ACA Could Lead Physicians to Drop Coverage of Medicare/Medicaid

[atlasshrugged]

My Father-in-law is a Urologist who owns his own practice. This week he met with a few members of the state board of medicine about upcoming changes due to the Affordable care Act. I asked him about what changes will be made to his practice. Without even hesitating, he said "We'll have to drop it." When I inquired further, he said "Well, every Medicaid and Medicare patient I see costs me money because the gov doesn't reimburse me like private insurance companies do. The increase in Medicaid to 133% of the poverty line will drastically cut our profits, so why should I offer services at a loss?"

It turns out, this isn't an isolated case. All 3 Physicians I shadowed this week (I'm Pre Med) told me they were considering dropping gov insurance. Other than big hospitals who have cheaper operating costs, Medicaid/Medicare don't pay enough to cover the expenses of tests and procedures. The future of Medicine will shift toward large hospitals like IHC. Plenty of aspiring Physicians (myself included) are hesitant to go to school for 12 years and not have the opportunity to be self employed.

 

[Al_Fundie]

My Father-in-law is a Urologist who owns his own practice. This week he met with a few members of the state board of medicine about upcoming changes due to the Affordable care Act. I asked him about what changes will be made to his practice. Without even hesitating, he said "We'll have to drop it." When I inquired further, he said "Well, every Medicaid and Medicare patient I see costs me money because the gov doesn't reimburse me like private insurance companies do. The increase in Medicaid to 133% of the poverty line will drastically cut our profits, so why should I offer services at a loss?"

It turns out, this isn't an isolated case. All 3 Physicians I shadowed this week (I'm Pre Med) told me they were considering dropping gov insurance. Other than big hospitals who have cheaper operating costs, Medicaid/Medicare don't pay enough to cover the expenses of tests and procedures. The future of Medicine will shift toward large hospitals like IHC. Plenty of aspiring Physicians (myself included) are hesitant to go to school for 12 years and not have the opportunity to be self employed.

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

 

[uscitizen]

IN KY dropping medicare/medicaid is about 1/2 of doctors business....
In some areas they would have to leave to get customers.

 

[uscitizen]

My Father-in-law is a Urologist who owns his own practice. This week he met with a few members of the state board of medicine about upcoming changes due to the Affordable care Act. I asked him about what changes will be made to his practice. Without even hesitating, he said "We'll have to drop it." When I inquired further, he said "Well, every Medicaid and Medicare patient I see costs me money because the gov doesn't reimburse me like private insurance companies do. The increase in Medicaid to 133% of the poverty line will drastically cut our profits, so why should I offer services at a loss?"

It turns out, this isn't an isolated case. All 3 Physicians I shadowed this week (I'm Pre Med) told me they were considering dropping gov insurance. Other than big hospitals who have cheaper operating costs, Medicaid/Medicare don't pay enough to cover the expenses of tests and procedures. The future of Medicine will shift toward large hospitals like IHC. Plenty of aspiring Physicians (myself included) are hesitant to go to school for 12 years and not have the opportunity to be self employed.

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

Ype what I would pay $250 cash for the private insurance company pays maybe $150.

 

[Al_Fundie]

My Father-in-law is a Urologist who owns his own practice. This week he met with a few members of the state board of medicine about upcoming changes due to the Affordable care Act. I asked him about what changes will be made to his practice. Without even hesitating, he said "We'll have to drop it." When I inquired further, he said "Well, every Medicaid and Medicare patient I see costs me money because the gov doesn't reimburse me like private insurance companies do. The increase in Medicaid to 133% of the poverty line will drastically cut our profits, so why should I offer services at a loss?"

It turns out, this isn't an isolated case. All 3 Physicians I shadowed this week (I'm Pre Med) told me they were considering dropping gov insurance. Other than big hospitals who have cheaper operating costs, Medicaid/Medicare don't pay enough to cover the expenses of tests and procedures. The future of Medicine will shift toward large hospitals like IHC. Plenty of aspiring Physicians (myself included) are hesitant to go to school for 12 years and not have the opportunity to be self employed.

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

Ype what I would pay $250 cash for the private insurance company pays maybe $150.

