Profundus

Help me out on this observation, please.

I have had a triple by-pass plus a replaced aortic valve, a bilateral knee replacement with one resulting in a staph infection over 3 months after the surgery. That prompted another surgery in which the incision was reopened entirely and the area "cleaned out" (I have no idea what they do). In between the fun and games at the hospitals, I had physical therapy relating to all the aforementioned procedures. All within the past 3 years. Throw in my wife's diagnosis of peritoneal cancer, her surgery and chemo treatments(which have resulted in remission since February) :>) and you get the idea of how many large provider charges I've seen.

This is what I saw as the hospital and doctor charges came in.....and I saw a ton of 'em. Firstly, the charges were significantly slashed by Medicare. When I say significantly. I mean 80 to 95%. Medicare cites the reduced amounts as "allowed"....and then everything follows their lead. The question that comes to my mind is, are these charges bloated by the providers? By law, Medicare obviously has the power to determine the maximum the provider can collect but the reduction seems to be Draconian.

I have to believe providers know what they're going to get but possibly continue to bill at the higher amounts in the event there's a significant change in the law which could net them some additional money later. Maybe there's a tax thing involved, too. You would know that.

Is it Medicare which essentially accounts for the problems you have described?

When I hear people talk about Medicare going bankrupt...it can't be because of their generous nature towards providers. I've seen that first hand. If they allowed charges anywhere near what the providers bill, the cost to Medicare would be enormously greater than it currently is. It must be the enormous scope of the plan and the inordinate costs to administer it...as happens with all government programs.

Your thoughts?