This weekend my mom was telling me about how her girlfriend just had a knee replacement surgery. My mom said, "I told her she should do it now. Once Obamacare is in full effect we're going to have a hard enough time getting to see the doctor we want to see. Having surgery will be nearly impossible."
Ok, so I know this isn't true, but what exactly is going on to cause people to believe things like this? That we won't be able to see "our" doctors or have the surgery we "want/need" when we want/need to have it. Etc. What's the deal?
I have not experienced healthcare in other countries, but it is my understanding that certain procedures in other countries have waiting lists. Perhaps there is fear that this will happen here. And it is true that finding a doctor that accepts any/your particular insurance may become difficult in the future - though I don't believe this is an immediate concern - because of lowered reimbursements for said procedures, especially with Medicare and Medicaid.
ETA: Perhaps one of the international GBCNers or Canadians can weigh in.
I have not experienced healthcare in other countries, but it is my understanding that certain procedures in other countries have waiting lists. Perhaps there is fear that this will happen here. And it is true that finding a doctor that accepts any/your particular insurance may become difficult in the future - though I don't believe this is an immediate concern - because of lowered reimbursements for said procedures, especially with Medicare and Medicaid.
ETA: Perhaps one of the international GBCNers or Canadians can weigh in.
My canada 'mom' needs to have an MRI on her knee; she injured it in Feb 2012. Because she lives outside of the city, has limited options for medical care and she has limited funds she is on the waitlist for every non routine test or service she needs. Because her knee did not heal properly she needs the MRI and the first available appointment is in March of 2014. While there is the option to pay to 'jump the line' she cannot afford to do this and therefore has to wait her turn.
I have not experienced healthcare in other countries, but it is my understanding that certain procedures in other countries have waiting lists.
ETA: Perhaps one of the international GBCNers or Canadians can weigh in.
This is one of my many pet peeves in discussion of American healthcare.
It's true that cross country comparisons show longer wait lists for certain elective or "semi-elective" procedures in certain countries. The most commonly cited one is hip replacements in the US versus Canada. But this is somewhat deceptive. If you are uninsured or underinsured in America, and you can't afford a hip replacement, you don't ask for one. This isn't recorded as being on a wait list or having any wait at all, even if in practice your wait is "infinity".
Second, different developed countries spend different amounts on health care. France and Germany spend a lot and have minimal or no wait times. UK and Canada spend less and have wait times. It's a pretty straightforward trade between speedy delivery of services + higher taxes versus wait times + lower taxes (the US is an outlier in health spending which is another kettle of fish).
anecdote: I had to wait thirty days to see a neuro-opthamologist for diagnostics in a large US metropolitan area for sudden partial blindness in one eye. I have large employer sponsored insurance.
I have not experienced healthcare in other countries, but it is my understanding that certain procedures in other countries have waiting lists. Perhaps there is fear that this will happen here. And it is true that finding a doctor that accepts any/your particular insurance may become difficult in the future - though I don't believe this is an immediate concern - because of lowered reimbursements for said procedures, especially with Medicare and Medicaid.
ETA: Perhaps one of the international GBCNers or Canadians can weigh in.
My canada 'mom' needs to have an MRI on her knee; she injured it in Feb 2012. Because she lives outside of the city, has limited options for medical care and she has limited funds she is on the waitlist for every non routine test or service she needs. Because her knee did not heal properly she needs the MRI and the first available appointment is in March of 2014. While there is the option to pay to 'jump the line' she cannot afford to do this and therefore has to wait her turn.
not trolling: what is the impact on her QoL of not getting treatment ASAP?
off-topic for niq, did you ever see my reply re: the notice of noncoverage?
Not until now, thank you!
As best I can tell it's for cases where mom wants to stay an extra overnight PP but the hospital doesn't consider it "medically necessary". We were never in that boat. I don't think we will be billed any extras for our ... "unusual" ... patient decisions during induction.
If we don't max out the deductible and OOP, I have no idea what will. omfg
ETA oh if you're on the app you can't see siggies either. Everyone is fine, now that babyniq has learned to latch and drink milk
My canada 'mom' needs to have an MRI on her knee; she injured it in Feb 2012. Because she lives outside of the city, has limited options for medical care and she has limited funds she is on the waitlist for every non routine test or service she needs. Because her knee did not heal properly she needs the MRI and the first available appointment is in March of 2014. While there is the option to pay to 'jump the line' she cannot afford to do this and therefore has to wait her turn.
not trolling: what is the impact on her QoL of not getting treatment ASAP?
They are retired and on a fixed budget. If they opt to not pay for utilities or food then she would have the $ to pay. They also live in a town of 2100 so there really arent any opportunities for work.
Yeah after 4 days, I am sure you were ready to get out of there and back home, stat!
I also thought of another example that came up today wrt a client.
