October 22, 2013
— Open Blogger Hello Horde! IÂ’m tsrblke (thatÂ’s Lke not ike).
I’ll be your host for today’s edition of “ACA, unintended consequences and you.” Today’s edition is called “NYT buries the lede.” The NYT recently ran a story that is quite tragic about a family that took their little girl in for work on her heart. Sadly, although they had insurance, they apparently got socked with tons of “out of network charges.”
Now people will likely want to hash blame all over the place here. ItÂ’ll be said the parents should have asked more questions (although do you ask who the assisting surgeon is going to be for your operation?) Or the hospital should have ensured everyone was a participating provider (that assumes a level of coordination I have yet to see at any hospital.)
So let’s pass on the blame for a moment and ask “How is Obamacare going to mes this up?”
Conveniently, the NYT sorta tells us: "It is conceivable that the problem gets worse for some people if the Affordable Care Act encourages narrower networks, which some people think it might do" - claims Timothy Jost, a professor at the Washington and Lee University School of Law and expert on health care laws.
Ah, some people think there will be smaller networks. Ignore that link in the quote that goes to an article saying that there are, in fact, smaller networks. ThatÂ’s just crazy talk! (by the by, at least one insurer in my area wonÂ’t have the largest provider in itÂ’s network.)
Something the NYT doesn’t discuss, but really needs to be brought up, is another odd consequence of Obamacare. As a result of the whole “Accountable Care Organizations” part of the law, hospital systems have been buying up medical practices like hotcakes. I remember being at one conference where a system VP said something akin to “we’re not sure what to do with these practices, but we keep buying them.” (I’d note that my PCP got bought out, and the integration has not gone well.)
Now, the article seems to imply that the new out of pocket maximums may help dampen the blow, but letÂ’s grab the first plan we can find on ehealthinsurance.com. Wow, those limits for out-of-network are just crazy. Well, there goes that.
So what does this mean? Well, I’m a PhD(c) so I have no real world advice for you. But here’s the lay of the land: Insurers, who are going to have to cut costs to avoid this “adverse selection death spiral” are going to use the biggest bargaining chip they have: cutting network size to pit providers against each other. Combined with the buyout of practices by hospitals, we could be in for a wild ride. I know very little about the nuts and bolts of provider/insurer negotiations, but if you live in a town with lots of competing providers (who may even move between hospitals) you’re going to need to pay special attention to everything going on. And what if your surgeon likes to work with an anesthesiologist who’s not in your network? Then you have some really hard choices to make.
And be prepared for doing bill analyses every time you have any major work done.
Posted by: Open Blogger at
09:23 AM
| Comments (253)
Post contains 549 words, total size 4 kb.
"To keep premium costs down, we have a new network of doctors and hospitals. Our goal is to work with doctors who will offer the best care possible--at the lowest cost. This means that THE NUMBER OF DOCTORS AND HOSPITALS IN OUR NETWORK IS CHANGING. THE NUMBER OF DRUGS WE NOW COVER IS ALSO SMALLER. But don't worry, we still offer quality coverage for you and your family." (caps lock added for emphasis)
So the number of doctors, hospitals, and drugs covered are all smaller. That's definitely a narrower network.
Well done, Democrats!
Posted by: AAA at October 22, 2013 09:29 AM (hQJ+o)
Posted by: Blacque Jacques Shellacque at October 22, 2013 09:29 AM (vd7A8)
Posted by: Jenny Hates Her Phone at October 22, 2013 09:31 AM (GmTxn)
Posted by: Chaos, it the other dark meat at October 22, 2013 09:32 AM (oDCMR)
Posted by: madamemayhem at October 22, 2013 09:32 AM (S2RnE)
About that out of pocket max..... What exactly does that mean? I called my states exchange "help" line and was told it means... well nothing. Co pays, still have to pay those regardless. Stuff not covered, pay up. So I said, I am seeing an out of pocket max of 6250 for one policy but in theory, I could pay 20K and was told yep.
Anyone know what exactly the out of pocket max really means?
Posted by: AndrewsDad at October 22, 2013 09:33 AM (C2//T)
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:34 AM (4df7R)
Posted by: t-bird at October 22, 2013 09:34 AM (FcR7P)
Posted by: Jenny Hates Her Phone at October 22, 2013 09:34 AM (GmTxn)
Anesthesiologist? We don't need no stinkin' anesthesiologist.
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 09:34 AM (0HooB)
Posted by: Mindy, back from the land of huge pickup trucks at October 22, 2013 09:35 AM (ZrNcx)
Posted by: Mr. Low Information Voter at October 22, 2013 09:35 AM (8ZskC)
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:36 AM (4df7R)
What "needs to be discussed" is that ChoomCare is being run by a bunch of America-hating wealth redistributionists, who are bent on funneling money to Community Organizers, terrorists and other tight buddyroos of President Historic First©.
Anyone outside of D.C. who tried a scheme like this wouldn't even get the courtesy of a trial. They'd go directly to prison.
The next president -- if there is one -- needs to grant Charles Ponzi a full posthumous pardon. The poor schmuck was a piker.
Posted by: MrScribbler at October 22, 2013 09:36 AM (kaGpp)
Posted by: artisanal 'ette at October 22, 2013 09:36 AM (IXrOn)
Posted by: Nevergiveup at October 22, 2013 09:37 AM (t3UFN)
Posted by: phoenixgirl @phxazgrl at October 22, 2013 09:37 AM (8JJ6O)
Posted by: Lester at October 22, 2013 09:37 AM (qTsuK)
Posted by: t-bird at October 22, 2013 09:37 AM (FcR7P)
A real man only needs a shot of whisky and a bullet to clamp between his teeth.
