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| Re: Gibbs Can't Name Countries Where Government Health Care Works Better (467295) | |||
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Re: Gibbs Can't Name Countries Where Government Health Care Works Better |
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Posted by trainsarefun on Fri Jun 26 20:55:28 2009, in response to Re: Gibbs Can't Name Countries Where Government Health Care Works Better, posted by Orange Blossom Special on Thu Jun 25 19:48:39 2009. My Hawaii reference was how htey had to get rid of their public option as far as I had heard.They had a public insurance program with open enrollment? I don't think many health plans give you an incentive to go there versus the ER which is a shame. I agree. I was thinking of "administration" costs, which I don't know if that includes all the billing mistakes hospitals make, or the sleazy practices of providers, but half of it must me the new regulations coming out of whatever state weekly. The software these insurance companies use are MASSIVE. Beyond massive. And they have to change and add things each time a new law goes into effect. It's really messed up. I think that it's a combination of factors. New regulations and law obviously add to the burden (e.g., in NY we just had a new law about outpatient surgery facilities). Sleazy practices, billing for procedures that aren't necessary but with aren't obviously frivolous (which is an interesting area itself, especially with probabilities) Well, I don't live in NY, and I don't live in Montana. What's good for whatever crook heading things from Massachusetts, Connecticut or even Indonesia shouldn't be telling the rest of the country what to do I don't want to see the country NY or Californiazed. and not to give too much harshness to those two states, I'll add Michigan in there. Otherwise, if administration costs are too high, then who cares. Go with one of the 1300 other companies out there. In too many states, there just aren't 1300 options. In mine, in most counties, count yourself very lucky if there are 13! So I would like to see one regulatory authority, which pre-empts state authority because I think that's necessary to have just one regulatory level, to register or license or whatever with, and then that entity can sell products all across the country. Actually, outside of a Medicaid option, what business is it of barackhossein's anyway? He's not smart enough or experienced enough to even talk about the subject. He's lies in the debates were still staggering. It's not the White Houses problem nor concern. By the same token, though, he's hardly any more stupid than the people in Congress. As I said, I don't view his plan as politically feasible or desirable given what he has to date made explicit about it. But it hardly seems to me that the bipartisan bill, the Healthy Americans Act, is any better. I do believe that reforms are necessary, and maybe the failure of these proposals will refocus attention on what I consider to be the core issues. And while we're talking of the hospital only catastrophic plans, that's basically what you get when you get auto enrolled in Medicare part A. With a high deductible and no out of pocket max. Perhaps a preview of whatever plan may eventually emerge. But who knows? We have very little detail at present. Closer to your neck of the woods than mine, I ran across this item in the Miami Herald while looking up some things about the abysmal South Florida real estate market yesterday, which seems to make clear that the freeloader problem with uninsured is quite real and even devastating, and even for thsoe covered Medicaid, hospitals and physicians aren't happy about that because of the decreased compensation for them. It's interesting enough for the general discussion that I'll excerpt it for others to follow the main points: ---- The Miami Herald Posted on Thu, Jun. 25, 2009 South Florida hospitals show signs of distress BY JOHN DORSCHNER jdorschner@MiamiHerald.com The past year has been brutal for South Florida hospitals -- and this year is likely to be worse. The Baptist Health system, which has been immensely prosperous in the past, suffered a $71.7 million loss in its 2008 fiscal year. Miami Children's lost $72 million. Holy Cross lost $25 million, and Mercy $34.8 million. All four of these suffered serious losses in their investment portfolios, but others, particularly Jackson and Homestead, are beginning to feel the effects of the recession as their number of uninsured patients grows. ''It's going to be a particularly tough year, more so for the public-financed facilities,'' said Linda Quick, president of the South Florida Hospital and Healthcare Association. Both Broward public