Socialized Medicine

DrugReptoNurse · Jul 23, 2009

This is information taken directly from the AANA website. If we go with socialized medicine CRNAs will take a pay cut. There is no way around it. Private insurance pays more for the same procedures. Government pays less hence.....we will make less.

GAO Report Confirms: Medicare Underpays for Anesthesia Services;

Nurse Anesthetists Assure Seniors Access to Safe Anesthesia Care

Park Ridge, Ill. - A new report issued by the U.S. Government Accountability Office (GAO) confirms that Medicare anesthesia payments are 67 percent lower than anesthesia payments from private insurance coverage, and that America's Certified Registered Nurse Anesthetists (CRNAs) are essential to ensuring that America's seniors have access to safe anesthesia care for surgery, pain management, and other needed healthcare services.

"Medicare pays about 87 percent of market rates for most services, but about 34 percent for anesthesia services--a level even lower than another government report found just five years ago," said Wanda Wilson, CRNA, PhD, president of the 36,000-member American Association of Nurse Anesthetists (AANA). "While the cost effective and high quality services of CRNAs have made it possible to meet the needs of seniors, such low reimbursements are not sustainable, nor are they good for the overall health of the Medicare program. The AANA is asking the Centers for Medicare & Medicaid Services and Congress to work together to reverse anesthesia payment cuts for all anesthesia providers and restore fair anesthesia payment. And we urge the public to join with us."

Despite the fact that Medicare payment for anesthesia services is far below comparable payments for other Medicare services, the GAO's August 27 report confirmed that the nation's CRNAs play a crucial role in ensuring that seniors have access to safe anesthesia services. "We generally found fewer anesthesiologists in localities with a greater concentration of Medicare beneficiaries," the GAO report stated. "In contrast, we generally found more CRNAs in localities with higher concentrations of Medicare beneficiaries."

In addition, the report shows that in localities where the gap between private anesthesia payments and Medicare payments are relatively small, anesthesia services are more likely to be provided by CRNAs. Conversely, in localities where the gap between private payments and Medicare payments is relatively wide, anesthesia services are less likely to be provided by CRNAs. These conclusions confirm the cost-effectiveness and efficiency of nurse anesthesia services.

"This report is confirmation that nurse anesthetists play a vital role in assuring that seniors have access to the surgical, pain management, and other healthcare services they need," said Wilson. "The report also demonstrates the importance of the Medicare payment policy which affords reasonable cost-based anesthesia care in select rural and critical access hospitals where CRNAs are typically the sole anesthesia providers."

PlainsBuffalo · Jul 23, 2009

DrugReptoNurse, how much less does the government pay for the same procedure than private insurance? And how much of a paycut can that difference mean?

VORB · Jul 23, 2009

...who cares if it raises taxes; we still have one of the lowest tax rates in the world. Americans whine too much...

Unfortunately, the top 50 percent of wage earners pay 97 percent of the federal taxes in the U.S., while the bottom 50 percent pay just 3 percent.

Ironically, it's usually those in the bottom 50 percent -- who essentially pay for little or none of the services they receive -- that whine the loudest when it comes to scaling back or eliminating services. They also see little or nothing wrong with raising taxes to pay for ever-expanding programs and services, because they won't have to pay for it. That's rather greedy and immoral in my book.

Trishalishus, PhD, CNS · Jul 26, 2009

Unfortunately, the top 50 percent of wage earners pay 97 percent of the federal taxes in the U.S., while the bottom 50 percent pay just 3 percent.

If it were true, why is it unfortunate?

Ironically, it's usually those in the bottom 50 percent -- who essentially pay for little or none of the services they receive -- that whine the loudest when it comes to scaling back or eliminating services.

No they don't - in fact, the less you have, the less likely you are to have access to a forum to be heard - or the education to know how to say it and retain your credibility and dignity.

Wealth

"In the United States, wealth is highly concentrated in a relatively few hands. As of 2004, the top 1% of households (the upper class) owned 34.3% of all privately held wealth, and the next 19% (the managerial, professional, and small business stratum) had 50.3%, which means that just 20% of the people owned a remarkable 85%, leaving only 15% of the wealth for the bottom 80% (wage and salary workers). In terms of financial wealth (total net worth minus the value of one's home), the top 1% of households had an even greater share: 42.2%." (Source, another source)

Taxes

"Under the U.S. income tax system, most of the taxes collected are supposed to be paid by the people who make the most money. Thanks to President Bush's tax cuts, that is exactly the way the system works, says the U.S. Treasury Department.

According to the Office of Tax Analysis, the U.S. individual income tax is "highly progressive," with a small group of higher-income taxpayers paying most of the individual income taxes each year." (source)

This subject is too easy to put spin onto - because when you start talking about who gets the most tax dollars spent on them, whoever controls the calculator wins: lies, damned lies and statistics" (Mark Twain)

Qwiigley, BSN, MSN, DNP, RN, CRNA · Aug 1, 2009

People who are saying that it is not socialized medicine and who are saying that nObama is not trying to get rid of private insurances are not looking at the entire picture.

nObama wants to make the gov't insurance policy cheaper, so that more people can afford it, right? Well, if it is cheaper, then people will buy that instead of Blue Cross, Aetna, Kaiser etc. The gov't can put any price it wants for its premiums. They do not have to show a bottom line, they can go into the red, they just either print more money or raise taxes.

If people go to the gov't plan, then that will put private insurances out of business. Short term the gov't can run in the red, no problem.

As for PAY; remember that Obama has already told the auto industry and the banking industry that their people make "too much money," and he has demanded that their pay get cut. It too can happen to you.

