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LibForestPaul
03-23-2010, 07:05 PM
I post this because it does not seem discussed much in the threads...

If every person is required to carry insurance, then every Doctor must accept 3rd party payments.
i.e. There are no more cash transactions (or at least insignificant percentage) of cash transactions with Medical Providers..

National Provider ID hoorah!:mad:

I knew of many Doctors who stopped accepting 3rd party, Medicare/Medicaid payments....


Furthermore, everyone now gets an entry in the Medical Information Bureau ...MIB, as well as likely a medical id number.

silverhandorder
03-23-2010, 07:14 PM
First four years there is no enforcement. So people who would not carry insurance in the first place would still be able to go to their doc. Now considering such doctors are less expensive and inssurances should go up a lot we might see people just opting in for a 2.5% fine and going to a doctor.

Situation is bad, really bad.

awake
03-23-2010, 07:15 PM
Don't worry... most doctors will grow to like their new monopolist cage. They will eventually use it to their greatest advantage. The new ones will not even know what was before government run healthcare and will blindly pledge allegiance.

In Canada our doctors are treated as if they are all excellent at what they do. The ones who are not know they are protected by the fact that patients are forced to see them and everyone pretends that this is freedom of choice.

MsDoodahs
03-23-2010, 07:48 PM
As far as I know, doctors are not required to accept insurance by the bill that was passed.

Just because people are required to BUY insurance doesn't mean docs are required to ACCEPT insurance.

silverhandorder
03-23-2010, 07:51 PM
As far as I know, doctors are not required to accept insurance by the bill that was passed.

Just because people are required to BUY insurance doesn't mean docs are required to ACCEPT insurance.

Yeah but it just like the situation now. Why should someone who pays for inssurance also pay a doc on top of it? There are ways around it but the masses don't care that much to jump through all the hoops.

I just think that they nipped it in the bud. Had they had no reform we would have had many doctors and patients avoid inssurance altogether.

Stary Hickory
03-23-2010, 07:57 PM
Yeah nothing happens for almost 4 years....before it kicks in Republicans ought to be able to repeal it rather quickly and painlessly. If they just grow a pair. They had better. This is their last chance, really.

Some people here are trying to reform the GOP (salvage it). Only because it makes sense to start with something rather than start anew. The GOP will get one last chance(a big one) they had better not blow it. If they refuse to listen, then well what can you do? I support influencing and reforming the GOP only because they say they want the same things. If they really are never gonna be fixable then might as well start over.

Live_Free_Or_Die
03-23-2010, 08:04 PM
I have a friend whose wife is in the medical profession and thinks people that talk about letting the free market work and getting rid of licensing and state mandated insurance laws are crazy. As soon as she gets a pay reduction or less work compliments of U.S. government intervention regulating medical costs I am going to laugh my ass off.

Dunedain
03-23-2010, 08:08 PM
I'm certain doctors will still accept cold hard cash for their services. But yeah, they would have to be forced to take people on the 'Bama plan.

MsDoodahs
03-23-2010, 08:22 PM
More docs will change their practices over to concierge medicine and avoid the entire mess.

aravoth
03-23-2010, 09:07 PM
My son has an extremely rare genetic disorder called "Congenital Indifference to Pain". He didn't even cry at birth. When we first discovered he was not responding to pain stimuli we told his doctor. He shrugged it off, saying that it was way to rare, to be a viable diagnosis

At around seven months old his right arm looked swollen. We took him into OHSU here in Portland, Oregon. They told us there was nothing wrong with his arm, because "it didn't seem to be bothering him". We again stated, "that is because he can't feel it". They ignored it.

At nine months his clavicle grew an enormous mass over it. Again we took him in. They told us he had an infection, and that it clearly wasn't bothering him, we said it wouldn't bother him, because he doesn't feel pain, again, they ignored us.

At twelve months his leg was swollen. They gave us a working diagnosis of "Pulmonary Angio Edema", a rare, and often fatal vascular disease. They told us it was ok for him to continue walking on it, becuase "it clearly did not bother him".

3 days went by, his leg seemed to get worse. We took him into the doctor, they xrayed him, and guess what? His leg was broke. This triggered a Child Abuse work-up.

That entailed a full body scan. Which revealed healed fractures to his right arm, and his clavicle. The exact areas of concern from the previous visits.

