McCain's health "plan"

[eridanus]

Originally Posted by Rustic23

I had a hard time figuring out where the conservators are. Board of Trustees - Kaiser Family Foundation

Sheila Burke, the 2nd person listed, helped elect George W. Bush, worked on the Elizabeth Dole campaign, and is part of the McCain 2008 campaign.

Tom Campbell, the 3rd person listed, is a former Republican Congressman.

[Martha]

Originally Posted by Rustic23

This is the second time I have seen the Kaiser Family Foundation quoted as if it has no political agenda. I am not say they do, or don't, however, I went to there web site and looked at their board of directors. I had a hard time figuring out where the conservators are. Board of Trustees - Kaiser Family Foundation On the other hand, it is easy to see people like Cokie Roberts, or Donna Shalala, lots of lawyers, not noted for conservative views, College professors also not noted for impartial views. So I for one take there studies with a grain of salt. The fact that you can find lots of people that agree with them does not make them right, just popular.

I know eridanus gave you some conservative names, but I did want to point out that lawyers as a group tend to be quite conservative.

[rs0460a]

Originally Posted by Want2retire

I think that if I were a military veteran, I'd want to have the option of going somewhere else for my medical care.

Most folks who have served in the military do not even get the chance to use the VA health care system, so by default, most go to an "outside provider".

First of all, there is a classification system even to be considered for services. A summary is found here:
http://www.va.gov/healtheligibility/...rityGroups.pdf

For instance, even though I'm a priority group 3, I don't (can't) use services unless they are related to my "service related condition", and some "minor" services, such as the annual flu shot.

I don't even go there for services that I could get, since my primary care doctor is "outside" the system, and handles my "minor problem" within the scope of my current medical plan (on my former employers retiree medical co-pay plan).

What happens (and why you see some news on the VA system) is the fact that the "worst cases" are taken care of the VA - many more of the "difficult cases" (due to the rating system). When you are "stacking the deck", you have a lot to overcome to come up with a good picture.

Does the VA do a good job? Yes. Do they have problems (especially due to funding) and need to do a "better job"? Of course.

Just a little info on the VA system for your reading pleasure (since "I'm there")...

- Ron

[youbet]

Martha.....

Thanks for posting the Hillary and Barack plan highlights and, more importantly, for including your comments. IMO, neither goes far enough towards being a universal plan.

youbet

[FIRE'd@51]

Originally Posted by Rich_in_Tampa

Physicians have a choice re: MC patients. They can "accept assignment" which means that you agree to consider MC payments as full fare and won't bill the patient for the difference, or you can NOT accept assignment in which case you can bill the patient for your full fee, and MC reimburses the patient for whatever they decide is full.

MC fee schedules are unrealistically low, and they pay only 80% of that as a rule. Bottom line is that in primary care, it is not financially feasible to run a private practice as a viable business if MC assignment is a major part of it. Of course, there is intense pressure from patients and the feds to participate.

It's a mess. Medicare supplemental tries to fill the gap, but is fairly expensive, too (though less so than full private insurance).

Rich, could you elaborate here? I always thought doctors either took MC patients or they didn't. The Washington Post article seems to indicate some doctors "cherry pick" by not taking new MC patients, but will continue to treat patients they already have who are on MC.

With regard to fees, for those doctors who accept assignment, my understanding is MC pays 80% of its allowed charge directly to the doctor, and the patient (and/or his supplemental insurance) picks up the other 20%. Are you saying that patients who choose not to purchase supplemental don't have to pay the remaining 20%?

You seem to be saying that, if I want to go to a doctor who isn't accepting new MC patients, I can agree to pay him his regular fee, and I can file directly with MC and get reimbursed for 80% of its allowed fee? I thought MC didn't allow this.

[Rich_in_Tampa]

Originally Posted by FIRE'd@51

Rich, could you elaborate here? I always thought doctors either took MC patients or they didn't. The Washington Post article seems to indicate some doctors "cherry pick" by not taking new MC patients, but will continue to treat patients they already have who are on MC.

With regard to fees, for those doctors who accept assignment, my understanding is MC pays 80% of its allowed charge directly to the doctor, and the patient (and/or his supplemental insurance) picks up the other 20%. Are you saying that patients who choose not to purchase supplemental don't have to pay the remaining 20%?

You seem to be saying that, if I want to go to a doctor who isn't accepting new MC patients, I can agree to pay him his regular fee, and I can file directly with MC and get reimbursed for 80% of its allowed fee? I thought MC didn't allow this.

It has been a while since I had to worry about this stuff, but as of a few years ago...

- either the doc participates or doesn't; if not, any patient can be seen, charged full fare, and the patient pays the full fee. MC pays some amount to the patient when the claim is filed, but usually quite low; supplemental helps fill the gap for the patient.
- if a doc participates, he/she does so for all medicare patients. My understanding is that it is not legal to have some MC patients on assignment (e.g. old patients) while some are not on assignment (new pts)
- if the doc participates, he/she agrees to take the medicare allowable amount as payment in full. This is usually waaayyy below the doctor's usual fee, and MC pays only 80% of this already discounted amount. It is not legal to seek payment of amounts over the allowable from the patient when under participation. So, usual charge: $100; MC allows: $66; MC pays $52.80; Due from patient: $13.20 as payment in full. Doc eats the difference.
- if no participation, usual charge: $100; patient pays: $100; MC pays patient: $52.80 along with a notice that their doctor is charging more than "usual and customary" for the service (does wonders for patient relations).

Hope that helps. Maybe someone more current with this will pipe up.