UD Health Care II

bhsmte

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First you have to convince people in the US that the government can "fix" something without making it worse.

As someone who has been in healthcare for over 20 years and has dealt with government run programs, that is a legitimate concern.
 
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Jan Volkes

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As someone who has been in healthcare for over 20 years and has dealt with government run programs, that is a legitimate concern.
How do you think the governments of "ALL" the other countries are able to manage it? is there something wrong with the American government that they can not be trusted to run a health care system? they seem to be doing OK with Medicare and Medicade, all that's needed is to extend those systems to cover everyone.
Could there be something wrong with "the American way"? should the "every man for himself" way of thinking be bred out of the children?
 
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How do you think the governments of "ALL" the other countries are able to manage it? is there something wrong with the American government that they can not be trusted to run a health care system? they seem to be doing OK with Medicare and Medicade, all that's needed is to extend those systems to cover everyone.
Could there be something wrong with "the American way"? should the "every man for himself" way of thinking be bred out of the children?

Medicare and medicaid aren't actually health care systems. They are government provided health insurance policies.

Of course, since you brought Medicare up, I'm going to quote the second sentence of the Trustees' Report for you.

Neither Medicare nor Social Security can sustain projected long-run program costs in full under currently scheduled financing, and legislative changes are necessary to avoid disruptive consequences for beneficiaries and taxpayers.

There are some news stories about state governments that are running out of money for Medicaid, too.

The US government also administers some health care services.

If you look at the IHS and the VA, those are also examples of how well they manage that.

So, the answer to your question is, "Yes, there is something wrong with the US government that it cannot administer a health care system."
 
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bhsmte

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How do you think the governments of "ALL" the other countries are able to manage it? is there something wrong with the American government that they can not be trusted to run a health care system? they seem to be doing OK with Medicare and Medicade, all that's needed is to extend those systems to cover everyone.
Could there be something wrong with "the American way"? should the "every man for himself" way of thinking be bred out of the children?

Let me tell you one experience, in dealing with Medicare.

I worked for a healthcare provider that saw mostly Medicare patients. We wanted to expand to a new state, which would require us to get a state license and after that, submit the location for Medicare approval. That is all fine, the government should make sure providers are meeting minimum standards for their patients.

Well, we got the state license and passed state regulations within a couple of months, we then went to an organization, which is considered the gold standard of certification in the healthcare arena (the Joint Commission) and paid there fees, because if we waited on the Medicare folks to visit our facility and do their review, it would have been a long wait. Medicare accepts Joint Commission certification and once we were approved by the Joint Commission, we could then just submit this certification to Medicare and get our provider number, so we could begin to bill Medicare for the services we provide.

Now, keep in mind, Medicare requires you to treat a certain amount of patients for a certain period of time (once the state approves you) before you can even have Joint Commission or Medicare come in for final approval, so they have test cases they can review. Also, keep in mind, we can't bill for these patients and we have to treat them for free, all while we are paying employees and paying for other expenses related to treating the patients.

So, we get approval from Joint Commission and submit our certification to Medicare, so we could get our number and starting billing and actually collecting money. Well, one month goes by and after several calls, Medicare finally calls back and says they have the certification and the number should be arriving within days. After another month and numerous calls, Medicare finally responds and says they are missing some information from our initial application and need it resent to them and I had sent this already to them, months prior, but they had lost it so I sent again. Another several weeks goes by and numerous calls unanswered and they finally respond and they say they are missing one other piece from the original application, but it is something different this time and this had already been sent to them months prior, because I kept a copy of everything that was sent to them. So I resend this information again and about a month after that and several calls, we finally get our number and are able to actually collect money, after treating patients for free, for about 6 months.

And, Medicare does not allow you to back bill for any patients, even when the review showed, we had treated them properly and were certified by the gold standard from Joint Commission.

All in all, it took Medicare several months to give us a simple number and they lost paperwork that had been sent to them months before and despite asking them if they had everything they needed and they replied yes, they would come back weeks later saying they were still missing something.

This wonderful display of efficiency, cost my company about $300,000 in lost revenue, which we could never recover.
 
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Let me tell you one experience, in dealing with Medicare.

I worked for a healthcare provider that saw mostly Medicare patients. We wanted to expand to a new state, which would require us to get a state license and after that, submit the location for Medicare approval. That is all fine, the government should make sure providers are meeting minimum standards for their patients.

