Obamacare 80/20 Rule Pays Off Big For California

I am sure that your "administrative costs" amount to insurance administration and specifically EXCLUDE the 5 gals in the office, the 2 nurses he has, the paperwork pusher he has, the people behind the scenes both at his office and at the hospital he is associated with, and, of course, whomsoever the government hires to determine how much whole wheat I eat, how much caffeine I intake, etc. And, let us not forget how many doctors and hospitals are dropping medicare because they are losing money due to the reduced funding.

 

I've had many discussion with my doc on this issue. I make a point, a year later he comes up with an answer. I could have told him the answer, but I want him to learn and not be all comfortable with the system.

In short, his answer (and mine ) is that the government doesn't pay enough to cover costs.

I didn't get into the reason WHY the government does this with him yet, but the answer is that it's a result of the compromise between those who want to help people by paying more in taxes and those who want to pay less in taxes and ignore people's sufferings.

As to why medical care costs so much, the answer is that the hospitals charge more to make up the difference, and make profit. It varies from hospital to hospital, but most hospitals are businesses. They need to be profitable. So they jack up the rates...insanely.

There's a HUGE problem with this system that some here may not have realized yet.

For poor people, and for those who are uninsured, and even insured people, they must pay the adjusted rate (usually), or go without service.

Instead of paying say $20 for treatment, they have to pay much more, $80...$100...$150. As a result, poor people, people without insurance, and even people with insurance tend to not accept the services they require to be healthy.

The system is FUBAR.

Yes, I'm using "FUBAR" a lot now. Deal with it or don't, I don't care lol

 

Medical professionals are too comfortable with the system to put up much of a fight for the poor. Some do, but most don't. Dentists in particular are very happy NOT helping the poor. In my state, some 80% opt-out of government programs, for example.

They are comfortable because they make lots of money and can legally ignore the poor.

 

That's too stupid to even address.

 

OOPS! Facts present a problem for you!

 

Try this one on, Teddy. Simply eliminating the medicare and medicaid fraud from the government programs would save California $60B (assuming that they are just average among Americans). http://www.forbes.com/sites/merrill...medicaid-fraud-is-costing-taxpayers-billions/ Now that is nearly 2,000 the saving you attribute to Obamacare. Really - and I can back up the math.

 

I'm all for eliminating fraud. It is the Republicans that protect it.

 

And commit it as well... Try this on Dicky boy.

Mitt Romney and Rick Scott both have Medicare fraud in their background, super PAC ad claims


The super PAC supporting President Barack Obama made a final pitch to Florida voters before Election Day: a TV ad comparing Republican nominee Mitt Romney and Gov. Rick Scott.

Showing a picture of the two men locked in a handshake, the ad urges viewers to "connect the dots."

"Scott ran a company that paid a record fine for committing Medicare fraud, then as governor Scott cut millions from health care," a narrator says. "Romney was director of a company that stole millions from Medicare. Now Romney’s plan would end Medicare as we know it.

"We’ve seen this picture before. Just connect the dots: If Mitt Romney wins, the middle class loses."

PolitiFact has investigated claims against both Scott and Romney about Medicare fraud during their business careers. Here’s a look at what we found.

‘Scott ran a company that paid a record fine for committing Medicare fraud’

In the spring of 1987, Scott purchased two Texas hospitals to start a company first known as Columbia. He quickly grew the company by purchasing more hospitals to create a large and profitable network.

In 1994, Columbia purchased Tennessee-headquartered HCA and its 100 hospitals, and merged the companies. Columbia/HCA grew to more than 340 hospitals, 135 surgery centers and 550 home health locations, employing more than 285,000 people.

Scott resigned as chief executive officer in 1997, the year that federal agents went public with an investigation into the company, first seizing records from four El Paso-area hospitals and then expanding across the country.

In time, it became apparent that the investigation focused on whether Columbia/HCA bilked Medicare and Medicaid for tests that were not necessary or ordered by physicians, and for attaching false diagnosis codes to patient records to increase reimbursement to the hospitals.

Scott resigned as CEO in July, less than four months after the inquiry became public. Company executives said that if Scott had remained CEO, the entire chain could have been in jeopardy. At issue, Scott said, was that he wanted to fight the federal government accusations. The corporate board of the publicly traded company wanted to settle.

And settle Columbia/HCA did.

In December 2000, the U.S. Justice Department announced what it called the largest government fraud settlement in U.S. history when Columbia/HCA agreed to pay $840 million in criminal fines and civil damages and penalties. Among the revelations from the 2000 settlement, which all apply to when Scott was CEO, were that Columbia overbilled Medicare for unnecessary tests and false diagnosis codes.

The government settled a second series of similar claims with Columbia/HCA in 2002 for an additional $881 million. The total fine: $1.7 billion.

As part of the 2000 settlement, Columbia/HCA agreed to plead guilty to at least 14 corporate felonies. A corporate felony comes with financial penalties but not jail time, since a corporation can’t be sent to prison. Scott himself was never indicted.

