<p>The point is the top research centers that people with serious conditions need to live are not covered by many of these plans. No doctor I have ever dealt with worked at the hospital. They came in, did their thing, and went back to their office or home if it was a middle of the night emergency. But, there are those who do. It’s beside the point.</p>
<p>I guess I don’t understand what that has to do with the ACA as it seems no different than before.
I’m also spoiled as U of M takes pretty much every insurance I have available to me and you’d be hard-pressed to find a condition they don’t have a specialist in.
Irrelevant to this thread though. </p>
<p>It has to do with access to doctors and hospitals being so limited by the exchange plans. And, sure it varies depending on state. That’s a problem imho if the goal is to help everyone because some people who need high level care the most aren’t going to get it… Read the NY Post piece. If it’s even just a little bit true, it’s not good.</p>
<p>That somehow Cezannes or Picassos in Cedar Sinai is a reason for justifying these narrow networks for very sick people is a clever distraction and not even accurate. The art collection was DONATED to Cedar Sinai. </p>
<p>The point of the article is that sick people with catastrophic diseases need complicated care from specialized hospitals, various specialists and expensive drugs. Obamacare is not setup to take care of them. I don’t know about other people, but I buy health insurance to protect me from the huge expenses incurred relating to catastrophic diseases or accidents. I don’t want insurance if it denies me the care I need if I get very sick.</p>
<p>Back up. My plan allows Dana Farber. And allows for addl scenarios if the case can be made. If there is an issue with MSK or you-name-it, the focus needs to be on what it will take to bring them into the fold- or get us in. Not some Chicken Little, the sky is falling stuff.</p>
<p>And the drugs. The drugs is huge.</p>
<p>The next time I am asked to donate money to help someone get specialized care for a stem cell transplant, chemotherapy or some other very specialized care, I am going to ask if their community hospital is providing it under their Obamacare plan.</p>
<p>You guys are confounding two different concepts – “rare” and “catastrophic”. Most “catastrophic” illness is not “rare”. (That’s a tautological assertion, inherent in the definition of “rare”). I am much more likely to be diagnosed with a common form of cancer than a rare one. Common cancers are expensive to treat and people die from them, but a research hospital might not do much different to treat it than the local facility. I mean, the first line of defense is probably fairly consistent no matter where you go. And most people are going to go to a facility nearby for logistical reasons. If they happen to live near the expensive research facility that can treat their illness, then that might be their preference – but if it’s a choice between a facility that is 10 miles away and one that is 1,000 miles away… the nearer facility is the one that makes sense. (I’m not aware of any insurance that would reimburse a family for airfare and hotel bills if they choose to relocate to get care at a particular facility)</p>
<p>Although I think you (Calmom) are vastly underestimating the level of care one needs for catastrophic diseases, I guess for those people who are afflicted with rare diseases, they can now go without the care they need because of an ill-conceived and highly flawed health insurance system foisted on more than half of the country that didn’t want it.</p>
<p>Relax, Goldenpooch. If you really and truly need a service which cannot be provided within the network, your doctor will make an Out of Network Referral, and you’ll get the service at in-network cost. </p>
<p>LasMa, I’ll let you test that hypothetical declaration with the insurance company. I am not going to take that chance.</p>
<p>Goldenpooch, I am concerned about the thousands of people with very serious, common conditions who weren’t able to get insurance because they couldn’t afford it and/or were denied coverage due to their medical history. Now those people can get care. These are real people including good friends and members of my extended family – they have real medical problems, some of which could be life threatening, and most are very grateful that they can see any doctor at all, which is a lot better than the position they were in before January 1. </p>
<p>That cat just looks so irritated. It should be happy that the ACA came to save the day!</p>
<p>My avatar reflects my feelings about the new CC board. </p>
<p>* I’ll let you test that hypothetical declaration with the insurance company. I am not going to take that chance.* </p>
<p>But you are willing to post, with such certainty, that they will be denied care or some other devastation.</p>
<p>“My avatar reflects my feelings about the new CC board.”</p>
<p>You think it’s adorable, yet you’re annoyed by it?</p>
<p>I agree.</p>
<p>What I’m not understanding in the Goldenpooch plan is what the vast majority of hospitals are for. Most people who are in the hospital are there for treatment of a serious condition: you don’t go to the hospital for the sniffles. For example, hospitals are full of cancer patients, because cancer is one of the most common ways to die, and before you die of it you get very sick- not to mention the people who are very sick with cancer but then recover. </p>
<p>But now under the GP plan, serious conditions are supposed to be treated by the superduper experts at Cedars Sinai and the Mayo Clinic and similar places. So (1) how are all those cancer patients and other very sick people supposed to fit in the few superexpensive superimportant hospitals, and (2) what are the rest of the hospitals for, now?</p>
<p>It is true that, at some points in treatment for some cancer patients, it’s necessary to get the opinion of an ultra specialist in that cancer- and possibly a master treatment plan. In many cases the patient then returns to the home doc and local hospital services for care. If a cancer patient required, say, a transfusion or developed a bad case of dehydration, he could go to the local hosp for treatment. Radiation or chemo might occur locally, If there were some complex issue, he might be sent back to the specialist facility. He might have routine specialist visits or some particular service or testing at the ultra place. </p>
<p>But what;s important is the OONetwork Referral process, which exists. As LasMa notes.</p>
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<p>Just the annoyed part. </p>
<p>I got italics the old way, with brackets. </p>