We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Without major changes, “we fear that very few providers will enroll … and that (Medicare) and the provider community will miss the best opportunity to inject value and accountability into the delivery system.”
By "accountability," I think they mean cheap. One of the reasons I agreed to post my thoughts at Maggie's Farm was because of our editor's "Ain't gonna work on Maggie's Farm no more" ethos. The Medicare and insurance company's regs drove me nuts, so I quit them all. See me, pay me. If you're rich, I'll charge you a lot. If you're poor, a little. Rightly or wrongly, I do it my way.
There are two simple things that can be done to reduce medical costs in the US: 1. Tort reform, so that everybody with a tension headache doesn't get a $700 cya CAT scan and OBs don't have to spend $200,000/yr for malpractice insurance, and 2. A wide market for interstate major medical insurance.
As a biller for a surgical practice that has great personal and professional significance to me, I could not agree with you any more. While I enter new Medicare fees into our billing software year after year, I am always nauseated - but not surprised - by the ever-DEcreasing reimbursement rates (and the ever-INcreasing malpractice premiums) for MDs. This system has caused a good number of my most trusted providers to ditch Medicare or leave practice altogether. As my South Bronx FDNY husband can also attest amidst his government-funded, project-ridden work neighborhood, our nation of entitlement is going up in flames. And it's our own dollars, too, that are catching fire.
The primary reason for the crazy healthcare system is the lack of a connection between the provider of service and the consumer of service. The connection has been restricted to only the service. If provider and consumer are not able to affect ALL portions of the transaction, including the price, then there is no way it will be efficient and cost effective.
My $.02 is this - we're told that Obamacare & other "health care" schemes are OK since states also mandate auto insurance...
Ookay - let me know where I can buy a Medical Insurance policy like my auto policy - the one where I can determine the $ values of coverage, I can even select types of coverage amongst those $ levels, and can even purchase insurance across state lines (gasp).