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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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I would look at Singapore for ideas. They went from a mainly government run system to a hybrid system in the later 1980s. Their Medisave / Medifund / Medishield system has been fairly successful. We couldn't copy their system (since Singapore is small and wealthy.. their system won't translate perfectly into our country) 'as-is', but we could take some pointers from it. Doing a little cut-n-pasting here: Medisave: Singapore does not have a free market for health care. What it does have is an alternative to the European/American welfare state, in which private saving and private insurance do what employers and governments do in other countries. The Singapore philosophy is: Each generation should pay its own way. Each family should pay its own way. Each individual should pay his own way. Only after passing through these three filters, should anyone turn to the government for help. How the system works. In Singapore, people are required to save for health care, retirement income and other needs. They can use their forced saving to purchase a home, pay education expenses, and purchase life insurance and disability insurance. For individuals up to age 50, the required saving rate is 36% of income (nominally divided: 20% from the employee and 16% from the employer). Of this amount, 7 percentage points is for health care and is deposited in a separate Medisave account. Individuals are also automatically enrolled in catastrophic health insurance with a deductible of about US $1,172, although they can opt out. When a Medisave account balance reaches about US $34,100 (an amount equal to a little less than half of the median family income) any excess funds are rolled over into another account and may be used for non-health care purposes. - See more at: http://healthblog.ncpa.org/medisave-a ... ore/#sthash.6QuwZmIo.dpuf Medifund is an endowment fund set up by the Government to help needy Singaporeans who are unable to pay for their medical expenses. Medifund acts as a safety net for those who cannot afford the subsidised bill charges, despite Medisave and MediShield coverage. Set up in April 1993 with an initial capital of S$200 million, the Government will inject capital into the fund when budget surpluses are available. The Government utilises the interest income from the capital sum, which stands at S$3 billion (FY 2012), to help needy patients who have difficulty paying their medical bills. MediShield is a low cost basic medical insurance scheme. Introduced in 1990, the government designed MediShield to help members meet large Class B2/C hospitalisation bills, which could not be sufficiently covered by their Medisave balances. To avoid problems associated with first-dollar, comprehensive insurance leading to unnecessary over-consumption of healthcare services, MediShield operates with co-payment features such as co-insurance and deductible where patients share part of the responsibility for his medical expenses. The co-insurance and deductible can be paid using Medisave or cash. Premiums for MediShield can be paid by Medisave. A very large medical bill can easily wipe out your Medisave balance. For this reason, you are advised to take up MediShield or an appropriate private Integrated Shield Plan in order to stretch your Medisave dollars. With an ageing population, the government decided to carve out a portion of Medifund as Medifund Silver to deliver assistance to needy elderly Singaporean patients in a more targeted manner. In November 2007, Medifund Silver was launched with a start-up capital sum of $500 million.
Posted on: 2015/6/9 18:38
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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I think you nailed it. Not sure what is the best way to fix it though. http://www.forbes.com/sites/danmunro/ ... ed-to-10-other-countries/
Posted on: 2015/6/9 18:11
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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Carepoint is a symptom of the problem:
Urban hospitals have an issue of going broke due to in part the crappy reimbursements and the counter-intuitive policies for controlling prices by the government. An example of the latter, a hospital can't advertise prices of procedures if they accept Medicade. Hospitals like Christ (which went bankrupt) are required by law to treat anyone who comes in through the door. A lot of those people are illegal aliens, Medicare, Medicade, or charity care recipients. Each group gets a standard reimbursement for a procedure which often barely or doesn't cover the costs. So one group gets gouged: People who are gainfully employed, have assets, but are out of network or don't have a health plan. That is the only place the money can be made. Here is one alternative to the current system: Dr. Keith Smith and Dr. Steven Lantier launched Surgery Center of Oklahoma 15 years ago, founded on the simple principle of price honesty. ?What we?ve discovered is health care really doesn?t cost that much,? Dr. Smith said. ?What people are being charged for is another matter altogether.? Surgery Center of Oklahoma started posting their prices online about four years ago. The prices are all-inclusive quotes and they are guaranteed. ?When we first started we thought we were about half the price of the hospitals,? Dr. Lantier remembers. ?Then we found out we?re less than half price. Then we find out we?re a sixth to an eighth of what their prices are. I can?t believe the average person can afford health care at these prices.? Their goal was to start a price war and they did. Their first out-of-town patients came from Canada; soon everyday Americans caught on. Matthew Gang, 22, tore his patella tendon, dislocating his knee-cap playing basketball earlier this year. Gang is from California and he is uninsured. Surgery in his home-state was going to be about $30,000. The posted price at Surgery Center of Oklahoma was $5,700, one-fifth the price. Matthew and his father Tom Gang flew from California to Oklahoma for surgery. Surgery Center of Oklahoma does accept private insurance, but the center does not accept Medicaid or Medicare. Dr. Smith said federal Medicare regulation would not allow for their online price menu. They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments. http://kfor.com/2013/07/08/okc-hospit ... ng-surgery-prices-online/ My wife's home country does the same thing from everything from knee replacement to reproductive services. One of the major hospitals that caters to foreigners is actually run by an American.
