Health Care Industry In Talks To Shape Policy

[Psychoblues]

Well,,,,,,,,,We already have seen clearly what THEY think, haven't we?!?!?!??!?!?!??!??!?!?

by Robert Pear
WASHINGTON

Since last fall, many of the leading figures in the nation’s long-running health care debate have been meeting secretly in a Senate hearing room. Now, with the blessing of the Senate’s leading proponent of universal health insurance, Edward M. Kennedy, they appear to be inching toward a consensus that could reshape the debate.

Many of the parties, from big insurance companies to lobbyists for consumers, doctors, hospitals and pharmaceutical companies, are embracing the idea that comprehensive health care legislation should include a requirement that every American carry insurance.

While not all industry groups are in complete agreement, there is enough of a consensus, according to people who have attended the meetings, that they have begun to tackle the next steps: how to enforce the requirement for everyone to have health insurance; how to make insurance affordable to the uninsured; and whether to require employers to help buy coverage for their employees.

The talks, which are taking place behind closed doors, are unusual. Lobbyists for a wide range of interest groups — some of which were involved in defeating national health legislation in 1993-4 — are meeting with the staff of Mr. Kennedy, Democrat of Massachusetts, in a search for common ground.

Mr. Kennedy is fighting brain cancer, and participants in the talks said his illness had added urgency to the discussions.

While President Obama is not directly represented in the talks, the White House has been kept informed and is encouraging the Senate effort as a way to get the ball rolling on health legislation.

Kennedy aides summarized discussions of the stakeholders, known as the “workhorse group,” in a recent memorandum obtained by The New York Times.

“While there was some diversity of views,” it said, “the sense of the room is that an individual obligation to purchase insurance should be part of reform if that obligation is coupled with effective mechanisms to make coverage meaningful and affordable.”

The ideas discussed include a proposal to penalize people who fail to comply with the “individual obligation” to have insurance.

“There seems to be a sense of the room that some form of tax penalty is an effective means to enforce such an obligation, though only on those for whom affordable coverage is available,” said the memorandum, prepared by David C. Bowen, a neurobiologist who is director of the health staff at the Senate Committee on Health, Education, Labor and Pensions.

The proposal for an individual mandate was one of the few policy disagreements between Mr. Obama and Hillary Rodham Clinton in their fight for the Democratic presidential nomination. She wanted to require everyone to have and maintain insurance. He said he wanted to “ensure affordable coverage for all,” but would initially apply the mandate only to children.

The 20 people who regularly attend the meetings on Capitol Hill include lobbyists for AARP, Aetna, the A.F.L.-C.I.O., the American Cancer Society, the American Medical Association, America’s Health Insurance Plans, the Business Roundtable, Easter Seals, the National Federation of Independent Business, the Pharmaceutical Research and Manufacturers of America, and the United States Chamber of Commerce.

Their motives vary. Some say the moment to overhaul the health care system has arrived because of a confluence of events, including Mr. Obama’s election, the growing number of uninsured and the relentless increase in health costs. Some want to protect the interests of their members and could ultimately oppose the legislation, depending on its details.

While a fragile consensus is slowly emerging, it is not unanimous. The Business Roundtable, representing big corporations, would place “an obligation on all Americans to have health insurance coverage” and says the government should offer financial aid to help low-income people buy it.

On the other hand, James P. Gelfand, senior manager of health policy at the United States Chamber of Commerce, said: “Forcing individuals to purchase insurance in the current market would be a disaster. Before we even have that discussion, we need to make health care more affordable and improve its quality.”

The current efforts contrast with the Clinton administration’s approach in 1993-4. The Clinton White House demonized health insurance companies, accusing them of “price gouging” and profiteering. Mr. Kennedy is trying to keep insurers and other stakeholders talking together in the same room. Getting affordable health insurance is now a top priority for small-business owners, who helped kill the Clinton plan................

