<p>Yes, I think they will take it more seriously this year.</p>
<h1>15656</h1>
<p><a href=“http://www.mgma.com/government-affairs/issues-overview/aca/aca-exchange-implementation-report/aca-surveyreport_online_2?ext=.pdf”>http://www.mgma.com/government-affairs/issues-overview/aca/aca-exchange-implementation-report/aca-surveyreport_online_2?ext=.pdf</a></p>
<p>23.5% are not taking ACA policies which works out to roughly 200,000 physicians.</p>
<p>The answer to question #1 is also instructive on what physicians think of ACA vis-a-vis their practice.</p>
<p>59.4% think it will have an unfavorable or very unfavorable effect.</p>
<p>Interesting link. ACA doesn’t really have a big impact on doctors, does it?</p>
<p>76.5% take ACA plans. TatinG, you are a glass half empty kind of person? Or 1/4 glass empty type person?</p>
<p>I look at questions and answers to 8 and 9.</p>
<p>Let’s be real. ACA does not have a big impact on doctor’s but it does have a large impact on lowering the amount of the uninsured and ACA does provide affordable costs to millions of Americans.</p>
<p>There are 150 million people on employer based health care, 50 million people on medicare, 70 million people on medicaid and 20 million with individual insurance. </p>
<p>You can double check my numbers. </p>
<p>So, the replies to 8 and 9 make sense. ACA is not making a large impact on doctors.</p>
<p>My family has experienced plenty of problems with ACA. I know the network issue is being worked on right now. It will take time.</p>
<p>Where I live, some of the doctors I talk to dont like the reimbursements they receive from Anthem so they aren’t taking ACA plans from Anthem. They won’t in 2015 either. They do take plans from Blue Shield and other companies.</p>
<p>However, I have heard Blue Shield has plenty of problems. Blue Shield is being sued.</p>
<p>I was told there are going to be changes in market share among the insurance companies in Cal in 2015. </p>
<p>There was a study on how many people change plans based on medicare and it wasn’t many so we will see.</p>
<p>Interesting survey, TatinG, but it doesn’t say what you said it says.</p>
<p>It’s a survey of medical practices that are members of MMGA, which is evidently a organization of medical practices. They did not survey doctors. They surveyed medical practices.</p>
<p>So even if we believe that the practices in the group are representative of all practices, the percentages given don’t translate to doctors.</p>
<p>That is, suppose 23.5% of all PRACTICES don’t take ACA exchange policies. How does that translate to numbers of doctors? We have no idea. Maybe solo practices are less likely to take ACA policies, but big practices do: then almost all individual doctors would be taking ACA exchange policies. Maybe solo practices take ACA policies, but big practices are less likely: then it could be that 50% of individual doctors, or even more, are not seeing patients with ACA exchange coverage. We don’t know.</p>
<p>You should read your links before you post them, lest you inadvertently misrepresent what they say. Always click the link!</p>
<p>Those numbers match up with what covered cal is seeing for 2015. The story was in the LA Times. </p>
<p>The numbers mentioned for 2015 are slightly hired than this survey. I think it is. 80 percent signing up.</p>
<p>I dont give a … If it is doctors or practices because the ACA population is relatively small and the impact on doctors is small.</p>
<p>Pick it apart if you want but here’s another survey with similar results.</p>
<p><a href=“http://www.physiciansfoundation.org/uploads/default/2014_Physicians_Foundation_Biennial_Physician_Survey_Report.pdf”>http://www.physiciansfoundation.org/uploads/default/2014_Physicians_Foundation_Biennial_Physician_Survey_Report.pdf</a></p>
<p>A survey of 20,000 doctors.<br>
46% give ACA a D or F grade.
