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Universal Healthcare and Physical Therapy
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Universal Healthcare and Physical Therapy - February 27, 2008 10:20:00 PM
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JDMBBuilder
Posts: 56
Joined: December 16, 2004
From: Long Island
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How will universal healthcare affect physical therapy reimburement and/or physical therapist salaries if it comes into effect? I've heard many different opinions about it...what's your take? Let's keep this civil...
< Message edited by JDMBBuilder -- February 27, 2008 10:33:48 PM >
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RE: Universal Healthcare and Physical Therapy - February 29, 2008 1:58:36 PM
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KIDPT23
Posts: 222
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From: Illinois
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If that happens our system will be operated like this....10,000-20,000 square foot facilities that has one doctor as the medical director...all the patients will be seen by nurse practioners and PA's and all rehab will be done by personal trainers
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RE: Universal Healthcare and Physical Therapy - February 29, 2008 2:45:04 PM
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aph401
Posts: 82
Joined: April 16, 2007
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FOR THE SAKE OF HEALTHCARE.. VOTE JOHN MCCAIN 08!
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RE: Universal Healthcare and Physical Therapy - February 29, 2008 3:11:13 PM
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T_Thom
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Given what is happening in the UK, AU, NZ, Scandinavia, etc. where there is universal healthcare, I think the model for PTs will be more like spine care program at the Virginia Mason Hospital in Washington State. How many Americans are making regular trips Canada & Mexico for drugs, and across the globe for various surgeries? Thailand, Singapore, and India for medical vacations to me is a sign things need to change.
The point of this type of system is to be cost effective AND treatment effective. Under the MD> PA/NP >Personal trainer model, many red flag diagnoses will be missed, and treatment will not be effective, thus driving up the cost of healthcare. Disease management and prevention will be a greater part of the focus, reducing and delaying the need for surgeries, and decreasing the burden on managing primary care or preventable issues in places like emergency departments.
< Message edited by T_Thom -- February 29, 2008 3:29:00 PM >
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RE: Universal Healthcare and Physical Therapy - February 29, 2008 4:10:36 PM
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orthotherapist
Posts: 218
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A true universal healthcare system will likely not occur anytime soon - too many hands (medical associations, pharmaceuticals) in the pockets of those (politicians) that are needed to have change occur.
Think about the economic impact of this type of change - not just in the medical community but throughout the economy. Healthcare as a component of GNP is huge (one reason UHC is pushed) thus the efffcts of changing it are far reaching.
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RE: Universal Healthcare and Physical Therapy - February 29, 2008 5:12:02 PM
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T_Thom
Posts: 63
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You are correct, orthotherapist. They with the most and best lobbyists wins.
What are the highest paying jobs?
25 occupations with the highest median annual earnings in May 2006: Bureau of Labor Statistics
Scroll to table 2/3 down on webpage.
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RE: Universal Healthcare and Physical Therapy - March 13, 2008 11:14:21 AM
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JDMBBuilder
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From: Long Island
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I think the problem with Physical Therapy reimbursement is that there is price gouging between the few top insurance companies. There is no room for comptetition between these companies. They all work together to cut reimbursement to the providers...now if we can eliminate this than hopefully reimbursement for PT will be better off. Here's an excerpt from Obama's plan...
- Lowering Costs by Increasing Competition in the Insurance and Drug Markets: The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. There have been over 400 health care mergers in the last 10 years, and just two companies dominate a full third of the national market. These changes were supposed to make the industry more efficient, but instead premiums have skyrocketed by over 87 percent.
- Barack Obama will prevent companies from abusing their monopoly power through unjustified price increases. His plan will force insurers to pay out a reasonable share of their premiums for patient care instead of keeping exorbitant amounts for profits and administration. His new National Health Exchange will help increase competition by insurers.
