Florida was slated to receive five billion a year for ten years for a total of over fifty billion dollars. These are not new federal taxes. These are federal tax dollars paid by the residents of Florida. Other states can say thank you Florida taxpayers.

Funny, I just opened another medical bill. This one is from a radiology company where I had some x-rays done.
The bill reads like this:
Xray Chest - 2 Views $88.00
Insurance Check $12.55
Insurance Write Off $60.45

Co Pay Due $15.00

The company gets $27.55 for a procedure that they charge $88.00 for. The reason that they charge $88 in the first place is that they know that the insurance companies are going to require a 69% discount. A person without insurance will pay $88.00.

I have been saying for years that this is a major factor in driving up the cost of health care and making it impossible for people without insurance to pay for. It's volume discounting run amok.

Not only that, but you have to run your educational system according to the rules and regulations set up by the federal government. Some of these may not work in Florida. What works in Montana doesn't necessarily work in Florida.

It might be better if the federal government didn't take this money away from Florida in the first place. Let us keep our own money and deal with our own problems. I don;t think that a plane ride from Tallahassee to Washington DC makes a person all that much smarter.

I am a retired RN in North Carolina - hoping to move to TV soon. These problems are not unique to The Villages hospital. Basically the same thing is happening everywhere. I've worked in several large hospitals, and like most of you I've had family members in a number of hospitals as well. My best advice would be to avoid the ER almost at all costs. They are strictly for true emergencies. Unless you have potentially life threatening symptoms try to see your personal physician before you go to the ER. And, at lease phone his emergency/night/weekend phone number and report your problem if possible, before you go to the ER.

I had an insuranc background (property/liability) however worked in Human Resoruces so was on the Life/health side too. I had a hate/love relationship witht eh fact that insureres got heavily involved in health isses in the 1980's (i.e second opinions, require authorizations for hospital stays, etc. some of it was good because of over use by both doctors and consumers and some of it interefered with medical best practices. the medical community adapted by uping their fees knowing cuts were coming.

To emphasis the point of overuse the only medicl area that could not be entire controlled was with those states that had No Fault Ins urance (PIP) flrodia, New York, New Jersey, etc. I can tell you factually some doctors, lawyers police officers, and their clients milk that system for all it was worth.

the Affordable Act is going to be all that is not good about our present system nd its going to be it on steroids. If you believe its bd now...just wait
Bottom line for me I wish the government and the insuranc ecompanies would let the market settle all of this.....but they won't lastly advances intchnology and the ability to extend life has also plenty of play here ....as does defensive medicine in order to avoid being sued or more to the pointthe fear that the docotr will lose a suit and his/her reputation especially if it is against a creative attorney like John Edwards of North Carolina who drove more doctors out of the state over his histronics in the court room

Florida turned down billions for high speed rail too. I'm not "smart" enough to know if this is good or bad---only time will tell. Since anything that might be political is not allowed discussion on TOTV, that's all I have to say about that!

PM sent your way....

G-Person..you're not asking a wrong question. There are no easy answers. However, let's assume for a minute that there was nothing else that TVRH could do. (I don't believe that for a minute) By cutting all of these incentives away from the professional staff, the hospital is left with choosing from people who essentially can't get a better deal anywhere else. That doesn't bode well for the hospital in general.

There are a set of problems that challenge the hospital that are unique to TVRH. We've talked about lack of beds, lack of an increasing revenue stream and lack of staff. Now, many of the kind of professional people you might want on staff can't live here. If you've got a sharp nurse or other medical professional in their upper-30's or early 40's who would be an asset to the hospital, where will they live? They'll have to commute. So if the hospital is going to pay poorly, why commute and have the fuel expense and travel time? In today's world it doesn't make any sense.

In the letter the hospital administration sent out, there wasn't a peep about consolidating multiple management levels, looking for savings in purchasing or service contracts or other areas of cost savings, only cutting professional incentives.

The vast amount of complaints on this board about the hospital is how slow everything moves. So if you cut the pay of the people who you're counting on to keep things moving, why in the world would they want to work harder for less money..AND..commute?

The letter sent out by the hospital does not sound like a comprehensive plan. It sounds like this was the EASIEST thing they could do. Bad for their staff and bad for their community.

More Medi-CAID dollars will not help TVRH one scintilla. The bulk of their income is from Medi-CARE. Medi-CAID revenue at TVRH is so small as to be irrelevant.

The Medicaid expansion called for under the Affordable Care Act would insure close to one million uninsured Floridians. Anyone earning 150% of the poverty rate would be eligible. This would probably apply to most of the employees of The Villages, plus most of the waitstaff and other service personnel.

Five billion federal dollars injected into the health care system in Florida would be better than having close to one million uninsured Floridians show up at the emergency rooms across the state and receive free health care. If hospitals didn't have to eat this loss, perhaps more jobs and benefits could be saved.

