "haves and have-mores"? The rich and powerful - throughout history - have worked hard to ensure they remain rich and powerful.

Now I'll wait for the usual nyah-nyah attacks of, "you're just envious".

Be my guest.

Since I'm your "guest". Americans have the equalizer of the voting booth. Fortunes have been made and lost here. There is no guarantee of future wealth just because a prior generation did so. An interesting point here is Democrats seem to have families like the Rockefellers and Kennedys which fit your profile.

I'm always polite to my guests

Yes, dynasties reproduce, it's just that some of them are a bit more cunning in hiding their avarice