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Pipe dream? Obamacare
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coboardhead



Joined: 26 Oct 2009
Posts: 1917

PostPosted: Sat Sep 21, 2013 5:19 pm    Post subject: Reply with quote

NOT A SINGLE ONE of my wife's patients is unable to continue to see her. NOT ONE under the ACA. Doctors choose to be network providers for dozens of insurance plans. This has been the case for decades.

There will be shortages of primary care providers. This has been predicted for decades. Specialists make considerably more money and this has reduced acces to primary care.

Medicare cut reimbursement to physicians over a decade ago. The cuts have been delayed on a yearly basis. These cuts would have resulted in the job losses earlier. Now, the cuts are in the form of requiring efficiency rather than across the board cuts...a better thing. Some hospitals are adding staff because they think they can produce a better product.
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isobars



Joined: 12 Dec 1999
Posts: 13804

PostPosted: Sat Sep 21, 2013 6:14 pm    Post subject: Reply with quote

When physicians move from private practice to hospitals, their efficiency drops by 30%.
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DanWeiss



Joined: 24 Jun 2008
Posts: 1926
Location: Connecticut, USA

PostPosted: Wed Sep 25, 2013 11:05 am    Post subject: Reply with quote

isobars wrote:
When physicians move from private practice to hospitals, their efficiency drops by 30%.


That's quite a statement and so overgeneralized as to lack meaning. Care to provide a direct citation?

As one married to a hospital physician and the son-in-law or a private practice doctor, my view suggests something totally different.

The private practice physician almost always accepts a variety of insurance. Beyond the actual patient care and lab work, all service must be coded, data entered, claims submitted, bills sent, and collection efforts made. Professional insurance must be applied for, updated and monitored. A physical location must be found, obtained and insured. Any employees must be found, trained and paid. All taxes must be calculated, withheld and paid.

In private practice all of this must occur in order to provide the first minute of patient care. If Mr. Fick's definition of private practice includes a group practice, then even more time and money must be spent defining the role of each doctor/nurse within the entity negotiated between all founders as well as with each new principal.

In hospitals, the doctor must perform direct patient care and oversee all nursing and support of each patient. Often, the doctors do not actually code but provide proper notes from which he billing codes are derived by administrative staff. All the other matters mentioned above are no longer the responsibility of the doctor, making the doctor available to see more patients and/or spend more time with each, though usually the former.

Thus, the efficiency of doctors in hospitals would seem to be higher than doctors in small, private practice.

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DanWeiss



Joined: 24 Jun 2008
Posts: 1926
Location: Connecticut, USA

PostPosted: Wed Sep 25, 2013 11:06 am    Post subject: Reply with quote

isobars wrote:
When physicians move from private practice to hospitals, their efficiency drops by 30%.


That's quite a statement and so overgeneralized as to lack meaning. Care to provide a direct citation?

As one married to a hospital physician and the son-in-law or a private practice doctor, my view suggests something totally different.

The private practice physician almost always accepts a variety of insurance. Beyond the actual patient care and lab work, all service must be coded, data entered, claims submitted, bills sent, and collection efforts made. Professional insurance must be applied for, updated and monitored. A physical location must be found, obtained and insured. Any employees must be found, trained and paid. All taxes must be calculated, withheld and paid.

In private practice all of this must occur in order to provide the first minute of patient care. If Mr. Fick's definition of private practice includes a group practice, then even more time and money must be spent defining the role of each doctor/nurse within the entity negotiated between all founders as well as with each new principal.

In hospitals, the doctor must perform direct patient care and oversee all nursing and support of each patient. Often, the doctors do not actually code but provide proper notes from which he billing codes are derived by administrative staff. All the other matters mentioned above are no longer the responsibility of the doctor, making the doctor available to see more patients and/or spend more time with each, though usually the former.

Thus, the efficiency of doctors in hospitals would seem to be higher than doctors in small, private practice.

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Support Your Sport. Join US Windsurfing!
617.259.0411
www.USWindsurfing.org

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pueno



Joined: 03 Mar 2007
Posts: 2573

PostPosted: Wed Sep 25, 2013 11:13 am    Post subject: Reply with quote

DanWeiss wrote:

That's quite a statement and so overgeneralized as to lack meaning. Care to provide a direct citation?

Relax, Dan. You're dealing with Mr. Fick-shun, who has perfected the art of lobbing rabid right-wing fertilizer Molotov cocktails just to watch them splat and sputter.

He has his head so far up his rectum he needs a glass navel to navigate.

Just laugh at Mikey... maybe pity him a little for his obvious psychological disability.
.


