Yeah! The government would NEVER make a dumbass decision for no good reason. These hospitals must be bad! DAMN THEM TO HELL!!!
Corn, were you planning on opening a private hospital? You seem pretty angry. Anyway, I cannot think of any reason why the government would pick on these guys for no good reason. If they've done nothing wrong then they can sue the federal government for discrimination.
Ah, so now we get to the crux of the matter: you have no problem with the government driving your competition out of business, as that will force people to come to your hospital. Now we see the evil exposed.More bullshit FUD from resident sock puppet.
I only know of a handful of doctor owned-hospitals in SE Michigan and most of them, like Garden City, are POS dumps, so who cares? Our entire health group (10+ hospitals in MI) is vamping up in anticipation of New Health laws and will happily absorb them and their small client base if they go under. So you're going to have to try harder than that to make your case that "access to care" is going to suffer. As if you gave a shit about that to begin with.
Here is an exact opposite story to yours about one of those doc owned hospitals here in Southfield who can and will do just fine with the New Health laws all the while operating in the shadow of a large system-owned Hospital:
http://www.crainsdetroit.com/article/20100307/HEALTH/303079994#
I thought neotards were survival of the fittest kind of guys anyway?
Besides, where is it written or even implied that these doctor owned hospitals need to survive in the first place TO IMPROVE ACCESS? That is what your stellar commentary is "concerned" with right?
If they go under we'll expand MORE than we already are so you can quit fake caring about improving access now Zed. We got it under control. You just worry about your next math quiz and leave the adult stuff to us.
And you liberals love the fact you are preventing someone from being in business for themself and making a profit.
And BTW...it was an R who helped draft the bill in 2003 Bush vetoed (Grassley)
edit: I agree conflicts of interest can arise in doc owned hospitals; however, if, as one poster noted, they are targetting the rich, so what? If there's a market for it, you should be free to do business.
Anyway, doctor owned hospitals are vertical monopolies, not free market entities, so if you believe in free markets you should be against them.
Michigan already has a strict quota for hospital beds in place. So, this battle has already been fought in SE Michigan.Ah, so now we get to the crux of the matter: you have no problem with the government driving your competition out of business, as that will force people to come to your hospital. Now we see the evil exposed.
I'm not sure what this reply has to do with my previous post.Michigan already has a strict quota for hospital beds in place. So, this battle has already been fought in SE Michigan.
The major players have consolidated hospitals. Several smaller neighborhood hospitals closed. Several larger neighborhood hospitals have changed hands.
In all, there are ~4 or 5 major players who control the majority of hospital beds in the area. A lot of the specialty care is referred back to the 'home' hospital.
Another major development--a for-profit company has recently announced they were in negotiations to purchase one of the larger non-profit groups. Part of the agreement is they will continue to serve the neediest of patients for at least 10 years.
As far as boutique services, there are several options available. One ironic development is that the larger 'bully' hospitals have expanded into this niche in the past decade.
The problem is the inability to nest Umbrella's quote in yours for context.I'm not sure what this reply has to do with my previous post.
ownt
Yes they can, but when physicians have a vested interest (more $$$), they are more prone to doing it then a non-profit private hospital.
And since when do two wrongs make a right?
A market is a means to an end, it isn't a goal. The free market isn't serving us well in some aspects of healthcare, and probably can't.
Anyway, doctor owned hospitals are vertical monopolies, not free market entities, so if you believe in free markets you should be against them.
And since when is this practice wrong? for fucks sake...making a profit is not criminal.
When did making money become something to be ashamed of? Did I miss the memo on that?
And since when is this practice wrong? for fucks sake...making a profit is not criminal.
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Because the left thinks making a profit in healthcare is somehow evil. they cant really explain why, other than emotional bullshit arguments, but I guess I missed the same memo.
So we are going to insure more people and have less hospitals.
Not really sure how that is going to work out
First off, you said brought up over-charging. Is that right or wrong? Are you saying it is OK to overcharge to make a profit?
And second, given that this isn't a freemarket, is it OK for physicians to cherrypick patients to maximize their profit?
If I open a business, say a restaurant, I expect to make a profit. If I can't, I go bankrupt and close. Now, I can't make people eat at my restaurant, I have to compete against other restaurants. I have to compete.
Now with these phyisican practices, they want a bigger profit. So they read the medicare/HMO reimbursement guidelines and cherrypick what pays good (and that they can perform), and open a clinic/hospital. They can screen their patients, and people that will make money (IOW, good insurance, or healthy patients that won't have complications) go to their clinic. The really sick or poorly-insured go to the regular hospital. And the neat trick is, they still make money for the procedure they do (unless the patient totally doesn't have insurance). They still get a check from medicare/HMO/etc for their procedure. Where is the competition?
There are usually at least two fees for procedures. There is a physician component for services they provide, say a cath or surgical procedure, and then there is the hospital component, for the providing the OR, supplies, nursing staff, recovery time in hospital, etc.
For some diagnosis codes, hospitals lose money. For some, they make money. Hospitals don't have a say in this. (that's really fair, don't you think?) Overall, they have to make money to survive.
Now comes Dr X, who sees that doing surgery Y pays not only a good physician charge, but a good hospital component. So Dr X opens his own place so he can get both payments. And what happens to the hospital? They have less profitable procedures, and thus make less (or no) money.
