In article , Peter
wrote:

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.

But in no other area is the government allowed to negotiate for
private companies, so this is a very misleading comment.



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.
Ahh, there is NO 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.
Because the government won't let anyone compete either legally or
otherwise. The new law doesn't address this since private insurance
companies aren't involved in Mcare even post "reform". In fact that
reform may actually end up costing seniors more depending on whether or
not private companies like GM, et al, pull the extra coverage they pay
for additional insurance for their retirees.

With
medicare no one is denied coverage on account of their medical history.

Which can be dealt with a whole heckuva lot easier than however many
thousdands of pages the current plan.


If medicare is such a terrible deal for physicians, why are any participating
at
all?
Because it is such a high percentage of their practice that don't
have choice. However, that is melting away.


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.
Which is also a problem with MCare. Indeed MCare leads the way on
this and has for at least the last 20 or so years.


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.
So take what you want and give the rest away.

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!

Of course it is. Mcare does exactly the same thing. The REAL racket
in this instance is MCare's payment schedules for the facilities fees.
Thus the Ortho and Heart docs can start their own hospitals and make out
like bandits. (in more ways than one).

--
I want to find a voracious, small-minded predator
and name it after the IRS.
Robert Bakker, paleontologist