26 states join Obama health care lawsuit in Fla

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Jiro

If You Know What I Mean
Premium Member
Do you know what medicare and medicaid reimbursement rates are? They do not reimburse fee for service. They determine what they think a procedure is worth, and reimburse by that table...on average 30-40 % below actual fee. That creates deficits.

actual fee... it's high enough already so even with 30-40% off that... money's still pouring into their pockets. such a lucrative business for them.

and we both know who chairs over regulation. lot of them are former CEO of ----- (insert big corporation name).
 

Jiro

If You Know What I Mean
Premium Member
Because without insurance, that woman would still be non-paying and we would still have to absorb those costs.

all for more reason why we need to focus on promoting preventative measures and healthy lifestyle, regulate the medical industry and not bend over to companies so that it's affordable for many.
 

jillio

New Member
actual fee... it's high enough already so even with 30-40% off that... money's still pouring into their pockets. such a lucrative business for them.

and we both know who chairs over regulation. lot of them are former CEO of ----- (insert big corporation name).

Let's see....especially with catastrophic care:

Hospital is responsible for paying for all medications, attending physician's salary, salaries of the various nursing personnel, the salary of the x-ray technition, along with the cost of the supplies and the equipment necessary, the salary of the MRI technition and the supplies and equipment, the salary of the lab techs and the equipment they must have, the bed, the building, the electricity, the back up generator, and the demand that people make that the hospital have all the newest and best equipment and treatments available. What do you think that costs per patient that, for instance, is being treated for recurring cancer?
 

jillio

New Member
all for more reason why we need to focus on promoting preventative measures and healthy lifestyle, regulate the medical industry and not bend over to companies so that it's affordable for many.

People without insurance do not get preventive care. They cannot afford to pay for the doctor's visit. Therefore, they wait until they are extremely sick and show up in the ER. Much more costly than preventive care, to be sure. But those who cannot afford the cost of the doctor's visit without insurance receive their healthcare that way. All the more reason to mandate coverage.
 

Steinhauer

Well-Known Member
Thank you for admitting we do not have a health care crisis in America. What we have is a health care COST crisis.
 

TXgolfer

Dream Weaver
Premium Member
I've often felt that the biggest culprit in rising health care costs are from various lawsuits. There are malpractice lawsuits, bad drug lawsuits, bad implanted devices lawsuits; the list goes on. Doctors and hospitals end up paying insanely high insurance premiums to cover themselves. That cost is passed down to us.

Yahtzee!
 

jillio

New Member
Thank you for admitting we do not have a health care crisis in America. What we have is a health care COST crisis.

Who admitted that we don't have a health care crisis in America? Exactly the opposite. Costs are the reason for the crisis and the health care crisis continues to raise costs. They feed off of each other, and are intimately connected.
 

Sosie

Well-Known Member
How 'bout dat health care reform? Keep your hands off my Medicare!!

Jillo, haven't you read AAP/PLAN - Psychology's Political Action Assn.?

December 13, 2010
Dear AAP Supporter,

We are very happy to report that a bill to freeze Medicare reimbursement for psychologists and physicians through the end of 2011 cleared Congress on December 9, 2010 and goes to President Obama for his signature. As a result of this action, the January 1, 2011 scheduled 25% cut in reimbursement has been averted for a full year. The measure also includes a one-year extension of the 5% psychotherapy payment restoration. This will ensure the continuation of $30 million in Medicare reimbursements for 2011. The bill also provides financial resources to the Centers for Medicare and Medicaid Services (CMS) to process backlogged payments for claims since January 1, 2010 to which the restoration will be retroactively applied.

This Congressional "doc fix" was spurred by intense lobbying efforts from a broad array of health care provider groups including the APA Practice Organization working together hand in glove with the political advocacy efforts of AAP. Congress does seem to understand that a massive reduction in Medicare reimbursement would cause a large number of providers to stop seeing Medicare patients. Military families also would have found their access to physicians jeopardized because their TRICARE coverage is based on the Medicare fee schedule.

