TWEETORIAL: Why tying “fair payment” to Medicare is disingenuous at best, & dishonest at worst 1/
Here’s CPI vs Medicare (credit @EdGainesIII). Pretty much flat since 1992. If it followed inflation, it reimburse 2.5 for every dollar reimbursed 2/ 
Economists love to argue this slide...306% Medicare sounds expensive right? /3
Yet by using a percentage, they completely ignore fact MEDICARE RATES ARE DIFFERENT FOR EVERY SPECIALTY. Despite previous slide, ED MDs still make less radiologists despite “charging Medicare 106% more”. /4
Why? B/c Medicare rates are a manipulated rate. It’s 🍎 to 🍊. For example, if I sedate an elderly pt in ED & disimpact them, I get reimbursed $0. If GI Dr does same procedure in endo suite, Medicare reimburses $253. That’s the game CMS plays /5
When someone uses a % of Medicare to claim something is overpriced, they’re not telling you what the unit of Medicare costs. This is intentional, to make it look worse. To illustrate this, let’s look at some common prices in “medicare rates”. /6
A Level 5 chart (highest level, treating a life threatening process) reimburses about $200. So 306% Medicare is $600. /7
Did you know plumbers charge 150-225% of Medicare on average? 🤭. /8
Here in Vegas, a meal in Robuchon is 2.1x more expensive than what Medicare reimburses for life saving work
Per CMS/market comparison, curing a DEADLY hangover is more expensive than saving a life /9
A meal in the best restaurant in Vegas is 212% Medicare /10
Pseudodoctors charge 200% Medicare. /11
Here’s the kicker, folks...we pay vets 400-750% Medicare to save our pets. /12
I propose instead of calling it a multiple of Medicare, @zackcooperYale re-calculate his figures at a Multiple of Plumber Hourly Dispursement Units (PHD) . Hence TeamHealth charges 4 PHDs for life-saving ED care. /13
Hence in America, per our health economists, life Saving care is approximately the equivalent 1 PHD, or 1 hr of plumber charges. /14
@michiganleg would like to cap lifesaving care at 1.25 PHD, or 1.25 Hrs of plumber work. I thought Michigan would think more of it’s citizens, but
