Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Medical practices and doctors can choose not to accept whatever insurance they don't want to. However, how would they know between the Anthem insurance I get through work vice the Anthem Insurance (by the same name) purchased via the exchange?
We can't be "punished" as we, as physicians, have the right to choose to see whoever we want (except in cases of emergencies on call). Slavery is illegal in America........................ for now. This issue has already been evaluated through the Supreme Court.
If we accepted the lower reimbursing plans, we would go broke. This, due to our overhead expenses, is the reality of medicine.
Due to cuts in medicare triggered by Obamacare, we have cut our medicare population from 40% to 5%. The reimbursement for many things we do was cut 50%; prior to the cuts, we were breaking even on medicare.
MANY of the exchange plans have very low reimbursement (thus lower prices) for physicians. For these plans, about the only place a patient could go would be state or county supported entities such as university hospitals or county hospitals. Oddly, many of the products are listing members of our clinic as providers, when in fact we are not, much to the dismay of patients who purchased these plans.
Where is your practice? In S. Florida, many doctors would go broke if they did not accept Medicare patients.
As to "many of the products are listing members of our clinic as providers, when in fact we are not," I'd have to see the "many products" before I'd believe this.
In the cases of "Obamacare-ACA" its not doctors who are refusing to see patients its the narrow networks that have been set up. When the various doctors refused to lower their fees they were cut out. It they keep refusing to lower their fees they wont have any patients or very few. What happens when they refuse to take Medicare, BCBS, Aetna, Cigna, Humana, etc? There are plenty of other doctors who will. Childrens Orthopedic Hospital in Seattle priced themselves outside almost every ACA plan and rather than lowering prices they are suing the State.
The first case of someone forcing someone else to do something is a group of doctors trying to extort more money from insurance companies and the insured.
You must have missed my post above. Why do you think many docs are selling their practices to hospitals and mega corporations.
They are sick and tired of playing the games.
The hospital Systmems are also gobbling up smaller hospitals. This is how they fight the ACA. It becomes a game of chicken. If hospital Systems control a market and is not in network.
What's HHS going to do?
Change the law again?
This is what I don't understand about ACA supporters. You folks claim a free system still exists.
But you also want to force things down people throat including price fixing. Agree or disagree?
I thought all you supporters said a free system still existed yet if hospitals and docs aren't in network than you want to force them into the network?
Where is your practice? In S. Florida, many doctors would go broke if they did not accept Medicare patients.
As to "many of the products are listing members of our clinic as providers, when in fact we are not," I'd have to see the "many products" before I'd believe this.
You'd be surprise at the ratio of medicare to private even in Florida. Many of my friends own their own practices. Their medicare population of the office isn't usually more than 35%. Many affluent people have medicare as a secondary insurance down in Florida. Either they have spouses who are younger still working, buy supplemental insurance or retired with nice fat health insurance policies from up North.
If a business is over 50% medicare. Some will take about 5% medicaid as well. It can become a struggle. There is over head to pay, leases to pay, equipment to pay as well
You must have missed my post above. Why do you think many docs are selling their practices to hospitals and mega corporations.
They are sick and tired of playing the games.
The hospital Systmems are also gobbling up smaller hospitals. This is how they fight the ACA. It becomes a game of chicken. If hospital Systems control a market and is not in network.
What's HHS going to do?
Change the law again?
This is what I don't understand about ACA supporters. You folks claim a free system still exists.
But you also want to force things down people throat including price fixing. Agree or disagree?
I thought all you supporters said a free system still existed yet if hospitals and docs aren't in network than you want to force them into the network?
I suppose if doctors and hospitals are not in the insurance networks then they won't have patients, won't get paid, go out of business.
I suppose if doctors and hospitals are not in the insurance networks then they won't have patients, won't get paid, go out of business.
Depends how you look at it. In Orlando. Florida Hospital Systems and Orlando Health divide the are. Florida Hospital generally controls the north end. Orlando Health the South End.
Both hospital systems have gobbled up medical practices (let's just say there are very few "independent cardiology practices") and gobbled up smaller hospitals.
So the question you need to ask is:
If the closest "in network" facility/provider is more than 30 miles away, where is the patient going to go for their regular care? Who's going to shoulder the blame? Hint: Blue Cross Blue Shield already "lost" the massive stare down with Florida hospital when the public was freaking out with the disagreement over payments Blue Cross needed to make to Florida hospital.
Remember the ACA does allow for LEGAL balance billing and hospitals and providers can balance bill if they aren't in network.
You just don't get the trend in healthcare. Super hospital system mergers. Wall Street forming super corporations controlling many markets (Mednax, Team Health, Goldman Sachs etc). Docs selling out medical practices. Hospitals strengthening their base by employing these docs.
These systems if strong enough for an entire region can just tell insurers to just F off if they don't meet their demands.
Can we'punish' the legislators who put the yoke of obamacare on our backs without reading or understanding the nuance of its language and then exempted themselves.
You'd be surprise at the ratio of medicare to private even in Florida. Many of my friends own their own practices. Their medicare population of the office isn't usually more than 35%. Many affluent people have medicare as a secondary insurance down in Florida. Either they have spouses who are younger still working, buy supplemental insurance or retired with nice fat health insurance policies from up North.
If a business is over 50% medicare. Some will take about 5% medicaid as well. It can become a struggle. There is over head to pay, leases to pay, equipment to pay as well
My husband and I have original Medicare + a comprehensive supplement plan. This past year has been particularly bad for us re medical issues and we've had to consult a variety of specialists. We've never been denied service, or even had to wait for an appointment. None of my over-65 friends have had a problem with getting medical care. However, my under-65 friends, who are still covered by very expensive insurance, are most definitely restricted in their choice of doctors.
Gosh, the dude who took care of our baby in the NICU had a Ph.D. and MD. He can EASILY sidestep into pure research, enter academia and disappear from the medical scene. Two time local US congressional candidate with an MD owns a software company and even codes his own software (In before "isolated incidents").
There's no starting over. The experience gained by practicing medicine is an easy transition. In our computational linguistics group, we have psychology and philosophy majors also. But I do enjoy people believing that highly educated doctors are one trick ponies.
Easier said than done, bub! I don't think you know as much about health care as you think.
My husband and I have original Medicare + a comprehensive supplement plan. This past year has been particularly bad for us re medical issues and we've had to consult a variety of specialists. We've never been denied service, or even had to wait for an appointment. None of my over-65 friends have had a problem with getting medical care. However, my under-65 friends, who are still covered by very expensive insurance, are most definitely restricted in their choice of doctors.
Let's say private insurance will pay $1800-2200 for a 2D echo/physician reading fee. (That's exactly what my bill was $2200 for our 11 month old) (That's the actual payment and not the master bill which is usually $2500.
Medicare will be lucky to be paid $300-400 plus professional fees. So around $500-600.
You only need 1 private for for 3-4 Medicare patients.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
