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I dont agree with this analysis, but Im more than willing to read up on it. > Medicare does not reimburse below sustainable levels > On average, you're losing

I dont agree with this analysis, but Im more than willing to read up on it. > Medicare does not reimburse below sustainable levels > On average, you're losing money on a per-patient basis for 40% of your patient basis.. I disagree with this conception of sustainable: at any point if you have two suppliers with price differenciation yes, one of them 'subsidizes' the other, but that doesnt make it so the latter doesnt bring revenue. If by law airlines could not sell coach anymore, they would all drastically go out of business, even though they dont make money on coach. Medicare does lower reimbursement but it only matters in so far they take the spot of a private insurer. Furthermore, sustainable implies that there would be no providers at medicares rates but that is not true: there would be less because they pay less, but you would still have providers. Second, accepting medicare is a hassle for providers but I assure you they dont do it out of charity. They give you infinite demand which means you can fill your non-private insurers slots with medicare and provide lots of revenue.

chimeracoder 9y ago
> Furthermore, sustainable implies that there would be no providers at medicares rates but that is not true: there would be less because they pay less, but you would still have providers. In most regions, Medicare reimburses rates that are less than COGS. If you have to pay $100 wholesale just for the supplies to perform a procedure, and you're only allowed to charge $93 for the procedure, you're going to go out of business very quickly. Your assertion that "there would still be providers" is wrong, because unless Medicare dramatically raised its reimbursement rates[0], most providers would go out of business overnight. Even if it were true that there would still be providers, just fewer of them (which is not true), you're at best arguing for something which, in your own words, would exacerbate the current shortage of practicing clinicians, which would drive up prices for self-paying patients even further and dramatically lower the quality of care for the entire country. > Second, accepting medicare is a hassle for providers but I assure you they dont do it out of charity. They give you infinite demand which means you can fill your non-private insurers slots with medicare and provide lots of revenue. Medicare doesn't give you "infinite" demand. But furthermore, having more patients doesn't help you if you're literally losing money on a per-patient basis. You can't lose money on margin but "make it up in volume". This is exactly why Medicare has to provide separate stipend programs to providers who aren't able to overcharge privately-insured patients and make up for their losses on Medicare patients that way. [0] which is the entire point of the comment that began this whole thread - Medicare would have to dramatically raise its reimbursement rates if it covered all patients

chimeracoder 9y ago

> Furthermore, sustainable implies that there would be no providers at medicares rates but that is not true: there would be less because they pay less, but you would still have providers. In most regions, Medicare reimburses rates that are less than COGS. If you have to pay $100 wholesale just for the supplies to perform a procedure, and you're only allowed to charge $93 for the procedure, you're going to go out of business very quickly. Your assertion that "there would still be providers" is wrong, because unless Medicare dramatically raised its reimbursement rates[0], most providers would go out of business overnight. Even if it were true that there would still be providers, just fewer of them (which is not true), you're at best arguing for something which, in your own words, would exacerbate the current shortage of practicing clinicians, which would drive up prices for self-paying patients even further and dramatically lower the quality of care for the entire country. > Second, accepting medicare is a hassle for providers but I assure you they dont do it out of charity. They give you infinite demand which means you can fill your non-private insurers slots with medicare and provide lots of revenue. Medicare doesn't give you "infinite" demand. But furthermore, having more patients doesn't help you if you're literally losing money on a per-patient basis. You can't lose money on margin but "make it up in volume". This is exactly why Medicare has to provide separate stipend programs to providers who aren't able to overcharge privately-insured patients and make up for their losses on Medicare patients that way. [0] which is the entire point of the comment that began this whole thread - Medicare would have to dramatically raise its reimbursement rates if it covered all patients