I am keeping an eye on it as it is being unfolded. I would like to think there will be improvements in terms of having the ability to buy into policies as part of a industry related group. Our premiums have soared with coverage being slashed. There are not a lot of choices for small business owners. Our business partner is on his wife’s plan through her employer . Pays a fraction of what we pay with much, much better coverage and low deductible
Not specific to ACA or AHCA, but other developments may actually worsen the shortage of physicians, particularly in underserved areas like the Rust Belt and Appalachia and less popular specialties like pediatrics and psychiatry.
@ucbalumnus, I saw something about this on the TV news. Very disturbing.
Perhaps US medical school graduates with $300,000 in student loan debt from medical school may not be financially able to practice in underserved areas or lower paid specialties even if they wanted to, hence the greater tendency for physicians in those areas to be immigrants who may have gone through medical school without such a debt burden.
If you look at the bogleheads.org website, so many of the MDs are planning how soon they can retire or at least cut back their hours to have a better work/life balance. That’s also very disturbing, as is the huge imbalance in salaries–some $400,000-800,000/year vs under $200,000 in other places with different specialties/non-specialists. It’s very scary and no one that I know is immune–docs retire, move, etc., and they may not have anyone to take their place who will accept whatever coverage you may have.
“I had to wait 4 months to see a pulmonologist in my state, even though I live in a large city and my allergist begged for me to get an appointment as soon as possible.”
All this shortage has little to do with ACA IMO. I had a very serious issue which required a referral to a pulmonologist back in 2010. I was told at first that the earliest I could be seen was 4 months out. It took some wheeling and dealing by my PCP to get me seen in 3 weeks instead. Had it turned out to be cancer, those 3 weeks would have been precious time and in 4 months I probably would have been dead.
These problems of shortages, as well as many other issues with the American healthcare system were not caused by ACA and will not be cured by the proposed GOP plan, IMO.
@doschicos "These problems of shortages, as well as many other issues with the American healthcare system were not caused by ACA and will not be cured by the proposed GOP plan, IMO. "
You statement is just not true, since more and more doctors and hospitals are dropping ObamaCare …that is a main reason today many can’t get in to see a specialist. I had to change my PCP 6 times in the last 5 years, because each year more and more doctors don’t take it. One insurance company even existed my state in the middle of the year!
At work we have only 3 choices. All the same company, just 3 levels of deductibles. Almost no reimbursement for out of network. 6 weeks to 3 months for certain types of appointments. Not ACA. So keep expectations low!
H wants to retire in 5-ish years, but I don’t know how we would afford insurance if I’m in a high-risk pool. Maybe I would just have to continue adjuncting until I could go on Medicare.
No, I was not saying that the MD shortages were caused by any particular program that is currently in place or anything that has been proposed. Someone upthread was mentioning provider shortages and I chimed in, agreeing that this is a HUGE crisis locally and nationally. I would like our leadership locally and nationally to address this but will not wade into politics, since this is NOT the venue to have it addressed.
I had to wait 6 months to see a GI. In the meantime, my pulmonologist in Colorado had the needed procedures done and we were able to cancel the GI appointment!
Here’s an article discussing the shortage:
The article does NOT include Hawaii or Alaska, which I suspect have more acute shortages.
Here’s an article specifically about HI medical shortages:
http://www.hawaii.edu/news/2015/01/20/hawaii-physician-retirements-could-worsen-doctor-shortage/
@gmfreedom The experiences that @HImom and I are both sharing were with insurance that was NOT from the exchange. Mine predates ACA completely. There is a shortage for specialists in many areas. THAT is not ACA related.
Are you on the exchange now and if so, what did you have for insurance before ACA?
@doschicos There is no shortage of specialists in my area, but almost all of them don’t take any insurance from the exchanges (that includes many specialty hospitals). ObamaCare changed the law in many way…for example it was ObamaCare legislation that disallowed a person who was self employed to get an insurance under small business qualification…that impacted millions of people. ObamaCare is a complete disaster.
@gmfreedom You talk about changing your PCP provider. You didn’t answer my questions. Are you on the exchange? What were you on before? I’ll add another - have you shopped for care outside of the exchange?
The posters who can’t get into a specialist in a timely manner aren’t having that problem because their insurance won’t be accepted - it’s because those specialist are booked for months in advance.
I almost had to wait for 3 months for an appointment with a urogyno for an problem that was undiagnosed for two months already and for which I had constant acute pain. Fortunately, my regular gynecologist was able to get me in.
it is extremely common to have to wait weeks or months to see any specialist. Heck, my PCP is booked solid for 8-12 months if you need your yearly -so I make mine at the time of my appt for the next year. Of course if you are sick they usually can take you same day or the next - but usually only see the PA (not that there is anything wrong with that.)
I have NYS employee insurance and almost every doctor, practice and every hospital in the Cap District takes my insurance and we still have to wait to get into specialists.
@doschicos I did answer your question…self-employed people were able to get small business health insurance before ObamaCare in my state. ObamaCare destroyed that.
I think, if they really and truly want a nationwide plan that works, they need to enlarge the pool by not having any employer coverage at all. Make the premiums deductible for everyone and have the huge population of the country together in one pool so the numbers have a chance to work
@emilybee “The posters who can’t get into a specialist in a timely manner aren’t having that problem because their insurance won’t be accepted - it’s because those specialist are booked for months in advance.”
Again…that is just not true. I did went to see a specialist…I paid out of pocket. Speaking of NYS…Sloan Kettering Hospital for example (the best cancer hospital in the country) no longer takes any health insurance from the exchanges because none of the insurances on the exchanges were willing to sign a contract with them. Sloan Kettering is NOT an exception.
@gmfreedom, the posters said it had nothing to do with their insurance. Read their posts.
“I think, if they really and truly want a nationwide plan that works, they need to enlarge the pool by not having any employer coverage at all. Make the premiums deductible for everyone and have the huge population of the country together in one pool so the numbers have a chance to work.”
If corporations wanted to dump coverage they wouid have lobbied for ACA or any universal health insurance plan - but they did not.
It costs them less to give their employees health care (and for which they get a tax break) then what they would have to pay to attract the talent they want.
OH, cr@p. I wanted a cheaper plan that eliminated ‘benefits’ I don’t need. Looks like that is not in the bill. People want CHOICE! I want to choose what kind of a plan is right for me. And this bill doesn’t do it.
Does the bill increase the reimbursements to doctors and hospitals? That’s the only way to get more providers taking the plans. My local hospital takes no Covered California plans at all.