Posted by: 404care.gov at October 22, 2013 09:37 AM (8ZskC)
Posted by: [/i][/b][/u][/s] Tami - GO CARDS - WOOHOO!!! at October 22, 2013 09:37 AM (bCEmE)
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 01:34 PM (0HooB)
"Yeah! All I need is the doctor and whoever the nurse is who delivers the knockout juice and we're good to go."
-Publik skool edgucaded LIV
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:37 AM (4df7R)
Posted by: Mindy, back from the land of huge pickup trucks at October 22, 2013 09:37 AM (ZrNcx)
Posted by: Nevergiveup at October 22, 2013 09:38 AM (t3UFN)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 09:38 AM (XIxXP)
Posted by: AOSHQ Post Patrol at October 22, 2013 09:39 AM (MhA4j)
Posted by: phoenixgirl @phxazgrl at October 22, 2013 09:39 AM (8JJ6O)
Posted by: Mindy, back from the land of huge pickup trucks at October 22, 2013 01:37 PM (ZrNcx)
It all becomes clear....
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:39 AM (4df7R)
Posted by: Nevergiveup at October 22, 2013 09:39 AM (t3UFN)
Posted by: Lester
=====
Oh. we'll let you know. You can count on that, EVIL REPUBLICANS!!...!!!
Posted by: The MSM Borg Collective at October 22, 2013 09:40 AM (HjPtV)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 09:40 AM (XIxXP)
Posted by: yankeefifth at October 22, 2013 09:40 AM (Z9EHQ)
Posted by: rickb223 at October 22, 2013 09:41 AM (h1D+w)
Posted by: CharlieBrown'sDildo at October 22, 2013 09:41 AM (oJ5Fd)
Posted by: phoenixgirl @phxazgrl at October 22, 2013 09:41 AM (8JJ6O)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 09:41 AM (XIxXP)
Posted by: Nevergiveup at October 22, 2013 09:41 AM (t3UFN)
Status report. FUBAR. Good job Dems!
Oh, and need to add. To Marco Rubio. If you are reading this. You're a traitorous piece of shit. Thanks.
Posted by: Minnfidel at October 22, 2013 09:41 AM (ixf9H)
Make that a stick, since they want to ban bullets.
Posted by: Blanco Basura at October 22, 2013 09:42 AM (4WhSY)
Posted by: rickb223 at October 22, 2013 09:42 AM (h1D+w)
Posted by: Nevergiveup at October 22, 2013 09:42 AM (t3UFN)
Of course, things can get better when everyone is on government health care.
Of course.
Posted by: Nickshaw at October 22, 2013 09:43 AM (9Xn+t)
Posted by: phoenixgirl @phxazgrl at October 22, 2013 09:43 AM (8JJ6O)
Posted by: yankeefifth at October 22, 2013 09:43 AM (Z9EHQ)
Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:41 PM (8JJ6O)
She used enough mousse and gel to create a functional crash helmet from her hair, so I'm sure she's fine. And a fetus is just a clump of cells, so who cares, right? Don't go treating it like a person. Then the Reichwingers win!
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:43 AM (4df7R)
Posted by: Boss Moss the Redskin Savage at October 22, 2013 09:43 AM (ujMoa)
Posted by: Nevergiveup at October 22, 2013 09:44 AM (t3UFN)
Posted by: Jay in Ames at October 22, 2013 09:44 AM (i2Lsf)
I need to talk to my PCP about accepting chickens as form of payment.
Posted by: Foghorn Leghorn at October 22, 2013 09:44 AM (EGPJQ)
Posted by: SpongeBobSaget at October 22, 2013 09:44 AM (epxV4)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 09:44 AM (da5Wo)
Posted by: yankeefifth at October 22, 2013 09:44 AM (Z9EHQ)
Posted by: [/i][/b][/u][/s] Tami - GO CARDS - WOOHOO!!! at October 22, 2013 09:45 AM (bCEmE)
Posted by: JT Marlin at October 22, 2013 09:45 AM (8ZskC)
Posted by: Inigo Montoya at October 22, 2013 09:45 AM (ukp+x)
Posted by: Chief of Just Us, John Roberts at October 22, 2013 09:45 AM (FcR7P)
Posted by: Jay in Ames at October 22, 2013 09:45 AM (i2Lsf)
Of course, things can get better when everyone is on government health care.
Of course.
Posted by: Nickshaw at October 22, 2013 01:43 PM (9Xn+t)
Next on the docket: requiring that all medical practices accept government-subsidized health insurance.
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:45 AM (4df7R)
Posted by: HeatherRadish™ at October 22, 2013 09:46 AM (/kI1Q)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 09:46 AM (XIxXP)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:44 PM (da5Wo)
INNA
[Irish Need Not Apply]
Posted by: CharlieBrown'sDildo at October 22, 2013 09:46 AM (oJ5Fd)
36 "We're headed towards a 2 tier health care system."
More realistically, it will be a 3 tier system like Argentina.
You'll have universal, single payer used mainly by the poor and lower middle class.
Unions and trade or business associations will have special clinics for their members, offering a better quality of service.
