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Old 12-10-2007, 10:50 PM
 
5,089 posts, read 15,341,901 times
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Quote:
Originally Posted by AMB8301 View Post
Durango and surrounding areas have a serious primary care doc shortage. It is hard enough to find a doc that will take new patients, (I waited 6 months on a list, and I have insurance), and almost impossible if you are a new patient and on medicare. I know of several people who are driving from Durango to Cortez because that is the only doc they could find to take them. I don't know if any family practice docs in the last couple years have taken any new patients with medicare. So many people do not have proper medical care that the city and the hospital teamed up to open a clinic as a stop gap solution until something else can be done. This takes many newcomers by surprise, medical care is something many people do not plan ahead for when they are moving.

There are several pediatric offices in town, they all are very busy. I do know that they have a high # of medicaid patients, which makes it difficult to break even. That is one of the reasons the large Valley Wide clinic shut down last year, their Durango clinic had very high operating costs (rent, etc...), and then a large amount of medicaid/medicare patients, they operated at a loss for several years.


Other things to think about is the altitude, Colorado isn't high, but it can be high enough for those who have respiratory issues. My grandmother moved here from FL several years ago to be closer to us, she is fine at sea level, but now has to wear O2 24/7 in CO. My second daughter was on O2 until she was 7 months old because of respiratory issues related to the altitude. Had we been at sea level, it is very unlikely she ever would of spent a day on O2. In hindsight, had we known it was going to be so long with her being on O2, I would of taken her to sea level for a while, but everyone kept thinking it was going to be any day, any day, and some how it turned into months... I am very familiar with the disadvantages of living in a rural area when it comes to medical care after her. Her docs were consulting with Children's very frequently, and the only reason we were not flighted there was because they/we all agreed there was nothing else they could do for her.


Interesting topic, I'm glad it was brought up.
Good Information. Most people when they are young do not think about Medicare because they are never going to get old. I was the same type; I knew nothing about medicare nor did I care. I was making good money, great job and BAM--I got sick, lost my job, my income disappeared and suddenly I had to understand medicare.

Medicare has many supplemental programs because basic medicare is not adequate to cover health issues. The problem is that in less populated areas, insurance companies do not provide these plans because it takes volumne to make a profit for the insurer and there are not enough providers--as you pointed out.

I was lucky that I lived in Denver Metro when I got ill. If I lived in a remote area I would have to relocate for the coverage and the care. I am also a Veteran and when I go to the VA Hospital, I talk to Veterans who take long bus trips to Denver to get care.

You have talked much about Durango and that is the area which is attracting many young, vibrant new rich and what you say you can have problems with finding a provider in that area. That means the other more remote and less disireable areas of the state must be more difficult for healthcare.

I have experience with Medicare but Medicaid is another big issue. Medicaid is a state program which is partially funded by federal monies. However, Colorado has had problems with providers withdrawing care because of poor reimbursement rates.

I know when your are a young and healthy--you do not care about this issue but you will have to face it sometime in the future. I wonder how many former young healthy residents had to sell and move when they got sick and old.

Livecontent

Last edited by livecontent; 12-10-2007 at 11:52 PM..
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Old 12-10-2007, 11:29 PM
 
8,317 posts, read 29,357,988 times
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Quote:
Originally Posted by livecontent View Post
I know when your are a young and healthy--you do not care about this issue but you will have to face it sometime in the future. I wonder how many former young healthy residents had to sell and move when they got sick and old.
That is another thing the real estate salesman won't tell people. My parents lived for years in rural Colorado--in an area that was full of retirees. Several elderly neighbors on all sides of them wound up relocating back to areas they had moved from (Florida, California, Front Range, etc.) when they started facing serious medical issues. Things have improved some in that particular area--new hospital with some additional specialities and services, but most more complex medical problems still mean getting treatment on the Front Range.

The comments about Durango are interesting--it probably has the largest variety of medical services in western Colorado, aside from Grand Junction. I think the medical situation in rural Colorado is only going to get worse. A lot of Baby Boomers have moved to rural Colorado--to an area where medical services can barely keep up now. What is going to happen when all of those people start getting old and sick (as livecontent said) and start demanding way more medical services? Get more doctors? Most places are having real problems getting them now.

As an aside, not that many years ago, when Colorado vehicle license plates were still county-coded (wish they still were!), it was a real interesting exercise to drive through the parking lots at hospitals and medical facitlities in metro Denver and see how many people from the rural areas (and not just from Colorado--Wyoming, New Mexico, etc., too) were there getting medical treatment. Many of those folks (me included, at the time) had to drive hundreds of miles to get those services. I wonder how everybody is going to like that when fuel is $5, $6, or more per gallon?
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Old 12-11-2007, 08:01 AM
 
Location: Foot of the Rockies
90,316 posts, read 120,147,178 times
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Hopefully, as more people move there, more physicians will be attracted there as well. Unfortunately, it will still be far from Denver, can't do anything about that. Health care is one of those "things" that is best done in the city/suburbs where there are a lot of facilities. I'm not saying rural health isn't doable, but they don't get the volume of cases to make providing the facilities worthwhile.
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Old 12-11-2007, 11:29 AM
 
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Regarding Medicare, it will probably get worse. There is a 10% cut in reimbursement scheduled to take effect 1/1/08, unless Congress does one of their famous last minute fixes.
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Old 12-11-2007, 11:57 AM
 
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Originally Posted by BarryK123 View Post
Regarding Medicare, it will probably get worse. There is a 10% cut in reimbursement scheduled to take effect 1/1/08, unless Congress does one of their famous last minute fixes.
That will have less effect on Medicare Health Plans that have contracted for services in 2008. That will effect more medicare receipients who use original medicare directly.

