H1B visas to foreign doctors willing to take Medi-Cal patients?
H1B visas to foreign doctors willing to practice here in necessary specialties.
That’s an interesting idea. Do you envision it being a separate system of providers and clinics for Medical patients only? The issue at hand is the low reimbursement rates so maybe H1B providers would need to get additional subsidies but those, of course, need to come from somewhere. Or there could be a reduction in required malpractice/business insurance.
Whether the doctor is foreign trained or not, the costs of paying staff, rent, costs of medications (for which Medicaid doesn’t fully pay), cost of equipment and supplies etc. will be the same.
As I understand there is now a lawsuit working its way through the courts. The plaintiffs are doctors suing the state for the low reimbursements for Medicaid payments.
We pay our doctors a lot more than other countries pay their doctors for the same doctoring. If we had more doctors, the cost of doctoring would go down.
In previous iterations of healthcare discussion, there was a poster - can’t recall his name at the moment - that was of the opinion that medical costs wouldn’t fall until we ‘ruthlessly crushed’ the salaries of everyone in the healthcare profession. He’d likely be clapping his hands at a plan to import indentured workers.
US doctors are handsomely paid but I think there’s a surcharge included for US lawyers.
There are many reasons why we are paying more
-High medical school costs. In many countries, the medical degree is 6 years, combined with a bachelors’ degree.
Other countries provide free (Germany and Britain etc) or low cost medical education.
-Malpractice costs. Our politicians are dominated by lawyers, unless we have tort reform,the overhead costs will not be lower.
-Administrative costs of running our health care system are astronomical. About one quarter of health care cost is associated with administration, which is far higher than in any other country.
-Patients demand expensive treatments.A person has a heart attack in the United States, they’re much more likely to get open heart surgery than they are in most other countries. High−cost diagnostic procedures such as CT scans and MRIs also are used far more frequently in the U.S. And the more the patient’s care is paid for by insurance, the less incentive the patient has to restrain demand.
In addition, we just have a more unhealthy population because US tops the list of 10 most obese countries.
Actually that is wrong both in detail-- the US is no longer the most obese country, it’s Mexico now-- and in fact. We’re fatter than many countries, but we don’t smoke as much.
And while demanding expensive treatments is a problem, it’s also a problem that we pay a whole lot more for the same treatment. It costs more in the US to have a baby, more for a hip replacement, and so on.
Dietz – was the chocolate cake good?
I’m hoping that the site-neutral payment by Medicare becomes a reality and migrates into private insurance. As expected, hospitals are trying to fight it: http://www.fiercehealthfinance.com/story/providers-protest-against-site-neutral-payment-proposal/2015-02-09
I’d like to see PCPs reimbursement substantially upped, and specialist reimbursement - especially for surgical procedures and interventional medicine – substantially decreased. That would fix a lot of problems.
^^You do know that specialists require several more years of training than primary care providers, don’t you? If the compensation went down, then there is less incentive for the best and the brightest to work several more years to develop the skills needed to eg. remove brain tumors or reattach hands or keep preemies alive.
So the latest screw up is erroneous 1095 A forms sent to an estimated 800k people. We missed a call from healthcare.gov a couple of days ago and they left a voicemail message. It was so garbled and heavily accented it was very difficult to understand. I listened to the message at least 5 times and couldn’t get much more than “additional information” and they left the 800 number to call healthcare.gov. When my wife called the 800 number the wait time was very long so she hung up. We thought maybe it was an additional attempt to get income verification information, which we mailed in a week ago, so we were just going to wait and see. Now I am thinking it was about the erroneous 1095 A forms, and we will wait until early March to see if we get a revised form. I wasn’t going to file my tax return before then anyway. The most disappointing part of all this was the garbled voicemail we received. When I googled the phone number that caller ID picked up from the call many people that were called from that same number thought it was a scam. Not surprising when you get a garbled message from someone with a heavy accent, allegedly from healthcare.gov probably phishing for your personal information.
