Word: pay
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Dates: during 1970-1979
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...effect, the Government would have the power to require that the fees received by hospitals from their bed patients be limited by a complex formula based on general inflation, local wage levels and each hospital's efficiency. The Government would order Blue Cross, Medicare and Medicaid not to pay a hospital more than the specified increase. Hospitals would be required to set aside part of the payments they received from private insurance companies. If these payments exceeded the prescribed limit, the hospitals would have to reimburse the insurers. If they failed to do so the Government would have the power...
...people choose whether they wanted to be protected by a consortium of commercial insurance companies, by Blue Cross-Blue Shield, or by joining independent group health plans or health maintenance organizations (H.M.O.s). Employers would be liable for the premium payments, estimated at $11.4 billion a year more than they pay now, but they could require workers to provide up to 35% of that amount. The workers' share would be related to their salaries. The Federal Government, as it does now, would pay the bills for most elderly and poor patients, but at a cost estimated at $28.6 billion a year...
...This insurance, subsidized by the Government, would provide a "core benefit package," including hospital and physician services, X-ray and lab tests, and would also probably provide some kind of catastrophe coverage. Cost of the total Carter plan to the Government: $15 billion a year. Employees and employers would pay $5 billion...
...first essential is to reform insurance practices. Some beginnings have been made: Blue Cross-Blue Shield will no longer automatically pay for a battery of tests administered to every patient who enters a hospital unless each test is specifically ordered by the attending physician. Insurance policies should be rewritten to pay for lab tests and other care administered in a doctor's office rather than a hospital. If Congress will not push the Blue plans and private insurers in this direction, corporations could and should. Exxon, General Motors and AT&T have the bargaining power that individual patients lack...
...Government should revise Medicare and Medicaid reimbursement formulas to pay hospitals a set amount for, say, removal of a gallstone, rather than costs-plus. Says Dr. Mitchell Rabkin, director of Beth Israel Hospital in Boston. "I'd like to see a system of incentives?say, if we saved money, that money could be split between the insurer and the hospital." Califano and some state regulators also are launching a drive to require that a majority of the directors of any Blue Shield plan be laymen. At present, many Blue Shield plans are dominated by doctors, who, to put it delicately...