‘Romney was director of a company that stole millions from Medicare’

Romney’s record at Bain Capital, the private equity firm he founded, came up frequently during the Republican primary. This claim refers to Bain’s history with a company charged with Medicare fraud in the 1990s.

The Boston media investigated the facts of the case when Romney ran for governor in 2002. It’s also addressed in The Real Romney, a biography by reporters with the Boston Globe.

The story begins in 1989, when Romney was the head of Bain Capital, which specialized in buying troubled companies, turning them around, and then selling them for a profit. That year, Bain invested in Damon Corp., a medical testing company based in Needham, Mass.

Bain took the company public in 1991, and Romney served on the company’s board of directors. In 1993, Bain orchestrated a sale of the company to Corning Inc., getting a handsome return on its investment and earning Romney himself $473,000, according to The Real Romney. After the sale, Corning closed the main facility in Needham, laying off 115 people.

In October 1996, federal prosecutors announced that Damon was agreeing to pay $119 million in both civil and criminal fines after pleading guilty to defrauding Medicare. The company was providing doctors with forms that didn’t make clear what tests included, so doctors were checking off additional tests that weren’t necessary, according to the Globe’s summary of the government’s case.

The overbilling went from 1988 through 1993, prosecutors said. "This is a case, pure and simple, of corporate greed run amok," U.S. Attorney Donald Stern said when the settlement was announced.

Romney was never implicated in the case. He claimed that he helped uncover the fraud, but Globe reporting put that claim into question. The Globe reported that court records showed fraudulent activity occurred under Bain’s watch, and that prosecutors gave the credit to Corning for stopping the fraud.
The Romney campaign, though, pointed us to Globe stories noting that Bain officials began investigating the billing practices when a competitor lab pleaded guilty to the same type of fraud. The campaign also emphasized that Bain was never a majority owner in Damon -- its ownership share peaked at 8 percent and was just 2.8 percent went the company sold to Corning.

 

LOL Don't threaten to use math against him!

 

I am sorry – word problems must have given you a fit in math class. Word problems are always muddied by general information and minutia. A good rule of thumb when confronted with one – is read the problem twice. So I suggest you read again what you originally posted.
It clearly states in your original post that the 36 million dollars is being paid to "customers". Yes it is possible small business is the only customer but we are given additional information "Consumer advocates are cheering the return of premium payments to businesses and workers". Certainly you must agree that "businesses" indicates a group larger than just small business. Therefore businesses = Large Business + Medium Business + Small Business + Any Other Type of Business = all businesses. Another factor to keep in mind when working a word problem is the word "and". The use of "and’ in a word problem serves the same function as the "+" sign in a typical numerical math problem. The rebate is being paid to businesses plus workers. A worker is anyone who is employed and not just by business. They can work for themselves, business, government entities, non-profits and etc.
Concluding the 36 million dollar rebate is being paid entirely to small business is an incorrect conclusion.
Blame whomever you want to but I hope this helped and didn’t go over your head.

 

Trust me, it did.

 

The only thing I was confronted with in your post #18 was my post. You added nothing that I could see. But that is probably the best post any Con on this forum has ever made. There is that.
You seem to be like most of your ilk in that you make a dumb assumption but offer up some lame excuse as to why you were actually right....which you clearly were not. But your "defense" and I quote, "It clearly states in your original post that the 36 million dollars is being paid to "customers". Yes it is possible small business is the only customer but we are given additional information "Consumer advocates are cheering the return of premium payments to businesses and workers"", still doesn't justify your creative calculations since you are using California's entire population instead of the number of employees those small businesses employ, a number you can't know so you made one up. You included no calculations your posts, just your results and you had to make a lot of assumptions to even do that and then kept them to yourself. Post #18 which I was referring to has nothing other than my post quoted. That was what my comment was directed towards. So all-in-all, a pretty lame time was had by you.

 

Still stuck on the idea that the entire 36 million is being paid to small business I see.

 

And just what is it in that even suggests that the only customers are "small businesses"? I see nothing that differentiates customers as small. medium, or large businesses let alone individuals.

 

Anthem spent 79.3% of their premiums on health services meaning 7/10ths of 1% of their premiums collected are being rebated. Chump Change.

 

I see that you are just as slippery with the facts as the rest of the Cons here. Noted! Remember, facts do not cease to exist just because they are ignored. The fact is, that in the very first sentence of the article I posted small businesses where specifically cited. How many employees those small business employ and the amount of money they eventually get refunded, we can't really know, but that doesn't seem to stop people like you from throwing cold water on good news. Of course, that is all you Cons ever do.

 

Perhaps it's that very first sentence were things start to get slippery or maybe it was title of your original post.

 

So the government is selectively picking companies to rebate the funds to? All of the medium, and large businesses plus individuals can go pound salt? Were that someone beside Obama, I would blanketly state you were lying. After what he has the IRS, FBI, OSHA, etc. doing, I am afraid that you might actually be correct.

 

doubled