At the top, you will have a private group like the Swiss Medical Clinics in Argentina, which are really first class operations. Purely cash for service, but actually fairly reasonably priced.
Posted by: jwest at October 22, 2013 09:46 AM (u2a4R)
Posted by: Flatbush Joe at October 22, 2013 09:46 AM (ZPrif)
Posted by: Mr. Low Information Voter at October 22, 2013 01:35 PM (8ZskC)
----
Because the dems called it "health care" not health insurance. They said everyone has a right to quality, affordable health care. The LIVs thought that "health care" meant medical care or medical treatment and were all like, "Hell yeh, everyone should be able to go the dr. or the hospital." So they voted to make "health care" meaning medical treatment more affordable. (They had noticed that their dr. bills were getting higher also.)
But that was NOT what the dems meant. They meant health insurance. And to be blunt what they REALLY meant was "We are going to destroy the private health insurance market and get single payer socialized medicine in the U.S. even if it kills you people."
What I want to know is when will someone on the Right stand up and say this bluntly without backing down or sugar coating it? Why in the bloody hell do the people on the right call it "health care" also? Do any of these people have a clue?
Posted by: madamemayhem at October 22, 2013 09:46 AM (S2RnE)
Then he can pay the anesthesiologist out of his own fucking pocket.
Posted by: Hollowpoint at October 22, 2013 09:47 AM (SY2Kh)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 09:47 AM (da5Wo)
Posted by: Nevergiveup at October 22, 2013 09:47 AM (t3UFN)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 09:48 AM (XIxXP)
Where it really get interesting is when you try to find specialists...
We've had this problem with TRICARE for years... case in point...
Tore an elbow Tendon... there are only Two Orthopedic Docs within 60 miles I could go to.... and although there is a HUGE Sports Medicine Group in Fresno, they will not take TRICARE...
Posted by: Screaming Liberal Skank at October 22, 2013 09:48 AM (lZBBB)
Posted by: Diogenes' Lamp at October 22, 2013 09:48 AM (bb5+k)
Posted by: imp at October 22, 2013 09:48 AM (niFY8)
The disconnect between what medical care costs and what people pay is the fundamental problem.
It's simple really....Until market forces are allowed to bear on health-care we are screwed.
Posted by: CharlieBrown'sDildo at October 22, 2013 09:48 AM (oJ5Fd)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 09:48 AM (da5Wo)
Posted by: Foghorn Leghorn at October 22, 2013 01:44 PM (EGPJQ)
My favorite Rodney Dangerfield bit was him talking about how he wanted to live on an old timey farm. The best line (delivered in classic Dangerfield style) was, "I wanna pay my doctor with a hog!"
I'm cracking up right now just thinking about it. NEVER fails to make me laugh.
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:48 AM (4df7R)
Posted by: phoenixgirl @phxazgrl at October 22, 2013 09:48 AM (8JJ6O)
We had two giant hospital corporations join together. Then, this year we noticed that the hospital corporation was buying all the doctor's practices. Some of the doctors stayed on as salaried employees and some retired in disgust. One doctor was finally forced to send a letter of explanation as to why he's gone and a new doctor is there in his place. The receptionist was still there, she made sure all the patients knew the doctor was not overjoyed to sell his practice to the hospital corporation nor was he thrilled with the doctor who replaced him, although the letter spoke glowingly about said doctor. He went to another county and became a hospital administration for a different hospital corporation. He seems to have given up delivering babies.
It makes me wonder what is going on. Is it no longer feasible for a doctor to have a private practice?
Posted by: just a citizen at October 22, 2013 09:49 AM (Nx76m)
Posted by: rickb223 at October 22, 2013 09:49 AM (h1D+w)
My dad used to take apples. Given the price of apples these days, a bushel seems like a better payment than billing Medicaid.
Unfortunately liability insurance carriers tend to demand dollars.
Posted by: HeatherRadish™ at October 22, 2013 09:49 AM (/kI1Q)
Posted by: Countrysquire at October 22, 2013 09:50 AM (LSJmV)
Posted by: yankeefifth at October 22, 2013 09:50 AM (Z9EHQ)
Posted by: rickb223 at October 22, 2013 09:50 AM (h1D+w)
Posted by: artisanal 'ette at October 22, 2013 09:50 AM (IXrOn)
Posted by: Nevergiveup at October 22, 2013 09:51 AM (t3UFN)
Posted by: Ambassador Stevens at October 22, 2013 01:48 PM (Pr6hk)
"Who are you?"
- LIVs
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:51 AM (4df7R)
Silly Democrats didn't realize I offered them a lifeline in August...
To provincial to recognize a good deal when it slaps them in the face.
Posted by: Ted Cruz at October 22, 2013 09:51 AM (Pr6hk)
=========
Take to aspirin and die quietly, comrade.
As you shuffle off, be warmed by the thoughts that those who never took a moment's care to provide for themselves will be now taken care of at your expense.
Go to sleep comfortably, for you have the gratitude of the State upon you passing.
Posted by: RoyalOil at October 22, 2013 09:52 AM (VjL9S)
Posted by: steevy at October 22, 2013 09:52 AM (zqvg6)
Posted by: Old Doc Brown at October 22, 2013 09:52 AM (8ZskC)
Posted by: Fritz at October 22, 2013 09:52 AM (UzPAd)
Posted by: DrDrill at October 22, 2013 09:52 AM (Z6fGK)
I'm cracking up right now just thinking about it. NEVER fails to make me laugh.