How would you like to be a doctor who has gone thru pre-med, med school, residency and a fellowship= years and years of schooling with tons of $$$$ in loans, only to be told that he can not make a decent living. That all of that sacrifice was for nothing? You will find that a many number of docs will quit and do something else. So far there is no law saying he has to practice medicine. So where will that leave the country?

Lastly, 75% of the US have insurance. 10% of the residents who do not have insurance are ILLEGALLY here. 10% are people who do not value buying insurance for one reason or another like they are young and healthy or would rather buy cigarettes than a insurance policy. That leaves 5% of the country who need help with insurance or medical help. Some are people who have pre-existing problems that the insurance companies will not cover. Some insurance co. will cover but the cost is ridiculously high. And some are just plain poor.

We need to help this last 5% We need to make a way for all of the insurance companies share in the cost burden of covering those people with chronic expensive conditions. Split them up evenly so the burden is not concentrated.

We would need to somehow ? get people to all contribute to a plan; even the illegals. (Maybe add 1% sales tax) Because you don't want anyone spreading disease.

And we need to prevent unreasonable lawsuits. Doctors are getting tests that cover their butt instead of what the pt needs. Put a cap on awards and get rid of frivolous lawsuits by making the loser pay all of the lawyer's fees (set fees).

I welcome comments on my thoughts. They are not perfect, but some of them could be a good starting point for those idiots making laws for us (congress).

What are we thinking? allowing a bunch of politicians who know NOTHING about healthcare to decide on our future? Our gov't ca not even run Medicare/MediCal/MediCaid. What makes us/them think they should run our healthcare?

Make them prove they can take care of what they have and then we will talk!

CRNAGAL · Aug 2, 2009

Quigley, I totally agree with you. Those are exactly the changes that need to be made. We just need to tweak the system, not overhaul the whole darn thing. Anyone who thinks CRNA salaries won't take a hit with Universal Health Control is kidding themselves.

aCRNAhopeful · Aug 17, 2009

How will Obama's proposed plan affect the world of anesthesia? I know that there are multiple bills right now so no one can know this for sure, but what do we know thus far about how CRNAs, MDAs, AAs will be affected by the possible reform. Been following very closely but its pretty hard to form an opinion with all the BS that surrounds it. Thanks for your thoughts!

Editorial Team / Admin · Aug 17, 2009

Threads merged.

bucknangler · Sep 3, 2009

If the Gov't can't manage and organize to pay the car dealers for the "Clunkers for Cash" program' what makes you think they can completely overhaul our healthcare system and pay MD's and Hospitals timely and accurately?

Get real! He is spending money we don't have and making the future of this country a disaster by creating an atmosphere of debt and promises we can't keep...just so he can hopefully get re-elected and keep democrats in office. And no, I'm not a republican.

Tell President Obama he can "keep the change".

Healthcare needs to be desided by the patient and their physician. Also, if they force their "public healthcare option" on us...then I think Congress and the President should use it as well....but of course, they keep their private gov't funded insurance!

reznurse · Sep 3, 2009

Wow, people are really misinformed. I worked for the USPHS (government run health care) and I never heard a single CRNA, or any other midlevel provider complain of their pay. The physicians were paid fairly and weren't required to work 60 hours a week. It was an excellent system. Thinking rationally about the system, if you cut the 20% of healthcare costs spent on billing services (don't know if everyone spends that much, but my brother who is an MD does) that would free up a lot of money. Also the compensation of a single insurance co CEO would pay for a thousand CRNA's salaries every year. From WEBMD:

United Health Group

CEO: William W McGuire

2005: 124.8 mil

5-year: 342 mil

diosadelsol, ADN, BSN, MSN, RN, APRN, CRNA · Sep 10, 2009

Only part of it is publicly funded. There will still be private insurance. Also, who cares if it raises taxes we still have one of the lowest tax rates in the world. American whine too much (says the American). I for one would appreciate being able to afford insurance while I'm going to school...again.
-b

You know what, I have worked my butt off to get to where I am, and I personally don't want to pay for your insurance while you go back to school. You either suffer without insurance until you graduate (and can buy it on your own or get it through your place of employment) or don't go back to school. Yea, call me whiney about higher taxes, so what!!? And as far as "only part of it is publicly funded" goes, I don't think you've read the bill - like most of the worthless politicians in Washington. However, if it passes, I hope you're happy with your pulic option and I hope you don't get sick anytime after that, because at that point the GOVERNMENT gets to decide who gets what and, unless you are indispensible, you get nothing! Good luck in school! :twocents:

aCRNAhopeful · Sep 11, 2009

I for one would gladly pay a bit more in taxes to pay for insurance while someone goes back to school. That seems like a worthwhile investment and use of my tax dollars. Where it upsets me is having to pay for those who try to scheme the system and avoid working all together. Unfortunately, the thing of it is we will all be paying for these people anyways through higher insurance premiums or through adding to the federal deficit or whatever. Thats the rationale behind mandating that everyone be covered, because its supposedly the most cost effective option. Am I skeptical of that claim? Yes I am, but I really dont think I or most others of us out here in the online blog world really have the background or knowledge to know. The current healthcare system is costing us dearly so I can't really be opposed to the notion that covering people will cost us less than letting someone become so ill that they need an ER visit and an ICU stay for free. We all want to lower our country's healthcare cost and pay the least amount to get it but we cant blindly believe that because we are not paying for it in taxes that we arent actually paying for it. And with all that said, there hasn't even been a proposed tax increase on the middle class to pay for this thing anyways...