I'm certainly not going to come in here and defend the ACA tooth and nail (In fact, I think it was lousy idea), but that is an objectively false statement.
How we voted in 2018
- Thread starter Watu3
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I'm pretty sure i have strep right now, just called my PCP, seeing him today. And if they couldn't see me today, i'm $50 away from an urgent care to be seen in 30 minutes. The hell you talking about? Unless you live in po-dunk city, you should have no worries.
Also, an NP is just as good as an MD at diagnosis and treating something as minor as bronchitis, strep, flu, etc...good lord.
Every single ER in the country will give you care no matter what. It's an objectively true statement, although that still is true after obamacare.
Going to the emergency room when something can't be let go any longer is not real access to health care, and is a lousy & costly way of going about it. So that is in reality a false statement before or after Obamacare. That was what Obamacare was supposed to chip away at, but failed to do so. I have a feeling any healthcare plan at this point would likely fail to do so. The government can't go at this in half measures, which due to lobbyists and congressional prejudices, is how they will probably go at it again.
Emergency care? Sure. Long term cancer treatments? Yeah, not so much. Again, I am not saying everything is now peachy, I am just saying access to medical care is not guaranteed, nor was it guaranteed before the ACA.
Yet the Nurse Practitioner charges as much or more than an actual General Practitioner due to the faster necessary time and they actually have less training. Also, they can easily miss things that a more trained individual might not. If you think that's not a problem you're wrong. Urgent care isn't $50 btw. At least not in my area. Try $130 minimum with insurance.
Also, it heavily depends on how busy your GP is. And you don't really get to choose from any doctor anymore because they may be out of network... so you're going to have real trouble switching GP's quickly if yours is too busy. Nothing about our system is efficient or customer friendly. Imagine if your car insurance company dictated which cars manufacturers they would let you buy based on the deals they had with manufacturer's networks.
You can't tell me that eliminating multimillion dollar CEO's wages and the need to pay investors wouldn't save people money in the end if we switched from private to public healthcare.
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Aca did not improve health care or health insurance. In many cases it was not Afordable.
More people lost their existing health insurance, than uninsurred people signed up.
Source for NPs charging more than an MD please. That would be interesting to see. My insurance with UHC is $50 copay for urgent care, $100 +10% for ER. $30 copay for a sick visit with either my PCP or an NP at his office. I dont care which one I see. I pay about $450/month for that coverage through my employer for 2 adults and 3 children. Works well for me. I have no complaints. Well, other than the premium was about $300 for that same coverage before Obamacare, but I can afford another $150 a month thanks to yearly raises.
Now I do agree that administrative costs are way too high. I don't have a problem with a Dr making bank, but an administrator making much much more than most MDs is.
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For example, my wife had a hernia repair. The surgeon charged $700, of which we paid $70 (10%). Anesthesia was $1000, ($100 oop). The hospital was $20k, ($1000 we paid). Its not Docs getting the most, its the hospitals. I have no issue paying two MDs caring for my wife for 45 minutes $1700 (if we didn't have insurance), while $20k to the hospital is just insane. That cost though is paying for nurses, that make around $35-40/hr on average, all the expensive equipment it takes to do surgery, administration people to organize all of it, etc. I'm not sure where cuts can be made but it does seem outrageous for a hospital to charge that much for a 45 minute surgery.
I'm sure the insurance company paid nowhere near 20K for that hospital stay. They negotiate the hospital's exorbitant prices down. The thing is, hospitals shouldn't need to be allowed to charge exorbitant prices for simple things like they do. You'll frequently see charges for common items that inflate costs by 100's of %.
Just visited Urgent Care in August for prolonged bronchitis. My charge (as I hadn't even begun to meet my deductible) was $170. That's the mandatory minimum set up by my provider (Cigna) with the only in-network urgent care in my city. They set it that high because it's a standard rate... so if you went in with a slightly more serious case it would cost you less... but most people don't need to go to urgent care for serious cases (which they should go to the emergency room for). They go for common illnesses. I could have gone to a GP for less, but mine was full that week and I felt like I was dying. Saw a NP. She checked chest with a stethoscope and they checked my temperature... then prescribed 3 medications. That was not worth $30 much less $170.
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Another huge problem is that there isn't a true free market in our country for Health Insurance. Most Americans get their insurance through their employer. They can't choose to go with BC&BS instead of United. Only their employer can choose that. It's not like car insurance, where you can look for a better deal elsewhere. It's basically indentured insurance unless you're self employed.