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:48 PM (4df7R)
-----------
Imagine paying a muzzie doctor with a hog... he'd probably prefer sheep. They don't slide around as much.
Posted by: Foghorn Leghorn at October 22, 2013 09:53 AM (EGPJQ)
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 09:53 AM (0HooB)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:47 PM (da5Wo)
I'm honestly surprised it didn't happen years ago. Now that we've got so many Baby Boomers shifting onto Medicare and more and more people moving onto Medicaid, with fewer and fewer providers accepting either, you'll start to hear rumbling about it very soon.
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:53 AM (4df7R)
Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 09:54 AM (VtjlW)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 09:54 AM (da5Wo)
Posted by: yankeefifth at October 22, 2013 09:54 AM (Z9EHQ)
Posted by: rickb223 at October 22, 2013 09:54 AM (h1D+w)
tweeting my junk seemed like a good idea at the time.
voting for Obamacare seemed like a good idea at the time
marrying Hillary's Muzzy Muff-Diver seemed like a good idea at the time
Posted by: Danger, Carlos Danger - Agent Double O Naught at October 22, 2013 09:54 AM (Pr6hk)
Posted by: Countrysquire at October 22, 2013 09:54 AM (LSJmV)
Posted by: just a citizen at October 22, 2013 09:54 AM (Nx76m)
Posted by: Mary Poppins' Practically Perfect Piercing at October 22, 2013 09:55 AM (zF6Iw)
Posted by: rickl at October 22, 2013 09:55 AM (zoehZ)
Posted by: Diogenes' Lamp at October 22, 2013 09:55 AM (bb5+k)
Posted by: imp at October 22, 2013 09:55 AM (niFY8)
Posted by: John the Libertarian at October 22, 2013 09:56 AM (/rhjC)
Posted by: BlueStateRebel at October 22, 2013 09:56 AM (7ObY1)
http://tinyurl.com/msf5ljm
Posted by: steevy at October 22, 2013 01:52 PM (zqvg6)
Jesus H. Christ.
"Now that you can get Obamacare, go ahead and drink yourself to distraction! Not only do you have the money, but when you end up in the ER after running your car into a phone pole at 125MPH, you're covered!"
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 09:57 AM (4df7R)
Posted by: LASue at October 22, 2013 09:57 AM (gjIQF)
Posted by: ScoggDog ... LiB Party at October 22, 2013 09:57 AM (uRcOW)
Posted by: imp at October 22, 2013 09:57 AM (niFY8)
Posted by: Jenny Hates Her Phone at October 22, 2013 09:58 AM (GmTxn)
Doc Hollywood was one of my favorite MJFox movies, before he went all Bathory in 2004.
Posted by: HeatherRadish™ at October 22, 2013 09:58 AM (/kI1Q)
Posted by: BlueStateRebel at October 22, 2013 09:58 AM (7ObY1)
90 " Keep increasing the costs, limit the choices, and the only place to turn will be single payer."
If we used my plan and got the deregulated free market non-catastrophic segment, we would have nurse practitioners in mall store fronts with "Broken Limbs "R" Us" signs.
It will be like Earl Scheib - We'll fix any break of any limb for $49.95.
If you've got a boil on your ass, there will be a specialty shop for that too. And anything else that ails you.
The market place will take care of everything once we get a chance to use it.
Posted by: jwest at October 22, 2013 09:58 AM (u2a4R)
>>You'll always be "TaserBike" to me.<<
I read it as "Taser Blackie", but then I'm just a right-wing racist.
Posted by: Roy at October 22, 2013 09:58 AM (VndSC)
Posted by: rickb223 at October 22, 2013 09:58 AM (h1D+w)
Posted by: yankeefifth at October 22, 2013 09:58 AM (Z9EHQ)
LIVs think of the world differently. To them:
"Out of network" means only getting one bar on their O-Phone.
"Co-pay" means not having enough on the EBT card.
"Provider" is the guy who gets smokes without the state tax.
Posted by: Foghorn Leghorn at October 22, 2013 09:59 AM (EGPJQ)
Posted by: Pelosi Schmelosi at October 22, 2013 09:59 AM (Mijq/)
====
I will agree with Hollowpoint on one thing - Republicans will have to come up with an ObamaCare alternative sooner rather than later. No cut and past job will pass muster with the people of this country.
Posted by: mrp at October 22, 2013 09:59 AM (HjPtV)
All of this over about 5 % of the population.
Genius.
And written by a guy in jail at the time. How could that not work out?
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 09:59 AM (0HooB)
Well at least the medicaid rolls are swelling so we got that going for the productive citizens.
Posted by: Worlds Most Interesting Man at October 22, 2013 10:00 AM (WGm5T)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 10:00 AM (da5Wo)
http://tinyurl.com/msf5ljm
Posted by: steevy at October 22, 2013 01:52 PM (zqvg6)
**
The website: "do you got insurance dot com"
grammatically correct for the O-bot generation.
Posted by: dananjcon at October 22, 2013 10:00 AM (wmU4G)
It will be like Earl Scheib - We'll fix any break of any limb for $49.95.
Call 1-800-DOCTORB! The "B" is for "Bargains!"
