Affordable Care Act Scene 2 - Insurance Premiums

Parent Cafe
11501

<p>Well, I guess others disagree…</p>

<p><a href=“http://centerforhealthreporting.org/article/lower-medicare-reimbursements-plague-county-doctors”>http://centerforhealthreporting.org/article/lower-medicare-reimbursements-plague-county-doctors&lt;/a&gt;&lt;/p&gt;

<p>Really folks, I concede. Everything is great with the ACA aside from a few annoying little issues which really don’t matter anyway (yawn) because not enough people (that matter) are affected. All will be well. Anyone voicing concerns or bringing info to the the thread which shows potential problems is just a complaining, self serving, selfish grousing ogre who wants to see others suffer. Providers are placing orders for Starbucks coffee and low fat baked good in order to hold open houses and lure in the large masses of newly insured population. They Hippocratic Oath will supersede all human tendency toward fiscal benefits. </p>

<p>Those with the means will continue to gladly pay into the system at a higher and higher rate, never ever using their (ill gotten of course) funds to circumvent the system…because the system will be WONDERFUlL and MAAVELUS.</p>

<p>And now…a round of Kumbaya…</p>

<p>I’m going to buy my party hat and streamers…see ya all at the grand opening.</p>

11502

<p>^^^^^^^Great Post</p>

11503

<p>Dietz199, I see Marin on the list. </p>

<p>What do you want? Do you want doctors to be paid more for medicare and medicaid patients?</p>

11504

<p>So if Medicaid clamped down in McAllen, TX, you’d hear screaming. Good link, romani. More specialist services, higher medicaid costs per person, “over-utilization.” </p>

<p>Dietz, did you see CF left an opening? </p>

11505

<p>Bluebayou, you know… That is how rumors start. Eventually your post will hit The National Enquirer and The Washington Times. :)</p>

11506

<p>Most doctors (specialists) will not see Medicaid patients. Also, many studies have shown that medicaid patients fare worse in outcomes than without insurance.</p>

<p><a href=“How Obamacare will hurt doctors”>Opinion - New York Daily News;

11507

<p>I agree that Medicare reimbursements are a problem. I could be convinced that doctors in Marin and Santa Cruz are unfairly reimbursed for Medicare compared to doctors in Santa Clara County.</p>

<p>However, you’re going to have a very tough time convincing me that this has one single thing to do with the ACA. “In 2007, the U.S. Government Accountability Office published a report supporting Santa Cruz and other California counties’ claims that the current geographic boundaries for Medicare reimbursement be revised.” It’s been an issue for decades.</p>

11508

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<p>Yeah, but it won’t count until you are featured on O’Reilly. :-j </p>

11509

<p>Real reform would eliminate Medicare and Medicaid. Both are heading toward bankruptcy and are increasingly restricting healthcare for its recipients.</p>

11510

<p>GP’s attitude is mind-boggling.
Fwiw: <a href=“http://www.medicaid.gov/AffordableCareAct/Provisions/Downloads/Q-andA-Managed-Care-Increased-Payments-for-PCPs.pdf”>http://www.medicaid.gov/AffordableCareAct/Provisions/Downloads/Q-andA-Managed-Care-Increased-Payments-for-PCPs.pdf&lt;/a&gt;&lt;/p&gt;

11511

<p>Romani…I just read your link. Took awhile. :)</p>

<p>Great link. Thanks.</p>

<p>LF…nice link.</p>

<p>bluebayou, not going to happen. I have to draw the line somewhere. :)</p>

11512

<p>“Yeah, but it won’t count until you are featured on O’Reilly.”</p>

<p>And he proclaims dstark is not so bad after all. </p>

<p>In other news, the visa holders are stuck and the marketplace phone line people claimed only people with greencards for 5 years are allowed. When our admin argued with them he was told to mail in the paperwork. I sent him some links and told him to point out the documentation.</p>

11513

<p>“And he proclaims dstark is not so bad after all.”. </p>

<p>I’m not. :)</p>

<p>So texaspg, were you told when you are going to hear back from the phone line people?</p>

