Tough road ahead for Obama care in states.

[trappincoyotes39]

New York doctors are treating ObamaCare like the plague, a new survey reveals.
A poll conducted by the New York State Medical Society finds that 44 percent of MDs said they are not participating in the nation’s new health-care plan.
Another 33 percent say they’re still not sure whether to become ObamaCare providers.
Only 23 percent of the 409 physicians queried said they’re taking patients who signed up through health exchanges.
“This is so poorly designed that a lot of doctors are afraid to participate,” said Dr. Sam Unterricht, president of the 29,000-member organization. “There’s a lot of resistance. Doctors don’t know what they’re going to get paid.”
Three out of four doctors who are participating in the program said they “had to participate” because of existing contractual obligations with an insurer or medical provider, not because they wanted to.
Only one in four “affirmatively” chose to sign up for the exchanges.
Nearly eight in 10 — 77 percent — said they had not been given a fee schedule to show much they’ll get paid if they sign up.
The survey invited doctors to anonymously share opinions about the new health care law, and many took time out of their busy days to vent.
“Obama Care wants to start right away, but who see all these new patients? Not me,” e-mailed one doc.
Another said, “I plan to retire if this disaster is implemented. This is a train wreck.”
“I refuse to participate in the exchange plans! I am completely opposed to this new law,” said a third respondent.
One doctor recycled the mantra used to attack addictions: “The solution is simple: Just say no.”
One physician was so disgusted, he threatened to taken only cash patients going forward.
“I am seriously considering opting out of all insurance plans including Medicare because of [ObamaCare].”
Some physicians said the pressure on insurance carriers to control costs is leading to rationed care.
“OBAMACARE is a disaster. I have already seen denial of medication, denial of referrals,” one doc said.
And they worry that stingy payments for medical services offered by insurers could put some doctors out of business and force others into retirement.
“Any doctor who accepts the exchange is just a bad businessman/woman. Pays terrible,” argued one doctor.
Said another MD, “Can’t imagine any doctors would be willing to work for so little money? All doctors should boycott.”
Doctors complained they’ve gotten the shaft for years even before ObamaCare.
“I get screwed from insurance companies already. I refuse to get screwed any longer,” one doctor said.
Others said they don’t have enough information to make an informed choice.
“This is a joke. We are flying blind,” said one doctor.

[trappincoyotes39]

SO how many more doctors in other states will do the same? What can the fed govt do about it? What will happen with care overall? Again this rushed legislation has more questions than answers it seems?

[PamIsMe]

"One physician was so disgusted, he threatened to taken only cash patients going forward"

Oh right, how many patients does he think he will be seeing then?

“OBAMACARE is a disaster. I have already seen denial of medication, denial of referrals,” one doc said.

It hasn't been implemented yet, so how is that possible?

"Doctors complained they’ve gotten the shaft for years even before ObamaCare."

lol Poor Babies. They signed deals with the health insurance companies for lower rates to patients with insurance and raised them for those who must pay cash. No one forced them. They did it to keep patients and assure they got paid.
If they can afford to retire because of the AHCA then they weren't doing all that badly financially.

Lots of scare tactics being used by the opposition, maybe it should just be given a chance, and 3 years from now when it is in full force voice their complaints about what IS and not what they think will be.

Pam

[trappincoyotes39]

Pam they are private business people and are stating what they worry about nd how to make a living. Also why the one docotor has said he will do is being
done in other states. There are doctors that are cash only and they survive. Some charge an up front fee to buy into their doctor group and then give people discounts on service. They don't need to see high numbers just have a good base of patients to make a living.

Here this is from AARP So it does happen and will the country see more of this in the years ahead?

AARP Home » Health » Health Insurance »The Doctor Will See Yo...
The Doctor Will See You but Not Your Insurance
Direct primary care physicians expect to be paid by you — directly
by Sid Kirchheimer, AARP, August 6, 2013

Health Law Answers


Ryan Neuhofel operates a pay-as-you-go family practice in Lawrence, Kan., giving his patients, like Bryan Welch, more personalized care. — Earl R. Richardson
En español l Fed up with waiting weeks for a medical appointment — and then getting only a few precious minutes with your doctor? The unnecessary tests and referrals to a specialist? Insurance hassles, red tape?


So are doctors. And a small but growing number are refusing to accept their patients' medical insurance. Instead, doctors are running their practices on a "membership" model that they claim allows them to spend more time with their patients and to provide better care.