Posted by: Dr. Nick Riviera, Hollywood Upstairs Medical School at October 22, 2013 10:00 AM (zF6Iw)
Posted by: DaveinNC at October 22, 2013 10:00 AM (boNGU)
Posted by: rickb223 at October 22, 2013 10:01 AM (h1D+w)
Posted by: Nevergiveup at October 22, 2013 01:51 PM (t3UFN)
The Tricare rate was WAY lower than the Doctors there would take for a walkin patient... I checked... and any test I wanted done would have to be scheduled by my Primary Care Doc to get insurance approved (at least that's what they told me over the phone...).
Point is... that when you lower the reimbursement rate, which ALL of these programs do, you give your patients less choice as to Doctor....
Posted by: Romeo13 at October 22, 2013 10:02 AM (lZBBB)
Posted by: yankeefifth at October 22, 2013 10:02 AM (Z9EHQ)
Let's review the facts of the case
44 million people uninsured (estimated)
11 million illegals
11 million making over $75,000 / year who self-insure
11 million already qualified for medicare / medicaid
11 million actual people looking for insurance
So we have killed the insurance of tens (if not hundreds) of millions for this quickly festering abortion????
Posted by: Math B Hard at October 22, 2013 10:02 AM (Pr6hk)
Posted by: Diogenes' Lamp at October 22, 2013 10:02 AM (bb5+k)
Posted by: madamemayhem at October 22, 2013 01:46 PM (S2RnE)
Sarah Palin has been saying this. There was an article linked here the other day where she said all this mess was a grand farce just to get people clammoring for single payer. But what's the dumb snowbilly from Alaska know anyway...
Posted by: Havedash at October 22, 2013 10:02 AM (BRhGr)
Direct pay and concierge service practices have been growing at a healthy clip for years - it's red hot right now. The real beneficiaries of this clusterfuck will probably end up being credit card or other finance companies. It won't be long before medical practices will be running used-car type ads that tout their ability to finance anyone with a pulse.
Posted by: Gristle Encased Head at October 22, 2013 10:04 AM (+lsX1)
Whee! Isn't the government great!
Oh, BTW, men are screwed under this system. Unless of course you say that you're a woman trapped in a mans body, and they I think they allow you 60 lifetime abortion credits since you don't actually have girl parts. But I think you may only be able to use those to purchase hormone treatments.
Posted by: shibumi at October 22, 2013 10:04 AM (25HWz)
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 10:05 AM (0HooB)
Posted by: Niedermeyer's Dead Horse at October 22, 2013 10:05 AM (DmNpO)
143 It will be like Earl Scheib - We'll fix any break of any limb for $49.95.
"Call 1-800-DOCTORB! The "B" is for "Bargains!"
Actually, it will be better quality and service than people get now. They will have a market-driven reason to treat you well, plus they will be specialists in that one small segment. That leads to increases in productivity through having the latest equipment and procedures.
Posted by: jwest at October 22, 2013 10:05 AM (u2a4R)
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 10:05 AM (4df7R)
Posted by: Niedermeyer's Dead Horse at October 22, 2013 10:05 AM (DmNpO)
The Fonz and Mr. and Mrs C. were good Republicans.
If Happy Days was on nowadays, no way in hell that would happen.
I don't remember whether Richie was campaigning for Stevenson in that episode. I just liked the "Ike" crack. In fact, a while back I went to Cafe Press and got an "I like Ike" sticker for my motorcycle helmet.
Posted by: Dr. Nick Riviera, Hollywood Upstairs Medical School at October 22, 2013 10:06 AM (zF6Iw)
Posted by: CareCredit at October 22, 2013 10:06 AM (GmTxn)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 10:06 AM (XIxXP)
Posted by: Mary Poppins' Practically Perfect Piercing at October 22, 2013 10:06 AM (zF6Iw)
Appalling, that. Right, fellow conservatives?
Posted by: Marco Rubio, Schumer's Bitch at October 22, 2013 10:06 AM (8ZskC)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 10:06 AM (da5Wo)
You wacko-birds are ignoring the fact that this is a small price to pay for the leadership of a such a set of creases
Posted by: David Brooks at October 22, 2013 10:07 AM (Pr6hk)
Posted by: wg at October 22, 2013 10:07 AM (ElPY7)
Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 10:07 AM (VtjlW)
bless him. Hes not around. The was in draft so he didn't know when it would be published.
OK, I'll have to remember to axe him next time.
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 10:07 AM (0HooB)
Posted by: Chad Henderson - Cockjockey at October 22, 2013 10:07 AM (LSJmV)
Posted by: Niedermeyer's Dead Horse at October 22, 2013 10:08 AM (DmNpO)
Posted by: Diogenes' Lamp at October 22, 2013 10:08 AM (bb5+k)
Posted by: Jay in Ames at October 22, 2013 10:08 AM (i2Lsf)
Posted by: Nevergiveup at October 22, 2013 10:08 AM (t3UFN)
Posted by: Niedermeyer's Dead Horse at October 22, 2013 10:09 AM (DmNpO)
Posted by: Math B Hard at October 22, 2013 02:02 PM (Pr6hk)
And, all they had to do was ask you to contribute on your IRS form like they ask for the dollar for political campaigns. Now that you see this, you'd give them a hundred bucks just to avoid this mess. And then they could send the uninsured a post card where they could check what insurer they want and it's done.
This is truly a mess like when the privacy laws came out and they would tell you you could not speak to the doctor about your own mother as you are not the designated family spokesperson. That's fine but she chose a family spokesperson who told the family to go to he two sticks as this was her area of expertise and she knew more than all of us. But then again, someone recently found out she's scheduled to inherit everything just her so this kind of stuff can be abused and not in a good way.