Who knows, the call might have been a scam. When the Anthem data breach happened, phishers were quick to pounce on it. That’s what they do, pick up on something that’s affecting a lot of people and start firing off emails and phones calls.
I started a thread about my friends situation, but though the posters here might know the most. A 22 yr old is 11 weeks pregnant. Went to dr. at 6 and 10 weeks. Was just told by the dr (who managed to stick in 2 ultrasounds at who knows what price) that her mothers insurance does not cover dependants for maternity. Pregnancy is not a qualifying event to get ACA or employer ins. She just missed the ACA deadline. On most sites it says she can not buy insurance at this time due to the deadline.
Is it true that a person can’t just call an insurer and buy coverage in any month of the year? She is not eligible for a subsidy, and even if she were, no subsidy is better than no coverage. She has a full time job, but they won’t let her sign up due to no qualifying event. She was told she could get on her company’s plan through Cobra, but it would be $$$. Her mom would drop her from her plan, but apparently that wouldn’t count, plus she has siblings on it so,I don’t know if she could be dropped (part of “family” coverage i assume). Please help, she’s not looking for free, but i don’t know if anybody will let her sign up! (Not Medicaid eligible either…decent job)
I feel,so bad for her, works hard, has insurance (she thinks), makes one mistake and it will cost her $$$ because nobody publicized the maternity coverage gap for dependants. When you cover girls up to 26 I’m sure plenty will,get pregnant…surprise! Now they’re going to be poor too.
Why would she need COBRA to get on her company’s plan?
Her doctor’s office really screwed up here in not telling her that she was uninsured in time for her to buy insurance.
@Patsam , ugh. She’s in a tight spot. At this point, she may only have two options: One, quit her job so she’d qualify for Medicaid (which takes enrollment all year round). She could take a low-paying job for the duration. It may be that 9 months of low income is better than 9 months of medical bills. Or two, take the Cobra. (Although I’m also confused – I thought Cobra was only for former employees.)
But first, I think they should double-check that “no maternity coverage for dependents” business. I’m not an expert, but that doesn’t sound ACA compliant to me. In fact, that was one of the big deals about ACA – forcing all plans to include maternity for all members, or so I thought. @Cardinal Fang and @calmom?
Sorry, Fang, I couldn’t get your “@” name right. I trust you’ll see this anyway. 
Nobody can get my @name. I don’t know how to do it myself.
After some Googling, I think that large employers can offer dependent coverage that doesn’t include maternity. No, it makes no sense to me either.
Patsam, it’s confusing to follow your “her” and “she,” when you mean the mom versus daughter. Who’s working, who isn’t?
If the daughter doesn’t qualify for subsidies, why can’t she go straight to an insurance company?
Hmm. I found this: [ObamaCare Extra Enrollment 2015 March 15 – April 30](ObamaCare Extra Enrollment 2015 March 15 - April 30)
So would Patsam’s friend qualify if her mom drops her effective 3/1?
LM, I’m looking. But I did see this-
"Maternity care and childbirth — services provided before and after your child is born — are essential health benefits. This means all qualified health plans inside and outside the Marketplace must cover them.
You get this coverage even if you were pregnant before your coverage starts. Under the health care law pre-existing conditions are covered, including pregnancy
You get this coverage even if you were pregnant before your coverage starts. Under the health care law pre-existing conditions are covered, including pregnancy"
^but this would apply if the D were getting her own plan. So she could go straight to an insurer and have everything henceforth covered.
I think the other question is does she qualify for a “Special Enrollment Period” SEP in the marketplace? And your question, can the mom just drop her? Or is losing insurance meant to be something other than a mom dropping a kid? I’m looking.
It looks like that Special Open Enrollment may only be for people who had to pay the penalty for 2014. They’re saying it was specifically set up because so many people were confused about the penalty. Presumably they’re doing their taxes now and are just discovered that they owe it, and now want to avoid most of it for 2015. I’m assuming that Patsam’s friend didn’t pay the penalty since she was enrolled through an employer plan.