<p>It’s not just the money. If you are an extremely good student who has the ability and drive to get into med school, do well, do well on Step 1, do a residency of several years, you are also likely going to want the intellectual challenge of a speciality and practicing with others like you. </p>
<p>I know, busdriver. I am spoiled. For years, I bypassed primary care doctors altogether and went straight to the specialists who would at least have a clue as to how to solve the problem. I have never met my assigned GP.</p>
<p>Tatin - I know a family of 6 kids who’s dad is a GP as are 5 of the children. The father wrote a book a few years ago about the issues with US medical care but I have no idea how he feels about ACA. His biggest beef was the lack of family docs and one on one attention so I’m guessing he will not think highly of this new system but I don’t know.</p>
<p>I rarely go to a GP or internist either. Like you, I bypass them and go directly to the specialist. </p>
<p>TatinG, I understand that there are many excellent reasons that a medical student would prefer to learn a speciality and work in an environment surrounded by other top specialists. I’m not knocking the students who do that at all. But that’s just one more reason why it makes sense for the government to be providing funding for training of GP’s in high need areas. It’s essentially the same logic as offering loan forgiveness for students in other professions, such as lawyers, who go into government or nonprofit work. </p>
<p>If you want to get people to make a less-popular career choice, then it makes sense to pay those people to do it. </p>
<p>I’d add that for many, there choice wouldn’t be neurosurgery vs. country doctor. For many the choice is simply no medical education at all, or some sort of government funding to get that education. </p>
<p>Hey, getting good service isn’t being spoiled, Flossy, too bad it’s not the norm. We can always go right to a specialist whenever we choose, without asking permission. It is so nice. I have been hearing the saga of what my Dad is going through right now. He’s with Group Health.</p>
<p>His toe has been causing him so much pain that he is partially bedridden, and just shouting out in pain for part of the day. It is curled under his other toe and just looks awful. They kept trying to blow him off by having him talk to the consulting nurse by telephone, who was encouraging the bogus and useless things he was trying to do to fix it. After he finally realized it was all useless, and she really wasn’t helping, they made an appt with his doctor. They couldn’t fit him in for a week. Then the doctor referred him to a specialist (10 day wait). My mother went with him, ready to scream for a specialist, as they always try to resist sending them in that direction. After the specialist sees him, God only knows how long he’ll have to wait for surgery. So much pain. He was in awesome shape for an 84 year old, still trying to exercise through the pain, but I don’t know what shape he’ll be in after all this waiting.</p>
<p>I could have gone to my surgeon immediately, directly. He would have scheduled the surgery ASAP. Needless to say, they got a lecture from me on why get Group Health Insurance when you can get something so much better. Sure, it’s fine for your periodic doctors visits (scheduled a month in advance), but not if you actually need a specialist! Sometimes people accept mediocrity as the norm, and they get used to terrible service.</p>
<p>He was in so much pain, he was actually trying to figure out a way to make it become gangrenous, so they’d have to cut it off. Not crazy, just desperate.</p>
<p>Group Health sounds like Kaiser. I about started screaming at the nice tele-counselor with her useless pamphlet driven asthma advice for my husband that was obviously intended to calm me down but I didn’t need calming down. He needed a competent specialist, fast. Sigh. </p>
<p>I think I would just bypass all the silliness if you know what you want. That is, if you can. Every time I call my insurance company, I get this automated question, “Do you want to talk to the My Health Coach Nurse?” I’m not a freaking idiot (no matter what some might think), I know more about my issue than they do! Useless.</p>
<p>I think we will be seeing a lot more of this “useless” stuff with ACA,. People seem to think it’s prevention. Kaiser loves this nonsense but you have to fight like heck to actual see a useful physician. Wellness seminars. lol. </p>
<p>A lot of people who have Kaiser love Kaiser. It has the biggest market share in California, at 40%.</p>
<p>My friend in N CA loves Kaiser, went on and on about how lucky he was to have them for his condition. </p>
<p>Here is an article which will raise dstark’s blood pressure’</p>
<p>“Behind the ‘4 Million Obamacare Enrollees’ Facade Is An Uncomfortable Truth”</p>
<p><a href=“Behind the '4 Million Obamacare Enrollees' Facade Is An Uncomfortable Truth”>http://www.forbes.com/sites/merrillmatthews/2014/02/27/between-15-and-25-of-those-who-make-their-first-obamacare-payment-could-drop-coverage-later/</a></p>
<p>The real question is not whether exchange subscribers will make their first monthly payment but will they make 12 of them in their first year.</p>
