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I always thought that Medicare & Medicaid are a scam to drain the nation of their wealth, until the nation is dead AND healthcare used to be a great deal more a

I always thought that Medicare & Medicaid are a scam to drain the nation of their wealth, until the nation is dead AND healthcare used to be a great deal more affordable before Medicare & Medicaid got involved in it. Now, senior folks get on Medicare until they've tapped out its lifetime benefits and then they go onto Medicaid. This is part of what has created the upteen millions of Medicare scams.

deleted 4y ago
[deleted]
arrosenberg 4y ago
The programs only exist because health insurance became unaffordable for seniors. Healthcare is expensive for the old! I’m not arguing against the idea that the program has fraud issues (Rick Scott made a fortune off of it), but its not going to be cheaper or better for the elderly if we let private companies exploit them individually instead of forcing them to defraud the government.
- OrvalWintermute 4y ago
  Medical insurance in general is a scam. Profitability of the insurer is tied specifically to claim denial and reducing expenses. Medical insurance transfers onto Doctor's Offices and Hospitals all the expenses of billing & coding which then also requires the doctor / medical provider spend 20-40% of their time doing billing & coding, and dedicated personnel to interface with the insurance companies and be involved in tracking down outstanding bills, getting pre-authed, negotiating settlements with insurance, getting "in network" etc. The whole insurance thing is a racket that has massively enlarged the costs of doing medicine.
  - nobodyandproud 4y ago
    You know what gets rid of paperwork? Nationalized health services. Look at South Korea for a palatable (to conservatives) example.
    - junofan 4y ago
      US healthcare spend is 2.5x South Korea’s GDP. It’s an entirely different beast to administer. There’s no magic wand. The reality is that healthcare is hyperinflationary everywhere, and the US is farther along the curve than any other country.
      - nobodyandproud 4y ago
        The US private healthcare system will be inefficient because it tries to apply market solutions across the board for a problem that isn’t well served by the market. Yet it’s extraordinarily inefficient because the private sector fights against any level of price-of-service transparency, which means even market forces cannot and do not apply. This problem has been well-studied and the solutions (more than one) are also well-known. The magic wand here is the blinders that have been pulled by politicizing healthcare.
    - refurb 4y ago
      There is still paperwork for nationalized systems.
  - smaudet 4y ago
    The whole private insurance is a racket, because private companies don't have many incentives to offer reasonable insurance. Public insurance, or community driven, is a different matter. Sure, someone can have a non profit racket, but if the insurance pool is communal with relatively low overhead, it can function much better. Universal care has different issues, but at least it is closer to communal in this sense, so better in that sense at least.
    - renewiltord 4y ago
      Public insurance is a sure-fire way to grow how much money goes to private healthcare providers. Just like this latest amyloid plaque crap, the whole thing will be aimed at ensuring that the public budget can be directed into something that is politically unassailable: spending as much money on old people as possible. Remember: you should never trade grandma for a dollar.
jewayne 4y ago
What? You're talking about two different things: Health insurance vs Long Term Care. There are no maximum lifetime benefits for Medicare Part A & B (health insurance) that I'm aware of. When you hear about a "Medicaid spend-down", it's all about reducing an elderly persons assets so that the state sees them as poor and Medicaid will pay their Long Term Care (nursing home) expenses. Medicare has almost nothing to do with the Medicaid spend-down strategy that I know of.
- dragonwriter 4y ago
  > When you hear about a “Medicaid spend-down”, it’s all about reducing an elderly persons assets so that the state sees them as poor and Medicaid will pay their Long Term Care (nursing home) expenses. Correct. > Medicare has almost nothing to do with the Medicaid spend-down strategy that I know of. Basically. Medicaid will pay Medicare premiums for dual-eligible beneficiaries, and many states have special coverage plans for the dual-eligible population, so there is a Medicare-related impact of the spend-down, but it has nothing to do with exhausting Medicare lifetime benefit limits (which do not exist, also, under the ACA, do not exist for other insurance, either.)
- ceejayoz 4y ago
  A/B definitely have some lifetime limits. https://www.aarp.org/health/medicare-insurance/info-02-2009/ask_ms__medicare_17.html https://www.aarp.org/health/medicare-insurance/info-02-2009/... > Medicare Part A covers a stay in the hospital for any single spell of illness or injury within a time frame of 90 days. This is known as a benefit period, and there’s no limit to the number of benefit periods you can have. But if you need to stay in the hospital for more than 90 days with the same illness or injury, you have the option of using some of your 60 lifetime reserve days. These allow you to extend your hospital stay for a higher copayment ($608 a day in 2014). You can use these days—one or more at a time, or as you need them—over the rest of your life. Once the 60 reserve days are exhausted, you would pay the hospital’s full daily charge (except for services covered under Medicare Part B, such as physician visits) if you need to stay in the hospital for more than 90 days in a benefit period. > Medicare covers only 190 days of inpatient care in a psychiatric hospital in your lifetime. > Medicare limits the amount of coverage you can get as an outpatient for physical or occupational therapy and speech-language pathology in any given year. In 2014 the limits are $1,920 for occupational therapy and $1,920 for physical therapy and speech-language pathology combined.
girvo 4y ago
Why did you always think that? Doesn’t seem true at all to me. Seems kind of wild that a country as rich and privileged as America struggles to provide healthcare to its citizens without going broke?

deleted 4y ago

[deleted]

arrosenberg 4y ago

The programs only exist because health insurance became unaffordable for seniors. Healthcare is expensive for the old! I’m not arguing against the idea that the program has fraud issues (Rick Scott made a fortune off of it), but its not going to be cheaper or better for the elderly if we let private companies exploit them individually instead of forcing them to defraud the government.

