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Healthcare people: wouldn't medicare for all (at current reimbursments) doom hospitals?
Posted on 3/18/19 at 9:46 pm
Posted on 3/18/19 at 9:46 pm
I came upon this graph today
Medicare pays 40% less than private health insurance for hospital services.
Hospital revenue (2013 data so somewhat old) breaks down like this
44% from medicare
13% medicaid
32% private plans
8% self pay
source for those numbers
So, 40% of hospital revenue (self pay and private plans) would be reduced by around 40% if medicare for all is enacted and reimbursement rates stay the same.
That amounts to a (32 +8) times .4 reduction in hospital revenue. 40 times .4= 16%.
In other words, if hospital services were all reimbursed at medicare rates, revenue would fall by 16%.
That could be extremely problematic, because....
A 16% reduction in revenue would mean most hospitals would literally fall into the red.
This is very problematic.
Another way of describing the issue at hand:
Medicare pays 40% less than private health insurance for hospital services.
Hospital revenue (2013 data so somewhat old) breaks down like this
44% from medicare
13% medicaid
32% private plans
8% self pay
source for those numbers
So, 40% of hospital revenue (self pay and private plans) would be reduced by around 40% if medicare for all is enacted and reimbursement rates stay the same.
That amounts to a (32 +8) times .4 reduction in hospital revenue. 40 times .4= 16%.
In other words, if hospital services were all reimbursed at medicare rates, revenue would fall by 16%.
That could be extremely problematic, because....
quote:
Overall, the report found hospitals' median operating margin fell from 3.4 percent in FY 2015 to 2.7 percent in FY 2016. Median operating cash flow also declined, from $76.4 million in FY 2015 to $75.9 million in FY 2016, according to the report.
A 16% reduction in revenue would mean most hospitals would literally fall into the red.
This is very problematic.
Another way of describing the issue at hand:
quote:
Medicare payments only covered 87% of costs in 2016, the most recent data available from the American Hospital Association. But private insurers paid nearly 145% of their policyholders' hospital expenses.
21
Posted on 3/18/19 at 9:48 pm to HailHailtoMichigan!
Yes, thats the goal
Just have 100% gubment hospitals, clinics and doctors
I mean, its free, money doesnt matter right?
Just have 100% gubment hospitals, clinics and doctors
I mean, its free, money doesnt matter right?
This post was edited on 3/18/19 at 9:49 pm
Posted on 3/18/19 at 9:49 pm to HailHailtoMichigan!
I’m in healthcare, simply put: even with a hypothetical limitless budget, the sheer logistics of Medicare for All would never ever work.
Posted on 3/18/19 at 9:49 pm to HailHailtoMichigan!
They wouldn’t be stuck having to provide care for all sorts of people who will never pay for it (the tab is being) so that’s a huge positive that needs to be figured in.
This post was edited on 3/18/19 at 9:51 pm
Posted on 3/18/19 at 9:50 pm to 225bred
I’m in healthcare too..one big ol VA
Posted on 3/18/19 at 9:54 pm to HailHailtoMichigan!
quote:
doom hospitals
Or force only government operated and funded hospitals with government paid doctors.
Posted on 3/18/19 at 9:56 pm to HailHailtoMichigan!
quote:
Medicare pays 40% less than private health insurance for hospital services.
In our hospital, this is incorrect. Medicaid/Medicare pays about 25% more than private insurance.
Posted on 3/18/19 at 9:56 pm to DavidTheGnome
quote:what % of costs go towards people who don't pay, though?
They wouldn’t be stuck having to provide care for all sorts of people who will never pay for it (the tab is being) so that’s a huge positive that needs to be figured in.
Posted on 3/18/19 at 9:59 pm to HailHailtoMichigan!
I am in cancer diagnostics and hospitals are already in pain affording the latest tech.
Posted on 3/18/19 at 10:03 pm to HailHailtoMichigan!
Entirely depends on the hospitals payer mix and percentage of bad debt. Rural hospitals with high percentages of uninsured or a high Medicaid insured patient population would realize an increase in revenue with a 100% Medicare population. While an urban hospital like Houston Methodist, with a high percentage of commercially covered patients, would absolutely have their budgets blown up if their reimbursements dropped to Medicare levels.
So, in short, your very best hospitals would be dragged down to the level of their more poorly performing peers.
MD Anderson, who has the best commercial payer contracts I've ever seen or heard of due to their high demand and renowned success as a nation leading cancer center, would be absolutely crushed at an institutional level for every non-research (i.e. non grant supported) department that primarily treats disease. Their international business may survive, but it's a small percentage of overall treatment revenue.
So, in short, your very best hospitals would be dragged down to the level of their more poorly performing peers.
