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Old 10-01-2013, 03:13 PM
 
Location: West Orange, NJ
12,040 posts, read 9,112,163 times
Reputation: 3300

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Quote:
Originally Posted by icelady View Post
IT is not political. IT is low reimbursement and ALOT of RED TAPE. Doctors offices are closing because of the RED TAPE and updating computers system. However iI am just advising pople to review the ins policy before accepting it. You need the info on DOCTORS HOSPITALS AND SPECILIST. Or you might regert that you signed up with that insurance company
that's funny, because my doctor's office is more profitable now because they implemented the electronic medical systems that ACA helped streamline.

what red tape? and if reimbursement is low, how is that due to ACA? did major insurance companies that opted to participate in the exchanges suddenly drop reimbursements? Please provide a source for these claims.
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Old 10-01-2013, 03:17 PM
 
Location: Southern end of the Great Plains
7,387 posts, read 7,154,887 times
Reputation: 9442
Quote:
Originally Posted by bradykp View Post
again, how will this doctor know someone obtained health insurance via the ACA exchanges?
I'm assuming that he was assuming that he will be able to tell. We spoke several months ago about this. There are certainly no laws (yet) preventing doctors from being political. Or maybe he's not being political. I know he already has a full load of patients.
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Old 10-01-2013, 03:21 PM
 
2,310 posts, read 1,786,638 times
Reputation: 5377
Maybe the sample is not statistically accurate, but I am generally pleased that so many of the posters here seem to understand the ACA.

Yes, there are the ignorant comments about 'not be able to see my Dr of choice, practices are closing, some places don't accept the ACA Insurance or we can't afford this plan', but generally way more people 'get it' than I ever imagined.

Some things, however small, reaffirm my belief that mankind is not as dumb as they sometimes seem to be.

Quite honestly. ACA is very simple, insures everyone who otherwise is leaching off of the rest of us, is very affordable, and seems to be a good program. It certainly will have teething pains , simply given it huge size, but once and for all, people who need medical care will now have insurance to cover it.

Without running the numbers the obvious effect is a huge reduction in our overall health care costs. The folks who previously used the emergency room for their GP (and paid nothing for the MOST expensive care possible) will now have a Dr, and access to routine care will prevent may illnesses from getting out of control and costing hundreds of thousands when they could have been treated for a couple of grand had they been seen early.

it's all good, and I am pleased that a great many people who post here understand that!
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Old 10-01-2013, 03:25 PM
 
Location: Ponte Vedra Beach FL
10,833 posts, read 8,053,617 times
Reputation: 3866
Quote:
Originally Posted by icelady View Post
IT is not political. IT is low reimbursement and ALOT of RED TAPE. Doctors offices are closing because of the RED TAPE and updating computers system. However iI am just advising pople to review the ins policy before accepting it. You need the info on DOCTORS HOSPITALS AND SPECILIST. Or you might regert that you signed up with that insurance company
You've said that twice - and you should probably say it two or three more times .

It's pretty obvious to me that at least a few people here aren't that familiar with health insurance (and the alphabet soup that comes with it).

FWIW - a preferred provider list in a PPO or a list of providers in an HMO network won't generally be in the insurance policy itself. They're usually separate books/on-line documents. Before I went on Medicare - I was in a national PPO where the preferred provider list was hundreds (if not thousands) of pages long. Robyn
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Old 10-01-2013, 03:27 PM
 
126 posts, read 328,434 times
Reputation: 53
As for the computer system it was very expensive and it was a mandate to all dr. offices because of aca. It was a week training and jamming down alot of info.on the operation of the system. That is one of the reasons dr. offices are closing because of the cost of system Dr's. are supposed to log in system and fill out information on each patient every visit to get reimbused for payment. and so on. Medcaid/medcare have dropped ther reimburstment rate agian. I know at one Doctors made alot of money but now it is becoming slim picking.
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Old 10-01-2013, 03:36 PM
 
Location: Southern end of the Great Plains
7,387 posts, read 7,154,887 times
Reputation: 9442
Most of us understand economics better than ACA because not even Congress understood their own law beyond that it was a way to buy votes and still not have to participate themselves. Pick your own simplicity. You will either share the costs of unpaid emergency room visits in your health care premiums or you will share the costs in your taxes and/or medical services.
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Old 10-01-2013, 03:47 PM
 
Location: Ponte Vedra Beach FL
10,833 posts, read 8,053,617 times
Reputation: 3866
Quote:
Originally Posted by Ted Bear View Post
Maybe the sample is not statistically accurate, but I am generally pleased that so many of the posters here seem to understand the ACA.

Yes, there are the ignorant comments about 'not be able to see my Dr of choice, practices are closing, some places don't accept the ACA Insurance or we can't afford this plan', but generally way more people 'get it' than I ever imagined.

Some things, however small, reaffirm my belief that mankind is not as dumb as they sometimes seem to be.

Quite honestly. ACA is very simple, insures everyone who otherwise is leaching off of the rest of us, is very affordable, and seems to be a good program. It certainly will have teething pains , simply given it huge size, but once and for all, people who need medical care will now have insurance to cover it.

