Will health care reform cap fees for docs?

well, I believe, doctors should be equalized payment for certain surgeries. In some parts of the country, they can chargee drastically, while lower in other parts.
Most people on even health insurance, never involve them selves with charges, because the insurance companies are taking over the bills. Medicare and even Medicaid, usually have set amounts that will be paid by these foundations. Many doctors either will or will not take medicare or medicaid, becasue they may do services not approved by them. Many doctors do not take it because of all the forms they have to fill out, and denial of claims.
One reason for health care to be monitored, is that some people are not getting the required testing before surgeries. If a doctor does not biopsy certain lumps or such before, they are allowed to perfom surgery anyway. This has happened here more times than I could begine to count. Over medication on clients is another problem. I think all prescription ads should be taken of the media and magazines, people read these things and suddenly doctors allow patients to medicate themselves, before futher researching certain drugs and their success ahead of time.
I love my friend who lived to be 106, told me that she had outlived 19 doctors, and every one gave her a fist full of precriptions, and, she promptly threw them away.
We need reform in a lot of areas. And, sorry Texas people, you are of the bush mentality. Rude and Republican, all for insurance drones that have taken over health concerns.

I JUST WANT TO LET YOU KNOW THAT I WANT MY HEALTH INSURANCE LEFT ALONE. I DO NOT WANT THE GOVERMENT RUNNING MY LIFE AS THAT IS FOR ME AND MY DOCTOR TO TALK ABOUT. MY DOCTOR DOES NOT ORDER ANYTHING UNLESS IT IS CALLED FOR. THE GOVERMENT CAN NOT RUN WHAT THEY HAVE GOING ON SO WHY MY HEALTH CARE?

I am horrified by the hecklers undermine democratic discussion at health care town meetings. It seems that these hypocritical Republicans take democracy as seriously as they take family values. I am a Canadian who believes that we have the best health care system in the world. Of course it's not perfect, but it is a lot better than yours. Republicans, stop the scare tactics that you used with the WMD's and start caring about the people you represent. Maybe then you'll start winning elections again.

Hey Ruth, the government wouldn't run your life any more, and likely a lot less, then your insurance company currently does. There's plenty to complain about regarding the government, but as far as providing medical care, it's not doing too bad a job with medicare and the v.a. Especially when you consider what those programs cost. The government also is responsible for the health care provided to it's active military, which is reported to be the best available, anywhere. If you're an extremely wealthy person, I'm sure you could hire a private doctor regardless if there were no longer employer based/private health insurance. But let us who want to get what we pay for to receive it, from a non shareholder-profit-only-minded government...

Rude and Republican
Me thinks we got a campaign slogan there.
... there is a lot of video of these protester types. If you are a health insurance company you might want to lower your risk by scratching those particular subscribers – they are obviously working on expen$ive medical problems.

A major problem is that all too often a new procedure or drug becomes available that is slightly better or perhaps only statiscally better but clinically irrelevant. Yet, this incremental benefit comes at a substantially higher cost. We need some objective body that will evaluate these new technologies and drugs. Those which show clear clinical benefit (including a cost:benefit analysis) should be adopted. Otherwise, insurers should be required to pay for the new drug/technology what they would for the old and the patient should have the option of paying the difference.

the problem with this bill is it does not allow you to pay for anything yourself if it is denied by the government's option. it also allows for the phase out of the private insurance industry. what will happen to the hundreds of thousands of people who work for insurance companies? i'm not opposed to having a better government option for people who NEED help. however, people should not be required to purchase healthcare or be fined by the IRS, and if the insurance company or public option determines the care is not worth the extra cost, it should be up to the PATIENT to make a personal committment to pay for it if they want it. These are some major problems with this proposal. This is why people like myself are against this proposal. Let's reform the problems we have, not completely change the face of our system.

