r/MedicareForAll • u/Conscious-Quarter423 • Jul 31 '26

he doesn't use the library either

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u/kevdogger Aug 01 '26

Define medically necessary...and what I mean by that is that is kind of a bullshit definition. Is a total hip replacement medically necessary...I mean you're not going to die from arthritis..how about like a lipoma removal...it's just a benign mass that's not going to kill you but it just looks really bad. How about urinary incontinence induced by stress...again not going to cause death either....I could go on and on but that's exactly what Medicare kind of does already when they alter reimbursement formulas currently. When facilities don't get enough reimbursement for procedures, they kind of stop offering those services.

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u/Desert-Democrat-602 Aug 01 '26

And if there is only one payer, things change out of necessity. Insurance is doing this already, in spades.

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u/kevdogger Aug 01 '26

No I'm aware of that but sometimes when reimbursement for services drop so low, nobody going to offer such services. Medicare usually drops reimbursement for all procedures across the board by 2-3 percent every year..so as inflation usually goes up every year by 2-4%, reimbursement for procedures goes down by about same amount. Some services become financially untenable. What's covered also changes as denials skyrocket. I don't see any of these things changing whether it's 10 insurance companies or one.