25% give it an A or B. </p>
<p>28% say they don’t take ACA. 33% say they do. 28.8% are unsure.</p>
<p>Most alarming, given the shortage of doctors: 39% plan to accelerate their retirement plans due to the changes in the healthcare system.</p>
<p>Aren’t there supposed to be a whole mess of doctors retiring because of ACA, too? I know all my friend’s with doctor husband’s are still practicing. The only retiree in my group has been a dentist and he sold his practice for a very tidy sum. </p>
<p>You give me a link and completely misrepresent what it says, and accuse ME of picking it apart? If you don’t want me to criticize your links, summarize them correctly instead of saying what you think must be true but which has no relation to your link. I know that corporations are people nowadays, but a medical practice is not a doctor. </p>
<p>Dstark, here’s what I found the LA Times saying about how many doctors are participating in exchange plans in California:</p>
<p>
</p>
<p>Nearly 90% versus about three quarters. That’s a big difference, though the LA Times is reporting about doctors in California, whereas the surveys were nationwide.</p>
<p>We shouldn’t take seriously what doctors say about retiring in response to the ACA. That’s not a criticism of doctors, it’s just that self-reports of that sort by anyone, not just doctors, turn out not to be accurate. If we want to know how many doctors are retiring early, we should just look at the numbers of doctors retiring early rather than listen to gripes.</p>
<p>‘Practices not taking ACA’ seems just as likely to mean the percentage of doctors not taking exchange plans is even higher. Just an opinion but what we’d like to believe, absent data, doesn’t really enter in to it. The narrow network problem backs up a poor participation rate, as does reports of practices spending a lot of time trying to determine whether a patient has an exchange plan or traditional coverage. That they’re reporting spending a lot time trying to do so, suggests something that can’t be good.</p>
<p>If a 75% participation rate is being dismissed as a glass 3/4’s full, we’ve pretty much admitted the whole thing was an expensive waste of time for all but a few. Got pre-existing conditions covered and we can now declare victory for our side and put our feet up on the couch.</p>
<p>I agree, catahoula: the link about medical practices doesn’t tell us anything about the number of individual doctors taking ACA exchange policies. So the link should not have been posted.</p>
<p>But I don’t see why a 75% participation is any kind of problem at all, except maybe for doctors. It’s a problem if there are not enough doctors, to be sure, and that has been happening in some cases. And inaccurate information about which doctors/hospitals are in which plans is a serious issue that needs to be remedied. But a 75% participation rate per se for 2014 doesn’t seem to me to be an issue. </p>
<p>Sure it does, Fang. Though imprecise in one respect, it’s not in others. That you found an aspect it doesn’t cover as well as you’d like, doesn’t really detract from it at all.</p>
<p>Besides doubting that the ACA is going to in anyway increase the population of doctors (which would be the desired response for a lack of access) I’ve got a question:</p>
<p>If the purpose of all this was to provide health care to a larger (almost complete) portion of the population, why wouldn’t we be extremely disappointed that the insurance provided wasn’t really insurance at all when attempts were made to use it? Seems a complete fail to me, notwithstanding the assurances that the same state that pressed for the cost savings narrow networks provide is being cheered on to punish those who provided them.</p>
<p>If anything fits the “take pity on me… murdering my parents has made me an orphan” meme, this seems to be it.</p>
<p>Clearly there are doctors/practices that don’t accept ACA policies. Nobody denies that. What else was the survey of the medical practices supposed to tell us? </p>
<p>
</p>
<p>The purpose of health insurance is to provide affordable health care to people, not to provide full employment for doctors. If a person’s health insurance allows them to see doctors to treat their health needs, it’s immaterial that there are other doctors out there that the person can’t see. </p>
<p>There is nothing whatsoever wrong with narrow networks per se, which is why Kaiser gets high reviews from patients. The problem arises when the networks are so narrow that there are not enough doctors, or not the right kind of doctors, to treat the subscribers to health plans. And that is mostly not happening. Most people with new health insurance are finding that they can go to the doctor and get health care. </p>
<p>Your continued efforts to claim that Obamacare is a failure are getting more and more ridiculous. By and large, it’s working, and it’s not going to go away.</p>
