News Republicans' Plan to Repeal Healthcare?

[Nusc]

So if the Republican party regain control of the house and senate, are they able to reverse the bill?

 

[DavidSnider]

Theoretically, yes.

But rolling back the entitlements that were passed in this bill would be political suicide.

 

[Nusc]

It's funny how people attack those trying to help them.

 

[russ_watters]

What do you mean by that? Who would attack who?

 

[Ivan Seeking]

Obama would never sign a repeal of the bill, so Congress would need the votes to override a veto. That requires a supermajority in both the House and the Senate - not possible. Beyond that, the Republicans would have to sell the idea of cancelling health coverage for sick children.

 

[lisab]

No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?

I know I linked to this in another thread, but it fit here too. http://www.frumforum.com/waterloo".

 

[Ivan Seeking]

The Republicans will now huff, and puff, and blow smoke from their ears in order to pacify their base, but it is all show.

Lisab, I thought that blog from Frum was right on. This turned out to be the Republican's Waterloo, not Obama's.

 

[calculusrocks]

Stuart Varney asked Ron Paul this on Fox Business Channel. Ron Paul says bankruptcy will repeal the legislation.

context - http://www.youtube.com/watch?v=PbOQE8hsQpo&feature=related

 

[humanino]

http://www.youtube.com/watch?v=PbOQE8hsQpo&feature=related

It's immoral because you do not have the right to medical care.

Sure. I only wish once this settled down and bankruptcy turns out not to happen, all those voices will find something more useful to do with their life than noise. Albert Camus once said

Those who lack the courage will always find a philosophy to justify it.

 

[Nebula815]

It could be repealed I think, or parts overturned by the SCOTUS maybe. All we heard was how it would "never" be passed, how it would be political suicide for the Democrats to pass it, well they passed it. To say it can't be repealed, I'm not buying. To say it will be difficult to repeal, I agree.

But if there is one thing Obama has shown a few times, it is that conventional wisdom does not always apply.

 

[Pattonias]

The only way that this will ever be repealed is if it fails in action. Unfortunately the more likely action, should the government bankrupt itself, would be to raise taxes to compensate for the extra expense. I'm pretty sure we should just get used to the idea of having national health care.

 

[Brian_C]

It can and will be repealed if enough people turn against it. See Prohibition.

 

[Nusc]

What do you mean by that? Who would attack who?

The Repbulicans attacking Democrats!


Their so afraid of government, it's pretty sad.

 

[Evo]

The truth is, we need medical coverage for those that don't get it through their employer or can't afford it. In the situation we are in with high unemployment, the number of Americans suddenly left without insurance has skyrocketed. This isn't acceptable in a successful western society.

Is the proposed solution perfect? No. Do changes need to be made for it to become a reality? Yes. Do we need it? Absolutely.

 

[Nebula815]

The truth is, we need medical coverage for those that don't get it through their employer or can't afford it. In the situation we are in with high unemployment, the number of Americans suddenly left without insurance has skyrocketed. This isn't acceptable in a successful western society.

Is the proposed solution perfect? No. Do changes need to be made for it to become a reality? Yes. Do we need it? Absolutely.

The proposed solution risks bankrupting the nation is the problem however.

 

[Gokul43201]

The proposed solution risks bankrupting the nation is the problem however.

Do you have a reference for an estimate of the risk? The CBO has released estimates projecting decreases in the deficit over the next 10 years.

See cost estimates: http://www.cbo.gov/publications/collections/health.cfmhttp://www.cbo.gov/publications/collections/health.cfm

 

[calculusrocks]

It's immoral because you do not have the right to medical care.

That's right.

Sure. I only wish once this settled down and bankruptcy turns out not to happen, all those voices will find something more useful to do with their life than noise. Albert Camus once said Those who lack the courage will always find a philosophy to justify it.

I'm convinced the philosophy you must be referring to is the philosophy of liberalism. What we've done over the last century is spend, spend, spend and take more and more liberties away. Now where are we?

http://www.bloomberg.com/apps/news?pid=20601087&sid=aVDEHvI9WH_Q

It takes courage to admit you have a problem, an addiction. Politicians are addicted to showing their generosity by spending other people's money and its running this nation straight into the ground.