It's called direct primary care, a less expensive offshoot of concierge medicine, which traditionally has been reserved for higher-income patients who pay thousands of dollars per year for longer appointments, better access and more personal care with their doctors. (But in addition to memberships, some concierge practitioners accept insurance; direct primary care doctors don't accept any insurance.)

So, is direct primary care right for you? Here are answers to some questions you may have:

Patients pay a monthly membership fee — typically $50 to $80. In exchange, they get a more generous allocation of appointments, sometimes for the same day or the day after they called. Appointments usually last longer than the average seven minutes per insurance-based visit. Doctors are often accessible via phone, email or Internet chat and some even make house calls.

At some practices, there are no additional copays. Routine tests and procedures are included. At others (usually charging a lower membership fee), certain services are provided at a significantly discounted rate, or a small fee may be charged if patients request more time with the doctor. Privately insured patients may seek reimbursement for such costs on their own.

Why is this happening?

Physicians and researchers cite three reasons — but all relate to one thing: insurance hassles.

Money: Under the traditional system, most medical practices need a large staff to ensure that they are reimbursed by health insurers. This results in higher overhead — which eats up to 60 percent of a typical practice's revenue — and forces doctors to see more patients in order to cover costs. At the same time, some insurance reimbursements to physicians have decreased in recent years. "Most estimates show that a medical practice spends 30 percent or more of its time and money just trying to collect payments from insurance companies," says Ryan Neuhofel, D.O. who operates a pay-as-you-go family medicine practice in Lawrence, Kan., consisting of himself and a nurse. (Both answer the phone.) "And when we're taking notes about patient visits or care, it's mostly about checking off boxes to satisfy insurance requirements."

Freedom: To get reimbursed, insurers may dictate how doctors must treat each patient based on their concern. "Sometimes, in order to get paid — and meet the insurance metrics model — all a doctor can do is order a test, refer the patient to a specialist or prescribe medication," says researcher Dave Chase. "Communication with patients is their most valuable tool, but they know that if they get into detailed discussions, it blows their productivity numbers."

Better care for patients: Without insurance mandates, doctors treat patients as they deem fit. The membership model provides a steady income, allowing doctors to see fewer patients each day — and therefore freeing the doctors to spend more time with each. Established direct primary care practices average 800 to 1,000 patients; a comparable insurance-dependent practice averages 2,500 to 4,000.

[trappincoyotes39]

Pam do you really believe in 3 years this will be a smooth running program that is the affordable care act? People will still see their primary care doctor and we will see no reduction in services offered? And prices will slow in annual increases on health care?

[mostinterestingmanintheworld]

Six people signed up for Obamacare the first day...........six?

This is a colossal bungle and it's going to kill people.

I've seen reports on my facebook page from friends that have had their insurance cancelled.

[thorsmightyhammer]

You have a face book page???

[thorsmightyhammer]

You have a face book page???

[PamIsMe]

"Patients pay a monthly membership fee — typically $50 to $80. In exchange, they get a more generous allocation of appointments, sometimes for the same day or the day after they called."

That may work as long as the Doctors limit the number of patients they will take a membership fee from, and they are all relatively healthy.
But what happens when they need hospitalization, surgery, chemo or radiation? Very few can afford to pay out of pocket for those kind of costs. And, if they
have only catastrophic care coverage, the Dr's monthly fee and insurance premium plus out of pocket expenses probably add up to the same or more thanthe premium for a good health insurance plan.
Sounds like a good deal for Docs and patient's getting the shaft as usual

"I've seen reports on my facebook page from friends that have had their insurance cancelled.


Well, it may be for the best. I've seen reports from people that state after their insurance company announced it was cancelling the coverage they had (because the insurance company didn't want to honor the provisions i.e. no upper limit on coverage, pre-existing conditions etc.) that when looking at exchanges found out they can get better coverage and lower deductibles, for the same or lower premiums than what they had. They won't know until they check it out.
People that haven't wanted to get themselves educated on the ACHA say and believe all kinds of things that aren't necessarily true.

"Pam do you really believe in 3 years this will be a smooth running program that is the affordable care act? "

Yes, I actually do. People resist change, it's human nature. With the Repub's right now putting out all kinds of distortions and outright lies that scare people, when it gets fully implemented things will settle down and people will relax.

I've never thought the ACHA was perfect, but it's a good start and no doubt will be tweaked as needed over the years. .

A couple articles a friend posted on MY Facebook page:

CHART: 'Winners And Losers From Obamacare'

talkingpointsmemo.com/livewire/chart-winners-and-losers-from-obamacare
Gruber summarized his stats: ninety-seven per cent of Americans are either left alone or are clear winners, while three per cent are "arguably" losers.