Dear Rachel,
There is nothing in this bill that says you are not allowed to pay for anything yourself. You can keep on paying the insurance companies that have bilked Americans out of tons of money. It is not phasing out insurance companies, but giving the little independent small businesses a chance to provide health insurance for it's workers. Competition is great. Only thing that it will demand is that insurance companies cannot deny insurance claims for pre existing deseases, which they have denied people over and over. Go and read the bill. Don't take the insurance companies propaganda, these guys do not want this bill to go forward, because they will have to pay out money that should have been paid for decades, killing many. This is the problem with insurance companies. They love you as long as they have you paying, but, when you have some catostrophic desease, they can and will increase your premiums so high, you and your company cannot afford to keep you. They also will deny you care with the pre existing desease forum.

Remember, the key is to pass something, anything, to protect us all from insurance companies, then, amend it later, if things do not work out. They should have been reined in decades ago..

A town hall meeting should be held in an adequate sized room for the voters to easily enter and exit. There should be written rules for answering and asking questions.There should be a time to submit written questions. No seats swhould be saved for anyone.No one speaker should monpolize the meeting.It is shame that senators and congress people don't know how to run an organized meeting. It makes you wonder what qualifies them to run healthcare!

What is so disappointing to me is that the government is going to pass the health care reform, because it doesnt have anything to do with them. The government has the best health care available so they would not be classified with every other American or illegal alien. It also bothers me that the federal government employs the most people in America and yet their employees does not contribute to Medicare, Medicaid, or Social Security. If the government wanted to help out America, why not change those laws. Next time everyone talks about a first for America, just remember what a bang up job this first has done.Thanks Mr.President.

Insurance companies are paying the riot groups 90 dollars per person a day to upset the town meetings. Why? Because of 12.9 BBBillion dollars in profits. Just how much health care courl be provided by elimination of all insurance?
Anyone with a brain goes and Reads the Bill. All these creepy Rush Limbaugh and Sarah Palin followers really have to get a grip on reality.
If health care goes on the way it is, all health care will be in jeprody. There are no death dictators in this bill to eliminate Palin's monolod son. She is so, so out of touch and sheer space cadet. Just like she used the earnarjs fir sine soccor stadium without even purchasing the land it was on. This woman is sign of the party misgivings.
We have the worse health care in the world, more third world than adequate given to other civilized countries. Only reliable health care is Mayo Clinic, they are the only shining light..

I am very glad my health insurance allows a certain amount the dr or hospital can charge. I get statements saying the hospital or dr has over charged and i dont need to pay that amount,giving me the right amount they allow the dr or hospital to charge for services.

I think health care insurance plans are fine for those who have it. Why not allow the Medicaid or Medicare to run the health care insurance not the governement. After all we go to state for help when needed not the government. Why not let the state law makers and the County Medicaid programs handle it.

Why not bring back the state making major decisions for us. Government needs to worry about getting the war settled and the deficit straightened out. New Jobs.Economy back on track. People without jobs,Jobs etc etc.

Why not just erase everyone debts and let us all start over.

Give everyone a chance to own a home.Not just pay rent.
Give first time buyers Automatic Loans & Morgage to buy a home or Start a business. Only guide line we should have on this is. If you have a job be auto approved for business or Mortgage loans Not based on how your credit rating is.

Ruth

Insurance companies are running your life between you and your doctor. They dictate to the doctor what treatments to order and what to prescribe by using their pocketbook. I guess decade of college, medical school, and residency means nothing to these pencil pushers.

Reason why doctors order all these unnecessary CTs, X-rays, and various tests is to limit their liability from lawsuits. If you fall from a chair and only get a scratch on the forehead, then go through emergency room to get treated? You will get the whole workup and all the tests/labs. Thats standard protocol. Blame it on the lawyers for the high costs.

And everyone blaming on costs of uninsured and illegals? Guess what? You are already paying for them through high premiums.

Now it makes me wonder. Who you think will really get affected negatively by this if we get the healthcare reform eh? I haven't heard a peep from Walmart or McDonald-like corporations. They hire large amount of employees and offer the lowest wages. Its in their best interests to drive this reform to the ground. And because these corporations are too cheap to offer affordable healthcare, their own employees end up using the emergency room as last resort. If you look back at it, they pretty much dumped their obligations to take care of their employee's health on rest of the society in favor of profits.

