Crisis in Health Care Concord NH Area (transplants, health insurance)

[Kelticnomad]

I was driven to write after calling dozens of Doctors Offices in the area I kept hearing sorry No New Patients It makes you feel so insignificant..rejected Sorry Folks had bad experiences 7 years ago with DH Clinic in this area..I felt like a wandering french fry at McDonalds If I don't laugh I will cry I called Concord Hospital and I was told to call back on Monday thats when they have new lists of Doctors who "May" be willing to take a new person in the area. But Folks I've saved the best for last I just got off the phone with a lovely gal (say 21) in the next town over ( I do want to be discreet and I was told Dr. X only accepts new patients if you agree to do an intake form over the phone. Then Dr. X will review your intake form and decide if he takes you or not. So my gut instinct wrong or right was to present myself as "Oh I won't be much trouble" type of Patient. What a horrific experience Then I was told Dr. X would review and make a decision in a week and if I don't hear from them to call them back" Should I just make my life easier and buy a Top of the Line Doctors Kit?? I have no problem seeing a Nurse Practioner ? If anyone knows anyone out there? Please feel free to DM me ty..Intersting I can self refer to a Specialist under my plan any time? This is a new twist So basically the only thing that I need is a PCP Primary Care Physician for.. is to refer for tests that I might need at any time Mm so maybe I should put an ad on Craigs List it would look something like this I think "Wanted Primary Care Physician Need PCP close to Concord Area I promise to only take 1 mintue of your time you will only need to sign for tests I might need. In fact you don't even need to think about the tests ..I will confirm all approved and covered tests with my Insurance Company. So I will bring lists with me just sign on the ordering form. Yes I'm your ideal patient 1 minute of your time and you can charge me for the full visit. I estimate that I will only need 7 mintues of your time per year" thank you

[WannaComeHome]

lol! I'm so sorry you're having such a hard time finding a Dr. good thing you still have a sense of humor (as you said: if you don't laugh, you'll end up crying)

Sorry I don't know any Drs up there, but I wish you luck!!!

[Kelticnomad]

Thanks for your reply I wish to spread laughter I mean if things seem ridiculous...I can get mad which I did a little and then when things seemed to get more ridiculous ..it just seemed I had to become ridiculous or sarcastic to cope. Believe I will let folks if I get selected by Dr. X based on my telephone intake interview...Gosh the suspense is killing me

[CometVoyager]

Originally Posted by Kelticnomad

I was driven to write after calling dozens of Doctors Offices in the area I kept hearing sorry No New Patients It makes you feel so insignificant..rejected Sorry Folks had bad experiences 7 years ago with DH Clinic in this area..I felt like a wandering french fry at McDonalds If I don't laugh I will cry I called Concord Hospital and I was told to call back on Monday thats when they have new lists of Doctors who "May" be willing to take a new person in the area. But Folks I've saved the best for last I just got off the phone with a lovely gal (say 21) in the next town over ( I do want to be discreet and I was told Dr. X only accepts new patients if you agree to do an intake form over the phone. Then Dr. X will review your intake form and decide if he takes you or not. So my gut instinct wrong or right was to present myself as "Oh I won't be much trouble" type of Patient. What a horrific experience Then I was told Dr. X would review and make a decision in a week and if I don't hear from them to call them back" Should I just make my life easier and buy a Top of the Line Doctors Kit?? I have no problem seeing a Nurse Practioner ? If anyone knows anyone out there? Please feel free to DM me ty..Intersting I can self refer to a Specialist under my plan any time? This is a new twist So basically the only thing that I need is a PCP Primary Care Physician for.. is to refer for tests that I might need at any time Mm so maybe I should put an ad on Craigs List it would look something like this I think "Wanted Primary Care Physician Need PCP close to Concord Area I promise to only take 1 mintue of your time you will only need to sign for tests I might need. In fact you don't even need to think about the tests ..I will confirm all approved and covered tests with my Insurance Company. So I will bring lists with me just sign on the ordering form. Yes I'm your ideal patient 1 minute of your time and you can charge me for the full visit. I estimate that I will only need 7 mintues of your time per year" thank you

Hi and welcome to the board kelticnomad!

From your post it appears you are locked in an HMO cause when you use a PCP it usually means that in-order to be referred to any kind of specialist you much first get a referral from your HMO PCP.

Having once been in an HMO I can tell you it certainly restricted my accessibility to many physicians. And the reason for this is because HMO's really do not compensate physicians very well and in fact if you are a surgeon, you probably will do everything you can to avoid being a Provider on an HMO!! And would you really want to be operated on by a surgeon who is disgruntled about his/her compensation!:confus ed:

I have discovered that insurance carriers are doing everything they can to lower compensation rates for physicians and even recruiting physicians from Pakistan and India, as well as other countries so that they can pay a lower or diluted rate to increase their profit margins.