Another Obamacare horror story debunked

www.latimes.com/business/hiltzik/la-fi-mh-debunked-20131030,0,6010994.story#axzz2jPbvn5sD

Pam

[trappincoyotes39]

Pam where we disagree is the fact that those people paying for doctors care on a monthly fee will get better care the numbers have shown that. Either way they still need a referral for anything major.

Plenty of people won't find the cost and deductible the same as well Pam. Not everyone is going to win under Obama care and to think that our services will stay the same? I will say I don't see that happening we will get eroded care because of the Obama plan and it will put more business and govt entities on a tighter budget in the future.

While I don't think it is all bad , remember private insurance is still calling the shots on coverage and increased cost to come. I will know what happens to my insurance In January and from what we are hearing it sounds like we should see a major increase in cost or our premium plan going away all together. So I will pay more for my insurance and a part of that will come from enactment of affordable care.

private insurance still has to make money or they will go out of business, no different than doctors and their staff.

I guess we won't know for awhile but it will be awhile before a good portion can even sign up for such care.

[PamIsMe]

"private insurance still has to make money..."

They will have millions more people paying monthly premiums, that should make them some money. Also should make hospitals and clinics more money since they won't have people with no money at all walking in using valuable emergency services and won't have to have people on the payroll for debt collecting.
I haven't seen any articles where the insurance companies are raving mad about Obamacare. Most of them just quietly went about preparing for the exchanges, and a number expanding into states where they weren't present before.

People have until March 15th to sign up, and until 2015 to prove they have insurance. It's not like they all had to do it in one day.

Health insurances rates have been going up almost every year for the past decade. Undoubedly some might becuase of the new provisions in the ACHA, but some will use it as an excuse for raising rates just like they have been anyway.

Insurance; life, health, auto, home owners, etc. has always been my pet peeve. They have most of us over a barrel,we need it "just in case".
Essentially they are betting that more than 50% of their insureds will not have any major claims, and never collect on it. And, if they weren't right, they wouldn't be in business.


Cheers,
Pam

[trappincoyotes39]

Pam NO debt collectors ? LOL You think this is all 100 percent bought and paid for care. Plenty of people will still have to pay thousands of dollars and not ALL will pay that off and what is the recourse? Sorry they still will need debt collection services.

[PamIsMe]

Ok TC, you win that point. No doubt lots of people will choose minimal coverage with high deductibles, which will still leave them will bills some of them can't pay.

But I do think it will take the strain off emergency rooms when people can go to a doctor's office for preventative care and not have to wait until they are deathly ill to show up at an ER. And it will save lives when people have coverage for follow up care.

Now what has to be done is figure out how to get more into General Practice and advanced Nursing and PA programs wtihout them being in debt for years.

Pam

[trappincoyotes39]

Pam do you know how many people already on the fed dole use an ER like an urgent care office?

Some that can't pay? There will be a large number of people being moved off of a premium coverage to far more modest coverage because of the rising cost of premiums in the future, you will have more blue collar people trying to make a living with a plan that will be unable to make payments due to our economy which by the way doesn't look to get better for some time.

[Schrader]

Pam,

The data that you used here is awful one sided...
talkingpointsmemo.com/livewire/chart-winners-and-losers-from-obamacare
Gruber summarized his stats: ninety-seven per cent of Americans are either left alone or are clear winners, while three per cent are "arguably" losers.

Those estimates were from a man named John Gruber...if you go back a few articles it states that he is an MIT economist and that he was an architect of both Romney and Obama's health care plan.

I find it rather biased to use an estimate from someone who structured and stands to gain from the ACA...he came up with it of course he will put out estimates like that!

[PamIsMe]

"I find it rather biased to use an estimate from someone who structured and stands to gain from the ACA...he came up with it of course he will put out estimates like that!"

I'd trust an estimate from an actual architect of the plan more than I would opinions and speculation from ones who voted 45 times to repeal the ACHA and their followers. They hate it IMHO because President Obama got it passed, and that's the only reason right now since it isn't fully implemented. A couple years from now, we'll see.

Cheers,
Pam

[Schrader]

His ESTIMATES are nothing more than his opinion and speculation. If he said anything else he would be saying that he messed up, that the system is flawed, that it won't work. He has to toe the line.

The second link you posted has been removed, so I couldn't check to see if it was also one-sided...

[Schrader]

Double tap.

