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  1. #1
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    Default Interesting medical cost/repayment numbers

    I know there are many physicians on the board that could list far worse cases (and gripes) than this, but I just learned this today and found it pretty crazy.

    In a Family Medicine Residency Clinic that performs newborn circumcisions...

    The bill for the procedure will be $637.00.
    Medicaid will reimburse $77.00 of that.
    The cost of the sterile kit for the procedure is $50.00.

    Net revenue to the clinic $27.00 to pay for an hour of the resident physicians time, a half hour of the attending physicians time, nurses, support staff, electricity....you get the idea.

    Thanks God I find other rewards in medicine.......

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    Didn't someone here say "the government screws up everything it touches"?

    Another reason why we don't need a federal government-run medical program. Who will want to be a doctor when they are making $15 an hour?

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    I thought medicaid was for older folks?
    If you don't make it, fake it.

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    Quote Originally Posted by Mark Phelps View Post
    Another reason why we don't need a federal government-run medical program. Who will want to be a doctor when they are making $15 an hour?
    Yeah, cos British doctors are so-o-o poor.

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    One should investigate just how little the insurance companies reimburse physicians...

    Not to metion the extortion known as malpractice insurance.

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    Ahh. My mistake. I agree with Pug here though. If they take a hit on circumcisions from medicaid they make it up overcharging the non-medicaid. Haven't seen many poor docs, unless they're just starting out.
    If you don't make it, fake it.

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    Default

    Malpractice is another story, but insurance companies pay out a bit more. It's not like you HAVE to take medicaid.
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    Don't get me started on this....

    That is why 90% of my received accounts are self pay. But the majority of what I do is non essential medicine.

    Most docs who see medicaid should hand the person $20 and tell them good luck.

    Chief your scenario does not include any overhead / operational cost at all. Crank out the dollar figure you need to make per 15 minute time slot to break even and you will go buy a bottle of scotch tonight.

    Not a wonder the average General Practioner spends 3 minutes with each patient before moving on. Sad state of affairs.
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    Quote Originally Posted by hoochman View Post
    Crank out the dollar figure you need to make per 15 minute time slot to break even and you will go buy a bottle of scotch tonight.
    Do I really need an excuse to buy a bottle of scotch?

  10. #10
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    What a racket.
    "You're wearing a replica today."

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    deleted
    Last edited by Mark Phelps; 02-02-2008 at 03:10 AM. Reason: delete

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    Quote Originally Posted by yahoojc33 View Post
    That's Medicare. Medicaid is for the poor and Mexicans, in need of hand-outs!
    Firstly, STFU. Keep your racist agenda to yourself, next time, Adolf.

    Secondly, Here's how I see the social medicine vs private medicine issue. You all pay insurance for medical care and the insurance company's legal responsibility to their shareholders is to not pay out. Why not make it a tax and cut out swathes of bureaucratic layers to save costs. You can still have private clinics for the rich who wish to get their bunnies new tits and all that, but you at least guarantee Joe American a healthcare system that is designed top down to keep him fighting fit.

    No?

    Let me recapitulate one important part: Medical Insurance company managers have a legal requirement to increase shareholder value. That is, effectively, their only job. Unfortunately, they can only do that by charging more and paying out less. They are required by law to pay out as little as they can.

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    My brother-in-law is a Doc, well, actually a physciatrist, does that count?

    He refuses to take patients with suicidal tendencies. He prefers to treat middle-aged wealthy housewives with low self esteem....

  14. #14
    Slamma-Lamma-Ding-Dong

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    Quote Originally Posted by Chief View Post
    Do I really need an excuse to buy a bottle of scotch?


    So I am an enabler?
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  15. #15
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    Quote Originally Posted by Pugwash View Post
    Here's how I see the social medicine vs private medicine issue. You all pay insurance for medical care and the insurance company's legal responsibility to their shareholders is to not pay out. Why not make it a tax and cut out swathes of bureaucratic layers to save costs. You can still have private clinics for the rich who wish to get their bunnies new tits and all that, but you at least guarantee Joe American a healthcare system that is designed top down to keep him fighting fit.
    Because the quality of EVERYONE's medical program goes down. Again, ever seen anything the government couldn't screw up?

    We have Canadian doctors and nurses here working all the time at the local hospital because they are fed up with their country's social medical program. You also have Canadian citizens crossing the border to have surgery because they can't wait or refuse to. Social medicine, where everyone gets equal benefits, sounds all warm and fuzzy....but hey, so does the CONCEPT of socialism.

    Also, not all insurance works the way you are describing. My company pays its own medical costs. Every dime that we pay in goes into a fund administrated by Blue Cross Blue Shield. BCBS handles the paperwork shuffle; but otherwise, we pay our own costs. The only time our insurance goes up is when the funds coming in are insufficient to cover the costs going out. Think I want to give this up for "stand in line" medicine?

    FWIW, my family insurance is $400 a month. $15 for a primary care visit, $30 for a specialist, $150 for emergency room visit. I'm quite content with that.
    Last edited by Mark Phelps; 02-02-2008 at 02:24 PM.

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    Quote Originally Posted by Mark Phelps View Post
    Because the quality of EVERYONE's medical program goes down. Again, ever seen anything the government couldn't screw up?
    If you want to pay for better care, there's no-one stopping you, even in the UK. I'm not saying the UK is a Socialist Utopia, and quite frankly I'm glad it isn't, but I simply cannot understand the fear the US has of socialised medicine when its entire farming industry is subsidised by the government. Why are farming subsidies good but medical ones are bad? At least be consistent.

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    Quote Originally Posted by Pugwash View Post
    Why are farming subsidies good but medical ones are bad? At least be consistent.
    I'm not saying it is. I live in the South, but will be the first to say subsidies of any kind are WRONG! Tobacco subsidies went "bye-bye" last year, and I hope more will follow suit. But until someone elects me president, there's not a lot more I can do except vote.

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    Quote Originally Posted by Mark Phelps View Post
    I'm not saying it is. I live in the South, but will be the first to say subsidies of any kind are WRONG! Tobacco subsidies went "bye-bye" last year, and I hope more will follow suit. But until someone elects me president, there's not a lot more I can do except vote.
    Then why not argue against Farming Subsidy, something you have already, instead of just saying something you'll probably never have is bad?

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    Quote Originally Posted by Pugwash View Post
    Then why not argue against Farming Subsidy, something you have already, instead of just saying something you'll probably never have is bad?
    Why not disagree with both?

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    Have you seen Michael Moore's "Sicko" ?

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    I'm not watching anything that Michael Moore produces. He's got his own agenda, I've got mine.

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    Quote Originally Posted by Chief View Post
    Do I really need an excuse to buy a bottle of scotch?


    Start thinking about all the that unreimbursed time you spend completing paperwork (FMLA, disability paperwork, prior authorization for second and third tier meds ect.). Unless you charge $450 per hour to complete paperwork and I write real slow.

    Thik about how much you lose with no shows for office visits. Or you could charge $100 per fifteen minute appointment no show.

    Think about all those people who lied about the insurance they had when they scheduled and then show up with a medicaid card. Or you could not take medicaid.

    Hey do not get me wrong. I do free medicine all the time. but it is planned event in third world country.
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  23. #23
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    Quote Originally Posted by hoochman View Post
    Start thinking about all the that unreimbursed time you spend completing paperwork (FMLA, disability paperwork, prior authorization for second and third tier meds ect.). Unless you charge $450 per hour to complete paperwork and I write real slow.

    Thik about how much you lose with no shows for office visits. Or you could charge $100 per fifteen minute appointment no show.

    Think about all those people who lied about the insurance they had when they scheduled and then show up with a medicaid card. Or you could not take medicaid.

    Hey do not get me wrong. I do free medicine all the time. but it is planned event in third world country.
    When people start talking about long hours and not getting paid extra for it, I think about the soldiers serving in Iraq. They work a whole lot of hours for not much pay. Also a planned event in a third world country.
    If you don't make it, fake it.

  24. #24
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    Default Not quite accurate

    Quote Originally Posted by Mark Phelps View Post
    Because the quality of Everyone's medical program goes down. Again, ever seen anything the government couldn't screw up?


    Also, not all insurance works the way you are describing. My company pays its own medical costs. Every dime that we pay in goes into a fund administrated by Blue Cross Blue Shield. BCBS handles the paperwork shuffle; but otherwise, we pay our own costs. The only time our insurance goes up is when the funds coming in are insufficient to cover the costs going out. Think I want to give this up for "stand in line" medicine?

    We have Canadian doctors and nurses here working all the time at the local hospital because they are fed up with their country's social medical program. You also have Canadian citizens crossing the border to have surgery because they can't wait or refuse to. Social medicine, where everyone gets equal benefits, sounds all warm and fuzzy....but hey, so does the CONCEPT of socialism.

    FWIW, my family insurance is $400 a month. $15 for a primary care visit, $30 for a specialist, $150 for emergency room visit. I'm quite content with that.

    In Canada there is a one payer health care system for a list of qualified services that is provided to all Canadains, landed imigrants and even some illegal inmigrants. Funding for the system is provided by provincial governments who pay all the bills. Private insurance can be obtained for services not covered by the system. For example visits to the GP are fully covered while cosmetic surgery is not.

    Equality in the Canadian system is a fallacy. Based on who you know or who you are you can and will receive different treatment. Que jumping is a common occurrence in Canada. If somebody is connected to a person working within the health care system, appointments, surgeries, MRI's, CT scans, specialist appointments and the like can and are obtained quickly and easily. People with no connections are ones who wait in Que and recieve a lower quality of medical service.

    Nurses are unhappy because their union tells them they are underpaid and overworked and are not respected by Md's and hospitals and the gov't. We have a drive toward the nurse practitioner by the nursing associations. Nursing associations have pushed for the Bachelor of Nursing to be a minimum qualification for nurses instead of the RN. However, because of a shortage of nurses gov'ts have reinstituted the 2 year RN program to run along with the 4 year BN programs. The LPN has been relegated to working in care homes. Rn's don't like the Bn's and LPN's do not like the Rn's and the Bn's don't like the Md's. In general nurses are a very unhappy llot and it is not because of gov't funded health care.

    Md's can be categorized in terms of job satisfaction by what they do: 1) general practitioners are generally miserable ... the are poorly paid relative to what Md's earn in other countries and relative to what other Canadian occupations earn. 2) Specialists are well paid and work reasonable hours and geerally happy. 3) Hospitalists work reasonable hours and are well paid.

    In Canada the medicine is not socialized as much as there is a single payer. Md's nurses, cares workers, hospital employees overwhelmingly are not government employees. They run the gamut from self employed professionals to hospital employees and private company employees. Hospitals and clinics are generally privately owned with exceptions being military and government owned facilities. I do not know the ratio for private to gov't hospital ownership. If a Canadian forum member knows perhaps they can let us know.

    The greatest weakness of the one payer Canadian health care system is in the cost of high paid bureaucracy. It is top heavy with many, many managers when more front line workers are needed. Too many bosses and paper shuffelers. There are whole departments divided up to handle billing when the system could be computerized and all those departments eliminated. Just one example of redundancies. Here is another. Hospital beds are valued by their designation. A surgical bed can have a daily cost of double that of a medical bed even though they share the same room and services. A hospital can then designate the ratio of surgical beds as say 10 to 1 over medical beds and bill more to the gov't even though a surgical bed can be filled by a medical patient. Patient status determined by which doctor admits the patient a surgeon or physician. Thus, cost is driven up.

    I believe that people enter the medical field to help people and earn a good living. Once in the system they discover there is an endless supply of people to help but only a limited way to earning a good living.... trading their time for money. Work more to earn more.

    The Canadian system has its own failings .... for example unlimited service is available to anybody. In the city I live we have system abusers who have upwards of 200 plus GP visits a year to different Gp's. Gp visits for a sore throat or tummy ache are the norm no the exception. Because the gov't is the only payer there is no incentive to keep costs down. Different hospitals are run differently and I am not generalizing only pointing out one flaw I am aware of. I am sure there are many more.
    Last edited by Raijor; 02-02-2008 at 04:25 PM.
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  25. #25
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    Same in France, all medical services free.....

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