- Lower prescription drug costs. The second-fastest growing type of health expenses is prescription drugs. Pharmaceutical companies are selling the exact same drugs in Europe and Canada but charging Americans more than double the price. Obama will allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S. Obama will also repeal the ban that prevents the government from negotiating with drug companies, which could result in savings as high as $30 billion. Finally, Obama will work to increase the use of generic drugs in Medicare, Medicaid, and FEHBP and prohibit big name drug companies from keeping generics out of markets.
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RE: Universal Healthcare and Physical Therapy - March 13, 2008 12:37:04 PM
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Kaden
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In the plan referenced above, who decides what is a "reasonable share." The current governement run program in Medicare consists of average reimbursement and outrageous administration costs. I am not sure how government (who can't even adequetly run MC or SS) overseeing a private organization(s) is going to improve the current situation.
Baracks plan on the surface looks great but how is he going to provide more regulation to private ins. providers without increasing their administration costs and giving them more reason to pass the increased cost onto the consumer.
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RE: Universal Healthcare and Physical Therapy - March 13, 2008 12:58:44 PM
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TexasOrtho
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Universal will likely mean more elligible patients at lower reimbursement per visit. Hard to see any model otherwise under any third party configuration.
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Universal Healthcare and Physical Therapy - March 13, 2008 1:06:39 PM
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Kaden
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Agreed Rod. The statement below was taken from Obamas website.
Affordable premiums, co-pays and deductibles
As you said, it would be hard to invision a system with lower premiums, copays and deductibles and add to that more eligble patients where reimbursement wouldn't be lower.
If reimbursement is lowered it will ultimately result in poorer quality care as fewer and fewer quality individuals choose to go into healthcare.
From a PT perspective I can't see spending 7 years in school, racking up 6 figure debt and come out of school to make less than we allready do. Imagine going to 7 years of school to come out and make 40K if reimbursement continues to fall. That would be a hard pill to swallow and I doubt many would choose to go that route.
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RE: Universal Healthcare and Physical Therapy - March 13, 2008 1:38:38 PM
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jesspt
Posts: 87
Joined: April 3, 2007
From: Illinois
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I agree with the posts above about the lower reimbursement rates, but I wonder if UHC comes to pass if the US will adopt a two-tiered system like the one in the UK. This might mitigate some of the effect of the lower reimbursement rates. Anyone with any thoughts on this?
_____________________________
Jess Brown, PT
Board Certified in Orthopaedic Physical Therapy
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RE: Universal Healthcare and Physical Therapy - March 13, 2008 8:35:14 PM
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aph401
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quote:
Baracks plan on the surface looks great but how is he going to provide more regulation to private ins. providers without increasing their administration costs and giving them more reason to pass the increased cost onto the consumer.
like ALL of his plans, it "sounds great" but any idiot knows we CAN'T AFFORD IT. give healthcare to everyone in the country, yeahhhh. change, yeaah. puh-lease! and who's gonna be paying for all of it? oh, we're gonna pay for it with the HUGE tax increase he wants, when single people at my hospital with no one to claim are already getting taxed at 35%! take out for insurance, 401k, etc, and that's about half your salary right there. i seriously don't know how anyone in good conscious could vote for him, ESPECIALLY if they work in healthcare.
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RE: Universal Healthcare and Physical Therapy - March 13, 2008 11:39:42 PM
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JDMBBuilder
Posts: 56
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From: Long Island
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what's McCain's plan?
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RE: Universal Healthcare and Physical Therapy - March 14, 2008 1:29:53 AM
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aph401
Posts: 82
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quote:
ORIGINAL: JDMBBuilder
what's McCain's plan?
first and foremost, for me personally, john mccain wants to lower taxes - agreeing with this issue is what, by default, makes me a republican. in terms of healthcare, i simply don't agree with the "big government" idea that clinton and obama represent - a throwback to the carter years - "government is the answer to all our problems", etc. EVERYTHING that the government runs is f*d up, to say the least. i think we can all agree on that. from the post office to the DMV. healthcare is not something that the government needs to run.. i wish people would watch the documentaries or news stories on the healthcare systems in europe and canada. it's free, but is it acceptable quality? thousands of surgeries get cancelled every year, people DIE waiting for the gov't to approve their applications to receive the lifesaving treatments they need. it is VERY INEFFICIENT.
