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But till now the government didn't FORCE you to participate.
You don't have to participate, you can pay the fine and pay for all your medical care out of pocket..or move to another country that doesn't force you to do anything..if you can find one that is...
many existing carriers will incur extra costs due to ACA. these extra costs are passed onto the consumer. i will pay $$ for zero return, thats a penalty we dont have a choice with. i want to move to a better place where my $$ contribution (penalty) to health care serves a better purpose, please tell me how i do this?
option-A, buy a plan in the Exchange = paying nothing for nothing to paying a lot for something
option-B, dont buy a plan = paying nothing for nothing to paying a penalty for nothing
so, under the ACA view of it, 'A' and 'B' above are options???!!
i understand the issue of paying nothing for ER services (a major issue in costs), but tell me, those who do this now will likely never pay the penalty, but you cant deny them ER services, so ACA in practice is dog chasing tail hoping the dog figures out the insanely stupid loop.
I agree chiropractic medicine has no place treating heart disease, impotence, or allergies.
There are studies available though that show it is effective in treating back pain. I have my own experiences to fall back on as well. A chiropractic adjustment relieved some serious pain in my upper back and shoulder. I admit, I was a skeptic until I actually got this treatment. I was 75% better right after the adjustment and literally 100% better within forty-eight hours.
You can't tell chiropractors to get licensed as physical therapists for a series of reasons:
1. Physical therapists can only perform their treatment with a prescription from a doctor and his supervision of the treatment. Chiropractic has been a separate school of medicine for over a 100 years.
2. Because of competition and rivalry between physical therapy and chiropractic, I suspect physical therapists would attempt to make chiropractors obtain admission to physical therapy school and redo their entire training. If you have some way to avoid that, than let me know what it is.
3. In my observation, physicians dole out physical therapy on a very limited basis. Its hard to get a prescription for more than a handful of treatments. I think chiropractors are qualified to decide how many treatments are necessary.
4. Osteopathic physicians do a certain amount of adjusting the spine as part of the routine treatment they provide their patients. How do you propose to limit them? Or, do you not propose to limit them simply because they are medical doctors?
In my observation, some chiropractors adjust too much. However, I think the best control over this is simply to limit--not prohibit--insurance reimbursement for services. I would perhaps pay for 10 adjustments per year patient. Than there would the issue of paying for any other treatment modalities besides adjustments. Not sure how I would handle that.
On another note, chiropractic care can be used to inflate an injury claim, but the same is true of other types of medical care as well. Ultimately, it can turn on a complex question of exactly what type and amount of treatment is really appropriate for a given medical condition. I agree there should be limits, but too many people still feel that decision is between only the patient and his/her physician.
BTW, I think you are dead on about the need to get young people to sign up for health insurance. Without their presence in the insurance pool, I see premiums inevitably increasing a great deal. The risk pool has to be lowered by getting young healthy people in it.
Mark - knowing you're a bright guy - you will of course recognize the difference between correlation and causation. A lot of back problems (and other medical ailments) are self-limiting - and resolve to a greater or lesser extent on their own. Back pain (and other simple pain - especially from trauma related events) can easily fall in that category.
IMO - back pain is a weird thing. My husband has suffered on and off with it for decades. About 10 years ago - he had an episode where he was in agony - couldn't do anything other than be on his back on the floor - and he was ready to undergo any ridiculous surgery available. And suddenly - one day - poof - it was almost 99% gone. Something shifted perhaps 1 mm in his spine - and - PTL - he was cured .
If he had gone to a chiropractor - or a faith healer - or simply gotten a massage the day before - he would have been a convert if he was a "believing" kind of person (which he isn't).
I now have some back problems as well. I recommend 2 things. Back exercises to strengthen "core muscles". And getting a doctor who isn't adverse to writing an Rx for a bit of narcotics for the "bad days". We were in Japan last month - walking about 3-5 miles a day. And we both would have wound up flat on our backs after about mile 2 without a little help from our local pharmacy.
I've only been to a PT once. Earlier this year. Judging from the way my appointments were scheduled - I think Medicare imposes pretty strict limits on PT that isn't perhaps connected to something like a stroke. I got 3 30 minute sessions. I personally would have paid more had I needed more - but I learned all the exercises I had to do in those 3 sessions.
I don't think chiropractors have much in common with osteopaths. Best I can tell - schools of osteopathy were started because there were so few seats in traditional medical schools. And best I understand things today - PCPs are about as equally well trained in medical schools as in schools of osteopathy. When you get to specialties - the mileage varies - often by a lot.
Since you're a lawyer - like I am - and presumably not a low income person (although you're younger than I am) - well here's the way my husband and I look at health care today. We want the best PCP we can afford. For us - that's a super experienced internal medicine doc at Mayo JAX (ten minutes away from us). It's a concierge practice - but our PCP docs can deal with 95% of any problems we have at a very high level. We don't have to deal with NPs - PAs - osteopaths - whatever (nor do we want to). And - although some people will ding me for this - I don't want to deal with people whose first language isn't English either. My 95 year old father (who lives here near us) and my husband - both have some hearing difficulties - they can't understand a word these people say. When we need a specialist (not often) - we can get that at Mayo too.
Mark - mark my words. Save up for this stuff - or you might wind up pretty unhappy in terms of health care down the road. Robyn
Robyn, these people have as many choices as the kid that was suggesting if he didn't like the schools he could just move...don't take this out of context and start another debate.