And why is that? I mean if you have auto insurance and you total your car, does the insurance company go to the dealership and pay less than what a cash paying customer would for a vehicle? Of course not. So , why is medical insurance different?

 

[uscitizen]

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

Ype what I would pay $250 cash for the private insurance company pays maybe $150.

And why is that? I mean if you have auto insurance and you total your car, does the insurance company go to the dealership and pay less than what a cash paying customer would for a vehicle? Of course not. So , why is medical insurance different?

Because they can be?

 

[Al_Fundie]

Ype what I would pay $250 cash for the private insurance company pays maybe $150.

And why is that? I mean if you have auto insurance and you total your car, does the insurance company go to the dealership and pay less than what a cash paying customer would for a vehicle? Of course not. So , why is medical insurance different?

Because they can be?

Ah, we have a winner.

 

[atlasshrugged]

My Father-in-law is a Urologist who owns his own practice. This week he met with a few members of the state board of medicine about upcoming changes due to the Affordable care Act. I asked him about what changes will be made to his practice. Without even hesitating, he said "We'll have to drop it." When I inquired further, he said "Well, every Medicaid and Medicare patient I see costs me money because the gov doesn't reimburse me like private insurance companies do. The increase in Medicaid to 133% of the poverty line will drastically cut our profits, so why should I offer services at a loss?"

It turns out, this isn't an isolated case. All 3 Physicians I shadowed this week (I'm Pre Med) told me they were considering dropping gov insurance. Other than big hospitals who have cheaper operating costs, Medicaid/Medicare don't pay enough to cover the expenses of tests and procedures. The future of Medicine will shift toward large hospitals like IHC. Plenty of aspiring Physicians (myself included) are hesitant to go to school for 12 years and not have the opportunity to be self employed.

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

You've jumped to the typical, incorrect conclusion. If Physicians are forced to accept Medicaid or, even worse, all forms of insurance, then the Gov/ Insurance Companies hold all of the cards. Then Insurance Companies decide it only costs $40 to run an X-Ray when in reality it costs $100. The Physicians should be forced to run at a loss? That's bogus. That's why Doctors accept some insurance companies but not others. Cheapo Insurance companies like Humana (they usually have reps at Wal Mart) are a pain in the butt to get payments from.

Your second mistake is to say that "Doctors should be forced to lower prices." Why? Do we force grocery stores to lower prices because of hunger? The value of a product is the price people are willing to pay. If you want Doctors to charge you less, boycott them until they do. But most importantly, Doctors charge so much and have the highest salaries because of all the crap they have to go through to practice. 8 years of post high school formal education plus 3 years of general residency and another 3 years of surgical residency. Most graduate with over $300,000 of debt. In order to put up with making no money for 14 years, people need a big carrot. If you force doctors to lower prices and take away their carrot, you'll end up with fewer doctors.

 

[atlasshrugged]

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

Ype what I would pay $250 cash for the private insurance company pays maybe $150.

And why is that? I mean if you have auto insurance and you total your car, does the insurance company go to the dealership and pay less than what a cash paying customer would for a vehicle? Of course not. So , why is medical insurance different?

Usually because there's some perceived value in insurance companies steering their customers toward certain doctors. When the insurance companies only pay $150, the doctors don't complain too much because they know in the future that same insurance company might have a patient that needs procedures that result in a profit.

 

[Luissa]

Medicare is actually paying what it is worth, not the jacked up price they charge the private insurance company.
It is the same at assisted livings etc. Medicaid pays less for a room, than a private payer would..... Because they can jack up the price for the private payer.

 

[M14 Shooter]

If they do, The Obama will penalize... er... tax them.

 

[atlasshrugged]

Medicare is actually paying what it is worth, not the jacked up price they charge the private insurance company.
It is the same at assisted livings etc. Medicaid pays less for a room, than a private payer would..... Because they can jack up the price for the private payer.

That's what I always assumed. But when my Father-in-Law charges Medicare for a procedure using an expensive piece of technology, they don't pay as much as it costs to run the tests. A big hospital would be able to make a profit from what Medicare pays, because they run so many more tests. But smaller practices end up losing money on Medicare patients.

 

[Avorysuds]

Nice to see someone talk about this issue that is in the field and not just an Obama-bot or an Obama hater.