In addition to freezing physician compensation at current Medicare levels, the legislation extends expiring Medicare payment policies and funds minor changes to Medicare, Medicaid, and the Children's Health Insurance Program. Of note, Congress has delayed the Medicare pay cut on 5 separate occasions this year amid much wrangling on how to finance it.

The proposed pay cut that has tormented Medicare providers and Congress alike is triggered by the sustainable growth (SGR) formula that Medicare uses to set doctors' reimbursement. The formula pegs reimbursement to growth in the gross domestic product. Provider groups contend that the formula is flawed because practice costs exceed gross domestic product inflation. The formula has mandated Medicare rate reductions every year going back to 2003, but Congress has postponed each one. Because the reductions accumulate over time, providers found themselves looking at a virtually bottomless reimbursement chasm on January 1.

We are all hopeful that the 1-year freeze will give us enough time to hammer out a permanent solution to the Medicare reimbursement crisis that health providers find more equitable and Congress finds affordable. The recent recommendations of a bipartisan commission created by President Obama to reduce the federal budget deficit may offer guidance. A report drafted by the commission's co-chairmen proposed freezing Medicare rates through 2013, reducing them by 1% in 2014, and then instituting a new pay formula in 2015 that rewards providers for the quality - not quantity - of their services.

Sincerely,

Stephen M. Pfeiffer, Ph.D. Nanci C.Klein,Ph.D.
Executive Director Chair

AAP Board of Trustees

Ronald E. Fox, PhD, PsyD

Douglas Haldeman, PhD

Nanci C. Klein, PhD - Chair

Michael Murphy, PhD

Gilbert Newman, PhD

Judith Steller, PhD - Secretary

Executive Director

Stephen M. Pfeiffer, PhD

Honorary Board

DorothyCantor, PsyD

Raymond Fowler, PhD

Alan Kazdin, PhD

Martin Seligman, PhD

Philip Zimbardo, PhD

Logo

CLICK HERE

AAP Website

That's good news that Medicare cuts averted, Jillo!!!
 

jillio

New Member
Jillo, haven't you read AAP/PLAN - Psychology's Political Action Assn.?

December 13, 2010
Dear AAP Supporter,

We are very happy to report that a bill to freeze Medicare reimbursement for psychologists and physicians through the end of 2011 cleared Congress on December 9, 2010 and goes to President Obama for his signature. As a result of this action, the January 1, 2011 scheduled 25% cut in reimbursement has been averted for a full year. The measure also includes a one-year extension of the 5% psychotherapy payment restoration. This will ensure the continuation of $30 million in Medicare reimbursements for 2011. The bill also provides financial resources to the Centers for Medicare and Medicaid Services (CMS) to process backlogged payments for claims since January 1, 2010 to which the restoration will be retroactively applied.

This Congressional "doc fix" was spurred by intense lobbying efforts from a broad array of health care provider groups including the APA Practice Organization working together hand in glove with the political advocacy efforts of AAP. Congress does seem to understand that a massive reduction in Medicare reimbursement would cause a large number of providers to stop seeing Medicare patients. Military families also would have found their access to physicians jeopardized because their TRICARE coverage is based on the Medicare fee schedule.

In addition to freezing physician compensation at current Medicare levels, the legislation extends expiring Medicare payment policies and funds minor changes to Medicare, Medicaid, and the Children's Health Insurance Program. Of note, Congress has delayed the Medicare pay cut on 5 separate occasions this year amid much wrangling on how to finance it.

The proposed pay cut that has tormented Medicare providers and Congress alike is triggered by the sustainable growth (SGR) formula that Medicare uses to set doctors' reimbursement. The formula pegs reimbursement to growth in the gross domestic product. Provider groups contend that the formula is flawed because practice costs exceed gross domestic product inflation. The formula has mandated Medicare rate reductions every year going back to 2003, but Congress has postponed each one. Because the reductions accumulate over time, providers found themselves looking at a virtually bottomless reimbursement chasm on January 1.

