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Old 04-11-2011, 05:56 PM
 
Location: Rutland, VT
1,822 posts, read 4,531,553 times
Reputation: 772

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Quote:
Originally Posted by 68vette View Post
This was an issue for the Catamount Plan. Some physicians were not accepting that insurance plan.

Every provider we see, including specialists in NH, accept Catamount, which is offered through MVP or Blue Cross Blue Shield (the enrollee gets to choose). Can you tell me who was not accepting that plan?
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Old 04-11-2011, 08:56 PM
 
1,135 posts, read 2,051,964 times
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Quote:
Originally Posted by Sherylcatmom View Post
Catamount's success is in the eye of the beholder. Without it, my spouse and I would be bankrupt. He developed a serious illness shortly after we enrolled in Catamount. We'd have been totally screwed with the private coverage we had before Catamount.

Lots of other self-employed people we know are very grateful to have Catamount. Even with deductible raise next year, no other option could come close to providing such good benefits at affordable rates.
I'm glad Catamount worked for you and your husband. But, if it were a success for the majority of Vermonters who need insurance, you can bet your bottom dollar that the lawmakers who created it would be patting themselves on the back.

Apparently, the state needed to get a certain number of subscribers in order for it to be viable and that never happened. Enrollment is at about 50 percent of what they projected it would be.

I've read about the healthcare debate in the newspapers and watched it on the news and heard every angle on VPR and I've never heard anyone say that Catamount is a success. Currently 7 percent of Vermonters are uninsured, about the same number as before it was introduced. During Dr. Hsio's study he found that most people who qualify but don't subscribe to it are unable to afford it.

Therefore, it's important that the next insurance plan the state creates meets the following criteria:
1) Affordable for Vermonters regardless of income.
2) Sustainable for the state to finance for the long term.
3) Provides care that at the very least is on par with private insurance and Medicaid.
4) Reimburses providers enough to keep them in Vermont and to allow them to turn a reasonable profit.
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Old 04-13-2011, 02:49 PM
 
Location: Winter Springs, FL
1,789 posts, read 4,067,917 times
Reputation: 925
Quote:
Originally Posted by Sherylcatmom View Post

Every provider we see, including specialists in NH, accept Catamount, which is offered through MVP or Blue Cross Blue Shield (the enrollee gets to choose). Can you tell me who was not accepting that plan?
I don't have list's, but some physicians due to reimbursment issues do not accept the plan. I'm sure the majority do, but with the direction our state health plan is headed, Catamount will most likely be dead in the water. Q & A - What
Physician group opposes governor
Gov.
Your health care and everyone else that uses this plan will have serious issues to deal with. The state is looking at this as a way to save money for themselves and does not care about the physician who provides the care or what this will mean for the patient. What if your physician said to you, sorry I can no longer take care of you. This is a very real situation.
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Old 04-14-2011, 02:43 PM
 
Location: Rutland, VT
1,822 posts, read 4,531,553 times
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The way our state health plan is headed, we won't need Catamount anymore. We'll get the care we need. All our physicians, including my husband's specialists, are positive about the prospect of universal healthcare in Vermont. Not one has expressed opposition, much less said they'd consider leaving.

Quote:
Originally Posted by 68vette View Post
I don't have list's, but some physicians due to reimbursment issues do not accept the plan. I'm sure the majority do, but with the direction our state health plan is headed, Catamount will most likely be dead in the water. Q & A - What
Physician group opposes governor
Gov.
Your health care and everyone else that uses this plan will have serious issues to deal with. The state is looking at this as a way to save money for themselves and does not care about the physician who provides the care or what this will mean for the patient. What if your physician said to you, sorry I can no longer take care of you. This is a very real situation.
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Old 04-14-2011, 03:07 PM
 
Location: Winter Springs, FL
1,789 posts, read 4,067,917 times
Reputation: 925
What the physicians are saying is the same as the Vermont Medical Society. VMS has expressed its serious concerns to the Governorís staff, emphasizing that the proposal would have an adverse impact on the financial viability of physician practices in Vermont, as well as on Medicaid patientsí access to care. Expanding enrollment in Medicaid without any limits on enrolleesí income will put physiciansí ability to provide care to their patients at risk at the very time government is seeking to fundamentally reform our stateís health care system.
This comes from VMS: Under federal law, Medicaidís payment must be sufficient to enlist enough physicians so that services under Medicaid are available to recipients at least to the extent that those services are available to the general population. The Department of Healthís Physician Survey for 2008 indicates that while 93 percent of Primary Care Physicians participate in Medicaid, only 69 percent are accepting new Medicaid patients compared to 80 percent accepting new patients in general. For internal medicine 88 percent are participating but only 44 percent are accepting new Medicaid patients compared to 65 percent accepting new patients in general. For family practice, 93 percent are participating, but only 66 percent are accepting new Medicaid patients compared to 78 percent accepting new patients in general.

Based on the 3-year old DOH survey, Vermont already appears to be in violation of the federal Medicaid physician access standard. The Governorís Medicaid expansion could force additional physicians in independent practice and those employed by hospitals to further limit the number of new Medicaid patients in order to remain solvent due to the programís below cost reimbursement and the likelihood of not being able to collect the $1,200 deductible.
Going by what the physicians are telling us (and what the numbers really show), you could be in trouble getting taken care of under the new plan.
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Old 04-14-2011, 05:25 PM
 
Location: Greater Boston
30 posts, read 58,780 times
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Governor Patrick of Mass. is celebrated in the National liberal media for his work on MassHealth ( a creation of Gov Romney). Of course, the media lapdogs...god, do they give up all semblance of impartial reporting...do not mention that about 50% of our citizens DO NOT believe MassHealth is working well. And, in todays reporting, the state is working out new options for those who are subscribed directly with the state plan: a restricted selection of doctors and hospitals. A lot of that is a result of the big name hospitals overcharging for procedures that are done as well for less money in community hospitals and because too much fraud has been found, ie. charging the state for gynecological exams for men.
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Old 04-14-2011, 05:34 PM
 
159 posts, read 349,908 times
Reputation: 163
Instead of single payer healthcare it should be called what it really is...taxpayer healthcare. Those who don't work or pay taxes will get the same health insurance as those who do work and pay for it all.

