M4A loophole

[Nikj]

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Question for those who are heavy into politics (posting in this forum since a lot of you talk about these issues.)

Reading through Bernie Sanders M4A plan, if it were to pass, its clear that some providers are worried about not being able to control private practices, like certain concierge services, or say as it relates to Anesthesiology, private gigs for outpatient/plastics office cases/pain etc.

However, it seems a loophole would be a situation where doctors charge patients a consulting fee, whereby the patient can pay the doctor a fee for access to a private communications line with the doctor, and since this does not seem like something that is covered my medicare, it would be legal. I do not know of any medicare law/rule that says that Physicians are required to provide their personal contact information to patients.

Would this not work as a loophole?

 

[VA Hopeful Dr]

MDVIP already does this

 

[Nikj]

MDVIP already does this

So essentially, the law would easily be bypassed? edit* and basically fee's can still be set by healthcare providers for access to their services

 

[deleted87051]

The problem is you will then have to practice trendy customer service driven medicine and give advice about how to keto diet.

 

[Nikj]

Found this interesting reddit post:

"The following is from Chaoulli v. Quebec (Attorney General), [2005] 1 S.C.R. 791, 2005 SCC 35 which is a Supreme Court decision regarding a Quebec law prohibiting private insurance. The SCC ruled the law was unconstitutional.

"104 The Charter does not confer a freestanding constitutional right to health care. However, where the government puts in place a scheme to provide health care, that scheme must comply with the Charter. We are of the view that the prohibition on medical insurance in s. 15 of the Health Insurance Act, R.S.Q., c. A-29, and s. 11 of the Hospital Insurance Act, R.S.Q., c. A-28 (see Appendix), violates s. 7 of the Charter because it impinges on the right to life, liberty and security of the person in an arbitrary fashion that fails to conform to the principles of fundamental justice.

105 The primary objective of the Canada Health Act, R.S.C. 1985, c. C-6, is “to protect, promote and restore the physical and mental well‑being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers” (s. 3). By imposing exclusivity and then failing to provide public health care of a reasonable standard within a reasonable time, the government creates circumstances that trigger the application of s. 7 of the Charter.

106 The Canada Health Act, the Health Insurance Act, and the Hospital Insurance Act do not expressly prohibit private health services. However, they limit access to private health services by removing the ability to contract for private health care insurance to cover the same services covered by public insurance. The result is a virtual monopoly for the public health scheme. The state has effectively limited access to private health care except for the very rich, who can afford private care without need of insurance. This virtual monopoly, on the evidence, results in delays in treatment that adversely affect the citizen’s security of the person. Where a law adversely affects life, liberty or security of the person, it must conform to the principles of fundamental justice. This law, in our view, fails to do so.""


In Canada, they found it illegal to make private insurance illegal. I'd imagine the same argument would be heard in the Supreme Court in a similar manner. It's actually a very interesting line of argument they made.

Essentially one could say that in the US Constitution we are also guaranteed life, liberty, and property (Amendment 5), and thus by not allowing a person to enter into a free contract with another person to intervene and provide potentially life saving care is unconstitutional.

 

[VA Hopeful Dr]

So essentially, the law would easily be bypassed? edit* and basically fee's can still be set by healthcare providers for access to their services

Sort of.

MDVIP still bills insurance/Medicare like anyone else. They just also charge a yearly fee for things like increased access (doctor's email/phone number), longer visits, guaranteed same day appointments. Stuff like that.

 

[deleted941485]

Found this interesting reddit post:

"The following is from Chaoulli v. Quebec (Attorney General), [2005] 1 S.C.R. 791, 2005 SCC 35 which is a Supreme Court decision regarding a Quebec law prohibiting private insurance. The SCC ruled the law was unconstitutional.

"104 The Charter does not confer a freestanding constitutional right to health care. However, where the government puts in place a scheme to provide health care, that scheme must comply with the Charter. We are of the view that the prohibition on medical insurance in s. 15 of the Health Insurance Act, R.S.Q., c. A-29, and s. 11 of the Hospital Insurance Act, R.S.Q., c. A-28 (see Appendix), violates s. 7 of the Charter because it impinges on the right to life, liberty and security of the person in an arbitrary fashion that fails to conform to the principles of fundamental justice.

105 The primary objective of the Canada Health Act, R.S.C. 1985, c. C-6, is “to protect, promote and restore the physical and mental well‑being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers” (s. 3). By imposing exclusivity and then failing to provide public health care of a reasonable standard within a reasonable time, the government creates circumstances that trigger the application of s. 7 of the Charter.

106 The Canada Health Act, the Health Insurance Act, and the Hospital Insurance Act do not expressly prohibit private health services. However, they limit access to private health services by removing the ability to contract for private health care insurance to cover the same services covered by public insurance. The result is a virtual monopoly for the public health scheme. The state has effectively limited access to private health care except for the very rich, who can afford private care without need of insurance. This virtual monopoly, on the evidence, results in delays in treatment that adversely affect the citizen’s security of the person. Where a law adversely affects life, liberty or security of the person, it must conform to the principles of fundamental justice. This law, in our view, fails to do so.""


In Canada, they found it illegal to make private insurance illegal. I'd imagine the same argument would be heard in the Supreme Court in a similar manner. It's actually a very interesting line of argument they made.

Essentially one could say that in the US Constitution we are also guaranteed life, liberty, and property (Amendment 5), and thus by not allowing a person to enter into a free contract with another person to intervene and provide potentially life saving care is unconstitutional.

Seems like although it isn’t legal to prohibit it they’ve done their best to relegate it to trivial matters. If anything the govt can find a way around it’s own rules

 

[Mman]

the "loophole" around medicare for all is continued private insurance that people can choose to purchase for access to superior care. Medicare literally cannot even pay for the services it currently provides as hospitals offset those costs with insured patients. If everybody gets medicare, the level of care will decrease for everyone except those that go outside the system.

 

[BLADEMDA]

the "loophole" around medicare for all is continued private insurance that people can choose to purchase for access to superior care. Medicare literally cannot even pay for the services it currently provides as hospitals offset those costs with insured patients. If everybody gets medicare, the level of care will decrease for everyone except those that go outside the system.

Sometimes you have to blow it up to fix it. That seems to be the philosophy of Warren and Sanders. Blow it up.

 

[Mman]

Sometimes you have to blow it up to fix it. That seems to be the philosophy of Warren and Sanders. Blow it up.

I fear that they believe Medicare actually works as is and that if we simply enrolled everybody, the healthcare problem would be solved.

 

[deleted941485]

I fear that they believe Medicare actually works as is and that if we simply enrolled everybody, the healthcare problem would be solved.

It will work just not for anybody actually providing the services

 

[deleted941485]

the "loophole" around medicare for all is continued private insurance that people can choose to purchase for access to superior care. Medicare literally cannot even pay for the services it currently provides as hospitals offset those costs with insured patients. If everybody gets medicare, the level of care will decrease for everyone except those that go outside the system.

Equality is what these people are obsessed about and patients don’t know anything about quality other than I got to see the doctor and he spoke to me.

They don’t care if they’re may be better care outside the system all they care about is everyone is treated the same.

 

[deleted87051]

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