Unfortunately, most of the people are in rural areas where there are not too many options for Medicare Health Plans, will continue to use original Medicare and will find more providers refusing new patients--so I agree it will get worse for those people.

Livecontent

I know what you are thinking--who cares, I am young, have money, have a good job, keep myself healthy.......
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Old 12-11-2007, 12:09 PM
 
26,111 posts, read 48,696,623 times
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Quote:
Originally Posted by livecontent View Post
That [10% cut] will have less effect on Medicare Health Plans that have contracted for services in 2008. That will effect more medicare receipients who use original medicare directly. Unfortunately, most of the people are in rural areas where there are not too many options for Medicare Health Plans, will continue to use original Medicare and will find more providers refusing new patients--so I agree it will get worse for those people.

Livecontent
Isn't there supplemental insurance (Medigap?) to cover shortfalls in medicare? I think I see where this is headed....Federal cuts mean more people will pay for private insurance....thus getting more medicare cost out of Federal budget....keep cutting until everyone just buys BC/BS or HMO coverage....eventually shut down vast bulk of medicare. Is that far fetched? Don't put it past them to transfer costs to us. Maybe that's where it always did belong, not sure.
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Old 12-11-2007, 12:42 PM
 
5,089 posts, read 15,341,901 times
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Originally Posted by Mike from back east View Post
Isn't there supplemental insurance (Medigap?) to cover shortfalls in medicare? I think I see where this is headed....Federal cuts mean more people will pay for private insurance....thus getting more medicare cost out of Federal budget....keep cutting until everyone just buys BC/BS or HMO coverage....eventually shut down vast bulk of medicare. Is that far fetched? Don't put it past them to transfer costs to us. Maybe that's where it always did belong, not sure.
Medigap(Medicare Supplement Insurance) is private insurance to cover the gaps in Medicare. These plans must meet strict regulations and all cover the same, regardless of company. The recepients is covered under original medicare and the insurance covers the gap. These plans are not federal funded. The government wants people to move away from these plans to federal funded plans because they provide better service for less or no cost to the recepients.

The Medicare Health Plans are plans that contract with the federal government and are funded by Federal Monies. These are better values for the recepients. In the case of the Medicare Advantage Plans such as HMOs, the government gives a fixed amount to the plan for every receipient to cover care, the receipient may have additional monthly insurance cost to the Advantage Plan, some plans have no additional costs. If a recepients chooses these plans, he is still under medicare rules, regulations, protections but must get all services from these plans.

There are other plans such as PPOs, Cost Plans, Fee for Service, Special Needs etc. they all have federal funding.

So the goverment is not shuting down the bulk of medicare--It is expanding with different plans. I am no expert and it is complicated but no big bad government has a plan of transfering the cost to us. However, the cost are rising, and taxes are needed to pay for it--so in a way it is paid by us, somewhere, somehow.

I would suggest that you go to the website Medicare.gov - The Official U.S. Government Site for People with Medicare and read more about it--and if you have difficulty understanding it--think what an old elderly, sick, handicapped individual has to understand.

Livecontent
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Old 12-12-2007, 10:30 AM
 
2,174 posts, read 4,260,359 times
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Quote:
Originally Posted by Mike from back east View Post
Isn't there supplemental insurance (Medigap?) to cover shortfalls in medicare? I think I see where this is headed....Federal cuts mean more people will pay for private insurance....thus getting more medicare cost out of Federal budget....keep cutting until everyone just buys BC/BS or HMO coverage....eventually shut down vast bulk of medicare. Is that far fetched? Don't put it past them to transfer costs to us. Maybe that's where it always did belong, not sure.
The 10% cut is to health care providers. So physicians in rural/shortage areas will be more likely to opt out of Medicare, adding to the shortage. When Medicare approves a service, they pay 80% of their allowed amount. The Medigap plans cover the 20% "copay" remaining. However, if a doc doesn't accept Medicare, the Medigap plans don't kick in - they only cover things after Medicare pays its share.
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Old 12-12-2007, 12:10 PM
 
Location: Las Flores, Orange County, CA
26,338 posts, read 93,407,924 times
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Just saw this. Fits the thread.

"The unhealthy truth about country living."

http://www.newsweek.com/id/76929
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Old 07-15-2009, 03:53 PM
 
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Durango............help here! Not going to happen! I have tried and tried unless you are on state insurance forget getting help in this town! I live and work here with no insurance and broke my arm and got no help at all for the bills that pile up!
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