Last edited by pueno on Wed Sep 25, 2013 11:16 am; edited 1 time in total
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mac



Joined: 07 Mar 1999
Posts: 4966

PostPosted: Wed Sep 25, 2013 11:39 pm    Post subject: Reply with quote

Pueno--none of us really deal with Iso, or the others here who refuse to read anything that might challenge their beliefs. We post so that lies don't go unanswered, and because there are some curious people who actually are interested in the truth.
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overpwr



Joined: 29 Jul 2013
Posts: 18

PostPosted: Thu Sep 26, 2013 4:00 pm    Post subject: Reply with quote

..."people who are actually interested on the truth"...That's funny. So tell me the truth Mac. If Obama Care is so great, why won't all members of Congress and their staff adopt it too? Do you, or anybody else for that matter, knows it's entirety? If the biggest fear that Republicans have is that Obama Care would actually work, why don't we just implement it on it's full capacity, no exemptions, to no one, now! If it works great, lets praise Mr. Obama for his fantastic work if it doesn't , who is he going to blame? The Russians? Just out of curiosity, do you think there is any connection between the Democrats wanting to pass on a Law to approve Gay marriage and the fact that now, under Obama Care, all of these Newly wed people will pay more as a couple than as single individuals? Do you know anything about ACA being based on individual plans, not family packages? And how about this rumor that what is coming next is the amnesty bill. Apparently this new bill will allow for an Illegal alien to became "Legal Residents". Under the new law, these new residents will be able to legally work, pay taxes and vote, but otherwise, not be able to "Legally" collect any Federal benefits including Obama Care. What it does, is actually create an opportunity for business to hire these new residents without having to legally have to pay for their Health Care. Now guess who will be getting fired from fast food restaurants, Targets, Safeways, Wall Marts, etc? Oh, I also heard that if grandma, on her 70's gets sick, and the neighbor next door who is around his 30"s get sick at the same time, guess who doesn't get the ambulance? Grandma doesn't pay into the system, good luck to her next life. But since some of you guys are way better informed than I, or even the President and his trolls for that matter, please, enlighten us. Oh yeah, and we are going to pull all of the money to fund of this shit out who's ass? Help us Mac, please tell us the truth...
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mac



Joined: 07 Mar 1999
Posts: 4966

PostPosted: Thu Sep 26, 2013 4:09 pm    Post subject: Reply with quote

Overpwr--what Congress wants to do, or doesn't want to do, has nothing to do with the effectiveness of Obama care. To think so is false reasoning. I think that they want to stay where they are because they think it is a better system for them, that is, they get better health care. That makes them what, hypocrites? The 1%? So? The purposes of the ACA were to 1) cover people that are not now covered by health care and use emergency rooms where they frequently don't pay their bills; 2) encourage a health care system that provides incentives for better health outcomes, not eligible procedures, and 3) begin experimenting with cost control approaches to try to slow the rate of increase of health care.

The ACA is actually accomplishing all of these things, and the willingness of Congress-people--of either party--to participate--is a red herring.

Now you also got a little gay-hate, immigrant-hate, and Russia-hate in there, but I'll leave those alone. They don't help your argument or your credibility.
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overpwr



Joined: 29 Jul 2013
Posts: 18

PostPosted: Thu Sep 26, 2013 5:07 pm    Post subject: Reply with quote

So far, all that you have mentioned is your own opinion to what you may think it will take place. ACA does not guarantee anything because it can't! Now to make sure votes are not lost, Mr. Obama does not want to implement it until after the elections in 2014. Credibility? Who's credibility are we need to be concerned with? I am just asking the brilliant minds in this forum for some answers. As far as I know, cost will go up, taxes will go up, and there is no guarantees what so ever that this is going to work during a time when a mistake of this proportion can cause great harm to the economy. Please as credible as you are, can you please explain the math? How can we afford to bring in all this people into the system and have no increase in costs? Maintain the same doctors? Really? And they all agree that over 30 million Americans steel won't have insurance. So what is the point of all this? Make sure that Obama has some kind of legacy when he leaves? And I am an Immigrant Mac. I used to live under socialized medicine and I know what a disaster it is. I just feel bad cause most of you think that this entitlement will help, but all that will do is cause more damage. And I hope that I am wrong by the way.
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coboardhead



Joined: 26 Oct 2009
Posts: 1917

PostPosted: Fri Sep 27, 2013 7:01 am    Post subject: Reply with quote

Overpower

I would start with the CBO report to begin to understand the ACA costs.

http://www.cbo.gov/publication/44176

Where did you immigrate from...why did the system not work?
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