U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > General Forums > Health and Wellness > Health Insurance
 [Register]
Please register to participate in our discussions with 1.5 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Jump to a detailed profile or search
site with Google Custom Search

Search Forums  (Advanced)
Business Search - 14 Million verified businesses
Search for:  near: 
Reply Start New Thread
 
Old 11-02-2013, 05:40 PM
 
Location: Ponte Vedra Beach FL
10,833 posts, read 7,726,965 times
Reputation: 3858
Quote:
Originally Posted by PippySkiddles View Post
I haven't found a plan I can afford so I suppose the subject is moot to me
Why not? It's supposed to be the "Affordable Care Act". Can you hum a few bars in terms of your personal situation? Robyn
Reply With Quote Quick reply to this message

 
Old 11-02-2013, 06:40 PM
 
1,322 posts, read 756,845 times
Reputation: 1191
Quote:
Originally Posted by Wardendresden View Post
U.S. News and World Report is somewhere between useless and less than useless for determining quality care. They place high emphasis on patient satisfaction which tends to be mostly in line with "bedside manner" as opposed to quality health care.

I want to know infection rates within the hospital, re-admission rates within 30 days, percentage of negative outcomes for procedures and surgeries such as appendectomies, gastric by-pass (boy, that one sucks in most hospitals), Cabbage procedures (heart stents), thyroid and gall bladder removal, etc. Every single hospital keeps this data but generally refuse to release this information unless required to by law. Whenever they do, they have to spend money to refine their operations, get rid of dangerous physicians (who might be bringing money into the hospital), and suffer negative public impact until their ratings improve.

My favorite example is in New York City, where 20 years ago a cardiologist was appointed as the state's "health czar" or commissioner or something. He got the state legislature to pass a law requiring all hospitals in the state to release information concerning negative outcomes regarding heart stents. The first year the information was released, of the 60 or so hospitals in New York City, the range of negative outcomes was from 1% to 18%. Two years later it had dropped to 0% to 9%. Hospitals actually did something. If you had that information prior to having stents inserted into your heart arteries, would you be more likely to go to a hospital where there was a one in six chance of a negative outcome?

Charles Ornstein: Should Hospital Ratings Be Embraced

That's why reading about "top" hospitals in the media is nothing more than hype. I prefer data. It is changing and hopefully for the better
Did you find The Joint Commission helpful at all?
Reply With Quote Quick reply to this message
 
Old 11-02-2013, 07:16 PM
 
Location: Denver, CO
3,005 posts, read 1,226,822 times
Reputation: 2447
Quote:
Originally Posted by ebbe View Post
Did you find The Joint Commission helpful at all?
The Joint Commission is an insider oversight group that my wife has had dealings with for over 20 years. She is the director of medical staff services, one of the areas surveyed by the teams to determine if doctors are credentialed properly. They do come into hospitals looking for specific data, but it is rare for a hospital to be put out of business by a finding from the joint commission. They get "warnings" and then the JC team will come back again in a year or so instead of the more usual three.

And, depending on the emphasis for the year, they will sometimes miss something important.

Just require hospitals to put the data on the internet--in short order there will be a huge improvement in health care in the U.S., instead of the four plane loads of people killed every week because they have been in our hospitals.

Quote:
• 12,000 deaths per year due to unnecessary surgery
• 7000 deaths per year due to medication errors in hospitals
• 20,000 deaths per year due to other errors in hospitals
• 80,000 deaths per year due to infections in hospitals
• 106,000 deaths per year due to negative effects of drugs
http://www.health-care-reform.net/causedeath.htm

My good friend's wife is a pharmaceutical assistant at a different hospital system than what my wife belongs to. He says they get their own hospital care OTHER than at her hospital system (whose name you would instantly recognize) because she says there is too much hurry in the pharmacy and mistakes occur at least five percent of the time. Would you want to be in a hospital with a five percent chance of medication error? Or an airplane where that much error occurred?
Reply With Quote Quick reply to this message
 