 

[Nebula815]

Do you have a reference for an estimate of the risk? The CBO has released estimates projecting decreases in the deficit over the next 10 years.

http://www.cbo.gov/doc.cfm?index=11378&type=1http://www.cbo.gov/doc.cfm?index=11378&type=1

The CBO is wrong. They have to use various assumptions in making their calculations. You could also look at the history of most all the government health entitlements. They never come out costing what they are projected to. The bill supposedly pays for itself by cutting Medicare, but it is also supposed to expand Medicare. Now anyone knows you can't expand Medicare with the same bill that is funded with cuts to Medicare.

When asked about this, President Obama couldn't answer and waffled on the issue completely. The Democrats know the bill will cost an astronomical amount, they will announce the need for new taxes to pay for it.

 

[turbo]

The truth is, we need medical coverage for those that don't get it through their employer or can't afford it. In the situation we are in with high unemployment, the number of Americans suddenly left without insurance has skyrocketed. This isn't acceptable in a successful western society.

Is the proposed solution perfect? No. Do changes need to be made for it to become a reality? Yes. Do we need it? Absolutely.

Can't agree more. My state is rural/forested with primarily seasonal and part-time jobs that don't offer any health-insurance, and income levels that don't allow workers to afford them. Without some fundamental reforms, more people would be left behind, denied preventative health care and denied treatment until their conditions got serious enough to to require ER visits, which we ALL pay for.

 

[Nebula815]

You're confusing Medicare and Medicaid. They're different programs.

Nope, I am aware they are different. The bill claims it will cut Medicare spending to pay for health reform and expand Medicare's future solvency. If you solely cut back $500 billion in Medicare expenditures that could make it more solvent, but if you then go and spend that same $500 billion for health reform, you cannot claim you made Medicare more solvent.

 

[Stanwyck66]

http://www.gallup.com/poll/126929/Slim-Margin-Americans-Support-Healthcare-Bill-Passage.aspx

Now that the fear mongering is over mostly, I predict popular support for this bill will swing substantially in favor of it.

 

[Nebula815]

http://www.gallup.com/poll/126929/Slim-Margin-Americans-Support-Healthcare-Bill-Passage.aspx

Now that the fear mongering is over mostly,

It isn't fearmongering. Fearmongering is when you make over-exaggerated claims of what the bad results will be if people do or do not do something.

Claiming that this bill will blow a hole in the deficit and debt isn't fearmongering, as the numbers don't add up and history is also a good indication.

Claiming that it gives government a lot more control over our lives is not fearmongering. In addition to the health insurance companies now being controlled by the government, you now literally will have the IRS being involved in a lot more of your life, and also this now gives the government the ability to justify regulations and taxes on all sorts of new things because "These things increase healthcare costs."

When "the government is paying for your healthcare," this happens. In New York State, they are trying to pass legislation to severely curb the amount of salt used in restaurant food. SALT! Something humans have been consuming for thousands of years.

The reasoning is that it will help curb healthcare costs.

I could imagine a tax on fast-food, a tax on soda, a tax on any kind of junk food, etc...regulations on this and that that we haven't thought of yet.

I predict popular support for this bill will swing substantially in favor of it.

Of course it will. And then when the nation is met with the staggering reality of just how much it costs, and thus has a crazy level of debt and deficit, and has to raise taxes, and then eventually start cutting benefits because there just isn't enough money, people will be screaming.

 

[Char. Limit]

I could imagine a tax on fast-food, a tax on soda, a tax on any kind of junk food, etc...regulations on this and that that we haven't thought of yet.

I see absolutely nothing wrong with taxing soda and junk food. If you can come up with a good argument on why we shouldn't tax those things... well, I want to see it.

Of course it will. And then when the nation is met with the staggering reality of just how much it costs, and thus has a crazy level of debt and deficit, and has to raise taxes, and then eventually start cutting benefits because there just isn't enough money, people will be screaming.

Too late, people (AKA conservatives) were doing that a year ago.

 

[Nebula815]

I see absolutely nothing wrong with taxing soda and junk food. If you can come up with a good argument on why we shouldn't tax those things... well, I want to see it.

So then you are okay with the government just being able to come and try to dictate and control your lifestyle?? Why not just ban them altogether then?

 

[Gokul43201]

So then you are okay with the government just being able to come and try to dictate and control your lifestyle?? Why not just ban them altogether then?

The government already had heavy subsidies on things that go into junk foods. How is that any less controlling of your lifestyle?

 

[Vanadium 50]

The question seems rather fuzzy.

Can the law technically be repealed? Of course - it takes a majority of both houses and the President's signature, or a supermajority of the President vetoes it.