Much More: http://www.nytimes.com/2009/02/20/us/politics/20health.html?_r=1

Leave it up to them and there will be nothing left but insurance premiums!!!!!!!!!!!!!

:beer::cheers2::beer:

Psychoblues

[Nukeman]

What would be nice is if the insurance industry would just pay a fair and reasonable amount for the care and testing being done. This especially goes for the Fed through medicare/medicaid...

IF and I say IF they would all just pay what is reasonable and quite paying pennies on the dollar we wouldn't be in this mess. Cost would come down in a heartbeat and it would be affordable.

Health care is falsely inflated due to limited payment by insurers and the feds...

The current rate of return for testing and care by CMS is 0.35 cents on the dollar so in order to even break even the health care industry has to charge 3 times what it needs to get any money, if they would just pay the proper amount than this would be a non-issue

I understand this is an oversimplification of the problem but it is where it all starts.....

[Psychoblues]

I think oversimplification is an understatement, nm, and I don't mean any offense by that!!!!!!!!!!!!!!

Just who is CMS and what do you intend to do about them?!?!?!?!?!?!???!

'cool one?!?!??!???!?!?!??!

:beer::cheers2::beer:

Psychoblues

[Nukeman]

I think oversimplification is an understatement, nm, and I don't mean any offense by that!!!!!!!!!!!!!!

Just who is CMS and what do you intend to do about them?!?!?!?!?!?!???!

'cool one?!?!??!???!?!?!??!

:beer::cheers2::beer:

PsychobluesIt is and it isn't oversimplification!!

CMS stands for Centers for Medicare and Medicaid Services.
They ultimately set the price for what they will pay, not a fair market value but what they "WANT" to pay and they change the rules as to how and when they will pay for hospitalization EVERY year and if you don't learn how to play their game than you won't get payed. Private insurance will follow what CMS does and that reduces the amount of pay by the insurers...

Basically it is like this CMS says they will pay 100 dollars for a 300 dollar test that is a take of 0.33 cents on the dollar, CMS does not allow the hospitals to charge ANY additional amount to the patient you take what they give you or you lose ALL from them (the word extortion comes to mind).

The private payers than "negotiate" by saying this is what we will pay take it or leave it. if you leave it than they take their customers to your competitor, which on the surface is a good thing but when they low ball the shit out of you and leave you with NO choice than that is not negotiating. Most of the cost problems can and should be laid at the feet of CMS

I could spend hours actually talking about how this works and to type it would take me days. I don't think Jimmy wants me to use that much bandwidth....:cool:

[Psychoblues]

Are their figures not based on prevailing circumstance and observation or is it true that they just "pay what they want to pay and that's it" like you say?!?!?!?!??!?!?!?!



It is and it isn't oversimplification!!

CMS stands for Centers for Medicare and Medicaid Services.
They ultimately set the price for what they will pay, not a fair market value but what they "WANT" to pay and they change the rules as to how and when they will pay for hospitalization EVERY year and if you don't learn how to play their game than you won't get payed. Private insurance will follow what CMS does and that reduces the amount of pay by the insurers...

Basically it is like this CMS says they will pay 100 dollars for a 300 dollar test that is a take of 0.33 cents on the dollar, CMS does not allow the hospitals to charge ANY additional amount to the patient you take what they give you or you lose ALL from them (the word extortion comes to mind).

The private payers than "negotiate" by saying this is what we will pay take it or leave it. if you leave it than they take their customers to your competitor, which on the surface is a good thing but when they low ball the shit out of you and leave you with NO choice than that is not negotiating. Most of the cost problems can and should be laid at the feet of CMS

I could spend hours actually talking about how this works and to type it would take me days. I don't think Jimmy wants me to use that much bandwidth....:cool:

Go ahead and use the bandwidth, nm. How much video/audio horseshit do you see here that is otherwise useless but equivalent to many thousands of pages of dialogue which is what this site is supposed to promote and represent, don't you know?!?!?!?!??!?!??!?!?!?!?!?!?

