More Obamacare Implosion

[revanneosl]

You are correct.

The only other problem I could see developing, is when some of these "altered" plans coming into play (no pre existing conditions etc. etc.), some doctors may choose to not participate in those plans, because the insurance company may lower their reimbursement to help cover their additional cost of covering higher risk patients.

There are no longer any insurance plans that are allowed to refuse to cover people with pre-existing conditions. None.

 

[bhsmte]

There are no longer any insurance plans that are allowed to refuse to cover people with pre-existing conditions. None.

I realize that which is part of my point. This increases insurance companies risk and when that happens, they either raise premiums and or reduce reimbursement to the providers to make up for it.

 

[NightHawkeye]

So it sounds like the Right are just pleased as punch with every hiccup in the rollout of the largest overhaul of the US Healthcare system in history.

So kudos for the Right for having SUCH GLEE at the difficulties. It almost seems to me that the Right are actually happy when people have limited access to healthcare and are even happier when any attempts to fix this system fail!

Frankly that looks a LOT like a bunch of psychopaths who rejoice at human pain and suffering.

Hi, Carlos.

I would merely suggest to you that people on the right are simply pointing out all the problems and inconsistencies with Obamacare ... just as those on the "left" did about healthcare in order to unleash this monstrosity. It seems to me that the drawbacks associated with Obamacare far outweigh the so-called advantages. Feel free to make a cogent argument in favor of Obamacare. May the proper arguments prevail.

 

[conamer]

There are no longer any insurance plans that are allowed to refuse to cover people with pre-existing conditions. None.

Which no longer makes it insurance. The costs are so high people won't sign up until they get sick further driving up the cost. It's like a home owner who dosen't buy home owners's insurance until his house burns down.

 

[TheBear]

Has anyone here signed up for it?

 

[Veritas]

Obama care is not a single payer system and these docs will still be seeing patients in various insurance plans, as they do know. Some docs take medicaid and some don't right now (just like medicare) and that likely won't change after Obama care gets going.

That is the goal. Obamacare is designed for failure. And in its place will be a singlepayer socialised system....exactly what Obama said he wanted years ago.

Why would a question need a source. You can answer it if you want. How would the doctor know that you bought it via the exchange as opposed to having bought the policy through some other medium? That information would be needed in order to discriminate against people who used the exchange. Also what would be the purpose of such discrimination? What on earth would the doctor gain?

Say person "x" bought policy "Y" through the exchange whereas Person "Z" bought that same plan , plan "Y", but didn't use the exchange. Why would the doctor service person "x" but not person " "Z" when they both have the exact same plan? It would make no difference whatsoever in any noticeable fashion to the doctor.

It just doesn't add up. That article is very suspicious to say the least.

You misunderstood. The post was addressed to someone who claimed the NY Post was making stuff up. I simply wanted to know where she got that information.

So it sounds like the Right are just pleased as punch with every hiccup in the rollout of the largest overhaul of the US Healthcare system in history.

So kudos for the Right for having SUCH GLEE at the difficulties. It almost seems to me that the Right are actually happy when people have limited access to healthcare and are even happier when any attempts to fix this system fail!

Frankly that looks a LOT like a bunch of psychopaths who rejoice at human pain and suffering.

Can I get another hanky?

I realize that which is part of my point. This increases insurance companies risk and when that happens, they either raise premiums and or reduce reimbursement to the providers to make up for it.

Correct. Ain't nothin free. The insurance companies are not going to absorb the additional costs. BTW, what you describe is what we call "adverse selection". Essentially, those that are the sickest will avail themselves to coverage while those that are healthiest will eshew it. Recipe for a perfect do-do storm.

Has anyone here signed up for it?

Won't. I don't qualify for subsidies and therefore won't be applying for an Exchange plan. Will continue to shop for coverage in private market....or....drop coverage.

 

[Belk]

Medicare is not a bad payer for providers if you are already certified and don't plan to expand which would require jumping through flaming hoops and long delays to get approved in the new locations.

If you are established and rely on a high number of medicare patients (because of demographics), they can be a good payer. Medicare is relatively easy to bill (if you have the proper electronic means to do so) and they typically pay within 20 days, which is very good. The reimbursement is average, but if you have enough patients it works out fairly well. Now, medicare can also crawl down your neck with payment audits etc, to make sure you are not billing falsely, but as long as you keep good records, this should not be a problem.

Family practice docs typically don't have a problem with medicare, but fewer specialists that perform surgeries don't like medicare as much, because private insurance companies typically reimburse much better for their type of care.

I would guess it depends on the specialty. my wife works for an eye surgeon and most take medicare since eye patients tend to be older and the high volume of patients in this area make it profitable.

 

[bhsmte]

I would guess it depends on the specialty. my wife works for an eye surgeon and most take medicare since eye patients tend to be older and the high volume of patients in this area make it profitable.

Exactly.

An eye surgeon wouldn't be in business without medicare, because cataracts etc are 99% medicare patients.

Let me put it this way, if a physician can do well without medicare, they won't bother dealing with those patients, because reimbursement is typically lower then most private insurance plans and way lower than worker's comp patients in most states.

 

[Belk]

Exactly.

An eye surgeon wouldn't be in business without medicare, because cataracts etc are 99% medicare patients.

Let me put it this way, if a physician can do well without medicare, they won't bother dealing with those patients, because reimbursement is typically lower then most private insurance plans and way lower than worker's comp patients in most states.