Now do not get me wrong, I do not ever want Government Run One Size Fits All Socialist Health Insurance! But at the same time what is happening now is just that with regards to all the Mergers and Acquisitions of our Health Insurers! SO because of all these Acquisitions we see more Insurance Monopolies which is now Corporate Socialism! They can Fix the Prices for what you pay and what the Provider gets paid!

Who is to Blame????
Your Elected Representatives are to Blame, as they can only reason in a Binary Mode, either they are Pro Insurance Company Socialism or they are Pro Government Socialism.

What we truly need and this will help drive down prices and make our health care system much more accessible is for our Lawmakers to make the Health Care Industry more Competitive and enhance our Free Enterprise system so we can build more hospitals which compete, build more medical schools (when was the last time in the USA we built a new Med School??))

And lastly stop these Mergers & Acquisitions and enforce the Sherman Anti Trust Laws!:co ol::cool :

We have too many Monopolies in this country and that is not Free Enterprise! If our Government should do anything they should make the most competitive Free Enterprise Economic System on the Planet and the only way you can do that is to stop Corporate Socialism by not allowing all these mergers and acquisitions!

[Kelticnomad]

Hello ty you comet for your reply. I have a background that is both a blessing and a curse I spent many many years as a Health Insurance Specialist and Employee Counselor. So unfortunately I know too much or I will be humble and say a lot Myth Number 1. Health Insurance Companies are bad because they are always cutting or restricting benefits e.g. HMO As I counseled folks the biggest shock to consumers/employees of medical/dental care was to learn it was the companies they work for that design the medical/dental plan they use. What am I talking about ? Well this part I know very well since I've sat in on a gazillion new or renewal health-dental insurance contracts and the scoop is this Company X tells the insurance company that they only wany to spend Y amount per year. The Insurance Company comes back and says well we can design this cheeseball plan for you that will strip your employees of a lot of good medical care or will have them paying more Company X says Great!! and announces to employees Oh WE had to change Medical-Dental Plans to save money. As employees see their health benefits dwindle and incur higher costs ...they unkowingly think ..dam those insurance companies. Employers tend to do this more in hard times when the attitude by employers is "Hey Pal you're lucky to have a job in this economy..if you complain you're out the door" So now I tell you all something else When jobs are plentiful...those same employers are sweating at the brow...yes they go nuts Lets make our health plans better so we can retain and attract good employees...in these situations the employers step forward and happily announces that they the employer have completed the upgrades to the plans...and there you have it

[Kelticnomad]

I wanted to reply separately to this one HMOs yes operate within strict guidelines of the typical PCP doctor referring to specialist. Consumers opinions vary widely depending on the HMO being used. This is common all over the US, some are good and others are mediocre or bad. Preferred Provider Plans a self designed HMO is whats happening in a lot of companies. The Insurance Companies will contract with doctors in certain geographic areas to be part of their network doctors. PPOs plan design varies ...most with needing a PCP for referral to a specialist....Our plan is rather amusing the design is that as a member I can self refer myself to a specialist no PCP approval necessary. As I said earlier the Company/Employer can stipulate certain elements of the plan design which is directly related to the preferences of management. Yes management if they have certain vested interest in certain benefit designs for themselves or their direct reports let me tell you it will be in there So actually for myself for every ailment I could just go see a specialist I don't need a PCP at all Yep and because I'm not a know it all I double checked this theory with the insurance rep yesteray The days that employers use a true indemnity plan are gone..there are only a few out there in the whole USA..these are generous plans that cover all doctors etc with small co-pays and fair reimbursements to Physicians..so there you have it take care Kelty

[WannaComeHome]

I know insurance with me is a little tricky. I, also, can self-refer to specialists (as long as they're in the 'plan') - except for the Physical Therapists that I prefer since they are hospital out-patient and apparently that does require a referral (not sure if it's the hospital or the insurance company that insists, but either way...).

A number of years ago my dentist dropped all HMOs unless they were PPOs (I think that's how it worked). I tried to whine a little because he is expensive using the latest gizmos like lasers instead of drilling and such, and he gave me this long rant about how it's actually cheaper for them if a patient doesn't even come in for their hygienist appt than if they do! I didn't quite follow how getting paid little is worse than nothing, but he was adamant. So... we now pay out of pocket (which hurts).

My PCP is also trying to get out of the HMOs and keep only medicare. He was going to offer one of those 'private doctor plans' where you pay a certain amount for the year to cover a variety of visits - and the ability to use his partner's name for referring any tests through your insurance company.. but I figured I go in so seldom that it just wasn't worth paying my insurance AND the dr. Apparently enough people felt this way that he didn't do it. but he did drop anyone who wasn't Open Access. Luckily I am, so I don't need to find a new dr.

Oy! I think half the trouble with the insurance companies is the self-perpetuating cycle we've gotten into. The doctors etc, pad up their bills with all sorts of items so they can try to get paid a decent amount - but the insurance company isn't dumb and knows bills get padded out so they pay out less and get difficult on covering various things.. and the patient in the middle can never figure out what's happening and if the tests that they really need are going to be covered/paid or not and if so when! and it all just cycles around.