Posted by: just a citizen at October 22, 2013 10:09 AM (Nx76m)
Posted by: Chad Henderson - Cockjockey at October 22, 2013 02:07 PM (LSJmV)
Get crotch rot and die, CHAD.
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 10:09 AM (4df7R)
Are you feeling better?
*hides stick behind back*
Asking because I care about you as a person.
*THWACK!*
Me - "Ow! Was that a bug?"
AtC - "No"
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 10:10 AM (0HooB)
Posted by: steevy at October 22, 2013 01:52 PM...............Good grief. TeH Stooopid, it burns.
Posted by: Minnfidel at October 22, 2013 10:10 AM (ixf9H)
Hah! An all-inclusive pre-injury release is unenforceable because it violates public policy.
Try again. (HINT: The best you'll get is an arbitration clause that may work.)
Posted by: Cicero (@cicero) at October 22, 2013 10:10 AM (8ZskC)
Posted by: Diogenes' Lamp at October 22, 2013 10:10 AM (bb5+k)
Posted by: Chad Henderson - Cockjockey at October 22, 2013 10:11 AM (LSJmV)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 10:11 AM (da5Wo)
***
Never underestimate the lengths to which an attorney will go to file a suit.
Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:08 PM (DmNpO)
Patients have been signing informed consent form here forever, there are also more malpractice suits than ever before.
Posted by: just a citizen at October 22, 2013 10:11 AM (Nx76m)
Posted by: steevy at October 22, 2013 10:12 AM (zqvg6)
Posted by: Jenny Hates Her Phone at October 22, 2013 10:12 AM (GmTxn)
The left wing said they would abolish poverty
The right wing said it would abolish bureaucracy
Odin said he would abolish ice giants
Where are the ice giants?
Vote odin
Posted by: Berserker-Dragonheads Div at October 22, 2013 10:12 AM (FMbng)
Pre-order your copies now!
Healthcare Tourism for Dummies
Black Market Healthcare for Dummies
Bone Setting for Dummies
Home Surgery for Dummies
Self-Surgery for Dummies
Death Panel Defense Strategies for Dummies
Posted by: For Dummies Publishing at October 22, 2013 10:12 AM (Pr6hk)
Posted by: Chad Henderson - Cockjockey at October 22, 2013 02:11 PM (LSJmV)
*uses lacrosse stick to launch Torso Sized Scorpion at Chad* Sic 'im!
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 10:12 AM (4df7R)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 10:13 AM (XIxXP)
Posted by: Purp[/i][/b][/u][/s] at October 22, 2013 10:13 AM (l5zzX)
Posted by: Chad Henderson - Cockjockey at October 22, 2013 02:11 PM (LSJmV)
Piss off, two-arm.
Posted by: Face Sized Spider at October 22, 2013 10:14 AM (zF6Iw)
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 10:14 AM (4df7R)
Posted by: Countrysquire at October 22, 2013 10:14 AM (LSJmV)
My dad was an anesthesiologist. One thing I can tell you for sure is that anesthesia by an M.D. is going to become scarce and expensive. And you are playing Russian Roulette if you don't have a M.D. doing your anesthesia.
Health care cost experts love to point at anesthesia by M.D.s as an "excessive" cost in the system. Insurers love to incent surgeons and patients to use nurse anesthetists instead. It's routine now for nurses to do the anesthesia for "routine" surgeries, but believe me, there is no such thing as a routine surgery. I personally know of three people who were killed by improper dosages of anesthetics given by nurses, and another that was paralyzed by a bad spinal. My dad never made a mistake in 35 years of practice.
When I had outpatient knee surgery a few years ago I had to fight my insurance company to get them to pay for a M.D. for my anesthesia. I would have paid for it myself if necessary, but it's just bullshit for them to claim a M.D. is not medically necessary.
This will be happening with other procedures and office visits before long as well. You won't get a M.D. for anything other than surgery. It's one of the easiest ways to cut costs, and also the most dangerous.
Posted by: rockmom at October 22, 2013 10:14 AM (aBlZ1)
Posted by: Oschisms at October 22, 2013 10:15 AM (hS/ze)
Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 10:15 AM (VtjlW)
Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)
All thanks to your hero John Roberts.
Posted by: buzzion at October 22, 2013 10:15 AM (LI48c)
Posted by: Boss Moss the Redskin Savage at October 22, 2013 10:15 AM (ujMoa)
Posted by: CareCredit at October 22, 2013 02:06 PM (GmTxn)
Yep, Care Credit/GE, Visa, MC, AMEX, whatever. Huge deductibles give people an incentive to shop around and/or negotiate services. Shitty reimbursement rates and endless red tape give MDs an incentive to work with credit card processors over insurance companies.
Posted by: Gristle Encased Head at October 22, 2013 10:16 AM (+lsX1)
Posted by: Nevergiveup at October 22, 2013 02:08 PM (t3UFN)
I'll have to look into that.... but if its a good deal... its probably no longer available.... LOL... \lets his pessimism out for a walk....
Thanks though...
Posted by: Romeo13 at October 22, 2013 10:16 AM (lZBBB)
Wait, I'll ask.
*in tiny baby's voice*
My life!