<p>Full employment for doctors wouldn’t seem to be anywhere close to the problem, given they’re declining the exchange plans. And health insurance that won’t get you treatment you can afford isn’t at all what was promised and is yet being payed for in several ways by the rest of us. </p>
<p>
Those two qualifiers are what I was talking about when I mentioned that 3/4 full glass, Fang. ‘mostly’ doesn’t seem to me to be the answer to ‘some weren’t insured’ - who, as I recall, were the reason for all this to begin with.</p>
<p>A failure? Lots of things that work badly aren’t considered failures (at least not enough they can’t be endured) but I think there’s miles to go before we can say that about ACA. Mid-November’s sign-up will be yet just one more metric to judge it by!</p>
<p>Let’s see what we can agree on. </p>
<p>People being unable to find out which doctors/hospitals are included in a particular health plan: BAD</p>
<p>Health plans offering no reasonably local doctors to treat certain conditions: BAD</p>
<p>High deductibles: sometimes a problem, sometimes a good thing</p>
<p>Facing a catastrophic health problem that would cost tens or hundreds of thousands of dollars, and having a deductible of $6000: way better than no insurance at all</p>
<p>Having insurance, but not using the insurance because you think you can’t afford the deductible: BAD</p>
<p>Agreed?</p>
<p>I think what we’d have to agree on would be the collective cost/benefit of all of them together, spread out over the entire population. Six people who met that catastrophic health problem thing really don’t outweigh the costs of all the rest.</p>
<p>Much chance of that?</p>
<p>Sorry, I wasn’t trying to trick you. I meant, you’d agree that for the particular individual who was facing the catastrophic health condition, it would be better to have to pay a large deductible than to have to pay the entire tens or hundreds of thousands of dollars. Right? </p>
<p>I was trying to list things that you would clearly agree with.</p>
<p>I went out for dinner with the owner of a group benefits brokerage last week who shared an interesting perspective, at least considering the source.</p>
<p>She actually thinks in the long run expanding base public health benefits gradually from both ends of the age spectrum would make more sense. So extending Medicaid to include everyone under 25, then 30 etc. to equalize the pool costs…then dropping the Medicare age accordingly until the base system offers coverage for everyone, including company employees. Leave the pharma, supplemental, etc. for the private market.</p>
<p>I pointed out that this would put her out of business. She said it would change her business for sure, but would create a more sensible system and put the group focus on competitive supplemental benefits and wellness programs. She felt it would level the playing field domestically for businesses and reduce the multinational control/influence on the economy.</p>
<p>Of course, what’s interesting to me is that this notion that I like came from a broker ;)</p>
<p>I agree with that concept.</p>
<p>Update on my hospital billing rigamarole. Got a printout of bill for $9.45 from the hospital last week and popped it in the mail on Tuesday thinking good thoughts that everything was straightened out. But alas, not so. Today I get another Notice of Debt Collection from a different law firm for owing $6.30! </p>
<p>Back to the phone and I call the hospital business office who again knows nothing and has not heard anything about a computer glitch. So, I ask them to just put me through to customer service. On hold again for about a half hour and when I finally get through I explain all over again and the women seems clueless but says hold on. She finally comes back after 10 mins or so and says yes, there has been a computer glitch and her supervisor has zeroed out both the $9.45 and the $6.30 balance and I owe nothing now. </p>
<p>I don’t even care about the balance being zeroed out - I am more concerned about my credit getting dinged so I ask to speak with the supervisor. She gives me supervisor’s private number and as soon as I hang up, I call. Got her voice mail and ask for a call back. </p>
<p>She was very prompt, apologized profusely and will also refund the $9.45 I put in the mail to hospital on Tuesday. She said the hospital is now zeroing out all the balances of people effected by the glitch. She told me they really don’t care about these small potatoes balances especially since it is the hospital’s fault - it’s the big balances owed they really care about. She also is contacting both the laws firms and will ask them to issue me a letter stating that collection notice was sent because of an error on the hospitals part and my credit will not be dinged. She also said she will inform the billing office so they can direct customers to her office immediately. </p>
<p>I think between just these two instances I have spent a good two hours on the phone trying to rectify the situation for bills totaling $16. I assume most people would just follow the instructions on the debt collection letter but for me it’s the principle of the matter. </p>