anyway, *steps of soapbox*, to answer your question.. i HIGHLY suggest everyone read this article:
In essence, McCain wants to create a kind of national insurance market that shoves more decision-making power into the hands of consumers; the Democrat candidates are aiming for a Medicare-like federal superprogram. Who has the best plan? Both have huge flaws, but on balance McCain's is better.
McCain's main pillar is the elimination of a tax break that employees receive if their employer provides their health care. That may not sound like a shocker, but it is. The exclusion dates from World War II, when the federal government imposed controls on wages, but allowed companies to compete for workers by offering tax-free health benefits in lieu of pay. The law is largely responsible for the nightmarish patchwork of corporate-provided medical plans we enjoy so much today. Employees and their unions demanded richer and richer packages, and employers complied, since they could buy far more benefits for their employees than workers could buy with after-tax dollars on their own. Americans have paid a steep price, however, by sacrificing their raises as corporate insurance bills exploded, never more so than now.
McCain suggests that we junk all that. Say you're earning $100,000 a year and your company provides about $9,000 toward your $12,000 family premium, which is about average. Today you're taxed only on the $100,000. Under McCain's plan, you'd also pay on the $9,000. That could mean an extra $3,000 or so in federal taxes alone. To compensate for the extra levy, McCain would provide a $2,500 federal tax rebate for individuals and $5,000 per family, meaning a family would simply subtract $5,000 from its tax bill, the equivalent of a big cash payment.
Here's where it gets interesting. Employers would no longer be able to buy more health care with $9,000 of their employees' money than the workers could buy on their own. The raison d'être for corporate health benefits would vanish. Employers have another compelling reason to pass the ball to the employee: While wages are rising around 3% ayear, their health-care costs are growing at three times that rate. "I predict that most companies would stop paying for health care in three to four years," says Robert Laszewski, a consultant who works with corporate benefits managers. Hence, an employer that pays $9,000 for your benefits would simply pack an extra $9,000 a year into your paycheck. (Why? Because in a competitive labor market, companies would have to hand over that cash to employees or risk losing them.) So you'd have $6,000 after tax, plus the $5,000 family credit, to buy insurance. That's $11,000 in new cash that employees can set aside for health care.
So what types of policies would they buy? Employees (and their families) with corporate plans - about 150 million Americans - would probably rush toward high-deductible, low-premium insurance, and use what's left over to pay cash for routine procedures. They would couple those high-deductible policies with Health Savings Accounts, which allow families to put away up to $5,800 ayear, before taxes, for medical expenses. Those plans cost about $10,000. That's not a huge saving from the typical $12,000 corporate plan, but it's a start. More than four million Americans already have HSAs, and the McCain plan would make portable, high-deductible plans the product of choice for a new generation of healthcare consumers.
Besides eliminating the employer exclusion, McCain's plan boasts another nice feature. It would allow consumers to choose an insurance plan that suits their stage of life. If you're young and healthy, for example, you probably want the cheapest plan you can get. If you're 45 and have four dependents, maybe you want something a bit more expensive and generous. Nine states, including New York, California, and Texas already require that as many as 50 benefits be covered, a list that ranges from in vitro fertilization to mental health services to prescription drugs. These requirements increase the cost of insurance; they're a major reason young people have dropped their coverage. Under the McCain plan, insurers in any state would be free to offer the plans with a vast variety of deductibles, co-pays and benefits. UnitedHealthcare and Blue Cross/Blue Shield plans already provide a menu of packages tailored to groups as varied as Gen Xers and retirees.