Posted by: John Edwards at October 22, 2013 10:17 AM (8ZskC)
B) Copy
*IV) Start italics [ i ]
**q) Paste
11010010) Close italics [ /i ]
Posted by: BCochran1981
*Preferably composed on Notepad or other simple text editor.
**After proofread, including closing tags, then paste to comment box.
Posted by: weft cut-loop [/i] [/b] at October 22, 2013 10:17 AM (cb5D2)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 10:17 AM (XIxXP)
I need to talk to my PCP about accepting chickens as form of payment. Posted by: Foghorn Leghorn at October 22, 2013 01:44 PM
You're going to horse-trade your offspring for healthcare? Good idea.
Posted by: Lester at October 22, 2013 10:17 AM (qTsuK)
Posted by: rickb223 at October 22, 2013 10:17 AM (h1D+w)
Posted by: Niedermeyer's Dead Horse at October 22, 2013 10:17 AM (DmNpO)
Posted by: Andrew at October 22, 2013 10:17 AM (VjlMj)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 10:18 AM (XIxXP)
Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)
I have a friend who is an M.D. who is an anesthesiologist. He tells me point blank, HE is the dude that keeps you alive on the table, not the surgeon.
Posted by: Berserker-Dragonheads Div at October 22, 2013 10:18 AM (FMbng)
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 10:18 AM (da5Wo)
This will be happening with other procedures and office visits before long as well. You won't get a M.D. for anything other than surgery. It's one of the easiest ways to cut costs, and also the most dangerous.
Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)
To repeat, if it weren't for the fact that we're all (well, those of us not of the Inner Party) fucked with Barkycare, I would be very, very, coldly happy at his voters dying off because of their Little Black Jesus.
Posted by: Mary Poppins' Practically Perfect Piercing at October 22, 2013 10:18 AM (zF6Iw)
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 10:18 AM (0HooB)
Posted by: Nevergiveup at October 22, 2013 10:19 AM (t3UFN)
Posted by: Countrysquire at October 22, 2013 10:19 AM (LSJmV)
Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)
There seems to be this misconception in the general population that you don't need to be terribly qualified to be an anesthesiologist. Some of my work involves interacting with health profession preparation programs, and I can't tell you how many people look at the average pay scales of various medical professions and say, "Wow, anesthesiologists make that much? Why?"
I blame pop culture, where all the bad guy has to do is douse a rag with chloroform and cover the ingenue's mouth and nose with it to knock her out before dragging her back to his lair. All you have to do is look at the Russian theater hostage fiasco to see how well that kind of thinking works.
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea [/i][/s][/u][/b] at October 22, 2013 10:19 AM (4df7R)
Of course unless you actually attended that economics class you took in college, or reads news sources other than the NYT or WaPo
Posted by: Torquemada at October 22, 2013 10:19 AM (Pr6hk)
Posted by: JoeyBagels at October 22, 2013 10:19 AM (IlnmK)
Posted by: BlueStateRebel at October 22, 2013 10:19 AM (7ObY1)
Seems like something called a "free market"* could solve this problem.
Of course, the Brits at one time had cash or independent doctors illegal to protect NHS. I suspect the same will happen with Odeathcare.
*no FSA, this is not a market where you get free stuff.
Posted by: Guy Mohawk at October 22, 2013 10:19 AM (ufpPl)
Posted by: John the Libertarian at October 22, 2013 10:19 AM (/rhjC)
Posted by: panzernashorn at October 22, 2013 10:20 AM (MhA4j)
Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 10:20 AM (VtjlW)
Posted by: Niedermeyer's Dead Horse at October 22, 2013 10:20 AM (DmNpO)
I'd like to pre-order my copy of Self-Medicating for Dummies.
Ten Surgeries You Can Do At Home.
The Kidney: Your Body's Own ATM!
Posted by: Mary Poppins' Practically Perfect Piercing at October 22, 2013 10:21 AM (zF6Iw)
Posted by: Minnfidel at October 22, 2013 10:21 AM (ixf9H)
"I'm voting for Obama because <<celebrity>> is!"
Posted by: HeatherRadish™ at October 22, 2013 10:22 AM (/kI1Q)
Posted by: Countrysquire at October 22, 2013 10:22 AM (LSJmV)
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 10:22 AM (XIxXP)
Posted by: John the Libertarian at October 22, 2013 10:22 AM (/rhjC)
Posted by: Diogenes' Lamp at October 22, 2013 10:23 AM (bb5+k)
Posted by: rickb223 at October 22, 2013 10:23 AM (h1D+w)
My son had his 3rd heart surgery (Fontan, but complicated because of dextrocardia) at CHOP and it was an unbelievably good experience, and everything was covered. Had to go there because the surgeon whi did the 1st two surgeries had retired.
I've feared that Obamacare will take care of these types of medical situations/needs by deciding that some kids aren't worth the expense (cue Ezekiel Emmanuel's rationing plans). No paperwork mess if you just don't bother doing it.
Posted by: Lizzy at October 22, 2013 10:26 AM (JRmiD)
have been under general anesthesia on numerous occasions and, frankly, it is far and away the scariest part of any procedure. When someone is taking away my consciousness, I want to know damned well that they can bring me back to consciousness as well.
Good enough is not good enough when it comes to anesthesia.
Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:20 PM (DmNpO)
Exactly. People don't realize that all anesthetics are poisons that can kill you if the dosage is wrong, if something goes haywire with your blood gases during surgery, if your potassium level is too low before surgery, etc. A spinal anesthetic can paralyze you or cause you a lifetime of pain if the needle is off by a millimeter or the dosage is wrong.