My wife is a pharmacist and talks about this very same thing. When people pay 4 bucks for medication (that they are on because they are fat in faaaar to many cases) and still complain, you know you have a problem with welfare.

 

[Vidi]

My Father-in-law is a Urologist who owns his own practice. This week he met with a few members of the state board of medicine about upcoming changes due to the Affordable care Act. I asked him about what changes will be made to his practice. Without even hesitating, he said "We'll have to drop it." When I inquired further, he said "Well, every Medicaid and Medicare patient I see costs me money because the gov doesn't reimburse me like private insurance companies do. The increase in Medicaid to 133% of the poverty line will drastically cut our profits, so why should I offer services at a loss?"

It turns out, this isn't an isolated case. All 3 Physicians I shadowed this week (I'm Pre Med) told me they were considering dropping gov insurance. Other than big hospitals who have cheaper operating costs, Medicaid/Medicare don't pay enough to cover the expenses of tests and procedures. The future of Medicine will shift toward large hospitals like IHC. Plenty of aspiring Physicians (myself included) are hesitant to go to school for 12 years and not have the opportunity to be self employed.

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

You've jumped to the typical, incorrect conclusion. If Physicians are forced to accept Medicaid or, even worse, all forms of insurance, then the Gov/ Insurance Companies hold all of the cards. Then Insurance Companies decide it only costs $40 to run an X-Ray when in reality it costs $100. The Physicians should be forced to run at a loss? That's bogus. That's why Doctors accept some insurance companies but not others. Cheapo Insurance companies like Humana (they usually have reps at Wal Mart) are a pain in the butt to get payments from.

Your second mistake is to say that "Doctors should be forced to lower prices." Why? Do we force grocery stores to lower prices because of hunger? The value of a product is the price people are willing to pay. If you want Doctors to charge you less, boycott them until they do. But most importantly, Doctors charge so much and have the highest salaries because of all the crap they have to go through to practice. 8 years of post high school formal education plus 3 years of general residency and another 3 years of surgical residency. Most graduate with over $300,000 of debt. In order to put up with making no money for 14 years, people need a big carrot. If you force doctors to lower prices and take away their carrot, you'll end up with fewer doctors.

Youre incorrect.

When we visit the doctors office, there are many different pricing structures based on what insurance plan we have.

No insurance means you pay the MOST. Insurance plans negotiate deals with physician groups to get a better price.

Its called bulk pricing.

Anedoctally, I was handed a $335 dollar bill for a doctors visit ( and a couple of tests ). When I asked if this was AFTER my insurance, the woman behind the desk said," Oh we dont have your insurance information!" She took it and magically the bill went down to $115 dollars, of which insurance paid 80%.


Also, the whole "price people are willing to pay" argument is completely bogus when it comes to health care. With health care, its "pay it or die".

 

[atlasshrugged]

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

You've jumped to the typical, incorrect conclusion. If Physicians are forced to accept Medicaid or, even worse, all forms of insurance, then the Gov/ Insurance Companies hold all of the cards. Then Insurance Companies decide it only costs $40 to run an X-Ray when in reality it costs $100. The Physicians should be forced to run at a loss? That's bogus. That's why Doctors accept some insurance companies but not others. Cheapo Insurance companies like Humana (they usually have reps at Wal Mart) are a pain in the butt to get payments from.

Your second mistake is to say that "Doctors should be forced to lower prices." Why? Do we force grocery stores to lower prices because of hunger? The value of a product is the price people are willing to pay. If you want Doctors to charge you less, boycott them until they do. But most importantly, Doctors charge so much and have the highest salaries because of all the crap they have to go through to practice. 8 years of post high school formal education plus 3 years of general residency and another 3 years of surgical residency. Most graduate with over $300,000 of debt. In order to put up with making no money for 14 years, people need a big carrot. If you force doctors to lower prices and take away their carrot, you'll end up with fewer doctors.

Youre incorrect.

When we visit the doctors office, there are many different pricing structures based on what insurance plan we have.

No insurance means you pay the MOST. Insurance plans negotiate deals with physician groups to get a better price.

Its called bulk pricing.

