I wrote on the other thread re: T.V. hospital and will here as well. Did any of you read Dear Heloise in today's (3/18) Sun? A person wrote in telling of their experience in an "ATLANTA" hospital.

I personally have always had good care at TVRH, even when they were slammed a year ago after hurricane Irma as well as the flu epidemic. I was there 3X during those months for dire health issues and surgery.

I sincerely hope you are right Gracie. And I truly mean that. But I remain concerned.

I think the boomers, especially the younger boomers, and those even younger than that, really need to be paying close attention and remembering that they do have their own critical thinking skills to apply. But (sigh) I fear Pogo might have been right.

It is a big picture and I believe the answers are in the middle.

How the system really works
 

I've been a healthcare consultant for 25 years or more and am still actively working. I'm almost afraid to post on here because when I do, people mostly tell me I don't know what I'm talking about. All I can tell you is I've done work for a large number of Fortune 500 companies so believe I have a pretty good grasp of how health care works (or doesn't...). If you google rural hospitals, you'll find many are closing because they only receive funds from Medicare and Medicaid which reimburses hospitals at far lower levels than private insurance for the under age 65 population. As an example, across the country, the Blues pay hospitals about 325% of Medicare on average. So that tells you why having people under 65 with commercial insurance (not govt.) provides more revenue to a hospital and does help attract better talent, money, and as a side impact, raise the quality of care simply because these facilities have more financial resources. Every time a politician tells you they are going to control the cost of healthcare by not increasing payments to Medicare providers, these are price controls. It's why the cost of healthcare rises so much on the other side of the coin, meaning the private side where they are subsidizing the govt. paid insurance. None of these comments are meant to indicate what's right, what's wrong, or what the fix is....only to help you understand how it works.....I'm sure many on here who won't believe what I say.......thanks...

I didn't understand your post and I tried. Who are "the blues"?? And, do you think this hospital, TVRH fits into the typical "rural hospital" you speak of or one with a lot of people backed by company insurance? Please clarify for me. I think you saying that our government entitlement of Medicare will cost us more because it is costing the country more?

I just want to understand what the number here mean. Aren't rural hospitals small by definition, something 25 beds or so? I don't think that Villages Hospital or the others in this area are rural hospitals, are they?

My guess is Blue Cross, Blue Shield.

Currently, Medicare pays out about $11,000 per year in benefits per eligible patient. This is about one-third more than the amount the average person pays into the Medicare system. So, Medicare is losing money and it is unsustainable. We need to either reduce the benefits or increase the cost to taxpayers. Or, just wait for the whole thing to collapse.

What I think is being said is that hospitals that have a large majority of patients on Medicare/Medicaid for the most part get less money than those who have more patients with private insurance. Private insurance tends to pay more. That leads to higher pay, better staff, etc.

From my experience the problem is the emergency room. There is simply not enough staff at times. I don't know what can be done about that. Regarding the waits that is to be expected especially without a life threatening emergency. Have spent hours at ER with Dad long waits, sometimes in waiting room. However, he was being evaluated and treated. A long wait Inman ER seems standard to me anywhere in the country.

I can't speak from experience with the hospital but according to a good MD friend of mine located here, it's extremely difficult to attract younger medical professionals to this area. The population is so much older and the overall lifestyle, recreational, restaurant, entertainment options aren't very appealing to younger people/families. Hospitals/med practices can't compete in the $$ area either compared to more urban areas and being within 25 miles of an urban area is a must for many. Unless there's a personal reason for one to move to the TV area, it probably isn't on anyone's top 10 list. This all starts to take it's toll on a hospital as older docs/nurses etc retire and they can't attract top talent.

I really find it hard to believe that Blue Cross pays more than 3 times as much for a procedure than Medicare. I have had the Blue Cross Federal employees plan for more than 40 years, and now that I am over 65, my Blue Cross preferred providers are limited to the Medicare approved amount even though I do not have Medicare Part B. This is the law. But, I have not had any trouble being treated by preferred providers, and I have not seen a tremendous drop in the reimbursement amounts that they receive.

I wonder how many people pay into Medicare their entire working life and pass away before becoming eligible to use the program they paid into for their entire life? What happens to those funds? Does The Dearly Departed's Family get that money back? Are there enough people who pass to help level out the field money wise?

It's an insurance premium just like the car insurance premium that you never get back. It goes to pay for medical care for those who need it. But, sadly, it still is not enough to cover the cost of the benefits that are paid out. The system is broke because they are not charging enough to cover the benefits that they pay. No, it does not level out.