Can the law be politically repealed? That's a question for fortunetellers, but it depends on how angry the populace stays in November, and/or November 2012. It's probably true that what looked like clever idea to make the bill appear to reduce the deficit - have ten years of revenues plus Medicare cuts cover six years of expenditures - doesn't look quite so good in this light, as the first four years have tax increases and Medicare cuts, but many of the benefits don't kick in until later.

Can the law be overturned some other way? There are two - one is that the law needs to survive a court challenge. I think it will, after Wickard v. Fillburn, but one can never tell. The other is that Congress can always refuse to fund it.

The most likely scenario for "repeal" in my view is that this law will be replaced with something smaller. That's something that requires less of a supermajority.

 

[Char. Limit]

So then you are okay with the government just being able to come and try to dictate and control your lifestyle?? Why not just ban them altogether then?

Well, considering that where I live, candy isn't even taxed, I'd be willing to put candy on the sales tax...

 

[Nebula815]

The government already had heavy subsidies on things that go into junk foods. How is that any less controlling of your lifestyle?

Well you have a point there, but I was talking from a basic assumption in which they aren't subsidized.

Well, considering that where I live, candy isn't even taxed, I'd be willing to put candy on the sales tax...

Just because something isn't taxed doesn't mean you should then tax it IMO.

 

[BobG]

The question seems rather fuzzy.

Can the law technically be repealed? Of course - it takes a majority of both houses and the President's signature, or a supermajority of the President vetoes it.

Can the law be politically repealed? That's a question for fortunetellers, but it depends on how angry the populace stays in November, and/or November 2012. It's probably true that what looked like clever idea to make the bill appear to reduce the deficit - have ten years of revenues plus Medicare cuts cover six years of expenditures - doesn't look quite so good in this light, as the first four years have tax increases and Medicare cuts, but many of the benefits don't kick in until later.

Can the law be overturned some other way? There are two - one is that the law needs to survive a court challenge. I think it will, after Wickard v. Fillburn, but one can never tell. The other is that Congress can always refuse to fund it.

The most likely scenario for "repeal" in my view is that this law will be replaced with something smaller. That's something that requires less of a supermajority.

The populace isn't particularly angry at Obama or Democrats now, so the anger would have to increase in order to give Republicans a majority in Congress, let alone a big enough majority to override vetoes.

"Overall, how would you rate the job each of the following has done in the 
efforts to address problems in the health care system over the past year, leading 
up to yesterday's vote in the House -- as excellent, good, only fair or poor? 
 
  
                             Excellent   Good   Only Fair   Poor   Unsure 
                                 %           %         %         %         % 
"President Obama"
   3/22/10                   18            28       20         31         3 
  
"Democrats"
  3/22/10                     7             25       30        33          5 
  
 "Republicans"
   3/22/10                    5             21       34        34          5

This, in spite of the fact that many feel that health care reform will be bad for them, personally, and in spite of the fact that many feel the reform will increase budget deficits.

"From what you know of that legislation, do you think the amount you pay for 
medical care would increase, decrease, or remain the same if it becomes law?"
  
                Increase       Decrease     Remain the Same      Unsure   
3/19-21/10      62              16                   21             1   
              
"From what you know of that legislation, do you think you and your family would,
 in general, be better off, worse off or about the same if it becomes law?"
 
                  Better Off      Worse Off     About the Same     
 3/19-21/10        19               47                   33     
              
"From what you know of that legislation, do you think you and your family would, in 
general, be better off, worse off or about the same if it becomes law?" If worse 
off or about the same: "Do you think other families in this country would be 
better off if that legislation becomes law, or do you think that legislation 
would not help anyone in the country?"
 
Better Off  Other Families Better Off  Would Not Help Anyone    Unsure   
     19                42                         37               2   
  
"From what you know of that legislation, do you think the federal budget deficit 
will go up, go down, or stay the same if it becomes law?"
 
  
                        Go Up       Go Down     Stay the Same       Unsure   
   3/19-21/10         70             12                 17             1

Obviously, feelings about the chances of health care reform working should create a situation where opinion could swing towards Republicans, but, for now, the fight seems to have cost Republicans more than help them.

http://www.pollingreport.com/health.htm

 

[Stanwyck66]

Claiming that this bill will blow a hole in the deficit and debt isn't fearmongering, as the numbers don't add up and history is also a good indication.

I suggest you look up the CBO report on the legislation that was passed, and they will put out another report on the amendments once they make their way through the Senate.

 

[lisab]

The CBO is wrong. They have to use various assumptions in making their calculations. You could also look at the history of most all the government health entitlements. They never come out costing what they are projected to. The bill supposedly pays for itself by cutting Medicare, but it is also supposed to expand Medicare. Now anyone knows you can't expand Medicare with the same bill that is funded with cuts to Medicare.