So yeah, even though the prices are cheaper, you are still paying more by other means (higher premiums).

The government already caps fees for doctors and nurses who care for patients who have Medicare and Medicaid. If you have private insurance, most fees are negotiated when the doctor or nurse signs on as a health care provider with that insurer, thereby limiting what the patient can be charged for every particular service. So, the "capping" of charges already exists to some extent for about 88% patients.

I wonder why the Democrats favor a system where the amount a doctor or nurse receives for a good or excellent outcome is capped, but the amount you receive if you sue (and win) for a bad outcome is not capped and is left up to a jury. This resembles a lottery more than a health court or other tort systems that exist elsewhere in the world. The Dems must want to keep the trial lawyer lobby money more than they want to reduce health care costs related to defensive medicine.

Insurance reform would be great, but not totally possible. Why not start with how Medicaid could be reduced: Send back the illegals to their own country and let their country take care of them! Then I know a man and woman who both went to the same Dr to get flu shots. He was on Medicare and was charged $80 his wife was self pay and paid $20 for the exact same shot! This is rediculous!

To Alex. All Democrats are not all against tort reform. Most doctors, and lawyers are Republicans.
Only 7% of those making over $250,000 pay any federal taxes at all. They have loop holes investment credit, I met a lawyer once where his entire firm worked for a pharmaceutical company, his job was major investments in future generation of living wills, he was working on at that time 16th generations of children yet unborn. They say that 27% of the rich pay most of the taxes, this is in sales tax from purchases, from property taxes on their 5th and 6th homes. etc. Maybe the not- so- rich could enjoy more benefits of health care or paying of taxes by purchasing things if the wealthy paid their share.

To Karen,
Medicare and Medicaid fraud is the drain on Medicare. My mom was charged $16,000 for home therapy after coming from a nursing home. This was a mere 6 visits where this woman from another country, maybe outsourced? She barely spoke English. 1/2 hour of writing, and the other half hour of telling my mother to walk to refigerator and back ten times, standing up and sitting down ten times. Lifting her legs on the bed ten times and other equally stupid exercises that they could have just mailed a little ourline of exercises that would help her and a 42 cent stamp. Who paid for this? Medicare.
Biggest drain on Medicare and Medicaid is the 3.1 Trillion dollars in billing expenses. Therapy is mostly a huge expensive scam.
My father had knee surgery, and, had therapy twice a week, He never did get out of a wheel chair.for over 5 years. All paid by Medicare.
My friend is currently doing therapy, at the cost of over 1,000 per visit, all paid by Medicare. She stands on one leg at a time to practice balance. Then step on some rubber thing the same way. She sees no improvement.

When I was in school we had Politician, anti-drug people, and President speeches, I wonder why all the outrage now. What lie are the parents telling their kids on why they can't hear him speak.

I love how the caller says "all doctors charge outrageous fees." This is ridiculous. The cost of doing medicine has become very expensive and charges simply reflect this. People do not realize that a surgeon doing a knee replacement gets ONE fee for the entire case – pre-op evaluation, the surgery, hospital follow-up, dealing with complications, post-op office visits, and of course being liable for all manner or lawsuits. Medicare pays me 20% of what private insurance pays. If a public plan ties their payment rates to Medicare, you will see a wave of physicians quit medicine immediately. You will be left with unqualified physicians and foreign physicians who would otherwise not be able to be a doctor in the USA.

Dr. Gupta,
Do you see some validity to a comment I overheard one day in a respiratory therapists offce some 15 years ago?

The speaker, being a boomer:

"Most Doctors who are going into the medical field today are going in for the money"

Now there are several doctors in our area who are specialists who will not see anyone with out the cash or insurance up front....
There are only 25,000 folks in the area.

The Hippocratic Oath is not in the hearts of most doctors I know of today or we would see more of in their deeds.
But what do you think on a scale of this overall statement?

