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Old 12-19-2013, 11:30 AM
 
17,060 posts, read 11,460,986 times
Reputation: 9020

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Quote:
Originally Posted by pollyrobin View Post
I've read all your links but they don't really support your argument much

"There is one well-recognized but very limited exception to the prohibition on co-pay waivers. This is a waiver based on demonstrated financial hardship. It is fine for the practice to waive the co-pay, even for Medicare patients, so long as such waivers are extended pursuant to reasonable, consistently applied hardship criteria, and are not provided as a routine matter. The practice should establish a process in terms of what documentation (e.g., tax return, unemployment compensation documentation) must be provided by the patient to qualify. " - See more at: Co-Pays and Courtesy: Clearing Away the Confusion

I'm sorry - I should have clarified co pays - specifically if you go out of network to a
physician or specialist, you pay a higher co pay, more than 20 percent.

I do not work in the health care industry (knock on wood) but fortunately or unfortunately my better half does. I am very familiar with the fee schedule of Medicare.
The fee schedule calculator they use now was tweeked under Bush. I'm not blaming him - he really had nothing to do with it - it just is what it is.

You are right - hospitals should not charge 10 X what something in a surgery center does.
Another reason why we need single payer

A hospital bases it's fees on what private insurance companies will pay. They inflate the prices because in the long and short run, private insurance companies profit; from high premiums and high deductibles. Remember, not everyone gets sick and ends up in a hospital under the age of 65 but you certainly will pay for the privilege of covering your ass for that "unexpected, high cost item" that has been inflated and probability wise, won't happen to you or that you will ever need.

I will tell you, as a supporter of Ron Paul and being a registered Libertarian of the Libertarian Party,
could not disagree more with him or my own party on a private health care
system in the united States from a realistic stand point.

It might have worked back in 1960 before we had heart transplants or PET Scans, but it won't
cut it today. Especially since we have corporatism in this country, not a free market health care
system.

My husband who is a surgeon/specialist sees patients every day that are in jeopardy of loosing their limbs, and in some cases, their dignity. He helps to alleviate that. The last thing he wants to think about is third party payers. It might be the nature of the BEAST, but it does not have to be that way:

The Expanded & Improved Medicare For All Act (H.R. 676) | Physicians for a National Health Program

And yes, he takes Medicare assignment

Sounds like he is a vascular surgeon. They, of course, did not get their reimbursement from medicare whacked this time through. I am sure that he would singing a different song (as would you) if his medicare fee schedule was cut 50%! Pride and self-righteousness only go so far, when one is not covering his/her overhead.

However, for those specialities getting these large cuts, it is simply not feasible to see medicare patients with an "open door" policy. Our state, again, is reimbursed the lowest in the US for medicare services, despite being ranked #1 for overall quality.

EVERYONE in our town (500,000) in specialites affected by the deep cuts are either limiting medicare slots each day, or dropping medicare entirely. It is a simple matter of economics.
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Old 12-19-2013, 12:12 PM
 
9,897 posts, read 6,631,165 times
Reputation: 2519
Quote:
Originally Posted by hawkeye2009 View Post
I am sure that he would singing a different song (as would you) if his medicare fee schedule was cut 50%! Pride and self-righteousness only go so far, when one is not covering his/her overhead.

However, for those specialities getting these large cuts, it is simply not feasible to see medicare patients with an "open door" policy. Our state, again, is reimbursed the lowest in the US for medicare services, despite being ranked #1 for overall quality.
I agree.
Docs are getting a raw deal in all this. They never did have a seat at the table and the AMA.... a voice of the majority of docs it did not make.

Equitably speaking, the disparity of income between specialties would shrink with a single payer national health care system.
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Old 12-19-2013, 12:24 PM
 
Location: Buckeye, AZ
25,534 posts, read 14,637,444 times
Reputation: 9261
Quote:
Originally Posted by pollyrobin View Post
I agree.
Docs are getting a raw deal in all this. They never did have a seat at the table and the AMA.... a voice of the majority of docs it did not make.
I think the issue with the law was Obama over-reached and over-promised. Now he's paying for this. I saw this all along from him and is a reason I never voted for him either time. I didn't believe the bill of goods he was trying to sell. What do you know, I was right sadly. Sure reports state the AMA was a part of the negotiations, but as we can tell with how many doctors are out of network now based on pay from the insurers, it shows that was a lie.

Quote:
Originally Posted by pollyrobin View Post
Equitably speaking, the disparity of income between specialties would shrink with a single payer national health care system.
Is that how it is in Canada or any of the European single-payer systems? Honestly, I never checked into them. All I know is in Turkey (I think) they have one set rate with a set coverage but then you could buy extended coverage if you want.
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Old 12-19-2013, 12:25 PM
 
8,321 posts, read 3,508,806 times
Reputation: 1592
Quote:
Originally Posted by hawkeye2009 View Post
Sounds like he is a vascular surgeon. They, of course, did not get their reimbursement from medicare whacked this time through. I am sure that he would singing a different song (as would you) if his medicare fee schedule was cut 50%! Pride and self-righteousness only go so far, when one is not covering his/her overhead.

