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Honored Contributor
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Registered: ‎03-09-2010

Re: OT- My doctor is dumping me

On 3/26/2015 Icegoddess said:

Not defending the insurance companies because I think they are a lot of the problem, but the ACA tells the insurance companies all sorts of things they MUST cover that maybe they weren't covering before depending on what plan you have. I have no need for pediatric or obstetric coverage (including pediatric dental and optical) but it must be included in my plan. Yet, I have to get separate plans for dental and optical for myself (and they aren't any good anymore). Also, remember the insurance companies are having to cover all those people with pre-existing conditions so those of us that are healthy are subsidizing the coverage for those that have a lot of expenses.

My daughter has run into this issue with her son's ADHD doctor changing over to cash only.

This is one of the great hallmarks of ACA. Although I am against insurance companies being involved in healthcare at all, at least now they are required to to provide coverage that wasn't available before, as well as preventing insurance companies from denying care to those with preexisting conditions.

Do you or I necessarily need coverage like obstetrics? I know I don't. But I also don't need schools anymore. Insurance is a pool into which we all pay, just as I still pay taxes for schools.

Is ACA perfect? Of course not. But at least tons of people can have coverage that was beyond their reach. That's better for all of us in a society. And to the poster who thinks it will go away in a year or so Wink, I don't think so. I think it's here to stay (maybe tweaked) just like SS and Medicare, which were also reviled by many in their time -- and to this day by some.


~Who in the world am I? Ah, that's the great puzzle~ Lewis Carroll, Alice in Wonderland
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Re: OT- My doctor is dumping me

On 3/26/2015 ChillyTulip said:

My husband opted out of insurance participation 5 years ago because he saw the writing on the wall. He didn't want the government and other third parties dictating the kind of medicine he practiced. With the roll out of the ACA has come a slew of new regulations---not the least of which is EMR and meaningful (we call it "meaningless") use--which simply put is the government telling us what is 'important" to document in the electronic record. Add to that the never ending paperwork, prior authorizations for even the most common medications, etc., etc., and more and more physicians have finally had enough. I remain employed part-time and my husband just shakes his head at the mound of extra work heaped on me by new regulations.

"Boutique" medicine is an antiquated term. These practices have been around for a long time and typically have very expensive fees associated with them. My husband's practice (more commonly called a DPC model---direct primary care) has grown substantially with the roll out of the ACA and the addition of very high deductible plans. Patients have to pay cash until they meet their deductibles, which in some cases can be as high as $12,500 a year. His fees for a family of 5 comes out to about $1500 a year. There are no co-pays for office visits and it includes an annual comprehensive exam. Best yet he has TIME to spend with his patients---his appointments are 30 minutes long. Sometimes longer. Most hospital employed physicians have quotas they must meet now---some being forced to see as many as 8 patients an hour. That's not medicine. That's an assembly line. And most importantly he doesn't have government intrusion and non-physicians dictating to him what he has to do. It's like the good old days---he provides quality care at an affordable price----and there are only two people in the exam room, the patient and him. Not the government. Not third party billers.

I applaud this! Good ole medicine!
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Re: OT- My doctor is dumping me

On 3/26/2015 jaxs mom said:

If insurance and the regulations associated with insurance policies weren't such an expensive nightmare to deal with Drs wouldn't want to go to cash only. To claim that the two are not related is just dreaming.

I'm not sure what you mean. Regulations on insurance companies supposedly keep them in line and prevent them from doing harm to us.

We belong to Kaiser, which in my state consistently rates as the best in customer satisfaction. Kaiser has come a long way from the 70s. I am ceaselessly amazed at the excellent medical services provided for my family. My last routine visit lasted almost an hour. I would not give it up for anything.

I wish that the healthcare system nationwide was based on such a model -- without any reliance on insurance whatsoever.


~Who in the world am I? Ah, that's the great puzzle~ Lewis Carroll, Alice in Wonderland
Honored Contributor
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Re: OT- My doctor is dumping me

O

I still doubt they could put in their contract they cannot opt out though. I would think that would be against the law. DH is in the same type situation with the Union but not getting ripped off. They have to take the Ins. they give them in their contract but they can opt out if they can prove they have Ins some place else.

Not wanting to derail the conversation, but am I right that Union Health insurance could cost $1600/month from the employee's cost? That seems awfully high to me or am I off base.

Honored Contributor
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Re: OT- My doctor is dumping me

I've had Kaiser and my parents still have it. I don't think it's the gold standard of care though. I forgot to mention, my uncle works for Kaiser as a medical professional. They are under a ton of internal regulations when delivering healthcare to patients.

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Re: OT- My doctor is dumping me

This has absolutely NOTHING to do with the ACA. People amaze me.
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Re: OT- My doctor is dumping me

On 3/26/2015 RespectLife said:
On 3/26/2015 traveler said:

Ahh, a bash ACA thread.

HARDLY a bash thread. OP is simply pointing out what has happened to her BECAUSE of it.

Sorry, OP, it has happened to many of my friends too. I don't care which way you spin it...if you are unable to stay with your doctor because of the new health care plans...you HAVE lost your doctor. They can't be expected to participate in the myriad of new plans! My friends did lose their doctors, NOT all doctors are participating in these new plans.

They lost their previous health care plans that were working for them and were forced into paying MORE for new high copay, high deductible plans.

Not ONE person I know has reduced rates. Not ONE person I know has lower copays. Not ONE person I know has lower deductibles. They are all paying higher premiums AND higher out of pocket expenses...such as 'Out of Network' would do to you in this case.