Cataract surgery is covered. Deductibles and coinsurance apply, etc etc. EXCEPT they only cover the standard def replacement lenses, NOT the new awesome HD lenses. HD lenses can be upwards of $3k/eye.
not trolling: what is the impact on her QoL of not getting treatment ASAP?
They are retired and on a fixed budget. If they opt to not pay for utilities or food then she would have the $ to pay. They also live in a town of 2100 so there really arent any opportunities for work.
I think I asked the wrong question then. You mentioned that she needs an MRI for her knee. Presumably she needs the MRI to diagnose some condition that needs treatment. What are the symptoms of that treatment? She has constant low-level pain? She has difficulty walking? She has difficulty walking hills or stairs? She can't participate in this year's Canadian Seniors' Ironman triathalon?
They are retired and on a fixed budget. If they opt to not pay for utilities or food then she would have the $ to pay. They also live in a town of 2100 so there really arent any opportunities for work.
I think I asked the wrong question then. You mentioned that she needs an MRI for her knee. Presumably she needs the MRI to diagnose some condition that needs treatment. What are the symptoms of that treatment? She has constant low-level pain? She has difficulty walking? She has difficulty walking hills or stairs? She can't participate in this year's Canadian Seniors' Ironman triathalon?
Sorry...my possessed laptop ate part of my post! Here is the other half.
Her doctor wants the MRI to see if anything is torn. She has constant pain, cant walk long distances, has issues with stairs and inclines. She has done all her physical therapy and its not getting any better. She is frustrated because it is a catch-22; she has 'free' healthcare but she cant get the help she needs in a timely manner because she does not have the disposable income to pay for a private doctor or treatment in the US.
So does this mean you aren't an Obamacare supporter?
There are aspects that I'm very excited about. Everyone should have access to purchase affordable health care, regardless of your workplace. I'm simply saying that covering preventative care 100% doesn't mean it's free--someone has to pay for it.
Right. For example, my daughter's immunizations were covered at 100%. However, our pediatrician's office is charging something like 50% more for immunizations (I compared DD1's bills to DD2's bills) perhaps because they know that insurance must cover them. Or maybe drug companies are charging more for the same reason - who knows. So our insurance company is paying a lot more money for preventative care and that money must come from somewhere - the premiums we pay.
Our family purchases individual coverage and our premiums have gone up about 25% each year since 2010. Our broker warned us that they might go up 50-100% for 2014. I'm actually hoping that the table that niq referenced is accurate because that means just a 30-40% increase for us.
I have not experienced healthcare in other countries, but it is my understanding that certain procedures in other countries have waiting lists. Perhaps there is fear that this will happen here. And it is true that finding a doctor that accepts any/your particular insurance may become difficult in the future - though I don't believe this is an immediate concern - because of lowered reimbursements for said procedures, especially with Medicare and Medicaid.
ETA: Perhaps one of the international GBCNers or Canadians can weigh in.
My canada 'mom' needs to have an MRI on her knee; she injured it in Feb 2012. Because she lives outside of the city, has limited options for medical care and she has limited funds she is on the waitlist for every non routine test or service she needs. Because her knee did not heal properly she needs the MRI and the first available appointment is in March of 2014. While there is the option to pay to 'jump the line' she cannot afford to do this and therefore has to wait her turn.
Same thing with my husband's aunt, who lives in rural Ontario. She needs some kind of heart testing done and is on a waiting list for an appointment. Fortunately she has the means to pay OOP to be seen here in the States. Her husband had a similar situation back in 2010 to have a growth in his lung checked out.
I have a question regarding people who will be buying their insurance through their state run program or through the federal health care exchange. Everything I see talks about monthly or annual income. Will assets be calculated in anything? I know someone who worked very hard all their life to build up a savings. They are now retired (but not of typical retirement age). They live very cheap and their income is technically near the poverty level. Will they be pushed into a higher income bracket because of their assets, or will the income on the taxes be all that matters.
I have a question regarding people who will be buying their insurance through their state run program or through the federal health care exchange. Everything I see talks about monthly or annual income. Will assets be calculated in anything? I know someone who worked very hard all their life to build up a savings. They are now retired (but not of typical retirement age). They live very cheap and their income is technically near the poverty level. Will they be pushed into a higher income bracket because of their assets, or will the income on the taxes be all that matters.
Thank you!
There are no asset tests or income disregards (something used for eligibility for stuff like food stamps) ... I'm on the phone but Google "affordable care act asset test" for more details.
As far as I know, assets don't matter. They will only matter for Medicaid spend-downs. Also if someone is retired, eventually they will go on Medicare. Medicare + a supplement and Rx plan for a 65 year old is going to be way WAY less expensive than a health insurance plan for a 64 year old available on an exchange, and much better coverage.