We need the system fixed, I just have no idea how. I definitely don't think a Government run system is the way to go. geez, that's all we need!

[Yankeehombre]

As an experienced veteran of the Seacost medical Industry , I can tell you that finding quality healthcare on the seacost, most of my doctors have been "transplants from more upban areas that seek the N.H. quality of life", often after having served in more in some prestigious institutions like Mass General (st. elsewhere)Lahey clinic in Ma, Johns Hopkins, here for the same reasons you are for that quality of life and recreation opportunities.

[Yankeehombre]

My own PCP physician is somewhat disheartened that current trend is he doesn't get to see his own patients in the hospital, even though he is on staff there. the "floor-doctor" sees the patients on behalf of the hospital. Idividual specialists physicians bill directly for things special sevices like MRI, Ultra-sound, etc. My own neurolgist never saw me during a recent blood [serious incident]clot in the brain, in a recent hospital stay[also on staff]. Somebody from her practice saw me on behalf of the hospital. She did see me at an office visit afterward., and gave her consent to tinkering of my medications re-billed for the office visit. I too was requested to reschedule another PCP office visit after the hospital stay, to keep my PCP up-to- date on medication tinkering ordered by the "floor-doctor". You might as depend on the hospital for your medical care + pay once. Medicare pays once reasonable + customary charges and overwhelmingly rejects the bulk of supplementary charges, leaving you holding the bag for "seeing your own doctor"in addition to the staff doctor.

[CometVoyager]

Originally Posted by Kelticnomad

I wanted to reply separately to this one HMOs yes operate within strict guidelines of the typical PCP doctor referring to specialist. Consumers opinions vary widely depending on the HMO being used. This is common all over the US, some are good and others are mediocre or bad. Preferred Provider Plans a self designed HMO is whats happening in a lot of companies. The Insurance Companies will contract with doctors in certain geographic areas to be part of their network doctors. PPOs plan design varies ...most with needing a PCP for referral to a specialist....Our plan is rather amusing the design is that as a member I can self refer myself to a specialist no PCP approval necessary. As I said earlier the Company/Employer can stipulate certain elements of the plan design which is directly related to the preferences of management. Yes management if they have certain vested interest in certain benefit designs for themselves or their direct reports let me tell you it will be in there So actually for myself for every ailment I could just go see a specialist I don't need a PCP at all Yep and because I'm not a know it all I double checked this theory with the insurance rep yesteray The days that employers use a true indemnity plan are gone..there are only a few out there in the whole USA..these are generous plans that cover all doctors etc with small co-pays and fair reimbursements to Physicians..so there you have it take care Kelty

All Good Points Kelticnomad! Yes some some HMO Plans do let their subscribers, within certain parameters, go directly to a specialist. But the specialist must be part of the HMO Network or it is not covered and to go off the network there is mucho red tape.

PPO's do enable subscribers to go directly to any specialist on the network without a having or being required to elect to have a PCP.

I am also aware that in New Hampshire to some degree you can design your plan but only within the plan options that the insurance carriers offers. Of course if you work for a large employer the employer may self insure say the first 10K of medical expenses and then the insurance carrier will pick up after the fist 10K but in New Hampshire each HMO, PPO and Indemnity Plan is required to contain certain standard policy provisions.

IMHO I would never again want to be in an HMO, as it is only a Service Contract similar to a Dishwasher Warranty! If you get really sick and want to say go to Boston or New York you are at their mercy! Where as a PPO at least lets you choose on or off network providers but if you go off network you get reimbursed at a much lower rate.

Personally I believe allowing Insurance Carriers to Form and Manage all these Provider Networks makes the Health Care Market less competitive and makes it a cherry deal for the insurance carriers, as they strong arm the providers into accepting inferior compensation so the insurance carrier can make a larger profit! The reason they have been successful at doing this is because our lawmakers enable insurance companies to buy out their competition thus reducing competition and messing up risk pools.

To make health insurance better in New Hampshire I would do the following;

• Make any kind of Insurance Provider Network Illegal!
• Prohibit all these Insurance carriers from buying out their competition and encourage the creation of more insurance carriers to compete against each other.
• Disband all HMO's and PPO's.
• Allow only True Health Insurance coverage to be marketed and sold meaning Insurance carriers can only sell Indemnity Health Insurance Plans that are based upon providing protection for unforeseen health risks.
• Build more American Medical schools and Graduate More Doctors!
• Build more Hospitals and prevent large hospital networks from buying up their competition.

In other words I want to see us get back to a competitive free market with regards to health care in New Hampshire! If you all think for a moment, do you ever remember your parents complaining about health insurance the way people complain today? No! That is because all we had back 30 years ago were true Indemnity Health Plans with lots of competition!:c ool::coo l: :c ool: