@justjess have you heard of subscription medical plans? I am shopping for a new doctor and found a couple that has something like this recently. This was an interesting article explaining the process. I think this would be an interesting way to break up the cost of healthcare. It looks like there is a subscription fee for doctor visits and insurance cover tests that are external to the doctor's office. This lowers the cost of insurance and provides services with a primary doctor at a much lower cost than this would be when it is combined with an insurance premium.
Healthcare is a much more complicated subject than we ever see discussed in the political sphere. There are just not enough people with a background in healthcare working as advisors in some capacity, to these presidential candidates. Medicare and Medicaid reimbursement is currently responsible for a significant decline in the quality of care that the healthcare industry is able to provide.
Most people don't know anything about the incentives and penalties that these programs issue to the facilities and physicians that accept these forms of payment, but these programs have a list of do's and don'ts for providers if they expect to reimbursed for their services that is a lot like walking through a minefield. People use these services thinking their providers are being compensated when they are not because they missed some little something. Most people know little to nothing about healthcare billing in general, but I think if they really knew, a lot of them would want nothing to do with the headache that is medicaid/medicare, which already is a form of universal healthcare.
A lot of the time, people just hear universal healthcare and it seems like something that they should support because they want to be someone who tries to defend someone experiencing injustice. But, yeah, Obamacare was a failure waiting to happen because it was like putting bubble gum on a leaking pipe. Traditional insurance are also not really an option either because they suck for different reasons too, but politicians often demonstrate very little understanding of healthcare billing and this is a big problem when it comes to political discussions regarding healthcare.
Obviously I agree that in theory, we have the money to pay for healthcare and I think military funding should be cut regardless because it is obscene. However, I think it is always important to look at the long term. Sometimes an easier short term solution can create new long term problems. I also don't see how legislation for a profit-sharing limit is something that is more complicated than changing the minimum wage at the federal level either. I think the main problem is that politics is a lot of smoke and mirrors. It is buzz words and celebrity status rather than a sincere profession.
Recurring revenue models, already firmly established in the healthcare industry, are taking hold in a new medical arena: the doctor’s office. Known by names such as membership medicine, concierge medicine, and direct primary care, these models are paid through subscriptions. Though...
www.ariasystems.com
If you give corporations and businesses a choice between increasing wages and profit sharing my guess is that most are going to want to increase wages. I think profit sharing would be a longer more brutal fight to have implemented. And while we fight for it people continue to suffer.
I’m well aware of medical billing and Medicaid/Medicare reimbursement issues. My wages are determined by Medicaid reimbursement - which I think I’ve explained elsewhere. I’ve seen how often the companies I work for get audited. My paperwork that I submit to support the Medicaid claims has to be exact, include certain phrases, be in black ink etc. I’ve had to go back and redo paperwork enough times to know that Medicaid will find any reason to deny a service claim in order not to pay. The same as the private insurance. Medicaid in my state is run by private insurance companies so I’m not sure how much of this issue falls to the fault of either one.
Part of the argument for universal healthcare is that it should decrease all of these issues. The need for medical billing would decrease, the part of costs written in to support profit margins and health insurance companies operating expenses will decrease etc.
In my own industry I see middle men siphoning off the providers reimbursement as the biggest issue. Medicaid reimbursed $32/hr for my services. The company I work for right now takes half, Ive worked for companies in the past that took more than half. The workers in my industry are not provided any benefits or guarantee of hours. We are not paid for any work we need to do that is not billable, if clients cancel we aren’t paid, we have no medical, pto, or retirement etc. Now that’s in Pennsylvania.. I have seen better working conditions for the same industry elsewhere in the country - on industry specific reddit boards and in indeed job searches. But even with all these problems I’d be living quite comfortable on the $32/hour my labor actually produces. My company can say they siphon off that much money because of expenses but this current company has only two people in the office that’s salaries need to be supported off 50 peoples reimbursement rates. That includes office administration, client recruitment and billing.Those two people handle all of that.
The demand for our services is really high so this isn’t an industry that needs to spend much for marketing or outreach. Clients come organically. Rents in my geographic location are very low so the cost of maintaining the office itself is minimal. The biggest expense is liability insurance. Which, yes is expensive but I’ve priced getting my own and I’d gladly trade carrying my own liability insurance for higher wages because it doesn’t cost that much on an individual basis. I’d still be way ahead of the game.
This is what I see to be the problem with for profit health care systems. A whole lot of middle men at every corner siphoning off absurd portions of money to line their own pockets. This shouldn’t be happening. It hurts the patients through inflated costs and it hurts the provider through lower wages then they deserve. Universal health care should eliminate this. Clearly, your going to have a lot of pushback because none of those middle men want to lose their meal ticket.
I looked at the doctor subscription service you provided. Seems a bit like what a hmo is supposed to be in theory but on a smaller scale. I could see that working well if your generally healthy, not if you have medical conditions since most of the care you’d need would still require insurance - diagnostics, testing, prescriptions. It’s also rather expensive - $1600/person for a family of 4 is $6400 per year and only your PCP visits would be covered. I don’t think that’s financially accessible to the vast majority of people. It isn’t for me, even if I was making three times as much as I do it wouldn’t make financial sense when I can go to the urgent care when I’m sick or a regular doctor for a physical for $150/visit. We would have to collectively go to 42 PCP visits per year to break even on the cost. I’ve never gone to the dr 10+ times per year unless I was really sick, which wouldn’t be entirely covered since part of those 10 visits would need to be with neurologists/specialists. If that included my diagnostics and medications it would be different, but it doesn’t. One of my sons medications without insurance is almost $1000/month. If I have an ms attack the hospital stay costs 10s of thousands of dollars. Costs aren’t this high, even uninsured, anywhere else on earth.
Again, I don’t know the exact correct answer but even as someone who relies on Medicaid reimbursements to support my family.. universal health care is the best seeming solution to most of this. And the most morally acceptable.
Edit: I’m supposed to be getting a raise by the end of the year and possibly benefits. This happened because the autistic community lobbied my state legislature to bring the state up to par with the standards for autism care seen in most of the rest of the country. The owner of my current company told me that we will be getting a $4/hr raise and benefits because the Medicaid reimbursement rate for our position is increasing by $20-30/hr. Many other companies in my area are not giving a raise in conjunction with this increase at all and the vast majority of my peers in this field aren’t even aware that this is happening, just that they need to take new trainings and fill out paperwork a little differently. The addition of medical benefits isn’t because of the increased reimbursement rate, it is due to my company being acquired by a larger for profit company that is required to provide medical under Obamacare (more than 50 employees, not eligible for the nonprofit loophole). I do not know what percentage of my medical benefits will be covered by the company - this is still a transition and none of that has been figured out yet. But if it is the minimum amount that Obamacare requires just to comply with the law it will possibly be an improvement for me (hopefully if it is a huge portion of my pay I’d be better off keeping my kids on chip) but either way most of this is only happening because the company that is taking over is one that is subjected to federal regulations whereas the ones I worked for previously weren’t.