They mis-diagnosed him multiple times over the course of several months, one of those times (his arm) resulted in a permanant deformity. Despite our repeated attempt to get one of them to listen to us about his lack of pain response, they never did. They pushed the issue of Child abuse as far as they could.

In the end, the situation was resovled when my Wife and I took our son on a flight to New York. We spoke with a specialist in Neurology, a woman that literally wrote the book on pain disorders. After several tests, she diagnosed him with "Congenital Indifference to Pain", she referred us out to an orthpedist in NY who works almost exclusivly with HSAN children(another group of pain indifferent people).

That Orthopedist does not accept insurance. He has, by far, the most modern equipment I have ever seen. And I work in the industry. One glance at his x-rays and he was able to tell the type of fractures, how old they are, and the kind of motion that could've caused them. He even Identified a new fracture, on his right foot, the same side as his broken leg. The reason his foot was broken, according to him, is because his broken leg was casted.....

Apparently with Children that have pain disorderes such as my son's, casting a broken limb is contraindicated. Because the child does not feel the pain of the break, the child will attempt to move the limb normally, even though they can't. My son, turned his broken leg inside of his cast so hard, that he broke his own foot.

Why is this significant? Because the people that mis-diagnosed him work at a public hospital, paid for with taxpayer dollars. And the people that Casted him work for Kaiser Permanente, the largest lobby for universal coverage in america.

Only the People that accepted no insurance could help my son. The Public Doctors, and the "universal coverage for all" doctors, not only misdiagnosed him multiple times, but they lied in his chart, they caused him injury, they ignored symptoms, and they caused a permanent deformity.

Whats the moral of the story?

Publicly funded Health care is not only tyrannical, it is extremely dangerous.

P.S. - If any of you have wondered where I have been for the last year, I believe that now, you have your answer.

TER
03-23-2010, 09:12 PM
My son has an extremly rare genetic disorder called "Congenital Indifference to Pain".

The Lord give you strength. I will pray for you and your family.

aravoth
03-23-2010, 09:47 PM
The Lord give you strength. I will pray for you and your family.

Thank you, his name is Connor.

silverhandorder
03-23-2010, 09:49 PM
Aravoth I don't get uneasy often. This story is tragic... I don't usually pray for people. Tonight I will be praying for your son.

Live_Free_Or_Die
03-23-2010, 09:56 PM
My son has an extremly rare genetic disorder called "Congenital Indifference to Pain". He didn't even cry at birth. When we first discovered he was not responding to pain stimuli we told his doctor. He shrugged it off, saying that it was way to rare, to be a viable diagnosis

At around seven months old his right arm looked swollen. We took him into OHSU here in Portland, Oregon. They told us there was nothing wrong with his arm, because "it didn't seem to be bothering him". We again stated, "that is because he can't feel it". They ignored it.

At nine months his clavicle grew an enormous mass over it. Again we took him in. They told us he had an infection, and that it clearly wasn't bothering him, we said it wouldn't bother him, because he doesn't feel pain, again, they ignored us.

At twelve months his leg was swollen. They gave us a working diagnosis of "Pulmonary Angio Edema", a rare, and often fatal vascular disease. They told us it was ok for him to continue walking on it, becuase "it clearly did not bother him".

3 days went by, his leg seemed to get worse. We took him into the doctor, they xrayed him, and guess what? His leg was broke. This triggered a Child Abuse work-up.

That entailed a full body scan. Which revealed healed fractures to his right arm, and his clavicle. The exact areas of concern from the previous visits.

They missed diagnosed him multiple times over the course of several months, one of those times (his arm) resulted in a permanant deformity. Despite our repeated attempt to get one of them to listen to us about his lack of pain response, they never did. They pushed the issue of Child abuse as far as they could.

In the end, the situation was resovled when my Wife and I took our son on a flight to New York. We spoke with a specialist in Neurology, a woman that literally wrote the book on pain disorders. After several tests, she diagnosed him with "Congenital Indifference to Pain", she referred us out to an orthpedist in NY who works almost exclusivly with HSAN children(another group of pain indifferent people).

That Orthopedist does not accept insurance. He has, by far, the most modern equipment I have ever seen. And I work in the industry. One glance at his x-rays and he was able to tell the type of fractures, how old they are, and the kind of motion that could've caused them. He even Identified a new fracture, on his right foot, the same side as his broken leg. The reason his foot was broken, according to him, is because his broken leg was casted.....