hospital districts and, to a lesser extent, Miami-Dade's Jackson Health System depend on property taxes, which are declining as housing prices fall. Rising unemployment has worsened the situation. Quick said a recent survey showed that every 1 percent increase nationally in unemployment leads to 100,000 newly Medicaid-eligible patients -- a prospect that sends shivers down the backs of hospital executives because Medicaid reimbursement rates are often below their costs. Still, many executives have been surprised that the recession hasn't brought more uninsured patients to their emergency rooms. .... Several hospital executives suggested the reason might be that, with more than 800,000 uninsured in Miami-Dade and Broward, uncompensated care is already sky high and the newly uninsured haven't been that way long enough to have their health status decline. Jackson Memorial, however, is getting hammered. The public system reported a surplus of $26 million for the fiscal year ending Sept. 30, including primary care and skilled nursing centers, but this year Jackson Memorial's uninsured patient load has increased from 15.4 to 19.5 percent. Jackson spokesman Robert Alonso reported the system is seeing a decline in revenue across the board -- from commercial insurance, Medicare, Medicaid and the half-penny sales tax. (The system also gets $178 million from county property taxes.) Cash on hand has dropped to $110 million -- enough for 23 days of operation. Alonso said Jackson officials have been talking to the Public Health Trust and to county commissioners about getting more tax dollars. By contrast, in spite of a drop in property-tax revenue, Broward public hospitals are doing quite well. Memorial Healthcare System, the South Broward public hospitals, raked in a total surplus of $120.8 million for its fiscal year ending April 30, 2009, assisted by about $20 million in one-time favorable settlements with public insurers, said CFO Matthew Muhart. Broward Health, which owns the North Broward public hospitals, had a $51 million surplus in the fiscal year ending June 30, 2008. That figure includes losses in the community health centers and physician practices. ''We continue to perform pretty strongly,'' said CFO Dawn Javersack. New patients are being drawn by new technologies, like the CyberKnife, for cancer radiation therapy. Broward Health has 140 days' cash on hand -- almost seven times Jackson's position. SUBURBAN SUCCESS Apart from its investment problems, the Baptist system continues to do well in the prosperous southern suburbs, led by Baptist Hospital with a net surplus of $81.6 million -- the biggest profit of any South Florida hospital. But the system's $1.4 billion investment portfolio experienced a stunning $210 million loss through the fiscal year ending Sept. 30, 2008, and the losses kept piling up in the months that followed. Altogether, Baptist's investments dropped 22 percent in an 18-month period ending April 1, said Lawson, still considerably below the 30 or 40 percent losses suffered by many individual investors in their retirement accounts. Miami Children's also had investment problems. The hospital eked out an operating surplus of $9.5 million, but ended up with a loss of $72 million because of investment losses and swap agreements in which it converted variable-rate securities to fixed rates, said CFO Pedro Alfaro. Much of those losses have since been recovered, he said. For the University of Miami hospitals, the latest report available from the state covers the fiscal year May 31, 2008. William Donelan, the medical school's chief operating officer, said he won't release the report for the year that ended last month until it has been audited and presented to the board of trustees. For fiscal 2008, the new University of Miami Hospital, formerly known as Cedars, suffered a loss of $11.5 million in its 560-bed facility, according to state data, but UM's two much smaller hospitals, handling the Sylvester Cancer Center and the Bascom Palmer Eye Institute, had a surplus of $42 million, mostly from out-patient services. .... `UNUSUAL INCREASE' In Miami Beach, Mount Sinai Medical Center had a loss of $13.8 million for the year ending Dec. 31. The hospital has suffered for years because of the city's demographics changing from the aged to the young. Chief Executive Steven Sonenreich said part of the 2008 loss was attributable to ''the unusual increase in charitable and uncompensated care,'' but added that the first-quarter 2009 loss was $447,000 -- or one-seventh of the 2008 loss on an annualized basis. Sonenreich attributed the revenue improvement to patient increases in cardiac surgery, psychiatric care and inpatient rehabilitation. |
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