[Wally_Kalbacken]

Medicaid and Medicare reimburse providers at rates so low that an enormous cross-subsidy from private pay insurance is necessary to keep providers whole. This is where the $61 aspirin stories come from. If the true cost of providing a given service is $100 and Medicare and Medicaid pay $81 for it - you shouldn't be surprised to see private pay insurance getting a bill for $165 for that procedure. That's the way she goes.

I once had the great misfortune of being married to my ex-wife. She was a bureaucrat involved in a Midwestern state's health bureaucracy. I'll never forget the day she came home to celebrate the brainstorm that hit her department. Through a complicated process nursing home facilities were able to contribute to the state -through a funding mechanism that effectively boosted the federal matching grant. To hear her tell of it - free money was falling from the sky - after all - they  were federal dollars. When I pointed out the fact that Wisconsin paid in about $1.84 on average for every $1.00 returned by the federal government - so that finding a federal dollar was no bargain, the point was lost on her. For some reason, in her view - state taxpayers were not federal taxpayers. This was the mentality of the typical state bureaucrat running the Medicare and Medicaid programs. This is why there will never be reform from within. If Bush has true chutzpah - he'll fix this too.

[cherry]

well said about how the medicare/medicaid programs are being supported not only by taxes but also by increased premiums paid by private citizens....

like me.....paying over $600 a month for two people on insurance and 3 on dental....geesh.....

of course , this is not a problem for the govt workers, so therefore, nothing will be done.....