We are all hopeful that the 1-year freeze will give us enough time to hammer out a permanent solution to the Medicare reimbursement crisis that health providers find more equitable and Congress finds affordable. The recent recommendations of a bipartisan commission created by President Obama to reduce the federal budget deficit may offer guidance. A report drafted by the commission's co-chairmen proposed freezing Medicare rates through 2013, reducing them by 1% in 2014, and then instituting a new pay formula in 2015 that rewards providers for the quality - not quantity - of their services.

Sincerely,

Stephen M. Pfeiffer, Ph.D. Nanci C.Klein,Ph.D.
Executive Director Chair

AAP Board of Trustees

Ronald E. Fox, PhD, PsyD

Douglas Haldeman, PhD

Nanci C. Klein, PhD - Chair

Michael Murphy, PhD

Gilbert Newman, PhD

Judith Steller, PhD - Secretary

Executive Director

Stephen M. Pfeiffer, PhD

Honorary Board

DorothyCantor, PsyD

Raymond Fowler, PhD

Alan Kazdin, PhD

Martin Seligman, PhD

Philip Zimbardo, PhD

Logo

CLICK HERE

AAP Website

That's good news that Medicare cuts averted, Jillo!!!

Thanks for posting it, Sosie. I was aware, as it has been discussed in the professional journals I receive extensively. But you have just made others aware, so thank you.:ty: It is a perfect example of the way that insurance carriers contribute to rising health care costs.

Yes, very good news that the cuts have been averted for another year. That means that practitioners will not have to raise rates over all to make up for the cuts, and everyone benefits.
 

jillio

New Member
Did you provide a source that says they don't?

Check the net. I located the information months ago and posted a link here in AD in one of the many threads on health care reform. I don't save all those links anywhere, and quite frankly, I don't have the time, nor the motivation to do it again. Want to check out whether it is true or not? Google is your friend.
 

TXgolfer

Dream Weaver
Premium Member
Check the net. I located the information months ago and posted a link here in AD in one of the many threads on health care reform. I don't save all those links anywhere, and quite frankly, I don't have the time, nor the motivation to do it again. Want to check out whether it is true or not? Google is your friend.

meh, it was your claim.
 

Reba

Retired Terp
Premium Member
Decision is in:

A federal judge in Florida has struck down as unconstitutional key parts of the sweeping health care reform bill. (CNN)

Florida Judge Rules Individual Mandate in Health Care Law Is Unconstitutional (FoxNews)
 

Reba

Retired Terp
Premium Member
A U.S. district judge on Monday threw out the nation's health care law, declaring it unconstitutional because it violates the Commerce Clause and surely reviving a feud among competing philosophies about the role of government.

Judge Roger Vinson, in Pensacola, Fla., ruled that as a result of the unconstitutionality of the "individual mandate" that requires people to buy insurance, the entire law must be declared void.

"I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the act with the individual mandate. That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system. The health care market is more than one-sixth of the national economy, and without doubt Congress has the power to reform and regulate this market. That has not been disputed in this case. The principal dispute has been about how Congress chose to exercise that power here," Vinson wrote.

"While the individual mandate was clearly 'necessary and essential' to the act as drafted, it is not 'necessary and essential' to health care reform in general," he continued. "Because the individual mandate is unconstitutional and not severable, the entire act must be declared void...."
Judge Rules Health Care Law Is Unconstitutional - FoxNews.com
 

jillio

New Member
meh, it was your claim.

Yep. And you are the one that doubts it. Be a man and prove me wrong. Do some actual research instead of just throwing out underhanded attempts to discredit. Show us that you have some degree of intelligence instead of trying to appear so with sarcasm.
 

TXgolfer

Dream Weaver
Premium Member
Yep. And you are the one that doubts it. Be a man and prove me wrong. Do some actual research instead of just throwing out underhanded attempts to discredit. Show us that you have some degree of intelligence instead of trying to appear so with sarcasm.

:lol:
 
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