MD Anderson, who has the best commercial payer contracts I've ever seen or heard of due to their high demand and renowned success as a nation leading cancer center, would be absolutely crushed at an institutional level for every non-research (i.e. non grant supported) department that primarily treats disease. Their international business may survive, but it's a small percentage of overall treatment revenue.
This post was edited on 3/18/19 at 10:06 pm
Posted on 3/18/19 at 10:05 pm to Nguyener
quote:
government operated and funded hospitals with government paid doctors.
Hey kids
Wanna go to 8 years of school and then some resident training to make $70k a year and you can only work in cities/states that the Government says you can?
Socialized medicine destroys quality doctors.
Posted on 3/19/19 at 12:42 pm to MSMHater
That doesn’t sound good, then
The hospitals that are in major population centers would get hardest hit
The hospitals that are in major population centers would get hardest hit
Posted on 3/19/19 at 12:55 pm to DavidTheGnome
quote:Inded. It would every patient bumpy covering expenses! Such an improvement.
They wouldn’t be stuck having to provide care for all sorts of people who will never pay for it
Posted on 3/19/19 at 12:57 pm to MSMHater
quote:For socialists... thst is success. No more inequality!
So, in short, your very best hospitals would be dragged down to the level of their more poorly performing peers.
Posted on 3/19/19 at 1:04 pm to HailHailtoMichigan!
Not just hospitals, literally every healthcare provider in existence today would have to close if they only had medicare reimbursement rates.
It “saves money” because they pay less than the cost of medical services provided.
It “saves money” because they pay less than the cost of medical services provided.
Posted on 3/19/19 at 1:05 pm to MSMHater
Uhh, no. Even rural hospitals would be crushed without being subsidized by local municipalities.
Your scenario completely leaves out the part where there is no more commercial contracted payments coming in the door. Those are what subsidize self-pays, no pays, and medicare patients. Without commercial coverage patients, and without an increase in medicare rates, every single healthcare provider will be operating in the red. Short of local tax money subsidizing them, it would only be a matter of time until they close.
Your scenario completely leaves out the part where there is no more commercial contracted payments coming in the door. Those are what subsidize self-pays, no pays, and medicare patients. Without commercial coverage patients, and without an increase in medicare rates, every single healthcare provider will be operating in the red. Short of local tax money subsidizing them, it would only be a matter of time until they close.
This post was edited on 3/19/19 at 1:09 pm
Posted on 3/19/19 at 1:09 pm to HailHailtoMichigan!
It would doom patients even more than it would doctors.
People often believe that doctors are just protecting their own salaries, which is true to an extent. They, like anyone else, are in the business of providing for their families and have made substantial investments in their careers that they expect to eventually have returns from.
However, doctors will always be in demand, and the job will always pay fairly well. Americans sure ain't getting any healthier... Doctors also take care of their own, and the families of medical professionals will always have quality medical care.
It's the general patient pool that will need to worry about how care is rationed in a universal care system. Under this system there would be a considerable decline in future physician talent due to decreased financial incentives, extended waiting times WOULD inevitably occur (it's an economic absolute once care becomes "free"), and people who think the government can't decline care the way that insurance companies do would find that line of thinking to be very false.
People often believe that doctors are just protecting their own salaries, which is true to an extent. They, like anyone else, are in the business of providing for their families and have made substantial investments in their careers that they expect to eventually have returns from.
However, doctors will always be in demand, and the job will always pay fairly well. Americans sure ain't getting any healthier... Doctors also take care of their own, and the families of medical professionals will always have quality medical care.
It's the general patient pool that will need to worry about how care is rationed in a universal care system. Under this system there would be a considerable decline in future physician talent due to decreased financial incentives, extended waiting times WOULD inevitably occur (it's an economic absolute once care becomes "free"), and people who think the government can't decline care the way that insurance companies do would find that line of thinking to be very false.
This post was edited on 3/19/19 at 1:10 pm
Posted on 3/19/19 at 1:11 pm to HailHailtoMichigan!
This is one of those things that sounds too good to be true. I love the thought and idea of being able to have healthcare for everyone. But the cost of actually implementing it would cause more harm than good, unfortunately.
Posted on 3/19/19 at 1:13 pm to HailHailtoMichigan!
Have to look at "expenses" too.
USA MD makes twice Dutch MD and Dutch live 2 years longer than Americans.
Insurance in Holland costs half USA.
USA MD makes twice Dutch MD and Dutch live 2 years longer than Americans.
Insurance in Holland costs half USA.
Posted on 3/19/19 at 1:15 pm to HailHailtoMichigan!
quote:
Medicare pays 40% less than private health insurance for hospital services.
This is simply not correct.
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