However, for those specialities getting these large cuts, it is simply not feasible to see medicare patients with an "open door" policy. Our state, again, is reimbursed the lowest in the US for medicare services, despite being ranked #1 for overall quality.

EVERYONE in our town (500,000) in specialites affected by the deep cuts are either limiting medicare slots each day, or dropping medicare entirely. It is a simple matter of economics.
When I retire I will be planning to stay right here in my small town. In larger areas docs can afford to cherry pick their patients to help them reach their financial goals. Indeed some may have to cherry pick to stay in business. We docs in small towns don't have that luxury, or maybe we don't need that luxury with our lower overheads.
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Old 12-19-2013, 12:43 PM
 
38,098 posts, read 19,130,748 times
Reputation: 12118
I didn't buy into Obama and his rhetoric because I could see through it. I was right but wish I was wrong.
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Old 12-19-2013, 01:02 PM
 
9,897 posts, read 6,631,165 times
Reputation: 2519
Quote:
Originally Posted by mkpunk View Post

Is that how it is in Canada or any of the European single-payer systems? Honestly, I never checked into them. All I know is in Turkey (I think) they have one set rate with a set coverage but then you could buy extended coverage if you want.
I just know in countries like Canada, France, Australia, Germany - their specialty docs get paid
less than they do here in the States. It makes sense that a unified control
of things would reign in health care costs (including delivery by docs) to a standard that is level and
not all over the place like it is here now.

Higher Fees Paid To US Physicians Drive Higher Spending For Physician Services Compared To Other Countries

"Public and private payers paid somewhat higher fees to US primary care physicians for office visits (27 percent more for public, 70 percent more for private) and much higher fees to orthopedic physicians for hip replacements (70 percent more for public, 120 percent more for private) than public and private payers paid these physicians’ counterparts in other countries. US primary care and orthopedic physicians also earned higher incomes ($186,582 and $442,450, respectively) than their foreign counterparts. We conclude that the higher fees, rather than factors such as higher practice costs, volume of services, or tuition expenses, were the main drivers of higher US spending, particularly in orthopedics"
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Old 12-19-2013, 01:10 PM
 
Location: Vegas
1,789 posts, read 1,737,916 times
Reputation: 1762
Default Top 10 Broken Obamacare Promises

The Foundry: Conservative Policy News Blog from The Heritage Foundation by Alyene Senger

Quote:
Since the passage of Obamacare in 2010, many of the President’s famous promises have been routinely broken. As he so ironically threatened in 2009, “If you misrepresent what’s in this plan, we will call you out.” To that end, here are 10 promises of Obamacare that have already been broken.
I don't need to comment on this as it speaks for itself @ Top 10 Broken Obamacare Promises
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Old 12-19-2013, 01:16 PM
 
38,098 posts, read 19,130,748 times
Reputation: 12118
Quote:
Originally Posted by Ponderosa View Post
More hyperbole and arm waving from the right about something (devastating the travel industry) that will never happen. Maybe my employer is cheap but I have not seen a policy that covered out of network in at least 10 years. Single payer would solve this problem too. People on medicare are free to live where they want and travel where they want without being concerned about health care should they get sick on their trip. Must be nice. FWIW, all the BCBS policies on my exchange have nationwide networks. They cost more than the narrow network plans as you might suspect. But it is nice to have that choice to pick a plan that suits your needs. Like I said, few employer plans offer out of network anymore.
It was an honest question. So out of network but how much more will premiums and deductibles be. I purposely purchased a policy that included out of network at reasonable monthly cost but I got the termination letter.

Obama lied. Why should we believe anything coming out of this administration?

So how much are you being paid Ponderosa?
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Old 12-19-2013, 01:57 PM
 
Location: SF Bay Area
14,330 posts, read 19,083,036 times
Reputation: 18436
Default Broken Congress b/c of Pubs, is THE problem

Our structure of government doesn't allow the President to act alone, except in certain circumstances. Whatever promises you hapless Conservatives point to, are instead a reflection of the pathetic Republicans in Congress who have obstructed.

Republican obstruction does NOT mean that President Obama has failed. Rather, Republicans have shown they FEAR the success they know the President can bring if he has his way.

"Broken" promises are a reflection of the Republican-tainted Congress.

What an idiotic, misleading thread title.
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Old 12-19-2013, 02:03 PM
 
Location: Vegas
1,789 posts, read 1,737,916 times
Reputation: 1762
Quote:
Originally Posted by LexusNexus View Post
Our structure of government doesn't allow the President to act alone, except in certain circumstances. Whatever promises you hapless Conservatives point to, are instead a reflection of the pathetic Republicans in Congress who have obstructed.

Republican obstruction does NOT mean that President Obama has failed. Rather, Republicans have shown they FEAR the success they know the President can bring if he has his way.

"Broken" promises are a reflection of the Republican-tainted Congress.

What an idiotic, misleading thread title.
What a ridiculous, bigoted reply. Give me one example of where "Republican obstruction" has done anything to change the way the ACA is being administered by the OBAMA ADMINISTRATION!!!!!
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