One of us is full of shit and I think it is you, nm.

But, I'll buy you a drink anyway!!!!!!!!!!!!!!!!

:beer::cheers2::beer:

Psychoblues

[Nukeman]

Are their figures not based on prevailing circumstance and observation or is it true that they just "pay what they want to pay and that's it" like you say?!?!?!?!??!?!?!?!




Go ahead and use the bandwidth, nm. How much video/audio horseshit do you see here that is otherwise useless but equivalent to many thousands of pages of dialogue which is what this site is supposed to promote and represent, don't you know?!?!?!?!??!?!??!?!?!?!?!?!?

One of us is full of shit and I think it is you, nm.
But, I'll buy you a drink anyway!!!!!!!!!!!!!!!!

:beer::cheers2::beer:

PsychobluesYou know psycho, I was actually going to discuss this with you. If you have to resort to telling me I am "full of shit" than I am done. Suffice it to say I have extensive experience in the health care arena, over 20 years of maintaining budgets, and dealing with the complete incompetence of CMS on a daily basis, how about yourself. When was the last time you dealt with any of this????:coffee:

Thanks for the drink but I unfortunately drink enough, especially after I have to deal with insurance carriers and CMS daily...!?!?!?!?!?!

[PostmodernProphet]

Since last fall, many of the leading figures in the nation’s long-running health care debate have been meeting secretly in a Senate hearing room.

interesting.....I recall the left went apeshit over "secret" meetings with oil executives....apparently, it isn't so bad if you're holding meetings yourself.....

[PostmodernProphet]

Health care is falsely inflated due to limited payment by insurers and the feds...

simple solution, then....everyone pays what the feds pay.....

[Nukeman]

simple solution, then....everyone pays what the feds pay.....uhhhhh NO. They reimburse at about 0.33 cents on the dollar, and Medicaid reimburses at about 0.12 cents on the dollar.

What would actually work is if everyone would agree on about 0.40-0.45 cents on the dollar, than drop the price for all to that level and everyone makes a livable wage and the prices are dropped by 60%. Here is the catch though, they HAVE to pay the needed amount.....

Contrary to popular belief MOST people in health care (close to 90%) are solid middle to low middle class. They are the first to get caught in the firing line for budgetary cuts. Quickest way to save money because the feds don't allow you to stop offering services and maintain accreditation to get paid....

[PostmodernProphet]

I'm sorry, Nuke.....but I'm not going to pay any attention to complaints that people in the medical industry aren't making a livable wage.....complain to your bosses, not your customers.....when you look at the medical buildings around town it's easy to see where the money ends up......

[Nukeman]

I'm sorry, Nuke.....but I'm not going to pay any attention to complaints that people in the medical industry aren't making a livable wage.....complain to your bosses, not your customers.....when you look at the medical buildings around town it's easy to see where the money ends up......True but when YOU go to the doctor or the hospital where do YOU go. The run down building or the newly remodeled place that looks clean and attractive with state of the art equipment and new technologies. IF and I say IF everyone could care less what their facilities looked like and would go for actual care you could keep cost down, unfortunately the consumer (patients) drive what a facility will look like.

I never said they don't make a livable wage!! Your words not mine, in fact I put MOST health care workers in the MIDDLE CLASS.

Do you have any idea why hospitals look the way they do as far as how storage and maintenance are concerned. We have SOOOOO many governing bodies at the local, state, and federal level it isn't even funny anymore. Some of the agencies even contradict each other so if your in compliance with one your out with another....

Everything cost money, HIPPA was one of the most expensive cost in health care in the last 30 years if not ever. The hundreds of BILLIONS of dollars needed to meet compliance with something that MOST health care facilities already did was a complete waste of money...... Hey it makes everyone feel safer about their information........

[PostmodernProphet]

True but when YOU go to the doctor or the hospital where do YOU go.

actually, I have lots of choices.....I could go here, about three miles away...

http://tbn1.google.com/images?q=tbn:Gc81RW6z2QyaNM:http://modernfireandsecurity.com/site/data/gallery/zch003.jpg

or I could drive eight miles instead and go here....

http://mca-architecture.com/portfolio/p_images/94059b.jpg

or I could drive all of twenty miles and go to Pill Hill in Grand Rapids where this is under construction, along with three other large buildings....

http://www.gftforex.com/temp/joestuff/vai-model.jpg

http://tbn2.google.com/images?q=tbn:wBxiWUMB12I3JM:http://farm4.static.flickr.com/3240/2802932459_66be318661_b.jpg

and that's just the hospitals.....my doctors needed new offices too....

http://www.ascribehq.com/assets/photos/large/0f0b78f683556cd18f43e1e3d7d5c27150c3f699.jpg

[Nukeman]

actually, I have lots of choices.....I could go here, about three miles away...

or I could drive eight miles instead and go here....


or I could drive all of twenty miles and go to Pill Hill in Grand Rapids where this is under construction, along with three other large buildings....


and that's just the hospitals.....my doctors needed new offices too...


I noticed you left the rest of my statement. I am quite sure you also have choices of any number of clinics and other hospitals in the Grand Rapids area.

I am quite familiar with that area.

I will state again it is the "consumer' that drives for the pretty buildings and state of the art equipment, if not for them DEMANDING everything looking new and polished you would not see it.

I will ask again, would YOU go to the run down clinic or the seedy Dr's office???? Or do you prefer the clean new building that makes you feel warm and fuzzy???

you could go here

http://www.mhweb.org/washtenaw/photos/umpsych.jpg

http://www.itascasurgical.com/images/clinic_surgery_o.jpg

http://www.ascribehq.com/assets/photos/large/6885d3e4b5ced64a541b6d9c98fdcabdf750306a.jpg

You know they all just look like typical office buildings. Yes some are VERY grand but a vast majority of the MONEY USED comes from endowments and donations. Most of the construction on hospitals does not come from the money made off of patients, that is primarily used for services, upkeep, new equipment, taxes, salaries.... etc.... etc.....

[PostmodernProphet]

where are there seedy doctor's offices?.....

[Nukeman]

where are there seedy doctor's offices?.....

Go to just about ANY inner city, YOU really need to either get out more or quite being obtuse....

Tell you what go to New Orleans and vist Charity Hospital, that is if they rebuilt it. run down and very OLD.

A lot of the hospitals are over 30-60 years old they just have additions added to them or in some occurences they are rebuilt.

Once again would YOU go to a run down OLD hospital or do YOU prefer the new ones???? It really is a simple question!!!!!

[PostmodernProphet]

Go to just about ANY inner city, YOU really need to either get out more or quite being obtuse....

sorry dude, but that third picture of Pill Hill in Grand Rapids is DOWNTOWN in the largest city within 100 miles of here....you said you were familiar with the area....you tell ME where you can find a seedy hospital around here.....

[Psychoblues]

Nm just came in to bitch about CMS, pimp. He/she obviously doesn't know a damned thing about the excessive costs of healthcare to common and regular Americans. I appreciate your conflicts!!!!!!!!!!

:beer::cheers2::beer:

Psychoblues

[PostmodernProphet]

Nm just came in to bitch about CMS, pimp. He/she obviously doesn't know a damned thing about the excessive costs of healthcare to common and regular Americans. I appreciate your conflicts!!!!!!!!!!

:beer::cheers2::beer:

Psychoblues

Psych, please don't appreciate my conflicts....it makes me feel unclean......

[Psychoblues]

:lol: :lame2: :laugh2: :lol:

Take a bath, slut!!!!!!!!!!!!!!!!!

