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If he takes patients from Medicare-BCBS and he takes group BCBS patients from large and small employers why should he refuse to take people who buy on the individual market. As an example I have BCBS from an employer my wife has BCBS which is ACA compliant and pays the full tab...no subsidy. My money-insurance is ok but hers is bad?? Something wrong here. BCBS should pull this doctor off their provider list and see how he likes it.
In your 1st scenario Medicare is primary and BCBS is the secondary. Many times BCBS policies don't
even pay anything as the secondary, especially if its not an emergency - Advantage 65 comes to mind.
Patients better take the time to know what their insurances cover and what doctors are on what
network. You can go on BCBS and just type in the docs name, so it's not a secret.
Maybe folks should make it a point to know which plans their doc is on, before they pick out a plan
if they are so attached to the doc. He'll know or his staff surely will know what plans he is on.
And, BCBS does not care what plans any doctor is on. They only care if they have to pay for a claim
or not pay for it, because of it. So many patients lie to docs when they change plans interim and
the doc is stuck holding the bag e.g. medicare part c advantage plans esp.
Like I've always said, all this "****" would be solved w/ a single payer national health care system.
But nooooooooooooooo, this country is stupid - a disease there is yet a cure
Lawyers and docs can certainly own their own offices. But there is is no real lawyer equivalent to a hospital. And there are many good reasons why docs should not be owners/controllers of hospitals. But that should be another topic.
Privates docs can always decide for themselves which plans and which patients they want to see or not. With Obamacare there is great worry that many new enrollees have such high deductibles, and the docs are simply more worried about being able to collect on fees. Real or imagined, I don't think anyone yet knows. And I'm a doc.
I have not been to a doc in many years or a hospital or any other provider who did not collect the deductible up front. They might agree to bill, but that is truly the exception where I live.
Anyone who has ever dealt with this mess we call a health care system in the US is familiar with the hassles. This entire thread is based on a singular example of what is common with all plans, especially those in the individual market, and is indicative of the pathetic desperation of the right to try to discredit the surprising success of the ACA to this point. As they have done from the outset, they point to a isolated, anecdotal and usually inaccurate story and extrapolate that to the experiences of millions of patients and thousands of providers who are in the ACA plans now. Pathetic is too charitable a term.
Lawyers and docs can certainly own their own offices. But there is is no real lawyer equivalent to a hospital. And there are many good reasons why docs should not be owners/controllers of hospitals. But that should be another topic.
Privates docs can always decide for themselves which plans and which patients they want to see or not. With Obamacare there is great worry that many new enrollees have such high deductibles, and the docs are simply more worried about being able to collect on fees. Real or imagined, I don't think anyone yet knows. And I'm a doc.
Out of curiosity, what are those "good reasons" why there shouldn't be doctor owned hospitals?
is indicative of the desperation of the right to try to discredit the surprising success of the ACA to this point.
Besides having pre existing conditions covered, there is nothing in the ACA that has been successful.
It is simply a government extension (mandate) of the same old ****ty system.
Without a public option, the ACA, NEVER should have been passed.
Simply EXPANDING MEDICAID is a band aid that is going to have to be ripped off in the future when it comes to paying for it, and it is going to hurt
Out of curiosity, what are those "good reasons" why there shouldn't be doctor owned hospitals?
You know conflict of interest - providing services motivated by profit. The same stuff hospitals do anyways but the CEO's get most of the profit, instead of the docs.
I have not been to a doc in many years or a hospital or any other provider who did not collect the deductible up front. They might agree to bill, but that is truly the exception where I live.
Generally this is true.
The worry is that many patients will then be cancelling their appointments at the last minute when they figure out they cannot afford the visit. So this would be a loss of the docs time.
But as I said, we really don't know if this scenario will be significant enough. I haven't yet been impacted.
You know conflict of interest - providing services motivated by profit. The same stuff hospitals do anyways but the CEO's get most of the profit, instead of the docs.
Odd rationale. There are plenty of industries where this could be an issue but why single out medicine? Unsustainable reimbursement rates, not allowing additional physician owned hospitals, talk about forcing doctors to accept Obamacare patients, etc, etc. Wow, does this administration have something against doctors? Seems that way.
Odd rationale. There are plenty of industries where this could be an issue but why single out medicine? Unsustainable reimbursement rates, not allowing additional physician owned hospitals, talk about forcing doctors to accept Obamacare patients, etc, etc. Wow, does this administration have something against doctors? Seems that way.
The basic reason is that in medicine, far more than most businesses, it is the doc that makes the major spending decisions.
Cherry picking of cases that are easier and cheaper to deal with, yet get full payment.
So the low payers, the no payers, the complicated, difficult and prolonged cases get shunted to another hospital.
Has this been proven to be the case? I would think, before banning something, there would be some empirical evidence to suggest this is the case. Obviously we would see widespread cases of doctor owned hospitals doing this while non-doctor owned hospitals did not. Otherwise, this decision was made on some other criteria and I would then question this decision.
Quote:
Originally Posted by Hoonose
The basic reason is that in medicine, far more than most businesses, it is the doc that makes the major spending decisions.
Really? I have not found that to be the case. In almost every business, the business owner is the primary person with control of the purse strings. There are many, many owner operator businesses in this country. Why is it fair to single out doctors?
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