Well, we got the state license and passed state regulations within a couple of months, we then went to an organization, which is considered the gold standard of certification in the healthcare arena (the Joint Commission) and paid there fees, because if we waited on the Medicare folks to visit our facility and do their review, it would have been a long wait. Medicare accepts Joint Commission certification and once we were approved by the Joint Commission, we could then just submit this certification to Medicare and get our provider number, so we could begin to bill Medicare for the services we provide.

Now, keep in mind, Medicare requires you to treat a certain amount of patients for a certain period of time (once the state approves you) before you can even have Joint Commission or Medicare come in for final approval, so they have test cases they can review. Also, keep in mind, we can't bill for these patients and we have to treat them for free, all while we are paying employees and paying for other expenses related to treating the patients.

So, we get approval from Joint Commission and submit our certification to Medicare, so we could get our number and starting billing and actually collecting money. Well, one month goes by and after several calls, Medicare finally calls back and says they have the certification and the number should be arriving within days. After another month and numerous calls, Medicare finally responds and says they are missing some information from our initial application and need it resent to them and I had sent this already to them, months prior, but they had lost it so I sent again. Another several weeks goes by and numerous calls unanswered and they finally respond and they say they are missing one other piece from the original application, but it is something different this time and this had already been sent to them months prior, because I kept a copy of everything that was sent to them. So I resend this information again and about a month after that and several calls, we finally get our number and are able to actually collect money, after treating patients for free, for about 6 months.

And, Medicare does not allow you to back bill for any patients, even when the review showed, we had treated them properly and were certified by the gold standard from Joint Commission.

All in all, it took Medicare several months to give us a simple number and they lost paperwork that had been sent to them months before and despite asking them if they had everything they needed and they replied yes, they would come back weeks later saying they were still missing something.

This wonderful display of efficiency, cost my company about $300,000 in lost revenue, which we could never recover.

So, it sounds like it's not worth it to treat medicare patients.
 
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Jan Volkes

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Let me tell you one experience, in dealing with Medicare.

I worked for a healthcare provider that saw mostly Medicare patients. We wanted to expand to a new state, which would require us to get a state license and after that, submit the location for Medicare approval. That is all fine, the government should make sure providers are meeting minimum standards for their patients.

Well, we got the state license and passed state regulations within a couple of months, we then went to an organization, which is considered the gold standard of certification in the healthcare arena (the Joint Commission) and paid there fees, because if we waited on the Medicare folks to visit our facility and do their review, it would have been a long wait. Medicare accepts Joint Commission certification and once we were approved by the Joint Commission, we could then just submit this certification to Medicare and get our provider number, so we could begin to bill Medicare for the services we provide.

Now, keep in mind, Medicare requires you to treat a certain amount of patients for a certain period of time (once the state approves you) before you can even have Joint Commission or Medicare come in for final approval, so they have test cases they can review. Also, keep in mind, we can't bill for these patients and we have to treat them for free, all while we are paying employees and paying for other expenses related to treating the patients.

So, we get approval from Joint Commission and submit our certification to Medicare, so we could get our number and starting billing and actually collecting money. Well, one month goes by and after several calls, Medicare finally calls back and says they have the certification and the number should be arriving within days. After another month and numerous calls, Medicare finally responds and says they are missing some information from our initial application and need it resent to them and I had sent this already to them, months prior, but they had lost it so I sent again. Another several weeks goes by and numerous calls unanswered and they finally respond and they say they are missing one other piece from the original application, but it is something different this time and this had already been sent to them months prior, because I kept a copy of everything that was sent to them. So I resend this information again and about a month after that and several calls, we finally get our number and are able to actually collect money, after treating patients for free, for about 6 months.

And, Medicare does not allow you to back bill for any patients, even when the review showed, we had treated them properly and were certified by the gold standard from Joint Commission.

All in all, it took Medicare several months to give us a simple number and they lost paperwork that had been sent to them months before and despite asking them if they had everything they needed and they replied yes, they would come back weeks later saying they were still missing something.

This wonderful display of efficiency, cost my company about $300,000 in lost revenue, which we could never recover.
I perhaps do not know enough about how the systems works but the first thing I must ask is this, why was all the necessary paperwork not in place before the business was started? were you led to believe that you would be able to claim for any past treatments that had been given? It might be inefficiency but it could also be indifference.
We can all give instances where even the best run companies have fallen down on the job, it might even be a case of the people running your business not getting all the information they needed before starting the project, for instance you did not know Medicare did not allow you to back bill for any treatment given to patients, why was that not known or were you led to believe that they would pay?

