I'm Voting for Bernie Sanders in 2020 smiling smiley

Again you have not thought through your argument. If the government controls all payments, doctors and hospitals can't just charge what they want. It's no longer capitalism when the government tells you what can you can charge. And as far as Satan and evil, if the shoe fits.

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Corrected: all sorts of
@Shop-et-al wrote:

@MFJohnston: "all"????? Please describe how he has interfered with your business.

Hard work builds character and homework is good for your soul.
Insurance companies control many of these charges as it is, except those controls are not applied evenly. Each insurer negotiates a rate for a given service. Rates have to have padding to make up for bankruptcies and for when insurers don't pay. (In Iowa, we have had many care providers, particularly in rural areas, go out of business because of insurance companies not paying within several months, possibly a year or more.)

With one insurance plan, the consumer is not hit with out-of-network costs, deductibles, or co-pays. They just go. The providers are just paid. Providers can stick to the business of health care and not have to treat patients according to what their insurance company will authorize. (Collection agencies do not get their cut.)

@tstewart3 wrote:

Again you have not thought through your argument. If the government controls all payments, doctors and hospitals can't just charge what they want. It's no longer capitalism when the government tells you what can you can charge. And as far as Satan and evil, if the shoe fits.


Edited 1 time(s). Last edit at 04/10/2019 07:56PM by heartlandcanuck.
To add, providers are free to charge however much they want now and they will be under Medicare for all. Just like now you can choose to go to a provider that cost more than your insurance is willing to pay and pay the difference out of pocket. There is no difference.

There are reasons that a body stays in motion
At the moment only demons come to mind
@MFJohnston: Good job. smiling smiley
_______________________

.. September is dressing herself in showy dahlias and splendid marigolds and starry zinnias. October, the extravagant sister, has ordered an immense amount of the most gorgeous forest tapestry for her grand reception. - Oliver Wendell Holmes
You two say two opposite things and then agree with each other. One says doctors can charge anything they want and Medicaid for all will pay a certain amount and then the patient is responsible for the difference. The other says patients are not hit with co-pays, deductibles or out-of-network costs. Which is it? Co-pays have their use and without them we would have irresponsible people ( the same type that only bought insurance only when they got sick or injured and then complained about pre-existing condition limits) go to the ER when their kid gets a skinned knee. Why not, they don't have to pay anything why not just take advantage of other people? And therein lies the problem with half the population. They want something for nothing, always using someone else's money to get what they want.
In Canada, every province runs its own. I am most familiar with Ontario's plan. In Ontario there are no deductibles and no co-pays. Sick? you go. Need a check-up? You go. having a baby? have a baby, and not worry about a stack of bills coming later. Fees are set by OHIP, possibly varying by cost of living where a provider is located. Doctors willing to work in remote, northern or rural areas may get a premium.

Some services are not covered, such as circumcisions. You pay extra for that. (There is a fee schedule posted at the entrance of a hospital with a list of non-covered treatments and their fees.) When I was a kid, I remember that "ward' coverage meant you shared a room with three other people, and my dad's plan at work covered the upgrade to "semi-private." I think privacy laws have changed that, though, so people get private rooms. Ontario used to have extra-billing, as in a doctor could charge above the set rate, but that changed in the 80's. The doctors went on strike in 92 or 93 for a brief time to raise the overall fee structure.

My chiropractor used to get a certain amount from OHIP and would charge a little more per visit.

Cosmetic surgery, unless it is reconstruction following an accident or sickness, is not covered under OHIP. You pay extra for that. Dermatology is covered, as in screenings for cancer or treatment for acne. A procedure such as microdermabrasion or chemical peels would not be covered. Patients pay extra for what is not covered.

I believe Alberta has private-pay urgent care clinics in addition to the regular clinics and hospitals. Having money will not bump you in priority for, say, a heart transplant but if the regular clinic is busy and you want the convenience of having something routine like a strep test done right away, that's what those clinics are for. I have no experience with those because Ontario did not have them and I was never sick on vacation to Alberta. The different provinces offer reciprocity, so if I was sick in Alberta, though I paid into OHIP, I could receive treatment there in the regular stream. I do not know how the private pay clinics work.

As for choice, one generally goes to a specialist recommended by their primary physician, like here. Sometimes that specialist is in another province, or even in another country. You may run into Canadians at the Mayo Clinic, for example, and it would be covered if there were no in-province options. It is similar to running into Americans at Toronto's Sick Kids' Hospital.