When asked about this, President Obama couldn't answer and waffled on the issue completely. The Democrats know the bill will cost an astronomical amount, they will announce the need for new taxes to pay for it.

Do you have any links to support your claim that the CBO is wrong?

 

[adrenaline]

http://www.pnhp.org/news/2010/march/politicians-didn%E2%80%99t-get-it-right

as pro single payer I hate this health reform bill, as a business owner I hate it more.

Right now I pay close to half a million a year in health insurance premiums for my 45 employees. This bill does nothing to prevent my carrier from raising premiums 178% like it has over the ten years I have been partner. So, since health insurance premiums are my second highest overhead, what is to prevent me from dumping my employees on the public exchange where they will get suboptimal coverage, higher copays and deductibles? The paltry 700 dollar fine per employee only applies to companies above 100 but even if I had to pay that, I would still reduce my overhead by dumping my employees onto the exchange. Small to medium size businesses will be dropping their excellent group coverage and letting their employees fend for themselves in the exchange.

Employers are now allowed to have "health screenings" and if the employee fails them ( say for diabetes) the employer will now be able to charge that employee a higher share of their employer sponsered premiums.

It did nothing for the fact that as an employer with majority female employees under 55 my premiums are 48% higher than a similar business size whose work force is predominantly male ( and if you don't think this affects hiring decisions in the work place you are way too innocent.)


Luckily, I am senior partner and believe in ethical business practices but if you don't think my Republican partners who look at the bottom dollar isn't trying to capitilize on this ( after all, half a million divided up as profit sharing among four partners...) isn't riding my a$$ about this already...


Now for individual policy owners this was a good reform for them.

 

[Char. Limit]

Well you have a point there, but I was talking from a basic assumption in which they aren't subsidized.

Just because something isn't taxed doesn't mean you should then tax it IMO.

I think that we should get a sales tax exemption to groceries. Groceries that mean things you need, REAL food. Candy doesn't fit that list. Soda does.

 

[Pattonias]

Perhaps the government could create universal eateries. No more people going hungry. It would improve health overall and create an equality of food quality for everyone. We would only be allowed healthy food at these eateries and we would only be allowed our rations every day. What we eat could be determined by experienced and trained professionals employed by the government at no direct cost to us. We would still have other places to eat, but these places would be taxed as "Cadillac eateries". In the end this would result in lower health care costs, and also reduce if not eliminate the number of people who don't have enough to eat. No more obesity for the United States. (In fact taxes would be higher for the obese as their increased wait is a greater burden on everyone else.) We could lead the charge against hunger as a nation.

 

[Ivan Seeking]

http://www.pnhp.org/news/2010/march/politicians-didn%E2%80%99t-get-it-right

as pro single payer I hate this health reform bill, as a business owner I hate it more.

As a small business owner, I love it because it makes health insurance affordable where it never was before. The biggest single impediment to most people considering opening a small business is the cost of health insurance.

As a small business, won't you receive a subsidy to offset the cost of insurance? Also, the cost for companies that don't comply is, I thought, more like $2000 per employee. There have been a lot of numbers tossed around over the last few days, but I thought that was the penalty. Perhaps that is only for larger companies?

My feeling is that this bill is a pig, but it's the only pig in town. After 70 years of failed attempts, if this hadn't passed, it may have been a very long time before any significant reform was seen. With that in mind, isn't it better to pass this and amend as needed, rather than allowing the current system to continue indefinitely?

I too would have preferred a single-payer system. Apparently that was too big of a step for now. I guess that one comes down to Senator Snow's vote in the senate... and the two Independents.

 

[drankin]

Perhaps the government could create universal eateries. No more people going hungry. It would improve health overall and create an equality of food quality for everyone. We would only be allowed healthy food at these eateries and we would only be allowed our rations every day. What we eat could be determined by experienced and trained professionals employed by the government at no direct cost to us. We would still have other places to eat, but these places would be taxed as "Cadillac eateries". In the end this would result in lower health care costs, and also reduce if not eliminate the number of people who don't have enough to eat. No more obesity for the United States. (In fact taxes would be higher for the obese as their increased wait is a greater burden on everyone else.) We could lead the charge against hunger as a nation.

This is crazy. Can you reference any government programs that support that this would be even mildly successful? Providing free healthy food is not going to prevent obesity. It will just give people more food to eat. Healthy food can make you fat too.

