Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts

Saturday, December 14, 2024

But I can tell you there are really two, two general patterns that really need to be looked at whereas a whole group is looking at what they call a vaccine there is another group looking at hospital homicides and I have to tell you unfortunately that it's both, in fact, the hospital homicides might be greater the acute renal failure so the sudden kidney failure where you didn't have a problem before and all of a sudden you have a problem seems to be occurring mostly in the hospital and it's occurring to the tune of about 100% increase and not during the year of covid but rather the when covid I should say when the CMS.gov.  and NCTAP program kicked in that's on the web you can find it at CMS.gov and look for NCTAP 

Saturday, December 7, 2024

doctors weren't getting paid. Bank accounts were empty. A lot of them were going under. So United Healthcare went out they said, "Hey, we can help you out. We're going to buy . . . we'll buy your practice, or Hospital, your Urgent Care, and they bought them

United Health Care owns Optimum Health, and they own Change Healthcare.  There are 158 subsidiaries underneath United Healthcare, some of which are overseas and most of those are pharmaceutical services.  So, yes, they are also part of the big Pharma.  So now they're insurance and big Pharma.  Change Healthcare, if you don't know what that is, is the service that processes the claims from the provider to the insurance company so the provider can get the pittance of money that the insurance company is going to pay them for their services that have been rendered.  Earlier this year, Change Healthcare got hacked.  It's almost been a year now.  They still aren't completely back up and running, so when this happened, United Healthcare . . .  I know you all think that doctors sit on piles of cash.  That's not how it works.  They have to get the insurance money on a regular basis to keep their money flow going.  Well, when you can't send your claims in because Change Healthcare has been hacked, and you can't mail it in . . . the doctors weren't getting paid.  Bank accounts were empty.  So a lot of them were going under.  So United Healthcare went out they said, "Hey, we can help you out.  We're going to buy . . . we'll buy your practice, or Hospital, your Urgent Care, and they bought them.  So now, now they're insurance; now they're Pharmaceutical; now they own the system that processes the claims.  Now they own the providers that use their insurance.  The providers are owned by United Healthcare and get paid from United Healthcare claims.  You know they're already in trouble with the DOJ because of all of this.  If this is not a monopoly, I don't know what is.

In 2023, their total revenue was $371.6 billion dollars, a 14.6% increase from 2022, and $22.4 billion in profit in 2023.  They paid out $281.4 billion in claims in 2023.   But let me tell you this. United Healthcare is the main insurance for Medicare, Medicaid, and ObamaCare plans. That is the main . . . it's 29% enrollment is United Healthcare under those three things.  Those are all government-run healthcare systems.  And United Healthcare is the main insurer for all of them. 

I don't know about you, but when a company decides to become that big that they are now the doctor, they're the provider, they're the insurance company, they are the pharmaceutical company, they're the company that processes their own claims . . .  . 

They did a study, and United Healthcare by a 90% margin denied more claims than any other insurance company on the market.  And again they are the highest enrollment for all of the government-run Medicare, Medicaid, and ObamaCare.  They deny, deny, deny, and then people die.  People die. 

Saturday, March 11, 2023

WARNING: on medicare & supplemental, ALL your rights are taken away when ADMITTED to hosp

Elder Care Laws state it differently.  Number 5 reads

You have the right to make informed decisions regarding your care. This includes being informed of your health status, being involved in care planning and treatment, and being able to request or refuse treatment. However, this right does not mean you can demand the provision of treatment or services that are deemed to be medically unnecessary or inappropriate. 42 C.F.R. § 482.13(b)(2). 

Thursday, August 30, 2018

"MEDICARE FOR ALL" WILL SHORT-CHANGE HOSPITALS . . . AND THERE WILL BE CLOSINGS

Medicare for All Would Decimate New York Hospitals
With election season heating up, so is the conversation about single-payer health care. Is it appropriate for New York? Is it appropriate for upstate? What about hospitals?
Upstate New York hospitals have their own unique geographic, economic and patient-mix factors; there are 54 hospitals and health systems in the Iroquois Healthcare Alliance’s region alone, and 217 hospitals throughout the state. Additionally, IHA members span over 28,000 square miles, across 32 counties of New York. Hospitals upstate range from large academic teaching institutions to sole community hospitals to 15-bed critical access facilities. Many are often the only safety-net providers in their communities. Single-payer for all of these hospitals is, therefore, obviously, complicated. ADVERTISING
What isn’t complicated is the apparent appetite for some level of government involvement in health care, mostly because it already exists. New York operates one of the largest Medicaid programs in the country, totaling nearly $60 billion annually, with 5 million enrollees. Approximately 1 in 3 New York City residents and approximately 1 in 4 in the rest of the state are enrolled in Medicaid.
Hospitals and health care providers throughout New York remain reliant on government, both Medicaid—and on Medicare—for patient revenue. In fact, Medicare is the largest payer upstate, because of the aging population. For upstate hospitals, Medicare accounts for 47% of hospital inpatient revenue, while Medicaid only accounts for 15%. Private insurers account for 20% of total inpatient revenue.
In dividing the tab for hospitals three ways between Medicaid, Medicare and private insurance, government (Medicare and Medicare) is the entity footing most of the bill. Unfortunately, government as a payer hasn’t exactly been a win for the hospital industry. Nearly half of all IHA member hospitals reported negative operating margins in 2016, and the median operating margin for IHA hospitals was a meager 0.3% that year.
Upstate hospitals are also paid less than their counterparts in downstate for the actual cost of both Medicare and Medicaid. Downstate hospitals receive 36.4% in Medicare, 21.6% Medicaid and 14.4% in private insurance. Looking at the data per day by payer, Medicare provides hospitals $2,337 per day upstate and $3,012 downstate. Medicaid follows a similar pattern: $2,150 upstate, $2,929 downstate.
But the most pronounced difference is in private insurance. These insurers pay upstate hospitals $3,767 per day and downstate hospitals a staggering $6,105. Private insurers pay over 60% more than government per day to hospitals located downstate.
A single-payer health system can only be examined, discussed and debated when the payer is known—and most importantly when the reimbursement structures are known. Single payer that uses rates similar to what private insurers pay downstate hospitals per day would be positive for upstate hospitals. A system based on the current rates being paid by Medicaid and Medicare would hurt all hospitals, particularly devastate upstate hospitals, and likely reduce access to health care in many communities.
Gary J. Fitzgerald 
President
Iroquois Healthcare Alliance

Gary North forecasts the problems correctly:
He sees what is coming: short-changing hospitals. At that point, they will start going bankrupt. There will be closings.
There will be rationing. People will not be able to schedule operations without waiting.
What will happen to people who cannot afford private healthcare programs, which will rise in price due to rising demand? The rich have concierge physicians. The upper middle class will start flying to the Caribbean. They will pay for the services they want. But the middle class will be caught in the rationing system.