BTW: not to get too political, but the governor, the state senate, all hospitals, the chamber of commerce, and others all supported this expansion.

Is a $2,000 Deductible 'Affordable'?

NEW YORK (CNNMoney)

Until now, much of the debate swirling around Obamacare has focused on the cost of premiums in the state-based health insurance exchanges. But what will enrollees actually get for that monthly charge?

States are starting to roll out details about the exchanges, providing a look at just how affordable coverage under the Affordable Care Act will be. Some potential participants may be surprised at the figures:

$2,000 deductibles, $45 primary care visit co-pays, and $250 emergency room tabs.

Those are just some of the charges enrollees will incur in a silver-level plan in California, which recently unveiled an overview of the benefits and charges associated with its exchange. That's on top of the $321 average monthly premium.

Obamacare: Is a $2,000 deductible 'affordable?' - Jun. 13, 2013

What is the cost for other states? And what is the cost for pre-existing condition insurance? Before Affordable Health Care Act, I was paying $368 in Michigan for a policy with a $7000 (yes, $7000) deductible due to a pre-existing condition. For a $2000 deductible, the cost would have been close to $1000.

Management doesn't cut management.

I'm not talking about taxes. When you accept Federal money to fill a budget gap, that money better continue to flow into your budget at the same rate or you will have a problem. Simple math, if I have a 10 dollar budget and I have five dollars of income, I have two choices: shrink my budget or increase revenue. If I increase my revenue and not cut my budget, I better be sure that revenue continues or I'm just prolonging the pain. This is exactly what happened in Marion County. Only there, the federal government shut off the spigot!

First let me say I am a strong advocate for Universal Care. The structure of the healthcare system is invalid for we pay only for services delivered regardless of true benefits for the patient. We see the doctors to often with unnecessary care in the US.
Time Magazine recently had an article on our healthcare system and the ‘charge masters’ which is a comprehensive lists of charges for everything (e.g.gauze pads, aspirins, saline solutions etc.) for hospitals use throughout the country.

At many establishments there is ‘circle the wagons’ mentality but some are taking a comprehensive review of the impacts on programs to reduce healthcare coats and improving health outcomes. The Affordable Care Act is here and we must deal with it. Here in The Villages they are implementing Village Health Care Centers (one currently at Colony) others soon to be opening that will hopefully look more at preventive measures of health (pro-active) which will lower the cost of healthcare and be more beneficial to all of us.

Thanks - I was unable to respond because you have your PM receive off. Thanks for the data though.

Russ

A new hospital was opened in my area two years ago, consolidating two others that had been around for the decades. It has less beds than the other two combined and was going to be a Level 2 Trauma Center. Still waiting for the Trauma Center and staff layoffs began three weeks ago. I asked why less beds when at times EMS had to be placed on divert, my answer was the state determines the amount of beds to be placed. This is going to become a nationwide problem.

A new hospital was opened in my area two years ago, consolidating two others that had been around for the decades. It has less beds than the other two combined and was going to be a Level 2 Trauma Center. Still waiting for the Trauma Center and staff layoffs began three weeks ago. I asked why less beds when at times EMS had to be placed on divert, my answer was the state determines the amount of beds to be placed. This is going to become a nationwide problem.

And now you see how evil are insurance companies.
 

Had you gone with the 2000 deductible instead of the 7000 deductible it would put the insurance company at risk for 5000/yr. And to cover you for that 5K they are charging you an additional how much? Using 950 as your "close to 1000" it would be 950 - 368 or 582 more dollars per month times 12 months for a bill of 6984 dollars to cover 5000 in risk. Of course some years you might not have 7000 in charges so the real risk is even lower than 5000. I'd love to own a business where you pay me 6984 and then I might have to give you 5000 maximum if things go badly for you.

What they covered after that $7000 was d*** little, and my pre-existing condition was at small risk of returning. So I think they made out like bandits. I have little sympathy for medical insurance companies. Why aren't they going after the hospitals who charge $6800 for a colonoscopy when other first-world countries charge $1500, instead of taking it out on their customers?

Our son tore his ACL in college in Maine, and because he wanted to have it fixed in MI so he could recuperate at home with us, the hospital here charged him $30,000 for the operation because he was "out of network" for his Maine insurance. If he hadn't injured himself in a school-sanctioned sport, he would have been liable. What kind of a rip-off is that?

There are less and less hospitals that are independant. Meaning that most are now owned by corporations, hedge-funds and investment entities. Business now runs almost all hospitals and clinics. Business people care about the bottom line. Don't mix up the compassion of nurses and doctors to the business ethic of making money. Most if not all of the corporations who own these hospitals don't even have a doctor on their boards.