Why are Medicare and Medicaid reimbursement rates so low?
A doctor friend of mine recently told me that when he bills a private insurer for a procedure, he normally gets between 40% and 90% of the cost reimbursed. But when he bills medicare he gets 20% of the billed amount, and when he bills medicaid he gets about 10% of the billed amount back.
So my question is: why do Medicare and Medicaid reimburse at such low rates?
That is simply the solution that has come from the Gov't to cut costs. They'll just not pay the provider. I have two Dr's in the immediate family. They at times get as low as 8-10 cents on the dollar. Many Dr's are simply opting out. I expect that to increase. Many people don't understand the difference between having insurance and actual care. This will get worse before it's fixed. In reality this creates even a bigger price distortion. The Dr's often over bill more to private insurers to account for the difference. In many cases they will turn a sinlge procedure into two or three procedures to actually get paid enough to stay in business.
The reality is that if health insurace was not only more privatized, but also used the way we treat other forms of insurance like auto and homeowners, the cost of care would go down dramatically. There is no price negotiation between the consumer and the health provider anymore. The system is a real mess. It's more of an economic problem than anything else, and people are looking for emotional solutions. People assume that if they paid for basic maintainence out of pocket it would be unafordable. That's nonsense. If most could not pay then the Dr's are going to have to lower costs. If not they would go out of business. Right now they can't lower their rates because they're not getting paid as it is and mandated to do many things they would not otherwise choose to do. The current laws have turned the system into a volume business like a fast food chain.
As a result Dr's don't make nearly what many think. The average compensation for a general internist in the US in now about 100k. Compare this to a NYC bus Driver. When you look at their salary after 5 years on the job plus benefits like insurance, pension etc, they make more in total compensation. If that's not a distorted market, than I don't know what is. No disrespect to bus drivers, but they don't need to go through the hellish gauntlet that a Dr's does to be qualified to operate on you liver.
This is a good answer, and in line with what I've read elsewhere. Someone else pointed to Lasik and cosmetic surgery as a model for the whole industry. Insurance won't cover those procedures, and costs have gone down.
Cosmetic surgery has come down in price while advancing in technology and availabilty. Rarely is it covered under insurance. A few exceptions like a breast reduction for someone with a back problem. But the answer is clear but not popular politicly
by Eric Seidel 6 years ago
Can anyone explain the Affordable Care Act to me?I was honestly going to make a Hub about this, asking this very question, and I had written 800 something words on the subject. Ok actually it's more like a mild rant, but I think this would be better as a Hubpages question rather than a Hub that no...
by Susan Reid 10 years ago
If you are insured through your employer, the answer is no. If you are an individual or small business owner, please share your thoughts.Did you know there will be online health care insurance marketplaces (exchanges) in every state?Is your state running its own exchange ... ...or is it...
by MikeNV 13 years ago
How many of you would accept a 21% cut in pay if you didn't have to? Doctors don't have to. How many. Leave your comment if you are willing to accept a 21% cut in pay.I just read this rather interesting comment..."OBAMA-CARE KILLED MY DAD ---- Obama just cut Medicare...
by Stacie L 11 years ago
Obamacare will save Medicare $200 billion by 2016by Joan McCarterFollow The Centers for Medicare & Medicaid Services actuary reports: "We have achieved significant tangible savings that have been passed on to beneficiaries," said Jonathan Blum, director of the Center for...
by Amanda S 11 years ago
Do you think people on welfare should have to pay a copay?It is no secret that the state of our Healthcare system is a mess and that welfare is abused. Having people on welfare pay copays, even something as nominal as $1 office visits, $2 urgent care, $10 emergency room $10 ambulance rides would...
by JAKE Earthshine 4 years ago
Everyone knew this atrocious scheme by Donald Trump was coming sooner or later, and we must Thank the Good LORD “Powerhouse” Nancy Pelosi and her new Progressive Democratic House of Representatives were voted in during the last midterm election and can now OBSTRUCT & Halt Trump’s and his...
Copyright © 2024 The Arena Media Brands, LLC and respective content providers on this website. HubPages® is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. The Arena Media Brands, LLC and respective content providers to this website may receive compensation for some links to products and services on this website.
Copyright © 2024 Maven Media Brands, LLC and respective owners.
As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.
For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://corp.maven.io/privacy-policy
Show DetailsNecessary | |
---|---|
HubPages Device ID | This is used to identify particular browsers or devices when the access the service, and is used for security reasons. |
Login | This is necessary to sign in to the HubPages Service. |
Google Recaptcha | This is used to prevent bots and spam. (Privacy Policy) |
Akismet | This is used to detect comment spam. (Privacy Policy) |
HubPages Google Analytics | This is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy) |
HubPages Traffic Pixel | This is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized. |
Amazon Web Services | This is a cloud services platform that we used to host our service. (Privacy Policy) |
Cloudflare | This is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy) |
Google Hosted Libraries | Javascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy) |
Features | |
---|---|
Google Custom Search | This is feature allows you to search the site. (Privacy Policy) |
Google Maps | Some articles have Google Maps embedded in them. (Privacy Policy) |
Google Charts | This is used to display charts and graphs on articles and the author center. (Privacy Policy) |
Google AdSense Host API | This service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy) |
Google YouTube | Some articles have YouTube videos embedded in them. (Privacy Policy) |
Vimeo | Some articles have Vimeo videos embedded in them. (Privacy Policy) |
Paypal | This is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy) |
Facebook Login | You can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy) |
Maven | This supports the Maven widget and search functionality. (Privacy Policy) |
Marketing | |
---|---|
Google AdSense | This is an ad network. (Privacy Policy) |
Google DoubleClick | Google provides ad serving technology and runs an ad network. (Privacy Policy) |
Index Exchange | This is an ad network. (Privacy Policy) |
Sovrn | This is an ad network. (Privacy Policy) |
Facebook Ads | This is an ad network. (Privacy Policy) |
Amazon Unified Ad Marketplace | This is an ad network. (Privacy Policy) |
AppNexus | This is an ad network. (Privacy Policy) |
Openx | This is an ad network. (Privacy Policy) |
Rubicon Project | This is an ad network. (Privacy Policy) |
TripleLift | This is an ad network. (Privacy Policy) |
Say Media | We partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy) |
Remarketing Pixels | We may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites. |
Conversion Tracking Pixels | We may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service. |
Statistics | |
---|---|
Author Google Analytics | This is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy) |
Comscore | ComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy) |
Amazon Tracking Pixel | Some articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy) |
Clicksco | This is a data management platform studying reader behavior (Privacy Policy) |