<p>“Lost in the discussion is that the individual health insurance market is very volatile, for several reasons. People who buy individual coverage tend to have lower incomes, and so a major car-repair bill or some other unexpected expense can cause them to miss their premium payments.”</p>
<p>I am beginning to believe the newspeople are reading this thread and stealing our deepest darkest thoughts. I am sure I said something similar several pages ago. ~O) </p>
<p>Gee, good thing the ACA drafters thought to write a 3-month grace period into the law, just in case some lower income person misses a payment due to some unexpected expense or other: <a href=“45 CFR § 156.270 - Termination of coverage or enrollment for qualified individuals. | Electronic Code of Federal Regulations (e-CFR) | US Law | LII / Legal Information Institute”>http://www.law.cornell.edu/cfr/text/45/156.270</a></p>
<p>^^^^^</p>
<p>Yeah, also stiffing the doctor rather than the insurance company if the lower income person stops making payments. </p>
<p>Maybe I will sign up for insurance at the beginning of the year, make one payment, get all the care I need in the next three months and let the doctor eat the costs. Wait 9 months and do it all over again. Nobody would play that game. Right?</p>
<p>"Maybe I will sign up for insurance at the beginning of the year, make one payment, get all the care I need in the next three months and let the doctor eat the costs. Wait 9 months and do it all over again. Nobody would play that game. Right?’</p>
<p>And what happens if you have a heart attack in month four? Or contract meningitis? Or break your leg? </p>
<p>I find it interesting that people think they can plan their medical issues and when they will need care. </p>
<p>Also, the providers will come after you if you do not pay. There are these things called collection agencies. </p>
<p>But, go on GP - give it a whirl and see what happens. </p>
<p>At this point, I am afraid to write any original thoughts here because I suspect all our ideas are getting stolen by lazy reporters and presented as their own!</p>
<p>There will be some stats in an year whether any of these views are real issues. Although GP would like to present every worst case scenario possible (like he would ever forgo insurance in the manner he claims - if anyone believes that, I have a bridge to sell) I contend there will be people dropping out because they can’t plan their finances and many are living paycheck to paycheck and paying an extra 100 or whatever will eventually turn out to be too much for them. I doubt they will do it because they intend to commit fraud although there will be people who do that since there are always people who like to commit fraud.</p>
<p>Collection agencies cannot collect anything from people who don’t have anything to collect. I don’t understand how people don’t seem to understand this very simple fact.</p>
<p>GP said he might try that*. I bet he has plenty the collections agencies can go after - on top of his credit being trashed. </p>
<p>I don’t believe most people will plan on doing what he suggests. Most people want to be insured. </p>
<ul>
<li>when **** freezes over. 
</li>
</ul>
<p>I am shocked. I had no idea people with poor health conditions were denied coverage. Now, not only were people denied coverage, but this led to the individual market being made up of primarily healthy people. Not much of an insurance market if unhealthy people cant get coverage, is it?</p>
<p>Then there was all this cancellation bs. Oh no! Millions of people had their plans cancelled. Millions of people LOST their insurance. "These people were going to hold onto their plans until they died. What a tragedy!!! </p>
<p>Oops… Most people… A super majority of people dont keep their plans and never did. I read that only 17 percent of people keep their plans for more than 2 years. Shocking isnt it?</p>
<p>Yeah… The stiffing. People are going to have $100,000 procedures done, not pay their $200 in premiums, and stiff the doctors and hospitals a total of $6,000.
I doubt this will happen too much, but it will happen. A gall bladder operation costs what? $100,000 at Cedars? I can see this happening at Cedars. :)</p>
<p>"People purchasing individual coverage historically have been healthy, because insurers in most states could turn down applicants if they had a major medical condition. Healthy people are more likely to drop coverage because they aren’t facing high medical bills.</p>
<p>Of course, people often drop their individual coverage for non-financial reasons, such as a spouse or the individual getting employer-based coverage; the individual turned 65 and joined Medicare; lost a job and qualified for Medicaid; or found a better deal and switched plans.</p>
<p>Insurers and actuaries interviewed for this piece say that the individual market turnover rate can vary based on company policies, and companies don’t always know why a person drops coverage, but a 30 percent to 50 percent lapse rate within 12 months seems to be pretty common. Of those who drop their coverage, perhaps half of them did it for financial reasons. "</p>
<p>Well, I don’t think most people will plan on doing that, either. Just as a few years ago I don’t think most people in my neighborhood planned on going into foreclosure, but it happened.</p>