Without government intervention… 

How well do Americans understand their health care system? Pretty much not at all. 

Never denied? Very reasonable cost? Secondary carrier picked up most of 20 percent? Cost savings? 

What this person points out are the major flaws of Medicare; virtually no care management or check on unnecessary care, his idea of cost saving is cost-shifting. Clearly the $95,000 quoted is not the actual price but part of a game between providers and the government. 

From my 17-year experience under Medicare, I have always had the freedom to use a physician of my choosing and have never been denied needed diagnostic tests or medical treatment. This government health care plan has worked flawlessly and at a very reasonable cost. Moreover, the plan greatly reduces the cost by setting allowed charges by providers. For example, I had several cardiac stents for which the total bill from the hospital and physicians exceeded $95,000. Medicare allowed only about $17,000 of these charges and paid 80 percent of the allowed charges. My secondary carrier picked up most of the remaining 20 percent. I can give a multitude of other examples of such cost savings. Hence, it would appear that without government intervention, medical costs would skyrocket.

From a letter to the editor Savannah, Ga

Here are the real numbers to focus on. Note that the total income is less than the total expenditures. We hear a great deal today about killing or gutting Medicare, but clearing changes are necessary. How would you change Medicare to make it sustainable? 


Categories: Medicare

Tagged as:

1 reply »

  1. Here is what this example highlights to me and many of us have point out: Price inflation. No hospital will stay in business if the government is going to pay only 18 cents on the dollar for what is billed. So the providers raise prices until the reimbursement finally equals actual expenses. The result is everybody has to pay the higher price unless your insurance company can get a better discount from the provider.

    Wouldn’t it be nice if the hospital bills $17k and the non-insured, government, and all the insurance companies paid $17k and then we all could actually be consumers for our non-emergency healthcare because we would know what the true costs are and not what they will accept.

    Now I wonder, in hospital billing offices, do they throw a party when some sick person actually pays full sticker price before they declare bankruptcy? Or is it like a casino and you get invited back for several nights free or get a TV comp’d in your room so that they can do more tests (at full price of course).


Leave a Reply to Dwayne Cancel reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s