The total lack of truthful information given to citizens while this was being hatched behind closed doors is a disgrace on this country. Remember "We have to pass the health care bill so you can find out what is in it". Sadly, now we know what is in it.

I wish you the best in trying to find the care you and your family need.

I so agree...everyone I know that had to go to ACA is having problems with the programs - from being told they are not registered, even though they paid the fee; to the program having lost their info; to their insurance rates/copays raised from previous, etc. Unbelievable expensive mess up for many Americans!

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Re: OT- My doctor is dumping me

On 3/26/2015 jaxs mom said:

I've had Kaiser and my parents still have it. I don't think it's the gold standard of care though. I forgot to mention, my uncle works for Kaiser as a medical professional. They are under a ton of internal regulations when delivering healthcare to patients.

jaxs mom, of course they are under a ton of regulations when delivering healthcare. I'm not sure how they could provide such excellent care to so many without them. It's not a mom-and-pop endeavor.

As for being the gold standard, I don't know. All I know is that we don't have to deal with so much that others seem to be going through and that we have been pleasantly amazed by the quality of service. The physicians we've seen over the years have been as good and often superior to those we encountered in non-Kaiser situations. Plus, all the other staff seem to have had tons of instruction on patient care.

I've had four foot surgeries in the last five years, and each time I was hospitalized, I received incredible care from beginning to end. It made the experience almost bearable.


~Who in the world am I? Ah, that's the great puzzle~ Lewis Carroll, Alice in Wonderland
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Re: OT- My doctor is dumping me

On 3/26/2015 corita said:
On 3/26/2015 RespectLife said:
On 3/26/2015 traveler said:

Ahh, a bash ACA thread.

HARDLY a bash thread. OP is simply pointing out what has happened to her BECAUSE of it.

Sorry, OP, it has happened to many of my friends too. I don't care which way you spin it...if you are unable to stay with your doctor because of the new health care plans...you HAVE lost your doctor. They can't be expected to participate in the myriad of new plans! My friends did lose their doctors, NOT all doctors are participating in these new plans.

They lost their previous health care plans that were working for them and were forced into paying MORE for new high copay, high deductible plans.

Not ONE person I know has reduced rates. Not ONE person I know has lower copays. Not ONE person I know has lower deductibles. They are all paying higher premiums AND higher out of pocket expenses...such as 'Out of Network' would do to you in this case.

The total lack of truthful information given to citizens while this was being hatched behind closed doors is a disgrace on this country. Remember "We have to pass the health care bill so you can find out what is in it". Sadly, now we know what is in it.

I wish you the best in trying to find the care you and your family need.

I so agree...everyone I know that had to go to ACA is having problems with the programs - from being told they are not registered, even though they paid the fee; to the program having lost their info; to their insurance rates/copays raised from previous, etc. Unbelievable expensive mess up for many Americans!

It's a shame, but I think they are hiccups that occur in the early stages of any such huge new program. Heck, they occur on a regular basis in both private and public sectors that have been up and running for years.


~Who in the world am I? Ah, that's the great puzzle~ Lewis Carroll, Alice in Wonderland
Respected Contributor
Posts: 3,357
Registered: ‎03-23-2010

Re: OT- My doctor is dumping me

On 3/26/2015 corita said:
On 3/26/2015 RespectLife said:
On 3/26/2015 traveler said:

Ahh, a bash ACA thread.

HARDLY a bash thread. OP is simply pointing out what has happened to her BECAUSE of it.

Sorry, OP, it has happened to many of my friends too. I don't care which way you spin it...if you are unable to stay with your doctor because of the new health care plans...you HAVE lost your doctor. They can't be expected to participate in the myriad of new plans! My friends did lose their doctors, NOT all doctors are participating in these new plans.

They lost their previous health care plans that were working for them and were forced into paying MORE for new high copay, high deductible plans.

Not ONE person I know has reduced rates. Not ONE person I know has lower copays. Not ONE person I know has lower deductibles. They are all paying higher premiums AND higher out of pocket expenses...such as 'Out of Network' would do to you in this case.

The total lack of truthful information given to citizens while this was being hatched behind closed doors is a disgrace on this country. Remember "We have to pass the health care bill so you can find out what is in it". Sadly, now we know what is in it.

I wish you the best in trying to find the care you and your family need.

I so agree...everyone I know that had to go to ACA is having problems with the programs - from being told they are not registered, even though they paid the fee; to the program having lost their info; to their insurance rates/copays raised from previous, etc. Unbelievable expensive mess up for many Americans!

Add me to the list. The government dictates fee schedules for Medicare thus, insurance companies take their cue from them.

I worked 20 years for an ortho surgeon. He is winding down his career and because of the high malpractice (Cook County, IL), $6500. a month rent, phones and 3 salaries, he is becoming a "Hospitalist". He is 69 years of age and is giving up doing surgery. It's his choice to do this but, he has been barely keeping his head above water. Also, he has gone without a paycheck since Christmas because of the cost of running the practice and paying his employees prior to himself. The office manager who is also the R.N. says she can barely keep up with all the changes in coding, billing, pre-certifications and insurance contract renewals. She is "this-close" to giving her notice. She says the entire health care rules and regulations are so confusing and one hand does not know what the other is doing when she tries to get answers and help. One hospital will not take BC/B S and another one will...Medicare patients were sold a bill of good when they signed up for Advantage Plans and she says most do not fully understand that they do NOT have choices and the need for referrals, etc. They were enticed by the low premiums. It's like the old adage, "you get what you pay for".

I could go on and on but I can barely afford to take more high blood pressure medicine!