When it comes to running healthcare systems all the other countries have the usual problems like an ageing population and their own individual ethnic problems but when it comes to health every person in the country usually understands that they are all in it together, the US does not see health in that way, it seems that in the US even health care is something people can make money from, in fact if it's not run for profit Americans think it will be inefficient, in the case of health nothing could be further from the truth, the American for profit system is the most inefficient system in the world, it cost an absolute fortune to run.

Have you seen the video's made of T R Reid the author on You tube? he went to all the industrialised countries to see how their health care systems worked? and then wrote a book about it, they are quite old now 7-8 years and it seems that no one has taken any notice of them, saying that I believe his book sold very well.

This is a talk he gave to doctors in Cleveland, to miss the preliminaries jump to 09:40.

 
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Jan Volkes

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So, it sounds like it's not worth it to treat medicare patients.
If you stop treating Medicare patients it won't be long before hundreds of thousands of Americans die because they can not get treatment instead of just tens of thousands.
The mind boggles when you think this is happening in the richest country in the world..........
where is all the money? who has it all?
 
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bhsmte

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I perhaps do not know enough about how the systems works but the first thing I must ask is this, why was all the necessary paperwork not in place before the business was started? were you led to believe that you would be able to claim for any past treatments that had been given? It might be inefficiency but it could also be indifference.
We can all give instances where even the best run companies have fallen down on the job, it might even be a case of the people running your business not getting all the information they needed before starting the project, for instance you did not know Medicare did not allow you to back bill for any treatment given to patients, why was that not known or were you led to believe that they would pay? If Medicare was a private business that had competition, they wouldn't be in business because of their errors that cost money to others, but you have no where else to go and are at their mercy.

When it comes to running healthcare systems all the other countries have the usual problems like an ageing population and their own individual ethnic problems but when it comes to health every person in the country usually understands that they are all in it together, the US does not see health in that way, it seems that in the US even health care is something people can make money from, in fact if it's not run for profit Americans think it will be inefficient, in the case of health nothing could be further from the truth, the American for profit system is the most inefficient system in the world, it cost an absolute fortune to run.

Have you seen the video's made of T R Reid the author on You tube? he went to all the industrialised countries to see how their health care systems worked? and then wrote a book about it, they are quite old now 7-8 years and it seems that no one has taken any notice of them, saying that I believe his book sold very well.

This is a talk he gave to doctors in Cleveland, to miss the preliminaries jump to 09:40.


That is the whole point, ALL paperwork was in place beforehand and Medicare even acknowledged they had everything they needed months before, yet they kept asking for information they later claimed they didn't get, when they had previously stated they did have it and it was a three ring circus. And yes, we did know Medicare did not allow back billing before you get your provider number, which was the whole point of us doing everything on our end in a timely manner to get the number and then Medicare dropping the ball completely so we had to continue treating patients for 3 months and not getting paid.

In 20 years of dealing with these types of government agencies the main problems are this IMO; they have little motivation to do a good job (they have no competition) and it shows in the complacency, inefficiencies and errors they make, that the business ends up paying for and in this specific case, it cost my company over $300,000 in lost revenue, that it had to eat.

As I have stated, I am for a single payer and healthcare for all, but my experience in letting the government run this thing, is scary based on my real life experience.
 
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bhsmte

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So, it sounds like it's not worth it to treat medicare patients.

When you have a business that provides a certain type of care that would encompass 95% Medicare patients, you wouldn't be in business if you didn't treat Medicare patients.

Now, there are some healthcare providers who will refuse to take Medicare, because there practice and or business is not reliable on that patient population and they will reject Medicare based on experiences I mentioned above.
 
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Panzerkamfwagen

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If you stop treating Medicare patients it won't be long before hundreds of thousands of Americans die because they can not get treatment instead of just tens of thousands.

In 2015, governments within the United States spent $1.4 trillion on health care. The United States government also spends a comparable amount to other countries on health care.

According this pie chart, total government spending within the United States in FY 2015 was over $6 trillion. That's almost a third of the economy.

The mind boggles when you think this is happening in the richest country in the world..........
where is all the money? who has it all?

That's a good question. Governments get over 1/3 of it.
 
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