<p>I looked up a friend of mine in sac area who is an oncologist. Seems part of Sutter accepting pretty much most plans and new patients. </p>
<p>Might have an accent and diplomas from India but I can say with certainty that the day he left, India lost one of the brightest minds. He went to a med school which accepts 25 students each year, went through PG program ranked number 1 in the nation, went through civil services exams and was ranked number 1 at graduation, spent 10 years in Govt admin and decided to pursue medicine again and moved to US.</p>
<p>“I mean, if you walk into an ice cream shop and are told that the only flavor is vanilla and a single scoop cone is $20, there’s not much point in holding your breath and stomping your feet and wanting chocolate. You either buy the $20 vanilla cone or you don’t.”</p>
<p>Maybe it’s my upbringing, but I am incapable of falling in line. When I am told you have no choice but to acquiesce, it makes me want to resist even more. I suspect it is why I was able to succeed as a self-employed business owner for over 20 years.</p>
<p>If I was living during the time when we were under the control of the British, I would have been riding with Paul Revere.</p>
<p>may be they can buy some treasury bonds with the surpluses. :p</p>
<p>GP - just suggesting that one may be fooled by a foreign degree and equate that with competency but you have some of the best minds around you toiling away in anonymity. Not everyone hangs out at UCSF, Cedar Sinai or Stanford.</p>
<p>“Texaspg, did you see the Calif budget news today?”</p>
<p>I wonder how much of this is coming from capital gains because of all the IPO’s and the surging stock market. Almost a repeat of the late 1990’s.</p>
<p>“The upshot here in NH is that 10 of the state’s 26 hospitals will either go out of business or be forced to sell to one of the approved provider hospitals. Anthem BCBS didn’t cut them out because of fee structures. They cut them out because the promised higher volume to the hospitals in the network.”</p>
<p>It doesn’t have to work that way. Seattle Cancer Care Alliance started "branding’ primary care hospitals, providers, and clinics (even SeaMar Health Clinic that serves mostly Hispanic immigrants) even before the ACA. It would be a waste of resources to have every cancer patient served by the top hospital (in our case, Fred Hutchinson), when the quality of care down the line might be just as good for what is needed. The only reason many people seek to go to the Hutch, or Sloan, or Cleveland is for the bragging rights to say they’ve been seen by the best. The reality is that, for many cases, they may not be the best, and having patients who don’t need their specialized services may even water down the quality. So the the others pony up, and they share marketing and branding expenses, co-training, protocols, etc., and every cancer patient who goes to SeaMar can say they’ve been seen by the Seattle Cancer Care Alliance. </p>
<p>I can easily see similar happening in New Hampshire. I would bet that NH already has primary, secondary, and tertiary ERs and/or burn centers, so this is just an extension of the same idea. (Having one network can be a plus, rather than a minus - though we know the industry is going to work to pocket every dollar of profit they can get!)</p>
I don’t know what you decided to do, but I’ve decided that the easiest path to verification and planning is:</p>
<p>1) Enter the income based on what’s in the 2012 tax return- because that is what is most likely to pass the verification step</p>
<p>2) IMPORTANT: Once you are approved for a subsidy, you do NOT have to take the “advance” subsidy, and you can decide how much of any such subsidy you take. So when it comes to specifying how much you actually PAY – then simply err o the side of being super cautious, and opt to defer all or most of your potential subsidy.</p>
<p>Then you are in the system-- already set up to easily set up the subsidy if you experience a financial reversal (for example, getting laid off from work) – but you aren’t setting yourself for a big bill if you are subject to clawback.</p>
<p>That’s not what is going on in NH. It’s the community hospitals that are being excluded. For example, the only hospital in the state capital, Concord, is not on the provider network. The only hospital in Portsmouth, major seacoast region, is not on the provider network. </p>
<p>According to my insurance agent, Anthem’s plan, as the grandfathered plans expire, is to cut back to this small provider network for all individual and small business plans in the state.</p>
<p>In some cases, the hospitals refused the Anthem reimbursement rates. In other cases, Anthem never even discussed rates (they were trying to limit the network size). Basically, they offer a network that has “adequate coverage” under the law.</p>
<p>I don’t really care. My doctor is on the list. My local hospital is not on the list, but since I don’t have any choice, I’ll just have to deal.</p>
<p>dstark - There are people who would do anything to avoid taking a handout. That used to be considered a virtue and I’d been wondering if there were still people around would bristle at the thought of government subsidies. I guess there are a few of those left. She’s also worried about quality of care.</p>
<p>Flossy, this is not a logical perspective unless you also believe that these same people should not send their kids to public schools or take financial aid for college, or even endowed scholarships.</p>
<p>The closest correlation to health care is education, not cars.</p>
<p>I’m not saying she should or she shouldn’t. But she was paying for health insurance and wanted to continue paying. The system forbid it. She was working and wanted to pay. </p>
<p>I think she would compare it more to food stamps than education. There used to be a stigma associated with that stuff. Obviously, for her there still is. She doesn’t think of herself as poor. She thinks of herself as working and was offended.</p>
<p>If she’s so hurt by taking the money for medicare then why note donate the difference between being on government health care and her previous private insurer back to the government?</p>
I am glad to read we dont really have to do that.</p>