@ Ruth

With all due, the only way the Federal Govt should have a hand in Health care is to ensure a level playing field for the citizens.

NO ONE CAN AVOID HEALTH CARE, there is no way around it, now or later in the golden years.....

The Federal Government is charged with putting in the rules of road to look out for the many......not pave golden roads for the few.

So however that is done is what their function is.

Let's see if they can do it....follow the process of how a bill gets to the Oval Office

And if the needs of the many are not met and protected like we do through MANDATORY car insurance we are hardly a country who believes in the Christian "Best Practices".

Obama made empathy a dirty word in some circles....but just imagine the total opposite of what you have that befalls citizens every day in health care issues....

@ Ruth

With all due, the only way the Federal Govt should have a hand in Health care is to ensure a level playing field for the citizens.

NO ONE CAN AVOID HEALTH CARE, there is no way around it, now or later in the golden years.....

The Federal Government is charged with putting in the rules of road to look out for the many......not pave golden roads for the few.

So however that is done is what their function is.

Let's see if they can do it....follow the process of how a bill gets to the Oval Office

And if the needs of the many are not met and protected like we do through MANDATORY car insurance we are hardly a country who believes in the Christian "Best Practices".

Obama made empathy a dirty word in some circles....but just imagine the total opposite of what you have that befalls citizens every day in health care issues....or a friend or loved one.

Dr. Gupta
One more thing
How come we do not have a sliding scale health care system?

All services available and pay according to income

@ JoesLovelyMother

"Now there are several doctors in our area who are specialists who will not see anyone with out the cash or insurance up front…"

Good for them. Doctors need to be paid for the services that they provide. "Without a margin, there is no mission." The doctor has to support the huge overhead of running a medical practice. Doctors are bilked constantly on the services that they provide, which is one of the many reasons the rest of us end up paying such a huge price.

@doc

I hoped that the doc would consider a sliding scale.
Not enough $ or not fair?
Consider just how many hours a worker has to work to pay for their professional care, THAT makes me sick. I know, empathy is a bad word right now.

I well understand the management, operations, and PROFITS of a medical office and practice.
I have seen a lot of physicians W-2 or 1099, etc.
I have seen them too for the minimum wage workers
In this area 50% live 200% below the poverty level
The next town with specialist services is 1.75 hour drive

.

Yes, I'm sure you have an encyclopedic knowledge of all doctors' incomes. Those incomes are at the expense of time, family, and at high personal risk.

It has nothing to do with empathy. The doctor has expenses that are not discounted on a sliding scale based on her patients' ability to pay. Does your grocery store or hardware store discount prices based on ability to pay?

Health care reform is essential and it needs to be revolutionary.
That being said, part of this country's "problems" is our overgenerous nature. Patients w/ serious medical conditions will oftentimes be referred from their own country to receive care here. This is not just South America, but also Canadians, who when faced w/ multiple problems and delays, will cross the border to receive what is in effect free care.

Part of the "problem" is that our medical science here has advanced to the point where we can give an extremely preterm infant a chance of survival. In Europe, they would just write of that 24 week infant. Here though, we struggle to keep the kid alive, and sometimes we end up w/ a healthy kid, but sometimes we either spend a lot of $$$ for a kid who eventually succumbs to infection or a kid who survives but with significant chronic medical needs. These burden cost more $$$ to the system.

Likewise, we're better about keeping people around at the other spectrum of life. Again though, this costs a lot of $$$.

It may seem cavalier or cruel to focus on cost-cutting measures on these two vulnerable groups, but to put this into focus, when you keep a 90 year cancer ridden body on the vent, you're effectively diverting money/resources to about 60 average healthy people...

The other system that is poorly thought out is the litigative system. No other country suffers from so many lawyers. At a certain point, they do not produce anything, so their only option is to sue whether there is merit or not.