Anedoctally, I was handed a $335 dollar bill for a doctors visit ( and a couple of tests ). When I asked if this was AFTER my insurance, the woman behind the desk said," Oh we dont have your insurance information!" She took it and magically the bill went down to $115 dollars, of which insurance paid 80%.


Also, the whole "price people are willing to pay" argument is completely bogus when it comes to health care. With health care, its "pay it or die".

It's not "pay or die," it's "pay or go to a different doctor." The reason doctors charge similar prices is because they all had years of student debts to pay off.

 

[Vidi]

You've jumped to the typical, incorrect conclusion. If Physicians are forced to accept Medicaid or, even worse, all forms of insurance, then the Gov/ Insurance Companies hold all of the cards. Then Insurance Companies decide it only costs $40 to run an X-Ray when in reality it costs $100. The Physicians should be forced to run at a loss? That's bogus. That's why Doctors accept some insurance companies but not others. Cheapo Insurance companies like Humana (they usually have reps at Wal Mart) are a pain in the butt to get payments from.

Your second mistake is to say that "Doctors should be forced to lower prices." Why? Do we force grocery stores to lower prices because of hunger? The value of a product is the price people are willing to pay. If you want Doctors to charge you less, boycott them until they do. But most importantly, Doctors charge so much and have the highest salaries because of all the crap they have to go through to practice. 8 years of post high school formal education plus 3 years of general residency and another 3 years of surgical residency. Most graduate with over $300,000 of debt. In order to put up with making no money for 14 years, people need a big carrot. If you force doctors to lower prices and take away their carrot, you'll end up with fewer doctors.

Youre incorrect.

When we visit the doctors office, there are many different pricing structures based on what insurance plan we have.

No insurance means you pay the MOST. Insurance plans negotiate deals with physician groups to get a better price.

Its called bulk pricing.

Anedoctally, I was handed a $335 dollar bill for a doctors visit ( and a couple of tests ). When I asked if this was AFTER my insurance, the woman behind the desk said," Oh we dont have your insurance information!" She took it and magically the bill went down to $115 dollars, of which insurance paid 80%.


Also, the whole "price people are willing to pay" argument is completely bogus when it comes to health care. With health care, its "pay it or die".

It's not "pay or die," it's "pay or go to a different doctor." The reason doctors charge similar prices is because they all had years of student debts to pay off.

You just negated your response.

 

[Intense]

Medicare is actually paying what it is worth, not the jacked up price they charge the private insurance company.
It is the same at assisted livings etc. Medicaid pays less for a room, than a private payer would..... Because they can jack up the price for the private payer.

Or... They jack up the cost to the Private Payer, to compensate for the losses from Medicare.

 

[Vidi]

Medicare is actually paying what it is worth, not the jacked up price they charge the private insurance company.
It is the same at assisted livings etc. Medicaid pays less for a room, than a private payer would..... Because they can jack up the price for the private payer.

Or... They jack up the cost to the Private Payer, to compensate for the losses from Medicare.

Personally, I think our technology has outpaced our ability to pay for it.

 

[Intense]

Indeed, I'm quite sure the government hasn't thought of this and won't force physicians who accept ANY insurance to accept ALL insurance. As well they should. Doctors should have to accept ANY insurance, this BS about having to find a doctor "in your network" does nothing to lessen the costs of medical care.

Come to think of it , neither does the ACA, what would help is if doctors were forced to lower their prices.

How is it that a $250 bill can suddenly be reduced to $150 when an insurance company gets involved????

Ype what I would pay $250 cash for the private insurance company pays maybe $150.

And why is that? I mean if you have auto insurance and you total your car, does the insurance company go to the dealership and pay less than what a cash paying customer would for a vehicle? Of course not. So , why is medical insurance different?

The Insurance Company does not replace your car. They pay you the replacement value, and you go to the Dealer or wherever. The Dealer is not your Slave. The Doctor is not your slave either. The first place the Government needs to start cutting compensation is Government Payroll and Benefits.

 

[Moonglow]

At the prices that doc's charge and the life they lead in the upper crust of society I can see where the difference between the Hippocratic oath and the want of money have conflicting interest.
Good thing the docs took chickens for payment when their hippocratic oath was more important during the early years of American medicine.