That is kinda my question on just that one section--what happens if the claimed savings don't show up? What if streamlining does not result in the cost-savings they claim?
People keep saying it but what if it doesn't show the "on paper" results?
You mistake me for someone who bought the Obama snake oil. Sorry...
I've been a health services researcher for too many years. I have the luxury of running randomized, controlled trials on our covered population and reporting the truth to the folks with the sharp pencils who care about giving a return to the shareholders for whom we work.
When someone tells you they're going to save you money by doing blah, blah, blah, pretty much 9 times out of 10 they don't when you look at the entire balance sheet. The academics in my field know this, which is why CMS holds some money back for Medicare Advantage patients and gives bonuses (on the order of tens of millions) when your process quality scores are better than your competitors. In healthcare it usually isn't about saving money, unless you're talking about getting people immunized and keeping people with chronic conditions out of the hospital. It's about giving *value* for your health care dollar. And the more things we Westerners figure out how to do to make your life longer and with higher quality, the more your lifetime health care expenses go up.
Save money? Bullsheet! Obamacare is going to cost my children and grandchildren a fricken fortune. There is no free lunch.
cxt wrote:Think about the vast $$$$$$ we lose in waste, fraud and abuse in Medicare/Medicade. You would think that since we know such widespread waste, fraud and abuse goes on we can fix it---but it has been going on for decades with no end in sight. If you can't even rein in waste, fraud and abuse--then how can people so blithely simply hope that you are actually going to get goverment to streamline?
You are preaching to the choir.
It is worth mentioning however that insurance companies are getting smarter and smarter about tracking down and prosecuting for fraud and abuse. There's a clear return on investment here. That's a line of work I almost got into. The only problem is that - as a former FBI agent told me who worked in this field - 'There is no rest for the wicked.' Every time you stop one brand of fraud, the bad guys figure something else out. It's Sutton's Law revisited. There's too much money involved for the bad guys not to try to figure out how illegally to tap into that spigot.
cxt wrote:Lots of claims are made "on paper" that never seem to work out in practice. Romany-care "worked" in a rich State with (as I recall) one of the highest physican to patiant ratios in the nation, with a pretty small population. So of course it would work if applied to 300+ million people.
Romneycare cost me my last job. When that went through, the price of health care went up in Massachusetts. That caused my parent company to create a forced merger between my division and a newly acquired one. They shut down all of IT, and shifted it over to the other company where it existed in Nepal. Not India, not the Phillipines... fricken Nepal! Then they took expensive professionals like yours truly working in remote locations and converted us from employees to subcontractors. The net is that they got around having to pay for our healthcare.
This will happen with Obamacare as well. We're already seeing companies reorganize to get around the mandates. At the end of the day, companies will do what it takes to make a profit, or go out of business.
Furthermore... If there's any truism in healthcare, it's that it is a regional phenomenon. What works in Rochester will not work in Des Moines. And what worked in Rochester yesterday won't work in Rochester today now that Kodak is going out of business. There's a reason why our Founding Fathers created a Republic and not a Democracy. States should have the right to do their own experiments to find out what works and what doesn't. I'm all for California mandating crazy things about automobiles. Let them try and succeed... or fail. We'll sit back and watch, and learn what to do in another region where priorities and needs are different.