I am not a legislator or a rocket scientist, but. at this time, Medicare, Medicaid and the VA system are run by the government and they cover the highest health risk people in our society. Infact if you talk to any medicare/va recipient, they do not complain about their healthcare. Commercial insurance covers healthy people with no pre-existing condition. If you talk to any commercially insured person, they...

Read more … am not a legislator or a rocket scientist, but. at this time, Medicare, Medicaid and the VA system are run by the government and they cover the highest health risk people in our society. Infact if you talk to any medicare/va recipient, they do not complain about their healthcare. Commercial insurance covers healthy people with no pre-existing condition. If you talk to any commercially insured person, they will give you an earfull about things their insurance did not cover. Simple math would tell you that if you pool all medicare, medicaid, va and a lot of healthy people (in a public health plan) then the cost would go down because you would spread the risk over a greater number of people (thats what insurances do). If we could make a public option available for say $ 150 per person and $ 300/= per family of 4 per month, and smart people can do the math. Then this public option would be very attractive to people. So if the public option became viable, then medicare medicaid and VA systems would be grandfathered in to the public option, with current funds that are used for these systems to pay monthly premiums for public option for the people covered by them now. We could do away with Medicare, and so there would be no reason for the working population to pay medicare tax, and that could be used to purchase either the public plan or add more to it and purchase a commercial plan. Companies could eliminate the HR division for Healthcare and concentrate money and resources on their core business.
This is not a republican or democratic issue, its an NATIONAL issue. Govt. provides for Public School system, does it have problems, absolutely, but the right to basic education is guaranteed by the govt. Healthcare should be too!! Do people go for private schools? Sure, they pay more for it. Should people be allowed to go for commercial insurance, absolutely, they just pay the premium.
Companies would not have to tag on cost of providing healthcare on to their products, thus making them more competitive in the world market.

I could go on.. really this is not rocket science..

Has anyone thought of doing a fee for service for lawyers??
Just as physicians have a medicare mandated fee schedule, perhaps the Bar association or the like could suggest a fee schedule for every type of service that lawyers provide. Based on time spent, and specialty. Fee should not be based on contingency as it is now. I suspect if that is done then frivilous lawsuits would stop. Only the cases with real merit would be persued. This coupled with Tort Reform would automatically reform Healthcare cost.

I am so tired of the healthcare debate, but I am loath to criticize without offering an alternative. So here's my idea. Let's open up the federal employee insurance plan to open admission. Congress uses the federal employee's health plan. So doing this would actually accomplish President Obama's stated goal of providing healthcare equal to that which Congress enjoys. The plan offers 10 choices for providers and a bunch of plans from all ten providers. Looks like a terrific plan! Under the current plan, the claim that the congress is trying to provide a healthcare plan equivalent to their own does not hold up to scrutiny. Douglas Elmendorf, director of the Congressional Budget Office testimony before the Senate put the cost of the current plan at 1.2 trillion over 5 years. The federal plan costs 15 billion per year for 8.5 million federal employees. If you extend that number to the 46.6 million (The President's number) uninsured, you get a estimated cost of 411.176 billion over the next 5 years. Why, if congress is proposing to recreate this plan, does the proposal cost 3x more? Why re-invent the wheel? I say use the framework that is already in place in the form of the Federal insurance plan.
The federal insurance plan it is simply a distribution point for private insurance plans with reduced costs due to collective bargaining, so there won't be an issue of putting insurance companies out of business. Add to this that anyone that wants to participate in this or any other plan must pay for their own premiums. To increase coverage, the premium payment should be made from pretax dollars. This allows anyone to who buys health insurance to have a tax break.) The carrot of tax breaks might look better than the stick of fines which is currently being proposed? The pre-tax break should also be extended to anyone who has any other healthcare plan. Best of all, this plan doesn't increase taxes on small businesses, the poor, the wealth, ect., ect., ect.... Any profits realized by the federal employees insurance plan can then be allocated to a slush fund to provide minimal membership in the plan for free to any family below the poverty line on a first come first serve basis. There problem solved. Hmmm maybe I should run for congress?