OrvalWintermute 4y ago
Medical insurance in general is a scam. Profitability of the insurer is tied specifically to claim denial and reducing expenses. Medical insurance transfers onto Doctor's Offices and Hospitals all the expenses of billing & coding which then also requires the doctor / medical provider spend 20-40% of their time doing billing & coding, and dedicated personnel to interface with the insurance companies and be involved in tracking down outstanding bills, getting pre-authed, negotiating settlements with insurance, getting "in network" etc. The whole insurance thing is a racket that has massively enlarged the costs of doing medicine.
- nobodyandproud 4y ago
  You know what gets rid of paperwork? Nationalized health services. Look at South Korea for a palatable (to conservatives) example.
  - junofan 4y ago
    US healthcare spend is 2.5x South Korea’s GDP. It’s an entirely different beast to administer. There’s no magic wand. The reality is that healthcare is hyperinflationary everywhere, and the US is farther along the curve than any other country.
    - nobodyandproud 4y ago
      The US private healthcare system will be inefficient because it tries to apply market solutions across the board for a problem that isn’t well served by the market. Yet it’s extraordinarily inefficient because the private sector fights against any level of price-of-service transparency, which means even market forces cannot and do not apply. This problem has been well-studied and the solutions (more than one) are also well-known. The magic wand here is the blinders that have been pulled by politicizing healthcare.
  - refurb 4y ago
    There is still paperwork for nationalized systems.
- smaudet 4y ago
  The whole private insurance is a racket, because private companies don't have many incentives to offer reasonable insurance. Public insurance, or community driven, is a different matter. Sure, someone can have a non profit racket, but if the insurance pool is communal with relatively low overhead, it can function much better. Universal care has different issues, but at least it is closer to communal in this sense, so better in that sense at least.
  - renewiltord 4y ago
    Public insurance is a sure-fire way to grow how much money goes to private healthcare providers. Just like this latest amyloid plaque crap, the whole thing will be aimed at ensuring that the public budget can be directed into something that is politically unassailable: spending as much money on old people as possible. Remember: you should never trade grandma for a dollar.

jewayne 4y ago

What? You're talking about two different things: Health insurance vs Long Term Care. There are no maximum lifetime benefits for Medicare Part A & B (health insurance) that I'm aware of. When you hear about a "Medicaid spend-down", it's all about reducing an elderly persons assets so that the state sees them as poor and Medicaid will pay their Long Term Care (nursing home) expenses. Medicare has almost nothing to do with the Medicaid spend-down strategy that I know of.

dragonwriter 4y ago
> When you hear about a “Medicaid spend-down”, it’s all about reducing an elderly persons assets so that the state sees them as poor and Medicaid will pay their Long Term Care (nursing home) expenses. Correct. > Medicare has almost nothing to do with the Medicaid spend-down strategy that I know of. Basically. Medicaid will pay Medicare premiums for dual-eligible beneficiaries, and many states have special coverage plans for the dual-eligible population, so there is a Medicare-related impact of the spend-down, but it has nothing to do with exhausting Medicare lifetime benefit limits (which do not exist, also, under the ACA, do not exist for other insurance, either.)
ceejayoz 4y ago
A/B definitely have some lifetime limits. https://www.aarp.org/health/medicare-insurance/info-02-2009/ask_ms__medicare_17.html https://www.aarp.org/health/medicare-insurance/info-02-2009/... > Medicare Part A covers a stay in the hospital for any single spell of illness or injury within a time frame of 90 days. This is known as a benefit period, and there’s no limit to the number of benefit periods you can have. But if you need to stay in the hospital for more than 90 days with the same illness or injury, you have the option of using some of your 60 lifetime reserve days. These allow you to extend your hospital stay for a higher copayment ($608 a day in 2014). You can use these days—one or more at a time, or as you need them—over the rest of your life. Once the 60 reserve days are exhausted, you would pay the hospital’s full daily charge (except for services covered under Medicare Part B, such as physician visits) if you need to stay in the hospital for more than 90 days in a benefit period. > Medicare covers only 190 days of inpatient care in a psychiatric hospital in your lifetime. > Medicare limits the amount of coverage you can get as an outpatient for physical or occupational therapy and speech-language pathology in any given year. In 2014 the limits are $1,920 for occupational therapy and $1,920 for physical therapy and speech-language pathology combined.

girvo 4y ago

Why did you always think that? Doesn’t seem true at all to me. Seems kind of wild that a country as rich and privileged as America struggles to provide healthcare to its citizens without going broke?