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‘Medicare for all’ advocates emboldened by ObamaCare lawsuit

Born Free said:
Then tell me why many Doctors will not accept Medicare patients?

I'm not aware that Medicare negotiates with anyone, they set the price as they see fit. And what they see as compensation is peanuts compared to what is necessary to keep the doors open.

Prove me wrong
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It's up to you to prove what you've alleged is true.

I've been on Medicare for several years, and never have had any problem getting providers to accept it. You might be thinking of Medicaid, which is quite different.
 
Dittohead not! said:
Where in that 563 page "summary" does it say that private insurance is subsidizing Medicare?
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It's implicit in the discussions of costs and margin. E.g., for acute care hospitals:

Summary of hospitals’ financial performance

The financial measures presented for 2016 present a mixed picture. All-payer margins were 6.8 percent, but Medicare margins were lower, at –9.6 percent in aggregate and –1.0 percent for the relatively efficient providers. While Medicare payments do not cover the full costs (fixed and variable) of the average hospital, they are approximately 8 percent higher than the marginal cost of adding additional Medicare patients. Therefore, hospitals with excess capacity have an incentive to serve more Medicare patients.
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Medicare reimbursement doesn't cover the costs incurred in treating Medicare patients. Which means commercial payments have to cover those costs in addition to covering the costs incurred by their own patients (plus provide the margins above cost used for investments in workforce, infrastructure, etc). If you moved the commercial part of the hospitals' payer mix to Medicare payment rates, then no one is providing the funding needed to cover the costs incurred for the hospitals' patients. Which means the average hospital would need to cut costs by 10% overnight just to get to breakeven. And those hospitals that can't do it--much more likely to be nonprofit hospitals than the for-profits--go under.

Making cuts that big is tough. A while back there was a thread zooming on one hospital's efforts to find ~1.9% in cost savings: An inside look at a top hospital’s struggle to cut costs
 
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Greenbeard said:
It's implicit in the discussions of costs and margin. E.g., for acute care hospitals:



Medicare reimbursement doesn't cover the costs incurred in treating Medicare patients. Which means commercial payments have to cover those costs in addition to covering the costs incurred by their own patients (plus provide the margins above cost used for investments in workforce, infrastructure, etc). If you moved the commercial part of the hospitals' payer mix to Medicare payment rates, then no one is providing the funding needed to cover the costs incurred for the hospitals' patients. Which means the average hospital would need to cut costs by 10% overnight just to get to breakeven. And those hospitals that can't do it--much more likely to be nonprofit hospitals than the for-profits--go under.

Making cuts that big is tough. A while back there was a thread zooming on one hospital's efforts to find ~1.9% in cost savings: An inside look at a top hospital’s struggle to cut costs
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While Medicare payments do not cover the full costs (fixed and variable) of the average hospital,
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They also do not cover the full costs to the patient. Medicare only pays 80%. The rest has to come out of the pocket of the patient, or from a supplemental insurance policy.
 
Dittohead not! said:
They also do not cover the full costs to the patient. Medicare only pays 80%. The rest has to come out of the pocket of the patient, or from a supplemental insurance policy.
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That's very true. But just to be clear, when they talk about margins that includes both what Medicare directly pays and what the patient pays (either directly or through a supplemental insurer that covers the patient's cost-sharing). Insurers have a fee with providers--negotiated in the case of commercial insurer, administratively set in the case of Medicare--that determines how much the provider is owed for a given service. How the responsibility for paying that fee breaks down between the insurer and the patient is covered by the terms of the patient's insurance policy.

So it may be that it costs a provider $100 to deliver a particular service. The fee they're owed is $90. In practice it may be that Medicare pays $72 and the patient is responsible for $18. But when you say the margin on Medicare payments is -10%, you're talking about the full $90 fee that's on the fee schedule.
 
 
Born Free said:
You posted opinions, not fact, my response was based on facts. Prove me wrong
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I don't know. I'm not wading through your links trying to prove your point for you. You'll have to quote the parts you think are relevant.
 
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