On 5/10/2010 11:23 AM, Kurt Ullman wrote:
In ,


Anyway, there is no such thing as THE government, just as there are no THE
(name
any group here). You are stereotyping. And, there is no "Obamacare". What
Obmama did, to the consternation of liberals, was stay out of the details and
encourage the Congress to compromise and develop the plan. That's why your
government will continue to be banned from negotiating drug prices for
Medicare
Part D and there is no public option in the current new law. It is NOT
Obama's
plan.

Of course their is THE government. It is pretty much everything done
under the ageis of legislation. BTW: While MCare itself can't negotiate,
each of the insurance companies that deal with Part D can and do. Most
get the same discounts for D as for their regular customers. I haven't
seen anything that shows anything but less costly medication.

A very misleading comment. No insurance company has the bargaining power of the
federal government because of the potential size of the purchases. Yes, the
insurance companies get a discount off list price, but when the federal
government is allowed to negotiate (military pharmacy and VA pharmacy inventory
for example), the discounts are much larger and the government pays a much lower
price than any private insurance company. That could have been the case as well
for Medicare Part D if big pharma had not bought off Congress with huge campaign
contributions.

Additionally, I would like you to say with complete honesty that when and if
you
ever turn 65, you will never sign up for Medicare for the remainder of your
life. After all, you want no involvement of the government in your medical
care.
Thanks for making the point. Mcare is bankrupt, pays about 60
cents for every dollar paid for by The Evil Insurance Companies, has so
many big holes in coverage that people have to spend large sums of money
in supplemental insurance, and the less pay is causing many docs to
restrict the number of patients if they don't just flat out refuse to
take them. What's not to love.

And I challenge you to compare the annual price of Medicare Part B premiums plus
the cost of a supplemental policy with the cost of a 65+ year old's premium for
an entirely private insurance policy providing identical coverage. Indeed, many
65+ year olds would have found (prior to the new law passed thanks to your nasty
government's interference) that they could not obtain private insurance. With
medicare no one is denied coverage on account of their medical history.

If medicare is such a terrible deal for physicians, why are any participating at
all? Saying that medicare only pays about 60% of private insurance policies
fails to provide the necessary nuances. Due to the perversity of the private
insurance company reimbursement schedules (which you are using as your frame of
reference to measure the medicare payment schedule) procedures pay well, and
time spent pays much less. The general practitioners, family practitioners,
internists and pediatricians have been screwed for decades. However, the
procedure-performing specialists get paid much much more than is really
appropriate. One of the primary reasons that I left private practice (in one of
the highest paying surgical specialties) was that I felt guilty about the
ridiculously high payments I received (many thousands of $$) for only an hour or
so of my professional time. I didn't go into medicine so that I could become a
multi-millionaire by the time I was in my late 30s while my colleagues in family
practice and pediatrics were working 70+ hour weeks to try to earn enough to
live a modestly comfortable middle class life style. But that was not and is
not "the government"'s fault!

You've got to get into the tiny details, the nuances, in order to accurately
assess the problems and the potential solutions. Broad generalizations flailing
against "government" generate heat, not light.