Ray From Cleveland
Diamond Member
- Aug 16, 2015
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Cash practices are specialty practices and a whole new ball game. We are talking standard healthcare corporations. How were you involved in the healthcare industry. I cannot figure out where you are coming from.If you have been in the health industry you know there is listed price for every procedure or product provided. Then each insurance company has a negotiated rate that is below the list price. Those negotiated prices can be different for different insurance companies. The lowest negotiated price is Medicare. If you do not have insurance or Medicare you pay the list price, which is higher than any negotiated price.The people who pay the most for services are those without insurance. Insurance companies put limits on what they will pay per procedure also. It is usually higher thamn Medicare. The unreimbursed care is the wild card. The government or us with higher procedure costs pay for it. Either way it is us.The reason Medicare works is because of private insurance. Medicare typically pays about 2/3 of the cost for care of their patients. Doctors and facilities up the price and recoup those losses via private insurance. That's why when you see medical facilities close down, it's usually in lower income areas where most of the clientele are government patients.
So you take away the avenue where medical providers offset their government losses, and the only thing you accomplish is the closing down of more facilities, and doctors leaving practice and getting into another line of work.
I'm very familiar with Medicare. I worked in the industry for about ten years long ago. Medicare used to be goldmine. They would waste money left and right. That didn't stop until Ronald Reagan became President and seen a problem down the road. He was right. Government not only allowed the program to be ripped off repeatedly, but making it insolvent for future generations. And here we are.
One thing I learned with government, and that is you can't charge one entity more for services than the other, so I don't know where you get this idea that the uninsured pay more than others. It's actually against the law.
Just the opposite actually.
Insurance and government are lined with red tape. It's a constant paperwork passing back and forth. In order to process all these bills, more personnel is needed by the provider.
A cash patient requires no paperwork; perhaps a receipt is all. There is no waiting for money, fighting to get the money, and no negotiations. That's why most cash customers actually pay a reduced bill compared to government or insurance.
We used to have meetings about changes in government requirements every other week which also affected private insurance as well. The office girls would go nuts claiming that government required them to do things they did a year ago, changed it, and then changed it back. On the other side, the red tape got so bad by the government that they hired Prudential Insurance to handle Medicare claims, because they couldn't process it all.
If you did any research on medical costs, the insurance industry sites making insurance claims on nickel and dime procedures like an office visit. Because of government regulations, it often costs the insurance company more money to process the claim than it does the bill itself. That's why one of the solutions to our medical cost problems are Medical Savings Accounts. It would eliminate the nickel dime claims that would be paid for by swiping your MSA card, and leave insurance companies and medical claims processing out of the picture.
I delivered and repaired home medical equipment, also referred to as durable medical equipment, or DME.
In DME, nearly our entire collections were from government services like Medicare and Medicaid, and about 30% private. So we mostly dealt with government.
To give you an example of how things worked, let's say that you were on Medicare or Medicaid. You needed a quad cane, which is an aluminum cane with four legs. We purchased the cane for about 30 bucks, and rented it to government for 20 dollars a month. It doesn't sound like much, but when you have 500 customers renting that cane month after month, it was a goldmine.
But we just didn't rent canes, we rented wheelchairs, wheelchair cushions, hospital beds, portable commodes, trapeze's oxygen tanks and gauges, oxygen concentrators, walkers, folding walkers, alternating pressure pads for our hospital beds, just a whole list of homeware items.
It all worked the same way. We purchased medical equipment, and rented it out for about 80'% of what we paid for it month after month. Mind you, at the time, we couldn't just sell the equipment to the customer saving money, government regulations were that we had to rent that equipment for years on end instead of selling it.
Again, that was until Ronald Reagan became President. Then he issued a initiative that long term patient get that same equipment, only purchased instead of month after month, year after year rental.