<p>Yeah, LTC is less risky. I don’t have unlimited benefits or anywhere near the $6 million I had with Blue Shield before Obamacare. </p>
<p>“Auditors identified 1,164 cases where recipients continued to receive a total of $2.39 million in benefits from six to 27 months after they were reported to be deceased. In a majority of sampled cases, store purchases and ATM transactions were made after the recipients’ dates of death, suggesting that unauthorized persons were using public benefits. In addition, the audit says that DTA paid at least $368,000 benefits to 178 guardians who were claiming deceased persons as dependents and $164,000 to 40 individuals being claimed by more than one guardian.” </p>
<p>And that’s only what they found. Imagine what they didn’t find. LOL</p>
<p>Ah, that’s better. :-)</p>
<p>“Their move had nothing to do with ACA or anything else other than a business decision to consolidate - and pocket $40MTexan taxpayer dollars.”</p>
<p>A business decision to relocate has everything to do with the business climate in the state. That includes taxes.</p>
<p>“A business decision to relocate has everything to do with the business climate in the state. That includes taxes.”</p>
<p>Didn’t read the article, did you? That doesn’t seem to be the reason Toyota has decided to move and it definitely has nothing to do with ACA. </p>
<p>"Toyota Motor Corp. plans to move large numbers of jobs from its sales and marketing headquarters in Torrance to suburban Dallas, according to a person familiar with the automaker’s plans.</p>
<p>The move, creating a new North American headquarters, would put management of Toyota’s U.S. business close to where it builds most cars for this market.</p>
<p>…about 75% of the Toyota branded vehicles sold in the U.S. are built in America — many of them at plants in Texas, Mississippi and Kentucky."</p>
<p><a href=“Toyota to move 3,000 jobs from Southern California to Texas”>Toyota to move 3,000 jobs from Southern California to Texas; </p>
<p>Also, according to this article, when all their cars were made in Japan and imported it was important for Toyota to be near the Port of LA - but that is no longer the case as most cars sold here are made here. </p>
<p>But it bodes well for the rest of Texas to become Austinized as people from CA move there - so I see it as a win/win. </p>
<p>“so I see it as a win/win.”</p>
<p>Good riddance to them. Any business unhappy in Ca, get out immediately, although don’t forget to visit and spend your money in our tourist destinations. </p>
<p>
Like little self-replicating bots from the doomed mother ship. </p>
<p>You might have meant something else entirely but that’s the image it paints for me. Anyway, when’s California going get proactive and build a fence?</p>
<p>“Not a chance.”</p>
<p>So GP, what do you plan to do about it - instead of just whining on this thread?</p>
<p>Deleted duplicate post. </p>
<p>“So GP, what do you plan to do about it - instead of just whining on this thread?”</p>
<p>Emily, the same thing you would do if Obamacare was repealed.</p>
<p>“Emily, the same thing you would do if Obamacare was repealed.”</p>
<p>And that would be? </p>
<p>^wait GP, you’d move to Canada?
:)</p>
<p>I’m passing this on as a PSA. I’ve not googled, chromed, or safaried it’s legitimacy. As per conversation with benefits/billing administrator at local hospital…hospitals, by federal regulation are not allowed to have doctors as employees. Her guess is the original intent was to prevent monopolies. Hospitals contract with docs and pretty much all docs local to a hospital will have facility priviledges. So, a hospital facility can be in network, but the doc seeing you may not be. The onus…in the past and going forward…will remain on the patient to figure it out.</p>
<p>The exception to the above are teaching hospitals. They can have Docs on the payroll. From this, a logical person might assume that all docs within an in network teaching hospital would therefore also be in network. However, since we are talking health insurance, logic may be of little value.</p>
<p>This might be an explanation to another question I’ve had…how can a Kaiser doc also show up as running an independent clinic. I guess Kaiser contracts all their docs but have by default made them in-network. And these docs - given the time and inclination - can have other jobs on the side :).</p>
<p>YMMV… </p>
<p>As far as I can tell, hospitals can buy entire practices of doctors, and lately they have been doing so at an increasing level:</p>
<p><a href=“Doctors Who Work for Hospitals Face a New Bottom Line - The New York Times”>http://www.nytimes.com/2012/12/01/business/a-hospital-war-reflects-a-tightening-bind-for-doctors-nationwide.html</a>
<a href=“Hospitals Are Going On A Doctor Buying Binge, And It Is Likely To End Badly”>http://www.forbes.com/sites/scottgottlieb/2013/03/15/hospitals-are-going-on-a-doctor-buying-binge-and-it-is-likely-to-end-badly/</a>
<a href=“http://www.deltahealthcare.com/pdf/Why-Hospitals-Buy.pdf”>http://www.deltahealthcare.com/pdf/Why-Hospitals-Buy.pdf</a></p>
<p>When the hospital buys the practice, as far as I can tell, the doctors become salaried employees of the hospital.</p>
<p>At my hospital, they are contractors, at least in the ED. The hospitalists upstairs, I get the impression they’re employees, but I’m not sure about that.</p>
<p>Why not extend Medicaid/Medicare to everyone? Set the premium and then offer either with or without a premium? People can choose private insurance instead or as a supplement.</p>
<p>Any prohibition about hiring docs had been based on state law. (I think we often forget states can add to federal requirements, usually as long as it doesn’t somehow corrupt the intent of fed laws.)</p>
<p>So, a hospital facility can be in network, but the doc seeing you may not be. This needs to be clarified with the insurer. I was told that if the facility is covered and some misc doc performs some service, he or she is considered in network. My specific question, though, was if an additional doc or lab performs something without some foresight on my part. Whatever it is, just ask the people who would be paying via your policy. </p>
<p>Momfromme, remember there was a terrible hubbub from some powerful media that we were headed for socialism. </p>
<p>“Why not extend Medicaid/Medicare to everyone? Set the premium and then offer either with or without a premium? People can choose private insurance instead or as a supplement.”</p>
<p>Because it has to be paid for, somehow.</p>
<p>I have heard (no cites, sorry, I read it somewhere) of cases where the hospital was in-network but the hospitalist was not. </p>
<p>I notice that Colorado has the in-network law that I think should be enacted everywhere: “Here in Colorado, insurance carriers must treat Hospitalists [doctors whose practice is entirely in the hospital] as if they are in-network if the patient had no choice of physician. This means that your claim must be treated as if we had a contract with your carrier because you had no choice at the time the treatment was rendered.” (Except I think this should be on the hospital, not the insurance company. But at least it’s not on the patient in Colorado.)
<a href=“http://inpatientmedicineservice.com/faq.html”>http://inpatientmedicineservice.com/faq.html</a></p>
<p>I think it was dietz who raised that concern.<br>
From Aetna, as an example-
*Sometimes, you don’t have a choice about where you go for care. Like if you go to the emergency room for a heart attack. When you need emergency care, some of our plans pay the bill as if you got care in network. For those plans, you pay cost sharing and deductibles based on your in-network level of benefits. You do not have to pay anything else. Other plans pay the bill differently. Under those plans, you may be responsible for more than your in-network cost sharing. The additional amounts could be very large.</p>
<p>To find out how emergency services are covered under your plan, look at your health plan document called “Certificate of Coverage” or “Summary Plan Description.” Or contact us…*</p>