Old 11-03-2013, 06:01 AM
 
20,798 posts, read 31,393,156 times
Reputation: 9864
Quote:
Originally Posted by PippySkiddles View Post
I haven't found a plan I can afford so I suppose the subject is moot to me
Well, how much can you afford and how much do you make?
Reply With Quote Quick reply to this message
 
Old 11-03-2013, 11:07 AM
 
Location: SW Florida
2,749 posts, read 1,002,395 times
Reputation: 2879
Quote:
Originally Posted by Robyn55 View Post
None of this is entirely accurate. For example - Mayo JAX accepts Medicare patients - but not "Medicare assignment" (the last is kind of "vintage" for most health care providers - used to be common maybe 20 years ago - but is almost extinct today). You are personally responsible for bills you incur there and pay them directly. Mayo will bill Medicare and your Medigap carrier - who then send whatever they owe for your care directly to you. In some cases - you're asked to sign papers acknowledging that you will personally be responsible for X dollars if Medicare/Medigap don't pay. This happens most commonly to us when it comes to lab work and tests where Medicare/Medigap reimbursement isn't a sure thing.

This system has worked out fine for us - because neither we nor our doctors are into a lot of unnecessary/questionable lab work or tests. Also - we get a lot of FF miles/points when we pay our bills through a credit card .

To the best of my knowledge - Mayo isn't in the insurance business. Robyn
LOL, your post here probably answers my questions about whether or not concierge practices will also accept Medicare/medigap insurance- seems as though they will. Do they require those patients to pay out of pocket the difference between the Medicare/medigap payments they get ( which add up only to 100% of the Medicare allowable payments) and what the providers bill to Medicare? I'm guessing that if they don't accept "Medicare assignment", this would be the case. But is it?
Reply With Quote Quick reply to this message
 
Old 11-03-2013, 12:33 PM
 
Location: gazing @ the Blue Ridge Mountains
9,780 posts, read 6,650,435 times
Reputation: 13394
Quote:
Originally Posted by golfgal View Post
Well, how much can you afford and how much do you make?

COL and repayment of loans for college are never figured in. IF they were I would no doubt qualify for Medicaid
Reply With Quote Quick reply to this message
 
Old 11-03-2013, 12:41 PM
 
20,798 posts, read 31,393,156 times
Reputation: 9864
Quote:
Originally Posted by PippySkiddles View Post
COL and repayment of loans for college are never figured in. IF they were I would no doubt qualify for Medicaid
COL IS factored into the ACA subsidies....why do repaying loans have to do with your health insurance??? Should have thought of that before you took out too many loans I guess...
Reply With Quote Quick reply to this message
 
Old 11-03-2013, 01:56 PM
 
Location: gazing @ the Blue Ridge Mountains
9,780 posts, read 6,650,435 times
Reputation: 13394
Quote:
Originally Posted by golfgal View Post
COL IS factored into the ACA subsidies....why do repaying loans have to do with your health insurance??? Should have thought of that before you took out too many loans I guess...

wow......just wow.
Reply With Quote Quick reply to this message
 
Old 11-03-2013, 02:14 PM
 
20,798 posts, read 31,393,156 times
Reputation: 9864
Quote:
Originally Posted by PippySkiddles View Post
wow......just wow.
No, just common sense.....
Reply With Quote Quick reply to this message
 
Old 11-03-2013, 03:03 PM
 
414 posts, read 417,016 times
Reputation: 370
Stop going to the marketplace and go to the insurance company website for information on what plans allow you to go to what providers and what hospitals. That is the ONLY place to get the most accurate information. You really are stupid if you look anywhere else and yeah...DUH...CALL YOUR DOCTOR OR HOSPITAL to clarification.
Reply With Quote Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


Reply
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:

Over $84,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > General Forums > Health and Wellness > Health Insurance

All times are GMT -6.

2005-2014, Advameg, Inc.

City-Data.com - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 - Top