Edited 2 time(s). Last edit at 04/10/2019 11:44PM by heartlandcanuck.
I can foresee Americas version looking like a combination of Alberta's and Ontario's. Basic, routine care would be covered for everyone. Concierge clinics may offer urgent care services. (I am not in favour of the concierge model because it creates a two-tier system. When you have the mayor's kid sitting in the same waiting room as the guy from the doughnut shop, the minimum standard tends to be raised for everyone.)
There is not going to be "America's version". The only people who want it, want it because they can get something for nothing. When you tell people how much it's going to cost, what it's going to do to death rates, what it's going to do to cancer outcomes and how much they're going to be paying for it they don't want it.
If you want a clear view of what the Canadian system is all about, 60 minutes did a show on it. I'm sure it's on YouTube because it's devastating for your argument.
I pray we're not going to end up with Canada's Health system...say it isn't so....

Live consciously....
60 minutes did a show on it? That hour sure outweighs more than a quarter century of my own experience. I think I would talk to more Canadians if you want to learn how the system is up there. I was pretty transparent that I am most familiar with the Province of Ontario, not the other provincial systems. Whenever anyone talks about the "Canadian National Health System" I know they are full of it because it is provincial/territorial.


@tstewart3 wrote:

There is not going to be "America's version". The only people who want it, want it because they can get something for nothing. When you tell people how much it's going to cost, what it's going to do to death rates, what it's going to do to cancer outcomes and how much they're going to be paying for it they don't want it.
If you want a clear view of what the Canadian system is all about, 60 minutes did a show on it. I'm sure it's on YouTube because it's devastating for your argument.


Edited 1 time(s). Last edit at 04/11/2019 02:19AM by heartlandcanuck.
I don't see people fleeing to America from Canada for healthcare. I do see people going to Mexico for healthcare.
@johnb974 wrote:

I don't see people fleeing to America from Canada for healthcare. I do see people going to Mexico for healthcare.

If Canadians came to the US for helthcare, instead of waiting the 39 weeks to get care, they would pay full price for it. They are already paying the high cost of their forced system.

"One Ontario woman, Judy Congdon, learned that she needed a hip replacement in 2016, according to the Toronto Sun. Doctors initially scheduled the procedure for September 2017 -- almost a year later. The surgery never happened on schedule. The hospital ran over budget, forcing physicians to postpone the operation for another year."
Read the full article: [www.forbes.com]
Here is the last paragraph:
Americans shouldn't fall for these rosy promises. As Canadians know all too well, when the government foots the bill for healthcare, patients are the ones who pay the biggest price.

Edited 1 time(s). Last edit at 04/11/2019 11:05PM by tstewart3.
@tstewart3 wrote:

@johnb974 wrote:

I don't see people fleeing to America from Canada for healthcare. I do see people going to Mexico for healthcare.

If Canadians came to the US for helthcare, instead of waiting the 39 weeks to get care, they would pay full price for it. They are already paying the high cost of their forced system.

"One Ontario woman, Judy Congdon, learned that she needed a hip replacement in 2016, according to the Toronto Sun. Doctors initially scheduled the procedure for September 2017 -- almost a year later. The surgery never happened on schedule. The hospital ran over budget, forcing physicians to postpone the operation for another year."
Read the full article: [www.forbes.com]
Here is the last paragraph:
Americans shouldn't fall for these rosy promises. As Canadians know all too well, when the government foots the bill for healthcare, patients are the ones who pay the biggest price.

You can always find a few stories to fit any side you want. I still don't see people in Canada fleeing to America for healthcare. We do have people going to Mexico on medical tours for services, because they cannot afford services here.
In America we don't have a capitalistic system for healthcare, it not really a free market. The federal government is not permitted to negotiate Part D drug prices with drug companies, as federal agencies do in other programs. Taxpayers for forced to pay whatever the price the drug companies charge. This is why drug company profits have soared, and Medicare part D is going broke.
@johnb974 wrote:

In America we don't have a capitalistic system for healthcare, it not really a free market. The federal government is not permitted to negotiate Part D drug prices with drug companies, as federal agencies do in other programs. Taxpayers for forced to pay whatever the price the drug companies charge. This is why drug company profits have soared, and Medicare part D is going broke.