And if surgery Y gets it reimbursement cut (it happens)? Dr X closes his clinic, and moves it back to the hospital. Dr X still gets his physician fee for service, and the hospital gets another money-losing patient.
And I am not even mentioning how they can further manipulate the process, where even if surgery Y pays well, if a very-sick patient comes along, and the physician feels that he is likely going to have a long hospital stay because of risk factors/complications, the physician dumps the patient to the hospital, to eat the cost of the prolonged hospital stay, while he still gets his fee for service.
So you can see, in the real world, there is already plenty of abuse by physicians for gaming the system. It certainly isn't all the hospitals fault. In fact, in a lot of cases, the hospital is hostage to its physicians since they decide who gets admitted and what gets done.Of course, this is only one little facet of all the problems healthcare in this country has, and no system will be perfect anyway. But that doesn't change the fact that many things are wrong.
But because of seeing this happen all the time in real life, like I said, I won't lose sleep if a few physician groups don't open their own clinics to game the system.
First off, you said brought up over-charging. Is that right or wrong? Are you saying it is OK to overcharge to make a profit?
And second, given that this isn't a freemarket, is it OK for physicians to cherrypick patients to maximize their profit?
If I open a business, say a restaurant, I expect to make a profit. If I can't, I go bankrupt and close. Now, I can't make people eat at my restaurant, I have to compete against other restaurants. I have to compete.
Now with these phyisican practices, they want a bigger profit. So they read the medicare/HMO reimbursement guidelines and cherrypick what pays good (and that they can perform), and open a clinic/hospital. They can screen their patients, and people that will make money (IOW, good insurance, or healthy patients that won't have complications) go to their clinic. The really sick or poorly-insured go to the regular hospital. And the neat trick is, they still make money for the procedure they do (unless the patient totally doesn't have insurance). They still get a check from medicare/HMO/etc for their procedure. Where is the competition?
There are usually at least two fees for procedures. There is a physician component for services they provide, say a cath or surgical procedure, and then there is the hospital component, for the providing the OR, supplies, nursing staff, recovery time in hospital, etc.
For some diagnosis codes, hospitals lose money. For some, they make money. Hospitals don't have a say in this. (that's really fair, don't you think?) Overall, they have to make money to survive.
Now comes Dr X, who sees that doing surgery Y pays not only a good physician charge, but a good hospital component. So Dr X opens his own place so he can get both payments. And what happens to the hospital? They have less profitable procedures, and thus make less (or no) money.
And if surgery Y gets it reimbursement cut (it happens)? Dr X closes his clinic, and moves it back to the hospital. Dr X still gets his physician fee for service, and the hospital gets another money-losing patient.
And I am not even mentioning how they can further manipulate the process, where even if surgery Y pays well, if a very-sick patient comes along, and the physician feels that he is likely going to have a long hospital stay because of risk factors/complications, the physician dumps the patient to the hospital, to eat the cost of the prolonged hospital stay, while he still gets his fee for service.
So you can see, in the real world, there is already plenty of abuse by physicians for gaming the system. It certainly isn't all the hospitals fault. In fact, in a lot of cases, the hospital is hostage to its physicians since they decide who gets admitted and what gets done.Of course, this is only one little facet of all the problems healthcare in this country has, and no system will be perfect anyway. But that doesn't change the fact that many things are wrong.
But because of seeing this happen all the time in real life, like I said, I won't lose sleep if a few physician groups don't open their own clinics to game the system.
Imagine you had a child (you might, but doubt it). Imagine your child needed a kidney transplant. Now, imagine the insurance company dropped you because risk analysis showed that after 3 years the likelihood of a transplant increased by 50%.
I speak from personal experience. Call that an emotional argument if you want, but let me ask you this: If this was your mother, father, or anyone else and you got screwed by the system, would you be saying "they need to make a profit, I understand"? Of course not.
Making healthcare reform anything but a human story is silly. We're not talking about profit from selling cars here, people. We're talking about the health of your family, my family and our neighbor's family. The right has promoted this whole "you can't get car insurance after you wreck your car" story, and that's just ridiculous.
Instead of putting the focus on where healthcare reform is really needed, you all jump to your idealistic grounds of intellectual simplicity and make it into a "they demonize profits" situation. That's clearly not the case.
And I'm not even on the left. I only call it for what it is. NO ONE is arguing that physicians, surgeons, etc. should make a profit and a healthy one. The sad reality is that it might be as little as 1% of those that *#&$ the rest of us, and that 1% casts a cloud on what is otherwise a great industry of passionate people that literally do perform miracles and should be compensated accordingly.
The rule being discussed here prevents medicare/medicaid patients from going outside the big-corporate mainstream for their care. This actually hurts their level of care. Granted that there are only a few of the smaller physician-owned hospitals where those patients may have been accepted in the first place, it still makes absolutely no fucking sense that we would further limit their access to more choices and avenues for care.
Seriously, this is dumb.
It's also tremendously sad that making a profit in any business, however minimal, is slowly becoming a crime in this country...
What's stopping them except they'll no longer get the benefit of socialist programs?It's also tremendously sad that making a profit in any business, however minimal, is slowly becoming a crime in this country...
And lastly, plenty of people argue against making large profit in health care. Garfield for one. I happen to think its not an issue, and will happily agree to disagree with those who do.
What's stopping them except they'll no longer get the benefit of socialist programs?