Yeah, and self employed is a joke. My uncle is a computer programmer for oil companies, and has been working as a contractor for years. He only has the incredibly unsubsidized choices that make insurance not even close to a feasible option.
I.E. it's an even worse option for many people. Therefore... not a free market.
Choosing one company that your employer tells you too or nothing is not a free market.
Hm... I visited my lawyer and asked him a question and he charged me $300 for a 10 minute visit. His advice saved me a big hassle.. I'm pretty sure your visit to the ER got you back on your feet and functioning... so.. how do you put value on that?
I still had bronchitis for another month after that visit. It didn't really help much at all. Also, I had to pay for the medication they prescribed which is what I actually needed. I had already determined what I had via internet research, diagnosed myself, and looked up possible medications. Literally the only positive thing she did for me was give me a prescription.
80% or more of doctor visits are exactly this way. You know you have a sinus infection, bronchitis, the flu, etc... The only reason you're going in is to get meds. You call your GP and they can't see you for a week. What good does that do anyone? So you trot into a minor ER, see someone you've never seen, tell him/her what wrong with you and they write the script and send you on your way after you pay the bill. Surely there's a better way.
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Some of us really liked those cheap insurance options in the individual market that covered exactly what we needed covered until they became illegal.
Choice is obviously a bad thing. As were my $10 co-pays but raising my deductible from $1000 to $5000 and doubling my premium in year one was apparently perfectly acceptable. That's 400 doctor visits per year if my math is correct.
Still don't see a source for NPs making more than MDs. I'm sure my NP friends would love to know how that works.
But in general, I agree that healthcare is out of control for many people. It'd be nice if it was just like car insurance, but I don't think it can be that way with all of the extremely tight government regulations that are placed on it on it.
But in general, I agree that healthcare is out of control for many people. It'd be nice if it was just like car insurance, but I don't think it can be that way with all of the extremely tight government regulations that are placed on it on it.
I didn't say they make more salary than doctors. I said NP's in urgent care facilities are being billed at the same or higher rates as GP's in private practices. I'm not sure how much the ownership of a urgent care facility is skimming from NP's rather than Doctors are making off of their private practices. All I know is a GP visit was less than an urgent care visit with a NP.
Yes but a teledoc can't actually do any of the minimal necessary checks even a nurse would do as they can't be in the room with you. That's the only problem I see. It could lead to a rash of misdiagnosis.... mistaking complex problems with simple ones.
I think tele health is good... but it's not the end solution. The end solution is getting rid of the necessity for insurance companies all together. Cut out the middle men.
My expat friend from Canada moved to the US entirely because Canada medical system refused to care for any longer because her issue was terminal.
She came to the US and receives more care than she had access to in Canada. According to her she’d be dead if she stayed in Canada.
She also told me our free clinics are of the same quality as the top practices in Canada.
Yet again I’m not against healthcare reform it is desperately needed, but nothing has been brought to the table that works in the US.
And, Aston, we can’t just “blow up” the existing insurance companies. The amount of law suits that’d occur from attempting this would stop it in its tracks. I suspect this is one of the bigger reasons we will never have healthcare that looks like other countries. Should it be blown up? Most likely. Is it realistic? Not that I can picture, happy to be wrong here.
My gp is from Canada. He has nothing good to say about their healthcare system, or obamacare.
He would bring his mothers here to see doctors.
He would bring his mothers here to see doctors.
Then you see, govt regulations got in your way. You could have prescribed it to yourself and just gone to the drugstore. Seriously, you did all that and you want more govt involvement....wow.
I agree. Do away with health insurance entirely. That will have the effect of driving costs way down. Without that huge pool of money sitting out there subsidizing the costs of treatment, the costs will begin to reflect market value.
I understand why they don't just allow people to prescribe things for themselves. For one thing they can be wrong. For another, there are prescription abuse issues. I have no problem with the government necessitating me to see a licensed physician for a consultation before getting prescription drugs. I have an issue with the government allowing a medical industry (and an insurance industry) to take advantage of one of the most important aspects of prolonging my life.
She would be one of the few. Something like 87% of their population supports the continuance of their public health system.
Also, in polls more Britains and Canadians say they're satisfied with the quality of their healthcare than Americans do.
As to insurance companies you wouldn't blow them up per se.... but covering everyone in America with a public option would effectively make them unprofitable and they would almost immediately fold. You would probably still see some private insurances bought by the wealthy that guaranteed them access to high end service (which they already pay for anyway) over and above that provided by and for the common folk.