I have a question regarding people who will be buying their insurance through their state run program or through the federal health care exchange. Everything I see talks about monthly or annual income. Will assets be calculated in anything? I know someone who worked very hard all their life to build up a savings. They are now retired (but not of typical retirement age). They live very cheap and their income is technically near the poverty level. Will they be pushed into a higher income bracket because of their assets, or will the income on the taxes be all that matters.
Thank you!
There are no asset tests or income disregards (something used for eligibility for stuff like food stamps) ... I'm on the phone but Google "affordable care act asset test" for more details.
I'm five too...the comments about preventative care and pre-existing condition things - a few comments have been made about how "some one will have to pay for it" meaning that premiums might rise. Granted, I'm coming from a different perspective...but isn't that okay? I mean, isn't it better that everyone has healthcare (particularly those with pre-existing conditions that, I assume, need care) than only some? And preventative care - well, over the long term, preventative care reduces overall healthcare spending, so isn't that good, too? I mean, caring for the needs of those who need the help - doesn't that ultimately benefit everyone?
I wish I could pay OOP to skip the wait list in the US. When I was violently ill from my trip to Mali over the past few weeks my options were urgent care (useless for tropical disease) an 8 day wait at my GP or the emergency room. So I self medicted with antibiotics my travel doc had prescribed for emergency situations and waited it out while I was unable to process solid food for 18 days. At least it was a great weight loss plan.
That's better than the dermatologist where I can't get an appointment without 2-3 months notice. I pay $2500 a year on premiums for coverage I never use because by the time I can actually see a doctor I'm either healed or have just given up on whatever minor ailment is bothering me.
Find a new GP. All GPs I have been to have same day appointments and I have never had problems getting to see one.Â
Do you live in DC? It's really fucking hard. I have finally found a GP taking new patients who can get me an appointment within a month, but this doc is nowhere near mx. I was calling places in January, and 8 weeks was the soonest I could get in. One place said they could get me an appointment in May. This is part of why I've been to urgent care 3 times in less than a year. Finding a psychiatrist in DC who is both accepting new patients and taking insurance is like trying to find a needle in a haystack.
But I think mx's bigger point is that there as much as people love to bash the Canadian system for access issues, but we are not without our own access issues in the US.
Post by SusanBAnthony on Aug 26, 2013 19:53:14 GMT -5
I think one aspect of the wait time concern, is that if all these currently uninsured people suddenly have insurance, and go to the doctor, then there will be wait time because the patient loads all increase.
That may happen, but it won't be an overnight thing where Boom, 5 month wait instead of 3.
Great thread! What about for people on Medicare who,have a prescription plan and also a supplemental plan? My Faux News watching 85 year old father claims he's going to be "forced onto Obamacare" and is up in arms about it. I told him I didn't think that the ACA would impact him in any way. What I told him will impact him (potentially) is what entitlement reform ends up looking like. If Medicare is cut as a result of that, change will happen (but not due to ACA).
Post by SusanBAnthony on Aug 26, 2013 19:57:39 GMT -5
And bwa ha ha about just finding a new doctor. That might work fine for a GP in many places. I live in a small town near a big city, and I can find a GP no problem. But when I needed to see a dermatologist for a rash spreading over my entire body, they all had months long waits if they took new patients at all. I only eventually got in when I broke down crying on the phone to a receptionist. It was poison ivy y'all. Kill me now, I was so embarrassed. My kids see specialists for a genetic condition and sometimes have to have procedures such as MRI's. We routinely wait at least 3 months if not 6 to get appointments.
Great thread! What about for people on Medicare who,have a prescription plan and also a supplemental plan? My Faux News watching 85 year old father claims he's going to be "forced onto Obamacare" and is up in arms about it. I told him I didn't think that the ACA would impact him in any way. What I told him will impact him (potentially) is what entitlement reform ends up looking like. If Medicare is cut as a result of that, change will happen (but not due to ACA).
Was I correct?
He already has socialized medicine. Lololol that he hates obamacare. God I hate the olds. I believe you are correct that nothing will change for him with obamacare. If Medicare is cut overall that could affect him. The main thing I have seen so far is as medica/Medicaid payments are lowered, some doctors and hospital syste,s stop accepting it. Mayo clinic made the news a year or two ago when it stopped accepting either Medicare or Medicaid or both (cant remember) became reimbursement was so low. But that has nothing to do with obamacare.
Great thread! What about for people on Medicare who,have a prescription plan and also a supplemental plan? My Faux News watching 85 year old father claims he's going to be "forced onto Obamacare" and is up in arms about it. I told him I didn't think that the ACA would impact him in any way. What I told him will impact him (potentially) is what entitlement reform ends up looking like. If Medicare is cut as a result of that, change will happen (but not due to ACA).
Was I correct?