Michael Jackson was killed by the anesthetic Propofol. On his last tour he traveled with an anesthesiologist. Dr. Murray had given Propofol to him dozens of times with no problem, but he was a heart surgeon and not a trained anesthesiologist.
Posted by: rockmom at October 22, 2013 10:26 AM (aBlZ1)
People are afraid of the prospect of paying out of pocket for good reason. Imagine someone making $50k / yr suddenly discovering that they require $200,000 of medical treatment.
Who wouldn't be worried in that scenario?
Posted by: Hollowpoint at October 22, 2013 10:26 AM (SY2Kh)
http://tinyurl.com/k86zefj
Posted by: just a citizen at October 22, 2013 10:27 AM (Nx76m)
Posted by: Beagle at October 22, 2013 10:32 AM (sOtz/)
Posted by: Minnfidel at October 22, 2013 02:21 PM (ixf9H)
When I was very young almost nobody had insurance. I grew up in a small town in Kentucky where people were generally poor or middle class. My dad gave people a year and sometimes more to pay his bill. He got paid in vegetables, hams, etc. One lady made him a quilt because she had no money. He regularly wrote off bills for many people. My mom did his billing at home and he didn't even have a business office.
In 1974 the IRS changed all of this. They told my dad he could no longer write off an unpaid bill unless he made at least three attempts to collect it. He could no longer barter for payment. So he had to hire a clerk, rent an office, and start hounding people. He hated it and they hated him. That same year he got hit with a frivolous malpractice suit and his practice's insurance premium went from $20k a year to $100k. (His annual income at that point was about $60k and he had 3 kids in college.)
In two years he raised his rates by 400%.
Posted by: rockmom at October 22, 2013 10:33 AM (aBlZ1)
Posted by: Jenny Hates Her Phone at October 22, 2013 10:34 AM (GmTxn)
Posted by: panzernashorn at October 22, 2013 10:34 AM (MhA4j)
That scenario is exactly what insurance is for. But people have been conditioned to avoid paying out of pocket for anything, and *that* is the big problem. Office visits, birth control, etc. are routine care and should be paid for out of pocket.
Posted by: Jenny Hates Her Phone at October 22, 2013 02:34 PM (GmTxn)
What we are getting under Obamacare isn't insurance anymore at all. It is closer to a prepaid health care plan that you may or may not ever use. That's why the new policies are so bloody expensive.
If you can't price it for risk and the consumer cannot choose their level of coverage, it isn't insurance.
Posted by: rockmom at October 22, 2013 10:41 AM (aBlZ1)
Posted by: not the mama at October 22, 2013 10:42 AM (5dxeo)
I always figured "tsrblke" meant taser bloke. Perhaps an English self-defence fan, or something.
OK, you are right. I still got nothing.
Posted by: Igotnothing at October 22, 2013 10:47 AM (LvQK2)
Posted by: Jenny Hates Her Phone at October 22, 2013 02:34 PM (GmTxn)
Another part of the problem is that costs have been so skewed by the current system (people not paying, medicare/medicaid not paying enough) that the prices of even routine procedures are completely skewed. One of my friends recently had to pay out of pocket for a urine culture, which cost $350 (that was just the lab work.. the doctor's visit was another bill). Insurance companies negotiate those prices down to something reasonable (at least under $100) but individuals don't have that ability. Regular folk can't afford to pay those kind of prices for routine care.
Posted by: not the mama at October 22, 2013 10:47 AM (5dxeo)
The hospital in my town got in a dispute with Cigna and is now out of network. For an in-network hospital, I have to drive to Nashville and have.
Networks can be a bitch.
Posted by: SGT Dan at October 22, 2013 11:12 AM (jCQ+I)
Posted by: tsrblke PhD(c) (No Really!) at October 22, 2013 11:16 AM (GaqMa)
Gotta get mine in: I'm a tricky diagnosis, I never get anything normal, and most medications work backwards on me. Been that way my whole life. I've had conditions that took five doctors a year to diagnose, one of which only 3 other people in the US had. As one said, "For someone who's sick, you're pretty healthy." And I am. But once I get sick it's a nightmare for everyone, but I'm very lucky: thus far, they've all been easy to resolve (once they figure out what's wrong).
I learned a long time ago when you've got something tough, go immediately to the best whether he's in your network or not. Tell him up front you're paying cash. They almost always cut their fee by 30 or 50 percent. If you're lucky, the hospital they use for tests IS in network and those will be covered.
You'd have wound up there anyway and you can skip the four "in network" specialists and the time & copays you'd have to give them to not know what's wrong with you, let alone test costs.
But that taught me: health care isn't free. Insurance doesn't insure everything. Since I wouldn't walk into my own office without being paid for being there, why should someone who went to university 3 times as long as I did be expected to?
Posted by: Biblio at October 22, 2013 12:33 PM (7o8VY)
Under TFG-Care they would have even more motivation to do so, right? Seems like nothing will happen unless it's an emergency for the next year. Who the hell knows what their coverage is?
Posted by: PJ at October 22, 2013 01:13 PM (ZWaLo)
Posted by: DaveinW-S at October 22, 2013 04:53 PM (af5Zq)
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Posted by: phoenixgirl @phxazgrl at October 22, 2013 09:28 AM (8JJ6O)