On the plus side... whatever agency was setup to act as the non-profit (that's an important distinction) intermediary would need quite a few employees across the US to make sure benefits were provided appropriately, so it wouldn't mean a complete loss for insurance industry employees... it would just mean that the business structure over their heads changed. No more CEO's. No more investors.
instead of government run HC. The government should have done what they do best; taxes.
They should offer generous tax breaks
to individuals who pay for HI,
to companies that provide HI to its employs,
They should offer generous tax breaks
to individuals who pay for HI,
to companies that provide HI to its employs,
That doesn't fix the fundamental problem in the equation... the middleman trying to make a profit for its head honchos and its investors. It just means it will cost the government more and perpetuate the problem further.
during the mid terms i saw ads that claimed that x was bad because he voted to create an age tax on older people who paid for their own insurance. obamacare was tied to the tax system.
And how does bernie think you pay for socialized medicine.
And how does bernie think you pay for socialized medicine.
I never said the ACA was an improvement in any way. I just said that not everyone had access to healthcare before hand either. I am not a defender of the ACA. I think it was a crappy half-measure that was mostly written by the insurance companies.
I am not sure if more people lost coverage than signed up, but it doesn't really matter. You are certainly correct that some people did indeed lose their insurance.
Exactly this. You've got an enormous industry that acts as a middleman, and they've got their hand in the till. Capitalism being what it is, they are trying to maximize their profits. They do that by denying services and/or increasing premiums.
I had a new daughter born this year in January. She was born on time, but had a congenital defect in her bowel that we didn't know about. She had to be flown to Albuquerque for a surgery. I have excellent insurance, but they denied the claim for the air transport, saying that she was stable at the time and could have been ambulanced to ABQ. I had actually asked the doctor exactly that. I literally said to the doc at one point while we were waiting on the pilot, "Can we ambulance her instead?". The doctor said no, because even though she was stable, she could deteriorate at any time, and you didn't want to be in an ambulance in the middle of nowhere if that happened. Apparently I was supposed to kidnap her and take her myself rather than let her go in the airplane? Seriously, the way they operate, it is implied that you should second guess the doctor's orders in order to save a few bucks.
I had to appeal it, get doctor's statements, etc, etc. They eventually paid for it, but I had to fight for it. I also got about 500 different bills from everyone that took care of her along the way. I took meticulous care to sort them, pay them and/or call the provider and work out a payment plan. Even so, I got turned over to collections for a bill that I misplaced over a matter of $60.
The system is badly broken even when it works.
Just FYI: Daughter is fine now, thankfully. She is in the 50% that have her particular disorder that responded very well to the surgery and recovered with no ill-effects.
Went through the same admin mess and expense with my wife's cancer treatment. She's fine, but in retrospect the health insurance administration took as much or more the time than her doctors visits, hospitalization, and treatments did. Particularly galling were hospital bills that listed $9,000 as 'miscellaneous' and repeated demands from insurance companies for information that hospitals and other services repeatedly ignored requests to provide.
Again, there are working healthcare systems in other countries that the US could emulate instead of trying to invent one from scratch here. Germany's, France's, Canada's and Japan's are all different and several keep insurance companies in the middle but as regulated utilities. It's not socialism, it's efficiency with improved results.
Actually the problem is a bit like guns, in that the US allowed a situation to develop that has such entrenched interests or other hurdle to cross that progress is nearly impossible politically. With guns, it's the NRA and the sheer number of guns already in people's hands. With healthcare it's the healthcare companies and big pharma's incredible profits that they will spend whatever it takes to protect. The ACA was developed in the context of $600M spent in lobbying by the healthcare industry and was immediately opposed tooth and nail by Republicans, so no problems were ever addressed.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779642/
Again, there are working healthcare systems in other countries that the US could emulate instead of trying to invent one from scratch here. Germany's, France's, Canada's and Japan's are all different and several keep insurance companies in the middle but as regulated utilities. It's not socialism, it's efficiency with improved results.
Actually the problem is a bit like guns, in that the US allowed a situation to develop that has such entrenched interests or other hurdle to cross that progress is nearly impossible politically. With guns, it's the NRA and the sheer number of guns already in people's hands. With healthcare it's the healthcare companies and big pharma's incredible profits that they will spend whatever it takes to protect. The ACA was developed in the context of $600M spent in lobbying by the healthcare industry and was immediately opposed tooth and nail by Republicans, so no problems were ever addressed.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779642/
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Aca is 100% democrat. Reps were not allowed to contribute. Actually the major obstical to aca passage were labor unions and 7 Democrat senators who had their arms twisted until they agreed