Makes sense. Plus there is the added burden of the federal inspections and keeping everything up to the higher code medicare requires.

 

[revanneosl]

There are no longer any insurance plans that are allowed to refuse to cover people with pre-existing conditions. None.

I realize that which is part of my point. This increases insurance companies risk and when that happens, they either raise premiums and or reduce reimbursement to the providers to make up for it.

You are correct. They will have to either raise premiums or reduce payments in order to preserve their profit margins. That is why profit needs to be taken out of the equation, and a single-payer system instituted.

 

[dogs4thewin]

You are correct. They will have to either raise premiums or reduce payments in order to preserve their profit margins. That is why profit needs to be taken out of the equation, and a single-payer system instituted.

Why it is a BUSINESS that is why quite frankly I even though I have them would not mind pre-existing conditions limits coming back. Insurance is a BUSINESS. Why do you suppose that my 20 year old cousin who have had several accidents in the past few years pays more for car insurance than my father who is 51 has not had an accident in years and VERY rarely gets traffic tickets it is isn't because they like M ( my father) better than B (My cousin) it is because B is one very young and two has repeatedly proven he is a high risk as opposed to not. Why do you think that my father, however on the other hand pays MORE in life insurance than B probably does well let us see 31 years and a cancer history mean that he is a higher risk. It is just the way insurance works. If I am willing to take the risk I should not have to be covered as long as I realize that means if I get sick I pay up or I do not get treatment. You should not be FORCED to get insurance, HOWEVER you should be willing to face the music if you do not and something happens.

 

[HorsieJuice]

Has anyone here signed up for it?

I live in MA, so I signed up 2 years ago. The program's been fine here.

 

[childofGod1]

Why would a question need a source. You can answer it if you want. How would the doctor know that you bought it via the exchange as opposed to having bought the policy through some other medium?

Insurance companies have different plans. I have had insurance through BCBS purchased through several employers, one union and two states. Same company, completely different plans with completely different fee payment schedules. Part of your ID number identifies which policy you have. Even the receptionist knows where you got your insurance. I had two insurance policies with them at the same time (his and hers) and the doc accepted one but not the other.

 

[childofGod1]

So it sounds like the Right are just pleased as punch with every hiccup in the rollout of the largest overhaul of the US Healthcare system in history.

So kudos for the Right for having SUCH GLEE at the difficulties. It almost seems to me that the Right are actually happy when people have limited access to healthcare and are even happier when any attempts to fix this system fail!

Frankly that looks a LOT like a bunch of psychopaths who rejoice at human pain and suffering.

I believe this system will ultimately fail. My hope is that it happens as quickly and painlessly as possible so fewer people suffer because of it. The sooner we get past this madness, the sooner we can do some real, common sense reform.

 

[childofGod1]

Why it is a BUSINESS that is why quite frankly I ven though I have them would not mind pre-existing conditions limits coming back. Insurance is a BUSINESS. Why do you suppose that my 20 year old cousin who have had several accidents in the past few years pays more for car insurance than my father who is 51 has not had an accident in years and VERY rarely gets traffic tickets it is isn't because they like M ( my father) better than B (My cousin) it is because B is one very young and two has repeatedly proven he is a high risk as opposed to not. Why do you think that my father, however on the other hand pays MORE in life insurance than B probably does well let us see 31 years and a cancer history mean that he is a higher risk. It is just the way insurance works. If I am willing to take rge risk I should not have to be covered as long as I realize that means if I get sick I pay up or I do not get treatment. You should not be FORCED to get insurance, HOWEVER you should be willing to face the music if you do not and something happens.

 

[TheBear]

I live in MA, so I signed up 2 years ago. The program's been fine here.

Is major medical coverage 80/20 or 60/40? Or somewhere else? Did your premiums go up or down? Did your annual deduction go up or down?

Just curious.

 

[Joykins]

A bit odd coming from a pediatrician, who does not currently deal with medicare, but could be because she isn't from this country and is more familiar with single payer systems.

They do deal with Medicaid (my relative is also a pediatrician--pediatric emergency medicine so has dealt with all kinds of young patients). Also Medicare for All as proposed is different in many ways from how Medicare now operates.

 

[HorsieJuice]

Is major medical coverage 80/20 or 60/40? Or somewhere else?

For things like hospital stays, I have a deductible, then then cover the rest. I did not choose a co-insurance plan.

Did your premiums go up or down?

The premium for my current plan is going down by a couple dollars, though looking at the connector a number of the less expensive, co-insurance options that had been available are no longer available. I now have one option comparable to my current plan that is about 20% cheaper.

Did your annual deduction go up or down?

Stayed the same.

 

[CarlosTomy]

I believe this system will ultimately fail. My hope is that it happens as quickly and painlessly as possible so fewer people suffer because of it. The sooner we get past this madness, the sooner we can do some real, common sense reform.

So you are saying you WANT TO GO BACK TO

40 million Americans unable to get access to healthcare

Millions of people frozen out of affordable healthcare because of "pre-existing conditions"

Countless children denied operations because they have reached "lifetime cap" for coverage

People having their insurance coverage revoked EXACTLY when they need it most for something like cancer because decades ago they had "acne" or some other modest issue when younger and didn't put it on their initial application (thereby saving the insurance company the hassle of covering them).

These are all things you think are LESS hurtful to people than a few computer glitches?

Really?

 

[cow451]