Medicare Part D is a voluntary insurance program for prescription drugs for people on Medicare. It became law in 2003 and has been in place since 2006. Private insurance companies offer a variety of plans subsidized by the government, and beneficiaries get to choose the plan that's best for them. In 2016, nearly 41 million Medicare beneficiaries were enrolled in Part D.
The current law says that "in order to promote competition," the health and human services (HHS) secretary "may not interfere with the negotiations between drug manufacturers and pharmacies and prescription drug plans." The negotiations for the best drug prices are between the insurnace plans and the providers. Other than to muck up the works, there is no reason for the Federal government to be involved.
"may not interfere with the negotiations between drug manufacturers and pharmacies and prescription drug plans." which means there is no protection for the taxpayers. Also by law if someone does not sign up for Medicare part D, they are penalized and have to pay an extra fee for the rest of their life.
The penalty: Part D if you opt out, the insurance will cost you more later. The penalty is 1 percent of the premium each month for every month you are eligible and don’t enroll. You pay this penalty for the rest of your life. They pressure people to stay on Medicare Part D
Estimating how much money could be saved if Medicare had been allowed to negotiate drug prices, economist Dean Baker gives a "most conservative high-cost scenario" of $332 billion between 2006 and 2013 (approximately $50 billion a year). Economist Joseph Stiglitz in his book entitled The Price of Inequality estimated a "middle-cost scenario" of $563 billion in savings "for the same budget window".
If you are in California, and on Medi-Cal anyone accepting Medi-Cal must accept a Medi-Cal payment as payment in full. They cannot bill you for any other cost. I've been going through this. I had a collection agency trying to collect from me what Medi-Cal did not cover. That is not legal in California. Know your rights.
MediCal is welfare. I see welfare as a very last resort not first option as a "progressive" would.
As for Medicare Part D, every person has to decide based on their health and Circumstance if they want to enroll in part D. For a person like me who takes no medications, it would be ridiculous to pay $35 a month for nothing. There are multiple other ways to buy drugs like GoodRx or other drug discounts. If you're really low income and need a particular drug, every drug company will give it to you for free or a rediced cost if you meet their requirements.
The fact remains that Medicare does not pay for drugs directly as in other welfare like Medi-Cal reason for them to negotiate with providers.
@Irene_L.A. wrote:

I pray we're not going to end up with Canada's Health system...say it isn't so....

I love my Canadian health care system.
I have plan AB and D through Medicare....and it's the best, I get my Pharmacy needs at little cost by having plan D and recommend it, not one negative from me, so my question is, why wouldn't anyone on Medicare get all three plans together, posting a Medicare law doesn't even apply to real life. I take eye drops saving my sight for very little and real cost is over 200.00 per month...for those going onto Medicare, do a seminar and learn for yourself, do NOT rely on the forum for information from someone who has not experienced it first hand.
AARP owns United Healthcare and is by far the best, I have been to every work seminar, and I have no co-pay
and will have (eventually) free eye surgery with a fabulous surgeon who is saving my sight.
Answering above post, plan D totally depends on one's needs, you may not need it as I didn't need it for many years, but sure glad I have it now as a senior, all Pharmacy needs are not covered by above mentioned GoodRX.
and most don't want to go on welfare (Medical), would rather do a job and pay the additional 35.00 and keep my pride.

Live consciously....


Edited 1 time(s). Last edit at 04/13/2019 01:12AM by Irene_L.A..
@prince wrote:

@Irene_L.A. wrote:

I pray we're not going to end up with Canada's Health system...say it isn't so....

I love my Canadian health care system.
I'm happy for you, I love my U.S.Medicare and the Dr. 's I see over and over and have gotten to know me.

Live consciously....
.

.. September is dressing herself in showy dahlias and splendid marigolds and starry zinnias. October, the extravagant sister, has ordered an immense amount of the most gorgeous forest tapestry for her grand reception. - Oliver Wendell Holmes


Edited 1 time(s). Last edit at 04/13/2019 01:19AM by Shop-et-al.
East Texans? Anyone? What about Hap and Leonard for Overseer? They might need a little assistance from Joe R. Lansdale, but that would be hysterical. With all that goofiness, there might be more endorphins. People who laugh have more endorphins and they don't need so much expensive health care. They just don't. (Elle Woods might campaign on that.)

.. September is dressing herself in showy dahlias and splendid marigolds and starry zinnias. October, the extravagant sister, has ordered an immense amount of the most gorgeous forest tapestry for her grand reception. - Oliver Wendell Holmes
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