I’m not sure what you mean by a public insurance plan capping fees. All insurance plans cap fees, if you mean that reimbursement is set at a fixed amount (either administratively or through negotiation) for providers.

Medicare outcomes are great, and satisfaction rates are high. Every proposal in Washington calls for the public option to pay higher rates than Medicare — somewhere between Medicare +10 and Medicare +20. And since the AMA has endorsed the strong public option by embracing the House plan, I’m guessing they aren’t too worried about docs going out of business.

Now, the cost for treating Jerry would go down (for Jerry) b/c the insurance exchanges proposed, and the public option, all cap total payments at a percentage of income as nearly every policy analyst recommends. The cost for treating Jerry would go down because both the House and Senate plan begin to readjust payments to create Accountable Care Organizations and medical homes. And, by the way, reimbursements are increasing for primary care physicians under Medicare, not decreasing.

The general cost of insurance will also fall as everyone gets into the pool with individual and employer mandates, which is much how the German system works — but I’m sure you know that already, being a good German and all.

And, for the record, single-payer is not on the table in Washington.

Single payer will slash administrative costs and eliminate insurance profiteering which is based on greed not sound healthcare.

Presently, “fees for service” tends to drive up costs, whereas reimbursement based on treatment and patient well being will drive them down. Clinics all over the country are dramatically lowering costs with this approach and the doctors and patients seemed to be thrilled.

Duke Hospital has 900 beds and 900 billing clerks-that’s because there are 1200 health insurance companies that Duke has to deal (fight)with. The public option makes 1201.——-Single payer–just one. That will save some money, don’t you think!

Simplicity that benefits everyone or complexity that benefits only a few. Single payer now!

Do you know any medical providers who are thinking of quitting their practice because of the unreasonably low reimbursements they receive for treating medicaid/medicare patients?

No? Single payer uber alles you say?

Viel Gluck.

You still haven’t answered how the costs of treating Jerry for a chronic illness will be reduced?

But by all means, lets continue to demonize the insurance companies.

We are led to believe that insurance drives down costs when actually it tends to pump them up. Providers charge an inflated “list” price, but what they actually expect is considerably less. The uninsured that are not aware of these negotiable aspects are getting clobbered when all they are trying to do is the right thing——pay their bills! You know, even if they knew they could negotiate, maybe they are still recovering from their illness or injury and just don’t feel up to it! The madness continues!

There are a thousand questions but only one answer—single payer.

Everyone – as Cheryl says – should pay what they can afford for health insurance. But, if you get seriously ill, that insurance should be a guarantee that all you have to worry about is getting better – not how you are going to find the money to pay for care.

That’s why we need reform. No one’s talking about removing “profit” from the system. After all, BCBS is now supposedly a “nonprofit” anyway.