NOW FOR THE DEMOCRATS. The core of their plan is a "pay or play" option for employers. Large companies would have the choice of either providing benefits for workers or dropping their coverage. If they chose the latter, they would pay a mandatory payroll tax to support a new government-administered system. That system would have two parts: a Medicare-like public program, and a menu of private options similar to the generous plans available to U.S. government employees today. Workers who are self-employed or lack insurance would go straight into one of these two options. Low-income Americans would receive federal subsidies to purchase the premiums.
In practice, the system would quickly swell the ranks of Americans with government-paid health care. Remember, health-care costs are rising far faster than wages, so companies have a strong incentive to pay the tax and erase that rapidly growing burden from the books. It's also likely that the government plan will offer better benefits than many, or perhaps most, corporate plans. In fact, the Democrats call for rich standard benefits packages based on the plan offered to federal employees. Those packages would have deductibles of just $300 and offer prescription drugs, mental health benefits, and "spinal manipulations" (i.e., chiropractic services), among a cornucopia of other benefits. As a result, the federal plan, potentially packed with new benefits pushed for by lobbyists for various medical specialties, will quickly cause an exodus from employer plans.
The standard benefits package isn't just a bad idea because it will substantially raise the cost to taxpayers. It will also make it virtually impossible for Americans to buy insurance tailored to their needs. Suppose you're one of those 25-year-olds. You probably don't want to spring for a full-blown plan that covers old-age diseases like Alzheimer's and would rather save some money and go with a low-premium, high-deductible plan. But the Democrat approach requires that any competing plans be "actuarily equivalent" (Clinton's term) to the federal employee plan - which translates as a generous minimum standard for health insurance. "With that mandate, you rule out high-deductible plans," says Gruber. "It would make it very difficult to design one that would qualify."
The Democrat proposals have some additional drawbacks. First, the Dems want to heavily regulate the insurance industry by limiting everything from profits to marketing expenses. If the earning power of insurers is determined by federal regulators, their pricing will be too, and thus they will evolve into the equivalent of public utilities. Would you rather have medical prices set by fiat or by nationwide market competition?
Second, the Democrat plan exacerbates the fundamental problem in the American health-care system, which is that no one has any incentive to care about price. (How much is that MRI center charging for your ankle scan? Who cares? Just hand over the $50 co-pay and never you mind.) Creating a huge new medical superstructure would shift far more spending to third-party providers, chiefly the federal government, giving consumers even less incentive to concern themselves with the price of an MRI - or any other service, from an elective wart-removal procedure to a life-saving heart bypass. "The Clinton and Obama plans would enormously increase total health-care spending, but disguise the extra costs by shifting them to taxpayers," says John Sheils of the Lewin Group, a research firm that does statistical modeling for health-care plans.
cnnmoney.com - Fortune - March 11th 2007
< Message edited by aph401 -- March 14, 2008 1:33:56 AM >
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RE: Universal Healthcare and Physical Therapy - March 14, 2008 10:39:12 AM
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orthotherapist
Posts: 218
Joined: February 6, 2007
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As I previously stated IMO not much will change regardless of who is in office. There are too many hands in the pot all making money off of the current system. Change one thing corpoorate behemoth ABC will complain and fight. Change another aspect company XYZ will fight and we all know that $$ rules the government decision makers.
As far as the plans you outline above where is the reference for this. I would be interested to read more. Does McCains plan require people to purchase insurance or can they chose to go without? Does it require insurance companies to insure all that come through the door (ie those with pre-existing conditions) or will they be able to "cherrypick"?
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RE: Universal Healthcare and Physical Therapy - March 14, 2008 11:06:20 AM
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A20RepSquat
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"a research firm that does statistical modeling for health-care plans."
Is this a pre-cursor to allow the health-care plans to actually write the laws?
_____________________________
David Adames, LMT, sPT
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RE: Universal Healthcare and Physical Therapy - March 14, 2008 12:26:02 PM
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Shill
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From: Madison WI USA
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In order for me to believe anything about anyone's plan, I would have to find the description of the plan in a reputable, unbiased place. Are there any unbiased sources of information such as this anymore?
