The Bristol Herald Courier today carried a lengthy article detailing Representative Rick Boucher’s “NO” vote on the House health care reform bill that passed narrowly. Boucher, representing the Ninth District in southwest Virginia, voted “NO” along with several other Democrats. You can read the article on Tricities.com if you missed it today in the newspaper, or stop by the library and read it.
The primary concern cited by Boucher is that hospitals and doctors would go broke under a public option:
“Southwest Virginians clearly depend on their community hospitals for their health care delivery, so we must take every step to make sure the financial success of our local hospitals is not placed at risk,” Boucher said. “I simply could not vote for legislation that would place their [hospitals] very survival at risk and the House legislation does that.”
I disagree with our Congressman in this matter on at least three points.
First of all, hospitals and doctors now make as much if not more from Medicare patients than they make from private insurance. Private insurers do not pay what doctors charge — look at your explanation of benefits, and you will see that your provider has been squeezed into a “network” plan in most cases, and the actual payment for in-network service is sometimes around 50% of the actual billed amount. If Medicare pays 80%, Medicare pays more than the large networks. Medicaid also pays well, and we are not hearing from doctors and hospitals regarding how much they “don’t earn” from Medicare and Medicaid. Their books are not open, and they do not have to share this information with us. We are hearing that hospitals and doctors are not adequately reimbursed by Medicare and Medicaid on a level with private insurance, but nobody is offering any actual numbers or annual reports of hospital profits that show a loss incurred by serving Medicare/Medicaid patients. They also neglect to tell us how Medicare supplemental plans figure into the mix, and you can bet that with a public option insurance companies would rush to market supplemental plans.
Second, doctors and hospitals currently spend significant time — and that means money, because they are paying staff — to sort through an ever-changing landscape of hurdles to payment constructed by insurance companies. Frequently this time is wasted, because claims are denied have to be re-filed or negotiated, or patients end up in financial difficulty or bankrupt. This process does constitute a cost or loss to the hospital, but that loss would disappear under a public option that served people well and prevented bankruptcies.
Third, doctors and hospitals can make adjustments. They can change to accommodate a new system. They can learn the ropes and adapt. People who need medical care are not as flexible. People cannot reinvent themselves to not need medical care. Illness, like the rain, falls upon everyone at some time or other, and medical care is a necessity that in a humane society literally must be available. And it must be available to everyone, or it does not work. Individuals, even those who are marching with the Tea Party brigade, will admit that they would rather live among healthy people than among people who are ill and can’t afford treatment. Lots of illnesses communicate to others, and I sincerely hope that all of people stocking the shelves of the stores where I shop have health care. I hope the person who cleans my office has good health care. I hope the person who puts my clothes on the hanger at the laundry has good health care. I hope my waitress at Logan’s has good health care. I hope my grandchild’s classmates have good health care….
I see the hour is late and I am becoming redundant. We need the public option. We all need all of us to be able to go to a doctor when we are sick.
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