Flame — HabitableZone

Flame » in reply to Get rid of it? No. But just for starters, we could try not to double it.

Actually, I doubt they'll take my advice
azstrummer — (archived)

The first thing I want to happen is to completely revamp Medicare before we add to the number of people covered by it.

Right now providers that sign onto that system get paid by the procedure. The last company I worked for, United Health Care, was a middle man contracted by the states to administer that mess and even though they had an amazing workforce that was extremely knowledgeable about the complex diagnostic coding and bizarre system of contracts, nobody could make heads nor tails of what was going on. They kept having to add more and more people. No technology or programming could make a dent in the errors and omissions.

The whole concept of paying by procedure makes our medical professionals into the equivalent of fender and body men. Most modern professional in the business community get paid an annual salary with stipulations for bonuses and compensation for excessive overtime. Their contract is based on their schooling and expertise. There is absolutely no legitimate reason our nation's physicians cannot be paid in the exact same manner. I'm not talking about paying everyone exactly the same. Doctors that go through additional training for more difficult specialties begin at a higher rate. Years of experience add to the salary range.

Performance factors could be written into bonus structures but extreme care would have to ensure that system wasn't manipulated at the expense of patients.

That simple first step would, in my opinion, cut Medicare costs by at least 20%. Some estimate it could go as high as 30%. A huge workforce that deals with medical claims would no longer be needed.

That logically makes the next steps easier which would be to slowly add in more and more age demographics into the system until everyone is covered. One also needs to remember that the additions would be people in lower risk categories than seniors and they should be less expensive to cover.

Without that first step, more money does have to initially go into the system if you want to add additional coverage. That scares me as much as it does you.

We need to remember that it wasn't primarily the physicians that created the present system of compensation for their craft. It was insurance companies because they knew they could tie in that system with one where they could justify denying service.

Now nowhere in the rules would any doctor be required to become a part of this new system. If they wanted to keep playing games with private insurers, they wouldn't have to sign up for the governmental program or, if they were smart, they'd play both fields and work part time in the government system and part time for high end insurance plans for the wealthy. I think though that the latter would fade as these care givers realized the tremendous empowerment they received under the national plan to make their own medical decisions and the huge reduction in costs to employ large medical claims staff if they keep working with the private insurers.

Art

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