Posted on: 2015/6/9 17:03
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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Da poor do not pay a dime for healthcare and just wave their Medicade card around and get all the free services hospitals have to offer. While John/Jane Doe get collection agencies on their ass.
Posted on: 2015/6/9 14:23
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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Home away from home
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2006/11/13 18:42 Last Login : 2022/2/28 7:31 From 280 Grove Street
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social cleansing of the poor
Posted on: 2015/6/9 9:23
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My humor is for the silent blue collar majority - If my posts offend, slander or you deem inappropriate and seek deletion, contact the webmaster for jurisdiction.
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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Carepoint. Rotten to the core.
Posted on: 2015/6/9 1:53
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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My lovely s-i-l (bless her soul) came to America from overseas for treatment of an aggressive breast cancer. The out-of-pocket rates for diagnostic tests varied so wildly it was insane. An MRI in Hackensack was thousands (with an "s") of dollars more than the exact same test at UMDNJ. We ended up having to shop her diagnostics from center to center.
If you are uninsured, you really have to be very careful and advocate for yourself if you are getting any kind of advanced care in a hospital setting.
Posted on: 2015/6/9 1:11
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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this is not capitalism, guy.
Posted on: 2015/6/9 0:50
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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And one of the biggest failures of Obamacare is how almost nothing was done to address this.
Posted on: 2015/6/9 0:43
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Re: Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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Home away from home
Joined:
2006/11/13 18:42 Last Login : 2022/2/28 7:31 From 280 Grove Street
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This is capitalism at its worse - We live in a user-pays society so these increases shouldn't shock anyone.
It's nothing new for patients to shop abroad for services - men and women suffering from vanity, have been having plastic surgery abroad for years
Posted on: 2015/6/9 0:33
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My humor is for the silent blue collar majority - If my posts offend, slander or you deem inappropriate and seek deletion, contact the webmaster for jurisdiction.
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Huge Hospital Markups in U.S. Dominated by For-Profit Chains
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Huge Hospital Markups in U.S. Dominated by For-Profit ChainsMichelle CortezCaroline Chen - June 8, 2015 — 6:15 PM EDT The two biggest U.S. hospital chains operate many of the facilities named in a new report as charging some patients prices far higher than what government programs pay -- 10 times as much, in some cases. Community Health Systems Inc. and HCA Holdings Inc. accounted for about half of the 50 hospitals with list prices higher than anywhere else in the U.S., when compared with what they’re allowed under Medicare. The research was published Monday in the journal Health Affairs. The study compared hospitals’ 2012 list prices with the the maximum allowed charges through Medicare, the U.S. health insurance program for the elderly and disabled. Across the country, hospitals charged uninsured and out-of-network patients an average of 3.4 times more than the Medicare amounts. The biggest case of price inflation in 2013 was at CarePoint Health’s Christ Hospital in Jersey City, New Jersey, for 14 cases of degenerative nervous system disorders. Patients were charged an average of $223,767, compared with the $8,083 allowed by Medicare. Read more: http://www.bloomberg.com/news/article ... ated-by-for-profit-chains
Posted on: 2015/6/9 0:26
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