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Don't kid yourself. Some of these Obamacare plans have such narrow networks that you can wait until the following YEAR to get an appointment.
Example: I had an injury for which my primary care doctor strongly recommended PT. I called 20 PT places until I found one that would accept the Obamacare plan. The problem was that this was September, and they had no openings until January. I waited.
But that's not even the worst of it. While I was paying my bill (which I had to pay fully since Obamacare has astronomical deductibles), the person next to me was paying in cash because she had no insurance at all. It was cheaper! I asked to then pay in cash, and I was refused: the PT place said I HAD to use the insurance. So not only did I pay $900 a month for insurance that doesn't cover anything, it actually forced me to pay MORE for a service than I would have had I not bought the insurance plan at all.
Yes. OBamcare is that bad.
What is this Obamacare you refer to? Is this an individual plan purchased through an exchange or something else?
I do appreciate the more affordable ACA compliant plans tend to have very narrow networks, especially in some states. And I also appreciate that some states allow insurers to operate even though their networks do not contain all specialties.
Your situation is as anecdotal as my own. We have a BCBS plan and I have yet to find any provider who is not a part of its vast PPO network.
What is this Obamacare you refer to? Is this an individual plan purchased through an exchange or something else?
I do appreciate the more affordable ACA compliant plans tend to have very narrow networks, especially in some states. And I also appreciate that some states allow insurers to operate even though their networks do not contain all specialties.
Your situation is as anecdotal as my own. We have a BCBS plan and I have yet to find any provider who is not a part of its vast PPO network.
It's an individual plan purchased through an exchange.
And it's hardly "affordable." True, it's very affordable for lower-income people, but for those with a straight middle class income (which Obamacare defines as $48,000 or more), there are no affordable plans. The lowest price plan was almost $900 a month, for a bronze, and that is more than twice what I paid just five years ago, pre-Obamacare, for a plan that was widely accepted and had a low deductible.
So here's a question: WHY did Obama push through a scheme plan that pretends to provide coverage while allowing some states to exclude specialists? It gave a windfall to insurance companies, allowing them all sorts of "outs," while enabling Obama to claim, falsely in effect, that all these people are "insured."
How any hospital can go "broke" when they charge $30 for an aspirin and many thousands of dollars for any simple procedure, is beyond me. Yes, they may have some indigents, but also enough paying customers to cover that expense.
I suspect poor management personally.
They go broke treating deadbeats. All they have to do is close the ER and then they can turn those away who have no money.
Wrong. Local taxes weren't included in that chart. For example, nearly all European countries have local property tax, just like the US. It's how they fund local services like schools, etc. To see the very few European countries don't have property tax:
Again, I think the Democrats should run on charging the middle class a 45% effective national tax rate in 2020, just like the countries with socialized medicine!
I never said anything about property taxes. Why would you bring that up?
How any hospital can go "broke" when they charge $30 for an aspirin and many thousands of dollars for any simple procedure, is beyond me. Yes, they may have some indigents, but also enough paying customers to cover that expense.
I suspect poor management personally.
Not true, most hospitals income is from Medicare and Medicaid, neither of which reimburse based on charges billed. The reimbursement is either based on the diagnosis/procedure performed or by per-diem rate. Even private insurance payers only contract based on a percentage of charges or fixed per-diem rate. The only ones billed full charges are self pays and since an overall majority don’t have insurance because they can’t afford it, you know the hospital isn’t going to see that money.
But most people aren't even on ObamaCare, so don't see how that has much to do with the situation. If you only read the article you'd know that ObamaCare had little to do with it. 36 percent of that hospital's revenue last year came from Medicare and 29 percent from Medicaid. So please pin the blame where it belongs, because it most certainly wasn't ObamaCare.
Exactly, and quite correct.
Charity hospitals, hospitals of last resort, whatever you want to call them have been closing and or in dire financial situations all over the USA for years now. Many have closed, and more are expected to shut down, so Hannheman won't be the last.
Nine years ago Saint Vincent's Hospital ended 160 years of caring for New Yorkers of all sorts in a spectacular bankruptcy.
Saint Vincent's made some very (very, very) bad management and other choices which in the end helped drive those final nails into coffin. But truth to tell Saint Vincent's was a charity care hospital. A place the wealthy, and or anyone else with good insurance (or can afford to self pay), avoid. In the end place was left with a huge patient mix of mainly Medicaid and Medicare. Neither program remotely covers actual costs of caring for patients.
This is what you've seen over and over again at charity/indigent/hospitals of last resort all over USA of late. Places just do not have a healthy patient mix that brings in well insured to offset the losses on indigent care and or from Medicare/Medicaid.