Apparently with Children that have pain disorderes such as my son's, casting a broken limb is contraindicated. Because the child does not feel the pain of the break, the child will attempt to move the limb normally, even though they can't. My son, turned his broken leg inside of his cast so hard, that he broke his own foot.

Why is this significant? Because the people that mis-diagnosed him work at a public hospital, paid for with taxpayer dollars. And the people that Casted him work for Kaiser Permanente, the largest lobby for universal coverage in america.

Only the People that accepted no insurance could help my son. The Public Doctors, and the "universal coverage for all" doctors, not only misdiagnosed him multiple times, but they lied in his chart, they caused him injury, they ignored symptoms, and they caused a permanent deformity.

Whats the moral of the story?

Publicly funded Health care is not only tyrannical, it is extremely dangerous.

P.S. - If any of you have wondered where I have been for the last year, I believe that now, you have your answer.

Another good example of the need for a market revolt. People who like to tell other people how to live will never recognize the inherent flaw. To these people there is nothing that can not be fixed with the use of force.

May natures god right the injustice your family and son endure.

vegaspilot03
03-23-2010, 10:02 PM
we will pull together, justice always comes through. it is inevitable.

Peace&Freedom
03-23-2010, 10:36 PM
What the HC hill does is more fully place upon medicine the same coercive regime that exists for education. Just as people opting for private education or home schooling are still also forced into funding government schools, now people who choose alternative/holistic medicine or doctors who don't accept insurance are still supposed to fund the insurance industry. Anybody choosing non-government approved resources have to double pay for both the state system, as well as for their personal choices.

Live_Free_Or_Die
03-24-2010, 01:30 AM
What the HC hill does is more fully place upon medicine the same coercive regime that exists for education. Just as people opting for private education or home schooling are still also forced into funding government schools, now people who choose alternative/holistic medicine or doctors who don't accept insurance are still supposed to fund the insurance industry. Anybody choosing non-government approved resources have to double pay for both the state system, as well as for their personal choices.

Education on steroids. If this bill holds up in the fall I envision a lot of medicare two stepping with policy and price fixing before legislating.

moostraks
03-24-2010, 06:50 AM
My son has an extremely rare genetic disorder called "Congenital Indifference to Pain". He didn't even cry at birth. When we first discovered he was not responding to pain stimuli we told his doctor. He shrugged it off, saying that it was way to rare, to be a viable diagnosis

At around seven months old his right arm looked swollen. We took him into OHSU here in Portland, Oregon. They told us there was nothing wrong with his arm, because "it didn't seem to be bothering him". We again stated, "that is because he can't feel it". They ignored it.

At nine months his clavicle grew an enormous mass over it. Again we took him in. They told us he had an infection, and that it clearly wasn't bothering him, we said it wouldn't bother him, because he doesn't feel pain, again, they ignored us.

At twelve months his leg was swollen. They gave us a working diagnosis of "Pulmonary Angio Edema", a rare, and often fatal vascular disease. They told us it was ok for him to continue walking on it, becuase "it clearly did not bother him".

3 days went by, his leg seemed to get worse. We took him into the doctor, they xrayed him, and guess what? His leg was broke. This triggered a Child Abuse work-up.

That entailed a full body scan. Which revealed healed fractures to his right arm, and his clavicle. The exact areas of concern from the previous visits.

They mis-diagnosed him multiple times over the course of several months, one of those times (his arm) resulted in a permanant deformity. Despite our repeated attempt to get one of them to listen to us about his lack of pain response, they never did. They pushed the issue of Child abuse as far as they could.

In the end, the situation was resovled when my Wife and I took our son on a flight to New York. We spoke with a specialist in Neurology, a woman that literally wrote the book on pain disorders. After several tests, she diagnosed him with "Congenital Indifference to Pain", she referred us out to an orthpedist in NY who works almost exclusivly with HSAN children(another group of pain indifferent people).

That Orthopedist does not accept insurance. He has, by far, the most modern equipment I have ever seen. And I work in the industry. One glance at his x-rays and he was able to tell the type of fractures, how old they are, and the kind of motion that could've caused them. He even Identified a new fracture, on his right foot, the same side as his broken leg. The reason his foot was broken, according to him, is because his broken leg was casted.....

Apparently with Children that have pain disorderes such as my son's, casting a broken limb is contraindicated. Because the child does not feel the pain of the break, the child will attempt to move the limb normally, even though they can't. My son, turned his broken leg inside of his cast so hard, that he broke his own foot.