He already has socialized medicine. Lololol that he hates obamacare. God I hate the olds. I believe you are correct that nothing will change for him with obamacare. If Medicare is cut overall that could affect him. The main thing I have seen so far is as medica/Medicaid payments are lowered, some doctors and hospital syste,s stop accepting it. Mayo clinic made the news a year or two ago when it stopped accepting either Medicare or Medicaid or both (cant remember) became reimbursement was so low. But that has nothing to do with obamacare.
Great thread! What about for people on Medicare who,have a prescription plan and also a supplemental plan? My Faux News watching 85 year old father claims he's going to be "forced onto Obamacare" and is up in arms about it. I told him I didn't think that the ACA would impact him in any way. What I told him will impact him (potentially) is what entitlement reform ends up looking like. If Medicare is cut as a result of that, change will happen (but not due to ACA).
Was I correct?
He already has socialized medicine. Lololol that he hates obamacare. God I hate the olds. I believe you are correct that nothing will change for him with obamacare. If Medicare is cut overall that could affect him. The main thing I have seen so far is as medica/Medicaid payments are lowered, some doctors and hospital syste,s stop accepting it. Mayo clinic made the news a year or two ago when it stopped accepting either Medicare or Medicaid or both (cant remember) became reimbursement was so low. But that has nothing to do with obamacare.
SusanBAnthony is 95% right and trolling @vagrrl's dad is the right thing to do here. The rest of this is just me being a pedant
Technically 85 year old Fox News watching dad has Canadian style single-payer, since the hospitals are still private. The VA is the only system of UK-style socialized medicine, where everyone is actually an employee of the government.
There were substantial Medicare cuts in the ACA. Overall Medicare spending will go down. But mostly by phasing out Medicare Advantage programs, which have completely failed to control costs. If you dad doesn't have Medicare Advantage he will mostly see benefits -- his Part D coverage will be a little more effective (no "donut hole"), there will be more wellness coverage, etc.
There's a great article in Wapo about a guy signing up for insurance through Kynect, the Kentucky insurance exchange, he signs up and tells the person helping him "this has got to be better than that Obamacare". I wanted to cry.
That's better than the dermatologist where I can't get an appointment without 2-3 months notice. I pay $2500 a year on premiums for coverage I never use because by the time I can actually see a doctor I'm either healed or have just given up on whatever minor ailment is bothering me.
I had this problem in Baltimore but I haven't had this problem since I moved to Dallas. There was a 6 month wait for the dermatologist and a 9 month wait for the allergist that were out of network b/c in network had longer waits.
I have had BCBS, Aetna and United Healthcare since moving to Dallas and my longest wait was 3 weeks for the derm and for a obgyn pap in network. I actually can see an allergist w/in 24 hours here. So I think it has a lot to do with the city you live in. Baltimore and Dallas are both large cities.
I think one aspect of the wait time concern, is that if all these currently uninsured people suddenly have insurance, and go to the doctor, then there will be wait time because the patient loads all increase.
That may happen, but it won't be an overnight thing where Boom, 5 month wait instead of 3.
Yes but wouldn't that just be an initial thing? What I mean is that they may go "hey I have never had x checked out before so now I will". It does not mean that they are going to now have frequent doc visits. I lived in S. Korea where all Koreans (regardless of income and age) along with all foreigners on work visa had access to standardized quality health care. I was seen in less than a week no matter the type of doc and it was all free.
I think one aspect of the wait time concern, is that if all these currently uninsured people suddenly have insurance, and go to the doctor, then there will be wait time because the patient loads all increase.
That may happen, but it won't be an overnight thing where Boom, 5 month wait instead of 3.
Yes but wouldn't that just be an initial thing? What I mean is that they may go "hey I have never had x checked out before so now I will". It does not mean that they are going to now have frequent doc visits. I lived in S. Korea where all Koreans (regardless of income and age) along with all foreigners on work visa had access to standardized quality health care. I was seen in less than a week no matter the type of doc and it was all free.
It should only be initial for something like a check up. ER's would in theory be less busy because people would see their primary care DR. instead. on the other hand, you could have someone with currently unmanaged diabetes, who now starts seeing a FP Dr., and they are gong ot be going regularly from now on. I just assume that will be a small percent increase and not noticeable to most people. It will be interesting to see what happens. There has been talk of a primary care shortage for awhile now, especially rurally, and they a definitely encouraging NP and other midlevel practitioners to help fill that gap.
I will happily bitch about it if I have to wait longer, but when it comes down to it, I would rather wait longer and pay more, but have everyone have access to healthcare. Obviously not everyone agrees. I have a self employed friend who buys individual insurance and she is super opposed because their premiums will go up next year. I just roll my eyes.
Obamacares a joke. I looked at my state premiums and there anywhere b/t $400-2200 a month. At $400 a month you have a 90% coinsurance and 5k deductible. For insurance that mimics a HMO with $30 copays, its $1100+. That's still not affordable for anyone and won't improve our nations health.