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RE: Universal Healthcare and Physical Therapy - March 14, 2008 1:05:09 PM
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aph401
Posts: 82
Joined: April 16, 2007
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quote:
As far as the plans you outline above where is the reference for this.
it's below the article - it's from fortune magazine and the article can be found on cnnmoney.com. it's entitled "why mccain has the best healthcare plan", written on march 11th by the editor at large. this was just the most clear and concise thing i've found, but this information is everywhere, in any article on the topic.
quote:
As I previously stated IMO not much will change regardless of who is in office. There are too many hands in the pot all making money off of the current system.
i respectfully disagree with this. congress is democratic right now, and should there be a democrat in office, things will get done. the problem lately has been that although we've had a republican in office, he can't do much considering congress is still mostly democrat. i think obama and clinton would have a much better chance of making drastic changes (for the worse).
quote:
Does McCains plan require people to purchase insurance or can they chose to go without? Does it require insurance companies to insure all that come through the door (ie those with pre-existing conditions) or will they be able to "cherrypick"?
no, mccain's plan does not require that people purchase insurance. as for cherrypicking, i don't have any specific information on that, but unless we go to socialized healthcare, there will be some of that just as there is right now and always has been. i don't see mccain's plan changing that either way. howver, that's just my opinon, i don't have any info on that. regardless, the downfalls of the clinton/obama plans are far bigger issues to me than the potential benefits of any of the 3's plans.
quote:
In order for me to believe anything about anyone's plan, I would have to find the description of the plan in a reputable, unbiased place. Are there any unbiased sources of information such as this anymore?
well, this came from fortune magazine which is, in my opinion, a very reputable source. however, this same information can be found on johnmccain.com as well as the websites of the other candidates. you can also read articles on the topic ANYWHERE.. they contain mosty the same info, as the plans outlined in the article have come straight out of the candidate's mouths. but i suggest everyone research thoroughly.. lots of info out there, and people need to understand these policies beyond the surface and the "healthcare for everyone" promises that are so appealing to many.
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RE: Universal Healthcare and Physical Therapy - March 14, 2008 1:56:11 PM
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orthotherapist
Posts: 218
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Must make statement first - I am not a democrat or a republican so i am not campaigning for one over the other:
On the surface the McCain plan sounds great - more money in my pocket, less taxes, etc. However costs are always shifted specifically in the insurance field. With his plan many younger workers may decide they are low risk thus not purchase insurance. Something catastrophic happens and now who foots the bill - you and me.
Fortune magazine uses example of someone with $100000 job (probably consistent with the average reader of this magazine) that has a job that provides insurance. I would have to say that this magazine likely has a high rate of readers that are licensed republicans based on the topics etc.
Once again I am not bashing you or your thoughts - strictly that we should be able to read between the lines, and not take everything we read as gospel. The way in we look at things is often clouded if we are already biased in our thoughts/ideas.
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RE: Universal Healthcare and Physical Therapy - March 14, 2008 3:02:41 PM
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aph401
Posts: 82
Joined: April 16, 2007
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well, i'm a republican so obviously i'm voting repbulican, but it's not biased to say that the democrat candidates want to socialize healthcare and raise taxes-- these are things they adamantly say themselves. personally, i'm completely against both of those things, and thus i'm voting john mccain. i work hard, sacrifice to pay for my insurance, and am sick of paying for government handouts for the people who don't. sorry if that sounds harsh, but that's how i feel. we do this enough as it is, i can't possibly bear doing it MORE. "get up and go to work every day: millions on welfare depend on your ass."
that being said, there is no "perfect" healthcare plan. you can't make everyone happy, and this is true of anything. you have to weigh the pros and cons of what you're offered and pick the best option.. and i believe most level-headed, hard working, sacrificing people do not want to see universal healthcare and higher taxes.
< Message edited by aph401 -- March 14, 2008 3:05:20 PM >
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