 

[Dembadon]

Perhaps the government could create universal eateries. No more people going hungry. It would improve health overall and create an equality of food quality for everyone. We would only be allowed healthy food at these eateries and we would only be allowed our rations every day. What we eat could be determined by experienced and trained professionals employed by the government at no direct cost to us. We would still have other places to eat, but these places would be taxed as "Cadillac eateries". In the end this would result in lower health care costs, and also reduce if not eliminate the number of people who don't have enough to eat. No more obesity for the United States. (In fact taxes would be higher for the obese as their increased wait is a greater burden on everyone else.) We could lead the charge against hunger as a nation.

This is a false analogy.

Many U.S. citizens band together and cook food for the homeless/hungry on a regular basis. However, one cannot set up a tent and start handing out insurance policies to those who need them. You don't need to own a food company to feed someone.

 

[Count Iblis]

So if the Republican party regain control of the house and senate, are they able to reverse the bill?

They need a 2/3 majority to overturn a veto from the President. If Repbublican candidates were to run on an agenda of overturning the health care bill, they will only get votes from conservatives.

 

[Count Iblis]

Perhaps the government could create universal eateries. No more people going hungry. It would improve health overall and create an equality of food quality for everyone. We would only be allowed healthy food at these eateries and we would only be allowed our rations every day. What we eat could be determined by experienced and trained professionals employed by the government at no direct cost to us. We would still have other places to eat, but these places would be taxed as "Cadillac eateries". In the end this would result in lower health care costs, and also reduce if not eliminate the number of people who don't have enough to eat. No more obesity for the United States. (In fact taxes would be higher for the obese as their increased wait is a greater burden on everyone else.) We could lead the charge against hunger as a nation.

Homeless shelters already offer free of charge food.

 

[Ivan Seeking]

They need a 2/3 majority to overturn a veto from the President. If Repbublican candidates were to run on an agenda of overturning the health care bill, they will only get votes from conservatives.

Note also that a majority of Americans support health care reform. 59% of Americans oppose this bill, but 13% do because it doesn't go far enough. That stats suggest that we may well see as much as 55% approval by next November.

Just try to sell people on the idea that we now want to effectively cancel insurance for sick children who were previously refused insurance due to preexisting conditions.

 

[adrenaline]

As a small business owner, I love it because it makes health insurance affordable where it never was before. The biggest single impediment to most people considering opening a small business is the cost of health insurance.

As a small business, won't you receive a subsidy to offset the cost of insurance? Also, the cost for companies that don't comply is, I thought, more like $2000 per employee. There have been a lot of numbers tossed around over the last few days, but I thought that was the penalty. Perhaps that is only for larger companies?

My feeling is that this bill is a pig, but it's the only pig in town. After 70 years of failed attempts, if this hadn't passed, it may have been a very long time before any significant reform was seen. With that in mind, isn't it better to pass this and amend as needed, rather than allowing the current system to continue indefinitely?

I too would have preferred a single-payer system. Apparently that was too big of a step for now. I guess that one comes down to Senator Snow's vote in the senate... and the two Independents.

The tax benefits won't offset the half a million a year I pay, and this reform bill made no provisions for the insurance company to not raise their premiums ( which they will since I now have to provide coverage for all children of employees until 26 years of age and more dependants). If I was a small business hurting and looking to cost overhead, it would be easier to dump my employees onto the public exchange and fend for themselves. That is the bottom line. Also, I have always felt it was unfair that I have to pay more in premiums just becau se my employees are predominantly female.

we needed a change yes but this pig is out of control . I already have a bloated clerical staff just to deal with 300 plus private insurances, I honestly don't see my self opeining myself up to twice that number by accepting the public exchange. My partners have already foreseen the beaurocratic nightmare.

 

[Brian_C]

They need a 2/3 majority to overturn a veto from the President. If Repbublican candidates were to run on an agenda of overturning the health care bill, they will only get votes from conservatives.

They will get plenty of votes from people who either got nothing from this bill, lost their employer provided coverage, or saw their premiums skyrocket as a result.

I think the Tea Party crowd actually helped the Dems pass this bill. They were able to argue that the bill represents real reform because all the 'evil right wingers' were against it. Reality is about to smack the American people right in the mouth.

 

[Ivan Seeking]

The tax benefits won't offset the half a million a year I pay, and this reform bill made no provisions for the insurance company to not raise their premiums ( which they will since I now have to provide coverage for all children of employees until 26 years of age and more dependants). If I was a small business hurting and looking to cost overhead, it would be easier to dump my employees onto the public exchange and fend for themselves. That is the bottom line. Also, I have always felt it was unfair that I have to pay more in premiums just becau se my employees are predominantly female.