In years past local or state governments would step in with some sort of funding to keep these charity care places open. Saint Vincent's was fully expecting such aid, and was turned down flat. New York state and city like local governments all over USA just don't have cash to funnel into hospitals that continue to lose money.
As for Obamacare in some instances that scheme is making things worse for charity/indigent hospitals.
Those newly insured patients often now are going to the better/wealthy hospitals now that they have coverage either on their own, and or via referrals by their new health plan. When they couldn't pay these places wouldn't let them get a foot past front door (if they could help it), so the uninsured or under insured stuck with charity hospitals.
Since nearly every state has some pool of funds to reimburse hospitals for "indigent care", if those numbers drop, so does the money that comes in from said pool.
There is still more forces at work.
Hahnemann hospital like Saint Vincent's and scores of others in USA were designed and built for a different era of healthcare. The previous model was very hospital centered, that is patients received a majority of their care on an inpatient basis, often with stays of two, three or more days.
As such you have these huge big barns of hospitals with hundreds of beds sitting on vast real estate. Meanwhile the 21st century model of healthcare is more focused on outpatient, and or as little inpatient time as possible.
Hospitals are not only losing revenue from shorter patient stays, but various procedures and surgeries that once routinely required a hospital stay, now are done on an outpatient basis. These huge old barns of hospitals are inefficient to run, and costly to keep open.
Also like Saint Vincent's (and other urban hospitals) Hahnemann sits on very valuable real estate. The reversal of white flight out of urban areas has lead to a building boom in NYC, Boston, Philly, SF, LA, etc... causing land prices to rise. Quite simply these hospitals are sitting on their most valuable asset, their real estate.
There were a few serious offers to buy Saint Vincent's out of bankruptcy and save that hospital. But the Rudin real estate family circled wagons and got lawyered up. Having entered into a previous RE deal with Saint Vincent's they weren't going to let prime Greenwich Village, NYC real estate slip through their hands. So in the end that was that; the hospital was shut down, land sold and redeveloped.
In closing, and to be fair there are a number of people who feel many areas of the USA have too many inpatient hospital beds. That it would be more efficient overall and less costly if some consolidation took place (read closing hospitals).
Problem is wealthy/better off hospitals want little to nothing to do with indigent, the poor, charity, uninsured patients. They will provide care because it is mandated by laws; but they'd rather not. You see this in how many try to divert the uninsured, Medicaid or whatever from their emergency rooms to other hospitals. Places are now even shutting down their ERs to keep from having to deal with people who cannot pay arriving and thus by law may have to be admitted.
So what some people in this thread have said is true, the problem does come down to access to good heath insurance. If you have "Cadillac" or "Gold" health insurance, places roll out the welcome mat.
I never said anything about property taxes. Why would you bring that up?
Because they are local taxes, and you insisted local taxes had to be added to compare the US effective tax rate paid by an average income household to that paid by the same in the EU-28. Not true. Local taxes weren't included in the EU-28 chart, so I didn't include them when comparing US and EU-28 effective national/federal income tax rates
We already are when you factor in our cost of health insurance, co-pays, deductibles, and co-insurance.
True. If I were to pay for the entire cost of my health insurance, I'd be paying 30% of my income just in premiums. Add the (luckily small) deductibe, co-pays for a few routine visits a year, plus co-pays for routine testing, and that's another 10% of my income. I'm not even counting dental and vision expenses. And there we are ...
Quote:
Originally Posted by middle-aged mom
Your situation is as anecdotal as my own. We have a BCBS plan and I have yet to find any provider who is not a part of its vast PPO network.
The HMO policy I purchased through the exchange is identical to the policy I have now through my employer. Low deductible, moderate co-pays, works on a tiered system, where the bulk of providers are covered, but the co-pays vary. If I choose a provider on Tier II or Tier III, I pay a higher co-pay.
They go broke treating deadbeats. All they have to do is close the ER and then they can turn those away who have no money.
That is correct.
A teaching hospital, however, will never close its ER.
Libs don't seem to understand that hospitals, like any business, needs to make a profit or it has to close.
All the liberal freebies and give aways sound great, but bankrupting more and more hospitals only worsens access to healthcare. Interestingly, the hospitals most vunerable are those that serve poor areas, such that those underserved areas get worse over time.
Exactly. More and more rural hospitals, for example, do not have ER's. Folks have to drive 60+ miles or be life-flighted to the nearest trauma center. I grew up in the rural Midwest, and the shortage of hospitals, and also providers, is a growing epidemic. While the band-aid approaches of telehealth, and NP's, and PA's staffing ER's seems to be the "fix" they are employing, they will never replace the need for doctors. These cost-saving methods come at an expense, and that expense is patient care.
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