I've noticed progressives, or liberals, or whatever they're calling themselves this week love to spend other peoples money, yet you never see a poor, liberal politician. As usual it's the working middle class that will pay, the poor and the rich both get a free ride.
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Old 04-15-2011, 06:05 AM
 
Location: Rutland, VT
1,822 posts, read 4,531,553 times
Reputation: 772
Quote:
Originally Posted by 68vette View Post
Going by what the physicians are telling us (and what the numbers really show), you could be in trouble getting taken care of under the new plan.

There's no consensus in the medical community about what you're saying. It's not "the physicians"; it's some physicians. I doubt very much we'll have trouble getting taken care of under the new plan, which is only in the very earliest planning stages.

Our own Rutland County Senator Kevin Mullin, as described in today's Rutland Herald editorial (emphasis mine):


"Mullin has questions about whether a single-payer system will work, and so he authored an amendment putting conditions on the approval of any single-payer system. A study would have to show that the financing of a new system would be sustainable and that overall costs would decline. It would have to show that reimbursements would be sufficient to keep doctors and other providers in Vermont and that the new system would benefit the state’s economy. Mullin’s amendment also requires that any new benefits package offered to Vermonters provide benefits comparable to those offered by Catamount Health."

Today's Free Press editorial discusses this, too.

Instead of being the voices of "no," my spouse and colleagues and I are the voices of, "We'll do whatever we can to make sure this plan works for the greatest number of Vermonters possible."

Last edited by Sherylcatmom; 04-15-2011 at 07:14 AM..
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Old 04-15-2011, 08:11 AM
 
Location: Winter Springs, FL
1,789 posts, read 4,067,917 times
Reputation: 925
I would not disregard the VMC, which represents about 2000 practicing and retired physicians, residents and medical school students in the state of Vermont . If the majority of the society did not have concerns about the state plan, the society would not take the stance it has. The numbers prove this already. By the state expanding medicaid to Vermonters, the state is using the law that any physician that participates in Medicaid can not deny services to a patient notwithstanding the lack of payment for deductibles or co-pays. The issue with the expansion of Medicaid without regard to income violates the social contract between the state and physicians to accept below cost reimbursement in order to care for those in the greatest need.

This info is from a survey of physicians in the state of Vermont: The Department of Healthís Physician Survey for 2008 indicates that while 93 percent of Primary Care Physicians participate in Medicaid, only 69 percent are accepting new Medicaid patients compared to 80 percent accepting new patients in general. For internal medicine 88 percent are participating but only 44 percent are accepting new Medicaid patients compared to 65 percent accepting new patients in general. For family practice, 93 percent are participating, but only 66 percent are accepting new Medicaid patients compared to 78 percent accepting new patients in general. If physicians are so excited about this program, then why are they not taking the patients that need their services now? One of the main reasons is the reimbursement rates are very low and the paperwork involved in dealing with medicaid is time consuming. The thing that is causing worry is that if the majority of patients a physician has to see are medicaid, the physicians reimbursement rates may make it difficult to get by on. As an example, using made up numbers. Say a hospital gets $1000 dollars to treat a patient with a pneumonia. The hospital treats and gets the patient out of the hospital as quick as possible. Any complications or overcosts are not covered. If the hospital can get the patient home and does not need to spend $1000 on the patient, they make a profit. If there are issues and it costs more, it is a loss. The problem is, if a hospital has losses in income and they can't save money on on the patient care side of things, then they need to save in other areas. Less staff, cheaper less reliable equipment, less maintained facilities, etc. As a society we have grown to rely on someone else to take care of us or fix what we have done to our bodies. People do not take care of themselves or we wouldn't have huge obesity rates, heart disease rates, diabetes rates, etc. This is why european countries can support a government run health plan. They are healthier than we are and rely less on medications and hospital/doctor visits. The reality is patients have to take better care of themselves with government run healthcare or it will tax the system beyond what it can financially handle.

There are some hospitals that overcharge for procedures or charge the wrong procedure, but this is not that common. Hospitals catch as much of this as possible on their own, because submitting a false charge is considered insurance fraud and the hospitals/physicians are subject to large fines. Insurance does need to be overhauled, but there are other options that will have less of an impact on patient care if the state run plan fails.
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Old 04-16-2011, 04:17 PM
 
Location: Syracuse, NY
723 posts, read 1,098,153 times
Reputation: 508
Quote:
Originally Posted by arctichomesteader View Post
It's a bad idea. It's one thing to have programs to provide healthcare for those who can't afford it, and entirely another to put the government in charge of everyone's healthcare. It will lead to shortages of medical professionals, rationing of care, delays, etc. This state can't afford to pay for everyone's healthcare without either raising taxes or limiting care.
Oh, if it passes and becomes law, I am *SO* on my way moving there!!!

I've been waiting for this for a LONG, LONG, LONG time to come to ANY state!

I'd rather pay higher taxes than be forced to file bankruptcy or take out 2nd mortgages on my home just to pay for medical care. At least the state of Vermont GDP should lower if they do sign it into law ( such as the case is with Canada who's GDP is lower than that in the US and they spend less per citizen when it comes to health care costs. )

If the governor signs it, when does it become law? ( I thought I seen once that for any state to enact a health care system for itself, the feds have to approve it first? )
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