I know that insurance companies will now be required to disperse 80% of the funds collected, for claims. So they do not have the option to arbitrarily raise prices without providing addtional coverage. At least, that's the theory as I understand it.

 

[Pattonias]

Is there any reason we couldn't pass insurance reform without the public option? Is anyone arguing that the reforms were not necessary? The biggest hang ups on the bill were over the universal public insurance option.

 

[calculusrocks]

Perhaps the government could create universal eateries. No more people going hungry. It would improve health overall and create an equality of food quality for everyone. We would only be allowed healthy food at these eateries and we would only be allowed our rations every day. What we eat could be determined by experienced and trained professionals employed by the government at no direct cost to us. We would still have other places to eat, but these places would be taxed as "Cadillac eateries". In the end this would result in lower health care costs, and also reduce if not eliminate the number of people who don't have enough to eat. No more obesity for the United States. (In fact taxes would be higher for the obese as their increased wait is a greater burden on everyone else.) We could lead the charge against hunger as a nation.

Doesn't Hugo Chavez do something like this in Venezuela?

 

[adrenaline]

I know that insurance companies will now be required to disperse 80% of the funds collected, for claims. So they do not have the option to arbitrarily raise prices without providing addtional coverage. At least, that's the theory as I understand it.

I will let you know , I just hope they don't raise their premiums over the next four years in a last hurrah...

 

[adrenaline]

Is there any reason we couldn't pass insurance reform without the public option? Is anyone arguing that the reforms were not necessary? The biggest hang ups on the bill were over the universal public insurance option.

This bill has no public option, only the insurance exchange where our federal tax dollars will now subsidize the private insurers like cigna, humana , blue cross etc etc. It's corporate welfare. They are trying to tack on an amendment but I'm sure it's not going to pass.

 

[calculusrocks]

adrenaline, is retirement an option in your situation?

 

[turbo]

I already have a bloated clerical staff just to deal with 300 plus private insurances, I honestly don't see my self opeining myself up to twice that number by accepting the public exchange. My partners have already foreseen the beaurocratic nightmare.

My cousin codes for a pediatric ophthalmologist who has many, many clients on Medicaid. The doc (who is also a friend of mine) doesn't mind the lower reimbursement rates because the coding for public insurance is very straightforward, and they don't delay and deny payments over and over again. That's very important for a small practice, because cash-flow problems and aged receivables can sink a small practice. When I was IT manager for a very large ophthalmic practice, one of my constant/recurrent duties was to identify insurance companies that were delaying or denying claims, resulting in receivables that were 60-90 days old. Banks don't like to extend your line of credit based on aged receivables like that. In my experience, it was the private insurance companies that caused 99% of the trouble by changing coding requirements, and kicking back any claims that were not properly coded to THEIR requirements, regardless of how many other insurance companies would have accepted the coding as submitted. We had three full-time coding experts for an in-house staff of 10-12 doctors, and those ladies were busy.

 

[adrenaline]

My cousin codes for a pediatric ophthalmologist who has many, many clients on Medicaid. The doc (who is also a friend of mine) doesn't mind the lower reimbursement rates because the coding for public insurance is very straightforward, and they don't delay and deny payments over and over again. That's very important for a small practice, because cash-flow problems and aged receivables can sink a small practice. When I was IT manager for a very large ophthalmic practice, one of my constant/recurrent duties was to identify insurance companies that were delaying or denying claims, resulting in receivables that were 60-90 days old. Banks don't like to extend your line of credit based on aged receivables like that. In my experience, it was the private insurance companies that caused 99% of the trouble by changing coding requirements, and kicking back any claims that were not properly coded to THEIR requirements, regardless of how many other insurance companies would have accepted the coding as submitted. We had three full-time coding experts for an in-house staff of 10-12 doctors, and those ladies were busy.

Your right, I tell people medicare pays me less but i probably spend 3 dollars for every 100 dollars i collect on clerical work and probably spend 33 dollars for every 100 i collect from private insurance. Most of us polled want single payer ( NEJM, JAMA) poll after poll shows most docs will take less payment just to deal with a more streamlined , consistent, single payer than the beurocratic garbage we have to deal with now.

How is this for a statistic, Duke Medical Center has 500 hospital beds and 500 full time coders, one coder per bed, what do you think the nursing ratio is?