11514

<p>That’s terrible, texaspg. Would your local Congressperson help you with the situation? If the marketplace is denying someone subsidies seemingly in violation of clear law, seems like getting some constituent service from your Congressperson would be in order.</p>

11515

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<p>Sez, you. :)) </p>

11516

<p>The problem is with registration. We have not gotten to the subsidies yet.</p>

11517

<p>T - Did someone try to speak with a supervisor?</p>

11518

<p>I like Flossy’s article too ( the one at <a href=“The Faces of Obamacare | News | North Coast Journal”>The Faces of Obamacare | News | North Coast Journal; )- but I do have to point out the limits of anecdotal information when it comes to the stories of various problems people face. </p>

<p>The article includes the story of a young woman who drove 6 hours to see a shoulder specialist in San Jose and then was turned away. I’m sure the story is true and I’m sorry that the woman did not think to check with the orthopedic specialist about her new insurance policy, or did not understand possible limits of her Anthem policy. The article says she can’t find an orthopedic specialist – I believe that is a reflection of her real experience.</p>

<p>But I know an orthopedic center in San Francisco that will take her coverage. I know because I had an uninsured friend in San Francisco who was signing up for Anthem and specifically wanted treatment at that center, and I advised my friend to call the center first to verify that they would take his insurance before he signed up – and he was told unequivocally that the center would be accepting all Covered California policies. I went to the center’s web site and found that they stated that they accepted all insurances, including the Covered Cal plans. And I also verified that they were listed on the provider list.</p>

<p>Is that the best doctor or center available? I don’t know – but it is good enough for my friend :wink: – and it certainly would be a possibility for someone who appears to be in the position of calling around with no guidance. </p>

<p>I tend to be a problem-solver: that is, if a person comes to me to vent or gripe about something in their life, I am likely to start suggesting solutions. I’ve never really mastered the art of simply providing a sympathetic ear and a shoulder to cry on. That’s a mixed blessing, obviously – but probably is what led me to a career as a lawyer. I like to help people fix their problems…</p>

<p>Not being able to find a doctor is a solvable problem - especially for a woman who is willing to drive 6 hours to see a provider. I understand that it is frustrating for her – but the bottom line is that it’s a matter of calling around until a doctor is found and then making an appointment. By solvable, I mean that an ordinary person can take steps to find a solution.</p>

<p>Not being able to buy insurance at all because of a pre-existing condition or not being able to pay premiums was a problem that was not solvable in that sense. Before 2014, the insurance companies had a right to turn away the man who was deaf – and there was nothing to do about it. Before 2014, the man probably would not have qualified for Medi-Cal. Those are the types of problems that can only be solved by legislation – and so that’s what happened.</p>

<p>I don’t doubt that it is frustrating when a person can’t find a doctor, or has to wait for an appointment, or learns that their old doctor won’t take their new insurance. I may be in that situation myself – unfortunately my own doctor seems to have a totally clueless billing person, so it will probably take a while to sort that out. But there is a difference between short-term frustration and an absolute roadblock.</p>

<p>The woman with the bad shoulder had no insurance for 5 years - so no treatment, no possibility of treatment. Now she has insurance, but still some frustrations in finding a doctor. That is a problem that can and will be solved. It might take weeks or even months to get it all straightened out, but it will be solved. Without ACA she’d be back in no-solution territory, with a bad shoulder and no prospects for insurance, other than finding a job with employer-provided coverage, or marrying someone with employer-provided coverage. </p>

11519

<p>I’d call my Congressperson. They have people dedicated to constituent service, to handling issues with government programs. Some Republican members of Congress are not helping people with issues with the ACA, but others are, on the basis that if there is a program, their constituents who are entitled to benefit from it should benefit from it.</p>

11520

<p>Or NILC, in Texas, the immigration law center, which I think was one of the links that said a work visa was good. I don’t know enough about the various “I” level documents.</p>

<p>Or is this a case where is has to be done on paper?</p>