:beer::cheers2::beer:

Psychoblues

[Nukeman]

sorry dude, but that third picture of Pill Hill in Grand Rapids is DOWNTOWN in the largest city within 100 miles of here....you said you were familiar with the area....you tell ME where you can find a seedy hospital around here.....
You know maybe "seedy" was an incorect term. YOU have yet to answer my question as to where you would rather go. Somewhere nice or some where old and in need of repair...

As for knowing the area, I worked at Bronson Methodist (in Kalamazoo)for a few years. While there we had a 50-60 year old hospital that was finally rebuilt in 1997-8. I know thats a little way from Grand Rapids.

So your primary complaint is that they must be making too much money because they have a nice building!!! Well lets just look at ANY and Law firm, Insurance, goevernment, or consultants building out there shall we, and how many of them get their construction cost from endowments and donations..

[Psychoblues]

Get real, nm!!!!!!!!!!!!!!!



You know maybe "seedy" was an incorect term. YOU have yet to answer my question as to where you would rather go. Somewhere nice or some where old and in need of repair...

He/she ate your ass up!!!!!!!!!!!!!!!!!

:beer::cheers2::beer:

Psychoblues

[Nukeman]

Get real, nm!!!!!!!!!!!!!!!




He/she ate your ass up!!!!!!!!!!!!!!!!!

:beer::cheers2::beer:

Psychoblues
hey psycho why dont you jsut kiss my ass:coffee:

I love how "he/she ate my ass up" becasue of ONE word. Whatever!!!!!!!!!!!

So avoiding questions and changing the topic is eating my ass up hmmmm I see how stupid your being this lovely morning....

[Psychoblues]

Truth is something you don't deal with well?!?!?!?!??!?!?!?!?!???!?!!?



hey psycho why dont you jsut kiss my ass:coffee:

I love how "he/she ate my ass up" becasue of ONE word. Whatever!!!!!!!!!!!

So avoiding questions and changing the topic is eating my ass up hmmmm I see how stupid your being this lovely morning....

Kiss this, nm: :pee: nm

:beer::cheers2::beer:

Psychoblues

[PostmodernProphet]

So your primary complaint is that they must be making too much money because they have a nice building!!! Well lets just look at ANY and Law firm, Insurance, goevernment, or consultants building out there shall we, and how many of them get their construction cost from endowments and donations..

all you need to do to determine where the money ends up in any society is to look at their buildings......medical buildings, government buildings, schools.....don't bother looking at our factories, mills, and power plants...they are all thirty years old and falling apart.....

[Psychoblues]

Give nm a break on this one, pimp.



all you need to do to determine where the money ends up in any society is to look at their buildings......medical buildings, government buildings, schools.....don't bother looking at our factories, mills, and power plants...they are all thirty years old and falling apart.....

Address the question/subject or just shut the fuck up, OK?!?!??!?!?!?!?!??!

:beer::cheers2::beer:

Psychoblues

[PostmodernProphet]

Address the question/subject or just shut the fuck up, OK?

???....I'm sorry you didn't know what the subject was Psych.....though it doesn't surprise me......

[Psychoblues]

You continue to be confused?!?!?!?!?!??!?!?!?!



???....I'm sorry you didn't know what the subject was Psych.....though it doesn't surprise me......

WTF?!?!????!?!?!?!?!???!!?

:beer::cheers2::beer:

Psychoblues

[PostmodernProphet]

You continue to be confused?!?!?!?!?!??!?!?!?!




WTF?!?!????!?!?!?!?!???!!?

:beer::cheers2::beer:

Psychoblues

reading your posts is like watching a cheap Japanese movie.....you lips are moving, but nothing intelligible is coming out.....

[Psychoblues]

You never answered the question and you want to whine to me about it?!?!?!?!??!?!?!?!??!?!



reading your posts is like watching a cheap Japanese movie.....you lips are moving, but nothing intelligible is coming out.....

Keep looking if you are seeking a sympathetic shoulder to cry on, pimp. I know you all too well!!!!!!!!!!!!!!!!!!!!

:beer::cheers2::beer:

Psychoblues