I will see what choices the people who work for me have. Note that they're not kids - and in some cases are taking care not only of their children - but their parents too (sandwich generation). Plus they've lived in this area for 3-4 or more generations.
And can you suggest places in the US that are much cheaper than the greater JAX area in terms of cost of living (that don't involve living in a slum)?
I know that WardenDresden guy thinks I'm some kind of hard-noised bit**. Guess I am to some extent. Like when it comes to comes to some 29 year old single mother with 5 illegitimate kids I read about in the "ain't it awful - the government is shutting down the "head start" place article that appeared in our local newspaper today." Could not care less.
OTOH - I care about the people who work for me. And I'll talk with them And draw my own conclusions. Robyn
I will see what choices the people who work for me have. Note that they're not kids - and in some cases are taking care not only of their children - but their parents too (sandwich generation). Plus they've lived in this area for 3-4 or more generations.
And can you suggest places in the US that are much cheaper than the greater JAX area in terms of cost of living (that don't involve living in a slum)?
I know that WardenDresden guy thinks I'm some kind of hard-noised bit**. Guess I am to some extent. Like when it comes to comes to some 29 year old single mother with 5 illegitimate kids I read about in the "ain't it awful - the government is shutting down the "head start" place article that appeared in our local newspaper today." Could not care less.
OTOH - I care about the people who work for me. And I'll talk with them And draw my own conclusions. Robyn
You are missing the point--people do have choices, but they aren't always easy. There are 1000's of places around the US where someone making 30K can live just fine--certainly not a fancy life but a clean, safe place in a nice town with good schools and a good community. I also know housekeepers that make a HECK of a lot more than 30K if they so desire..again, it's choices....
... There are 1000's of places around the US where someone making 30K can live just fine--certainly not a fancy life but a clean, safe place in a nice town with good schools and a good community.
That is well above the average household income in my township.
Insurance works on the law of Large Numbers--the more people you have on a plan, the less it's going to cost...it's that simple...how much less depends on who is on the plan. Liken it to public school funding...do you have kids in the schools now, probably not, but you did at one time or you yourself were. Your property taxes came no where near paying for what it costs to educate you, but spread that out over your entire community and everyone pays their share at some time or another. You paid into SS back when you were younger, did you pay in your full retirement benefit, no, now you are being subsidized by those that are still working (and for Medicare). It's how a civilized society functions really.
If the only people in a medical insurance system are "high cost" people - doesn't matter whether there are 5 of them - or 5 thousand - or 5 million. It's going to cost a ton.
FWIW - at least in the retirement forum - I don't see people looking to move in retirement where school taxes are very high (although they might stay put due to inertia).
Best I can tell right now from the anecdotal reports on the internet. Most relatively healthy relatively upper income people in most states are PO'd at their cost increases. And most relatively lower income income people can't afford the premiums. Only winners seem to be unhealthy upper income people. Happen to have been there - done that myself - in terms of the last category. Perhaps history doesn't repeat. Like some folks say - it just rhymes. Robyn
You are missing the point--people do have choices, but they aren't always easy. There are 1000's of places around the US where someone making 30K can live just fine--certainly not a fancy life but a clean, safe place in a nice town with good schools and a good community. I also know housekeepers that make a HECK of a lot more than 30K if they so desire..again, it's choices....
I happen to think the greater JAX FL area is one of those places - except when it comes to health care. We're not high cost spread here.
BTW - where do you live - and where are these mythical places where people who clean houses make a lot of money (places where they can also afford to live)? Robyn
You don't have to participate, you can pay the fine and pay for all your medical care out of pocket..or move to another country that doesn't force you to do anything..if you can find one that is...
NEWSFLASH!!!!!
"PAYING THE FINE" IS PARTICIPATION!!!!
I stole this:
Quote:
Let me get this straight....
We're going to be "gifted" with a health care plan we are forced to purchase and fined if we don't, which purportedly covers at least ten million more people, without adding a single new doctor, but provides for 16,000 new IRS agents, who have recently demonstrated their objective and professional integrity; written by a committee whose chairman says he doesn't understand it, passed by a Congress that didn't read it but exempted themselves from it, and signed by a Dumbo President who smokes, with funding administered by a treasury chief who didn't pay his taxes, for which we'll be taxed for four years before any benefits take effect, by a government which has already bankrupted Social Security and Medicare, Fannie Mae and Freddy Mac, and the Post Office all to be overseen by a surgeon general who is obese, and financed by a country that's broke!!!!!
many existing carriers will incur extra costs due to ACA. these extra costs are passed onto the consumer. i will pay $$ for zero return, thats a penalty we dont have a choice with. i want to move to a better place where my $$ contribution (penalty) to health care serves a better purpose, please tell me how i do this?
option-A, buy a plan in the Exchange = paying nothing for nothing to paying a lot for something
option-B, dont buy a plan = paying nothing for nothing to paying a penalty for nothing
so, under the ACA view of it, 'A' and 'B' above are options???!!
i understand the issue of paying nothing for ER services (a major issue in costs), but tell me, those who do this now will likely never pay the penalty, but you cant deny them ER services, so ACA in practice is dog chasing tail hoping the dog figures out the insanely stupid loop.
please explain these extra costs? can you name specifcs?
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