[PamIsMe]

"His ESTIMATES are nothing more than his opinion and speculation."

And so is anyone else's! but at least his is an educated opinion.


As for the second link: Another Obamacare horror story debunked, it's written by a Reporter:


By Michael Hiltzik
October 30, 2013, 3:26 p.m.



Deborah Cavallaro is a hard-working real estate agent in the Westchester suburb of Los Angeles who has been featured prominently on a round of news shows lately, talking about how badly Obamacare is going to cost her when her existing plan gets canceled and she has to find a replacement.


She says she's angry at President Obama for having promised that people who like their health plans could keep them, when hers is getting canceled for not meeting Obamacare's standards.

"Please explain to me," she told Maria Bartiromo on CNBC Wednesday, "how my plan is a 'substandard' plan when ... I'd be paying more for the exchange plans than I am currently paying by a wide margin."

Bartiromo didn't take her up on her request. So I will.

SEE ALSO: Why men should pay for pregnancy coverage

The bottom line is that Cavallaro's assertion that "there's nothing affordable about the Affordable Care Act," as she put it Tuesday on NBC Channel 4, is the product of her own misunderstandings, abetted by a passel of uninformed and incurious news reporters.

I talked with Cavallaro, 60, after her CNBC appearance. Let's walk through what she told me.

Her current plan, from Anthem Blue Cross, is a catastrophic coverage plan for which she pays $293 a month as an individual policyholder. It requires her to pay a deductible of $5,000 a year and limits her out-of-pocket costs to $8,500 a year. Her plan also limits her to two doctor visits a year, for which she shoulders a copay of $40 each. After that, she pays the whole cost of subsequent visits.

This fits the very definition of a nonconforming plan under Obamacare. The deductible and out-of-pocket maximums are too high, the provisions for doctor visits too skimpy.

As for a replacement plan, she says she was quoted $478 a month by her insurance broker, but that's a lot more than she'll really be paying. Cavallaro told me she hasn't checked the website of Covered California, the state's health plan exchange, herself. I did so while we talked.

Here's what I found. I won't divulge her current income, which is personal, but this year it qualifies her for a hefty federal premium subsidy.

At her age, she's eligible for a good "silver" plan for $333 a month after the subsidy -- $40 a month more than she's paying now. But the plan is much better than her current plan -- the deductible is $2,000, not $5,000. The maximum out-of-pocket expense is $6,350, not $8,500. Her co-pays would be $45 for a primary care visit and $65 for a specialty visit -- but all visits would be covered, not just two.

Is that better than her current plan? Yes, by a mile.

If she wanted to pay less, Cavallaro could opt for lesser coverage in a "bronze" plan. She could buy one from the California exchange for as little as $194 a month. From Anthem, it's $256, or $444 a year less than she's paying now. That buys her a $5,000 deductible (the same as she's paying today) but the out-of-pocket limit is lower, $6,350. Office visits would be $60 for primary care and $70 for specialties, but again with no limit on the number of visits. Factor in the premium savings, and it's hard to deny that she's still ahead.

Cavallaro told me a couple of things that are worth considering. First, what she likes about her current plan is that she can go to any doctor of her choice and any hospital. That's not entirely true, because her current plan with Anthem does favor a network. Plainly, however, it's broad enough to serve her purposes. She's concerned that the new plans will offer smaller networks, which is probably true, though it's not necessarily true that the new networks will exclude her favorite doctors, hospitals or prescription formularies.

She also mentioned that her annual income fluctuates. It can be substantially lower, or substantially higher, than it is this year. What if next year she earns too much to qualify for the subsidy? Also a fair point -- at her current income, the subsidy is worth more than $200 a month to her. But that's not the same as saying that "there's nothing affordable about the Affordable Care Act," because at her current income, the act is vastly more affordable to her than what she's paying now.

When she told Channel 4 that "for the first time in my whole life, I will be without insurance," it's hard to understand what she was talking about. (Channel 4 didn't ask.) Better plans than she has now are available for her to purchase today, some of them for less money.

The sad truth is that Cavallaro has been very poorly served by the health insurance industry and the news media. It seems that Anthem didn't adequately explain her options for 2014 when it disclosed that her current plan is being canceled. If her insurance brokers told her what she says they did, they failed her. And the reporters who interviewed her without getting all the facts produced inexcusably shoddy work -- from Maria Bartiromo on down. They not only did her a disservice, but failed the rest of us too.


Pam

[trappincoyotes39]

Question being,where is the hefty federal health care subsidy coming from and who is paying it?