Thread by @RTorof

Sadly, #MedicareForAll will not help #healthcare costs until the underlying problem with MEDICARE and the ENTIRE HEALTH SYSTEM is FIXED, a LONG 🧵 1 of 24 #Medtwitter @somedocs @AmerMedicalAssn @WCMSSM @MichStateMedSoc References: bit.ly/3rBcvGP bit.ly/3lE3nxf

2/ b/c @SenateFloor @HouseFloor & @CMSGov are yet again not fixing the true problem & instead are again targeting #Physicians by decreasing payments by another 9.75% on top of the fact that reimbursements to providers has already been decreased by 22% over the past 2 decades

3/ On average only 40% of the what your #insurance , including #Medicare , pays your doctor actually goes to the doctor as #income . The overhead costs to be a doctor takes at least 60% of the payment a doctor gets from Medicare or Insurance equivalent. bit.ly/3ptDX6B

4/ Medicare pays Hospitals things called Facility Fees to help pay for these overhead costs. But, despite the 50% inflation we have experienced since 1998, there has NOT been an increase in payments to non-hospital doctors but instead there has been an > 20% DECREASE in payments.

5/ The only people in the healthcare field that make money from the insurances are the following: Providers (= Physicians + NP's + PA's only), Pharmacy, Testing, Labs, and Hospital Facility Fees. All other players in the health system (like #nurses) bring no money into the pot.

6/ That means that the $150 your insurance pays "to your provider" for your office visit is ACTUALLY divided up to pay the following people: #CNA's, #MA's, #nurses, Billers, Office #managers , #Janitors, Receptionist, Answering Service, Security Guard, and lastly the #Provider

7/ BUT if the #Doctor is NOT hospital-owned, before they can pay themselves they also have to pay the following as well: Rent, Property Expenses, #Utilities #Maintenance Office expenses, Malpractice insurance, MOC, Licensure Costs, EMR costs, >$200,000 in #studentloans , etc

8/ Medicare physician payments from 2001-2020 has dropped by 22% when adjusted for #inflation & that overhead costs have increased by 39% in that same time period. "While Medicare payments to hospitals increased nearly 60% over the same time period." bit.ly/336KVXT

9/ This is why 67% of doctors are now hospital-owned. accntu.re/3Inezbu I say owned & not employed b/c they are commodities to be used to make #money to fuel the #hospital #csuite

10/ Hospital CEO's make on avg 351 times what the typical hospital #workers make bit.ly/3DoWe9Z and the CEO wants to MAKE MORE #money So how do they do that? They tell Congress, @CMSGov & YOU #Americans that Providers are the reason health care costs are so high. How?

11/ Here is their formula: 1st they make it impossible for doctors to be independent from a hospital system by convincing @SenateFloor @HouseFloor @SpeakerPelosi that hospitals are the only ones that should qualify for facility fees to pay overhead costs. bit.ly/332fiyx

12/ 2nd they convince #Congress that Hospital Employed Providers should get more money than their Private Practice Equivalents by creating the Outpatient Prospective Payment System ( #OPPS ) separate from the already established Physician Fee Schedule. bit.ly/3lAbxXi

13/ 3rd they convince Congress that the Physician Fee Schedule is the "real" reason why health care is so expensive and so Congress has created an Alphabet Soup of measures to systematically decrease physician payments every year since 1998. bit.ly/3GhWxpa

14/ Okay so now hospitals have ensured they get an extra fee whenever you see one of their doctors (the Facility fee) & they have ensured that doctors cannot practice on their own anymore. So what's next? They buy out the doctors of course! Leading to the fall of neighborhood Dr.

15/ Okay so now what? Didn't you say that Providers are not the only ones that make money and that overhead is a lot and that hospitals always want to make money? . . . Why Yes, Yes I did! So what do they do next?

16/ They create their own versions of the other money makers in medicine: Labs, Pharmacies, Imaging/Testing Centers. THEN they ENSURE (aka will fire them if they cause "leakage") that the providers ONLY refer patients to these HOSPITAL owned places bit.ly/3xTr6hW

17/ Now that they have their hands on all the aspects of medicine that make money they ensure that they all feed each other the same patients so they can milk the insurances for more money with their new found Facility Fee and OPPS (Again see bit.ly/3lAbxXi

18/ Wow! That was a lot of info! What can I do to help? Well first, realize that #Medicare4All canNOT work UNTIL the Hospital Controlled Health System we have in America is FIXED! The problem is the hospitals who control Congress which controls Medicare which controls insurances

19/ We need to write our #representative #senator and tell them to consult with and listen to @AmerMedicalAssn, listen to the #DirectPrimaryCare Community, listen to @PamelaWibleMD, Listen to #MedTwitter, Listen to the doctors of @somedocs

20/ How can you write your Congress? How do you know what to say, who to tell it to etc? Well the AMA has created a great system to help with that. patientsactionnetwork.com @PatientAction

21/ Currently the most pressing thing is STOPPING the blood letting of private practice reimbursements by another 9.75% by using this link bit.ly/3EtJDUz

22/ But I thought the AMA was bad? But, you do agree the system is broken and needs to be fixed right? So how do we fix it? You can also ask your doctor how they are doing and what you can do to help them fix this broken system we have.

23/ To my knowledge the AMA is the best option at this time but if anyone knows other organizations with as many connections, know how and finances to be able to fight the system for patients and doctors that is not the AMA. . .

24/24 . . . I am all ears and would love to learn of other organizations fighting the good fight to fix the broken, for-profit, patient harming, burn-out factory that is the current American Health Care System. Please comment with their info so that we may learn about them. END

@threadreaderapp unroll