DesideriScuri
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Joined: 1/18/2012
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ORIGINAL: eulero83
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ORIGINAL: DesideriScuri
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ORIGINAL: eulero83
if it's paid by taxes how is this different from a public system if not just by being more expensive as you pay the market price?
It's not paid out of taxes. It's not taxable income. If I were to make $50k/year and spend $5k for health insurance and/or qualified health care (to prevent elective surgeries and procedures), my taxable income drops to $45k. It's an incentive to get health insurance, and actively manage your health (especially since the payer is closer to the receiver, it behooves the person to be more practive).
What happens if Government negotiates reimbursements that are below the provider's actual cost of delivery?
In the UK, the doctors are paid a set amount for each patient under his/her care, regardless of he care given (if I understood FD correctly). While I do see that as a strong way to control costs, there may not be enough doctors that go along with that plan. It would definitely depend on where that reimbursement is set. That is an interesting option.
Isn't it already that way? You pay taxes on health insurance? my god you are in a worse situation than what I thought.
I don't pay taxes on premiums. But, any out of pocket spending is still taxable, unless you have a FSA (Flexible Spending Account). With an FSA, some of your pay is taken out of your earnings and put aside for qualified expenditures. That money is taken out prior to taxes being calculated. But, it doesn't carry over, so if you set aside $4k and only spend $1k, you'll be out that $3k. I set my FSA deduction so that my last pay deduction will result in my max out of pocket being put in my FSA. I will lose money because I didn't have anything to really use that money on. It's something that gets set prior to the year, and can't be changed for that year. I halved it for next year. Now, I'm looking to see what big expenditure I can have so I don't lose out on that money. lol
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I don't know what you mean with "negotiates reimbursements that are below the provider's actual cost of delivery" if it's a private provider that's impossible negotiation means both parties agree and no one would agree in loosing money, if it's a public provider the reimbursements are exactly the cost of delivery...
Let's take an MRI as an example. Using purely made up numbers, let's say it costs $1500 to get an MRI in the US. If the costs of delivery is $1250, without any slice going towards CEO pay (so it's just going towards paying for caregivers directly involved, utilities, etc.) or profit, the negotiated cost would be close to $1250. What happens if the government says, "you know, we're only going to pay you $1000 for MRI's?" What do you think happens next? If it's losing money, it's not like they'll "make it up with volume."
5% profit margin in 2012 in the Pittsburgh, PA area
4.94-7.54% profit margin for various types of US hospitals; 5.53% profit margin for all hospitals combined
That $1500 MRI might only drop 10%, which would still leave it well above the cost across Europe.
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also in italy it works the same way, but not all the doctors are paid that way by the SSN, just pediatricians and general practicioners, other are employed and get paid I think a montly wage according to their responsibility level in the hospital, believe me if they were not cool with that system they would have changed it.
Unless they couldn't change it.
But, there is another huge difference: Government doesn't own the most common care providers (they do own the VA). I've even made the comment before that the government would likely have to go in and take over the hospitals for a single-payer system to work in the US. You think there have been constitutionality issues raised with Obamacare? Just wait for the shit storm to hit if they try to actually take over the providers.
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What I support:
- A Conservative interpretation of the US Constitution
- Personal Responsibility
- Help for the truly needy
- Limited Government
- Consumption Tax (non-profit charities and food exempt)
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RE: US Health Care Costs - 
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