Without running the numbers the obvious effect is a huge reduction in our overall health care costs. The folks who previously used the emergency room for their GP (and paid nothing for the MOST expensive care possible) will now have a Dr, and access to routine care will prevent may illnesses from getting out of control and costing hundreds of thousands when they could have been treated for a couple of grand had they been seen early.

it's all good, and I am pleased that a great many people who post here understand that!
Funny - I get the exact opposite impression from my readings (not only here - but elsewhere).

I don't think people know a whole lot (in part because a lot of essential information isn't available yet).

Also - if I had to guess - the exchanges will wind up being a prime example of "adverse selection":

Medical Pastiche: Adverse Selection in Health Insurance

Perhaps if the penalties were realistically high to start with - this might not be the case. But the penalties are laughable (and also difficult to enforce).

If this thing was really going to work - President Obama wouldn't be trotting out currently uninsurable people with MS to support his case (like he did today). He'd be trotting out young healthy 28 year olds who plan to sign up tomorrow. But I don't think that will be the case. It takes a lot of insurance premiums from healthy people to cover someone with MS.

FWIW - I'm not indifferent to the plight of uninsurable people. My husband and I were in that category (my husband does in fact have MS - so we've been there - done that) - and in our state high risk pool for a couple of decades before we went on Medicare. But boy was that plan a money pit.* Even though people like us were paying really high premiums with big deductibles and co-pays (over $600/month each in our 60's with total maximum annual co-pays/deductibles of $13k). The last annual report I read - our plan was losing $5k+ per person per year.

Anyway - being on Medicare now - I'm just an observer for the most part - not a participant. Robyn

*The only reason the program survived at all - although it was closed to new enrollment in the 90's (as a result of lobbying by outfits like the Chamber of Commerce that wanted to keep down health insurance premiums) - is that the state didn't pay the losses. They were passed on to private health insurance companies that passed them on to their customers
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Old 10-01-2013, 03:56 PM
 
1,378 posts, read 818,720 times
Reputation: 1262
Quote:
Originally Posted by Rabrrita View Post
In my state the insurance company that insures the largest employer and almost all state workers is one of the compnaies selling on the exchange. Are you telling me your Doctor will give up that business just because they now sell on the exchange? That's total bull. My employee's health cards do not have our name on it because we are too small (still over 50) so the dcotor can't even use that line of nonsense to make the claim of not accepting exchange purchased insurance.

The doctor has agreed to accept certain insurance plans such as ABC Company's PPO plan. If the exchange insurance is a PPO from ABC Compnay, guess what?, your doctor WILL be accepting it.

I think your doctor is just playing you the fool because they think your that guliable to beleive what they say without checking the facts yourself. Look at it this way, what would you say if the doctor said they will not accept a Visa card applied for from some direct marketing application mailed to the person's home but only from those applied for on an application the person picked up at a bank branch. You would be laughing your pants off at that doctor because you know how stupid that explaination is, So who is the fool, the doctor who says it, or the idiot who belives it?
Please, where did I say my doctor? I was talking about a large medical practice that went before the state assembly. It has nothing to do with me personally. Don't shoot the messenger.
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Old 10-01-2013, 04:19 PM
 
Location: Ponte Vedra Beach FL
10,833 posts, read 8,053,617 times
Reputation: 3866
Quote:
Originally Posted by Ted Bear View Post
...Quite honestly. ACA is very simple, insures everyone who otherwise is leaching off of the rest of us...
How does it do that? Especially in states like Florida - where a large % of people who aren't insured aren't even here legally? The federal government seems more concerned about covering people you might consider to be leaches than protecting the people you might think they're leaching from:

Coverage Implications and Issues for Immigrant Families: ASPE Issue Brief

I really don't know how things work in other states. Here in Florida - in large relatively urban counties - like Miami-Dade County - where I used to live - there are big public hospitals that accept all comers (and almost always run big losses). These hospitals can wind up being pretty expensive for locals. For example - about 10% of my parents' property tax bill in Broward County - the greater Ft. Lauderdale area - about $750/year - went to pay for the losses in the Broward County public hospital system caused by people who weren't insured - many of them illegals. I'm sure there was something similar on my property tax bill in Miami-Dade County - but it's been a while (15+ years).

I now live in a Florida county with no public hospital. So I don't have to pay for any public hospital losses when I pay my property taxes. Not that my property taxes are low. They're higher than the Florida average. We just spend our money on schools (we're the #1 county in Florida in terms of schools). I'm content spending my tax dollars on schools. Wouldn't be so happy spending a bunch on health care for indigent illegals.

How does the ACA fix any of this? Robyn
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Old 10-01-2013, 04:51 PM
 
Location: California
25,468 posts, read 16,753,139 times
Reputation: 17874
Nobody has purchased through the exchange yet. If what OP says is true then medical practices will eliminate all those covered by the "exchange" companies including employee plans and private individual policies. That makes no sense at all. Suddenlly dumping BCBS patients from all walks of life because ACA?

It's not venom, it's you telling tales ("have you heard???") with no details. What the name of the big medical practice? Maybe someone knows more than you do about it and can jump in. I'm saying it's not going to happen though since I can just as easily buy outside the exchange as inside.
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