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Originally Posted by Ceece
I think she means "according to ME". Nobody is going to put Dr's in jail for giving a mamogram.
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Nice...Exactly, she can be fined but I think what she considers worse? I performing a procedure and then not getting paid for it therefore her practice absorbs the cost..
Quote:
Originally Posted by chica_bella813
Obamacare has helped tremendously and has regulated insurance companies (who pretty much run healthcare unfortunately) and has put more pressure on MD's to practice sound Evidence Based Practice. Ask your Internist about how HEDIS has been changed due to Obamacare. Without me saying much about my profession, Regardless to age, you will be thankful that healthcare can no longer be a free for all for profit in this country due to healthcare reform. I am glad that this law has been passed to regulate alot of things that were taking place behind the scenes in the healthcare industry.
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Nicely stated...
Quote:
Originally Posted by Priscilla151
Do you feel for all the uninsured who don't get diagnosed for many diseases because they can't afford insurance? Do you feel for all us tax payers paying for emergency room care for those without insurance? Do you feel for all those who can't get insurance because of pre-existing conditions?
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exactly..
Quote:
Originally Posted by OhioIstheBest
Total nonsense. People that go to the er without insurance pay for it themselves.
And if they can't (or won't) pay the hospital eats the cost.
Taxpayers don't pick up the tab for other bills people don't pay. Why are people dopey enough to think the taxpayer pays for unpaid hospital bills?
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lol...Do your homework prior to posting "
total nonsense"
"Those costs have prompted financially strapped hospitals to rely on
a complex system of shifting costs. Most of
the burden falls on taxpayers, with the government providing tens of billions of dollars annually to help hospitals care for the uninsured.
Privately insured Americans also pay a price as insurers raise premiums to reflect higher charges from hospitals."
This statement was retracted from this 2011 article..
Trauma in the ER: Who pays for the uninsured?
JUST THE FACTS..
ObamaCare Facts: Facts on the Obama Health Care Plan
Other Universal Health care models...wow, it seems as if our country is behind..
Where in the world can you get universal health care? - CNN.com
Cecilia Attias: Affordable Health Care Will Be Good for America
Healthy examples: Plenty of countries get healthcare right - The Boston Globe
I believe I have posted in this forum regarding Healthcare and ect but I could be wrong..
My two cents? The healthcare reform that has taken place already is helping many people not just the impoverished..
Obama has covered more children in this last 4 years than other president. These are the kids that fall between the cracks, the ones whose parents both work yet do not make enough money to cover their whole family medically.
“The working poor” They are the limbo class in this debate..The ones that are a hair above the poverty level and are not eligible for such county/government programs such as Medi-Cal or what is now called Cencal here in Ca at least nor are they eligible for “Healthy families” because they are above the eligibility bracket. What do these families do?
Also parents everywhere despite their income bracket are now able to have their “Adult” child covered under their medical plan per Obama, until the age of 25. I do not hear conservatives crying about this..
Obamacare has also placed stringent policies on private practices and private insurances in order to stop “Fraud” and costly uneeded diagnostic tests that are conducted yearly by Drs in order to get more money.
I see you most of you are non believers, including the OP..
I worked as a SX Coordinator for several years as well as was in charge of doing the coding ( Billing) for these private practices.
I have many friends in this industry as well as my ex husband who is an OR tech for the ER.
THE PRACTICES that often time occur are HIGHWAY ROBBERY.
How?
1. Drs. Asking their staff (coders) to bill for procedures that were not completed. I.e. claiming they performed a DX test which needs a certain machine and the DR does not even that machine in office.
2. Duplicating services. A patient is referred by a PCP AND THE specialist still orders a xray or MRI? These were already done and all that is needed is the ROI and for the tests to be sent over via fax.
Insurance companies are just as scandalous!
1. Not wanting to pay for a procedure that was completed after an auth was obtained? And the PCP was deemed in network? And the PCP did find that the patient needed this dx text completed and provided all paperwork and test with the determination/findings.
2. It has been established that a pt. needs a certain procedure done and this is allowable based on their private insurance plan, the dx tests have been done, the dr has stated the dx and submits it to the Insurance co?
Then the insurance co turns around and states that this procedure is not needed due to a minor discrepancy even though I myself have double and triple QA’d the docs myself.
The insurance co usually determines what is needed and when, they do not leave this decision to the MD’S they determine what they will pay and not pay for, it does not matter what the pt needs…
This is criminal.
The fact that Insurance hold most of the power as to how much certain procedures SHOULD cost and what they will cover! And the prices set are not determined by the DR but by the insurance companies themselves. Medical equipment costs, supplies, everything has a price and the DR does not determine this.
Obama is ensuring that affordable care is available to all in order to bring cost down. The insurance is no longer the ruler and middle man at the same time…
The conservative side has this theory that by making Insurance companies compete it will bring the prices down? Umm No, they all for profit, and they are the ones that offer prices to the MD’S to have them in their network..
This is a great example of an HMO..
Which states “If you are a part of network, we will tell you what you can do and cannot do, what a pt can have done and not have done and you will get a check every month for every pt in your practice regardless if they utilize your services OR not..
Which leaves millions uninsured and seeking help through CHC centers or the ER after the medical issue they have has been ongoing.
I.E. There is a man who has been having pains in his chest off and on for 6 months, it is not debilitating, the pain subsides after 7 minutes but during one of his “episodes” he is hurting and immobile.
One day the man collapses after doing yard work on a hot summer day and his family calls 911.
Let the price begin here…The ambulance trip 586-763..according to the ambulance association in the state of Ca depending where you reside..
The CARE RENDERED to stabilize him on his trip to the hospital being advanced cardiac life support? Around 5000.00 in Ca.
So PRIOR to getting to the Hospital which is called “Pre-hospital care” this man has already incurred around 5586-5763.00 even before getting to the hospital..
ER care for a victim of cardiac arrest that is uninsured? 10-14, 000.00 in Ca.
So the patient has now a bill of a total of around 15, 000.00 going with the cheapest number I found..
My point? Obamacare focuses on “Preventative care”
Which means that any AMERICAN has access to medical care if a issue should arise..
Now to the cognitively able person? This seems like a whole lot of common sense! But lately I have become convinced that “Common sense” is not so common.
Preventative care with the focus being on “PRE” means catching a potential condition in its early stages therefore making it more cost effective when the issue is in its early stages..
1. Heart conditions, most americans perish from myocardial infarctions on a grand scale. Should some of these folks had access to medical care? They would have been dx sooner, maybe with high BP ( Blood pressure) a murmur, artherosclerosis. Clogged arteries , high cholesterol, therefore allowing the MD to place them on meds..cutting down the costs of late stage issues and ER VISITS
Wow..TO THE OP…