Why is this significant? Because the people that mis-diagnosed him work at a public hospital, paid for with taxpayer dollars. And the people that Casted him work for Kaiser Permanente, the largest lobby for universal coverage in america.

Only the People that accepted no insurance could help my son. The Public Doctors, and the "universal coverage for all" doctors, not only misdiagnosed him multiple times, but they lied in his chart, they caused him injury, they ignored symptoms, and they caused a permanent deformity.

Whats the moral of the story?

Publicly funded Health care is not only tyrannical, it is extremely dangerous.

P.S. - If any of you have wondered where I have been for the last year, I believe that now, you have your answer.

My heart goes out to you. The local hospital just put us through almost 2 years of hell for a child with behavioral issue because they believe she is a mental disorder case and we were failing to get her medical care to hide abuse. I hate doctors after all the hassles we have been through and social services, blech don't get me started. They had to get her in their custody to see for themselves that she has no reasoning skills and we weren't instigating her behavior. Have you had the response yet regarding how sorry they are, you are just 'different'? I wish I had a penny for every time we have heard it....

You will be in my thoughts and prayers. Lucky that you could afford to get outside help. Like you we had to network outside of the system to respond and those trapped within will continue to be crushed. It angers me to no end and we are still paying the bill for something we did not do just to respond to their false allegations!!!

tangent4ronpaul
03-24-2010, 07:04 AM
More docs will change their practices over to concierge medicine and avoid the entire mess.

A doctor in NY was shut down for doing that - told he was running an insurence company without a licence. There is a thread about it here somewhre.

-t

silverhandorder
03-24-2010, 07:05 AM
A doctor in NY was shut down for doing that - told he was running an insurence company without a licence. There is a thread about it here somewhre.

-t

Fuck... you got the article on that still?

MsDoodahs
03-24-2010, 07:13 AM
A doctor in NY was shut down for doing that - told he was running an insurence company without a licence. There is a thread about it here somewhre.

-t

I use a physician that operates a concierge practice.

It is in no way illegal and there are many physicians who have already shifted their practice to the concierge method.

Krugerrand
03-24-2010, 07:16 AM
Here's a pediatrician that does concierge in SW PA:
http://www.pinnaclepediatrics.com/

I'd expect more of this. This guy does exclusively house calls - which makes a world of sense for me for a pediatrician. Taking kids to the doctors always ends up w/ more sicknesses.

MelissaWV
03-24-2010, 07:29 AM
There are a lot of stories along the lines of avaroth's, and what gets me is when people who've had those experiences are pro-bill.

I have heard similar experiences capped off with something along the lines of insurance not covering it because of some obscure reason... and then the person turns around and says it's important for everyone to have health insurance? Even President Obama talks about his mother "battling with insurance companies" while she was sick. Why oh why would you MANDATE that ALL OF US have to go through the same "battle"? Who really thinks that insurance companies will suddenly change some of their worst practices, now that they have a guaranteed clientele?

I am not entirely anti-insurance, but the quality of care and the low premiums I have been used to are going to go away over the next couple of years. Yesterday confirmed what I'd suspected ever since the bill passed: my primary care physician is retiring. He lost two more patients to old age, and I am moving, and he sees the writing on the wall about the bill. He said, when we talked yesterday, that he's had more than enough money to retire for well over a decade now, but he enjoys practicing medicine and kept at it. However, he spent most of Monday explaining the healthcare bill to patients instead of talking about what's wrong with them. He and I share a lot in the realm of political opinion.

Basically, he forsees rising premiums, rising processing times (claims already take a long time to process... but now there will be much longer processes put in place), and diminishing quality. Without more new primary care physicians, the system will not be able to handle it, and most insurances that the Government will spring for (he guesses) will rely on the ole "go to your doctor, get a referral, go to the specialist, go back to your doctor for another referral the specialist suggested..." routine. He also said that he wasn't sure where I should go to get my labs done, because there is going to be a hell of a backlog coming up.

It was generally a gloomy visit.

So, no, doctors aren't really forced into the system... and a portion of them will just retire rather than deal with having to learn a whole new system and waiting even longer for basic reimbursements.

MsDoodahs
03-24-2010, 07:38 AM
I also expect the concierge practice model to experience a lot of growth.

Also, I think there will be a lot more 'medical tourism.'

The result of "healthcare reform" will be something those who supported it didn't expect to get: a two tiered healthcare system.

The vast majority of people will suffer under "healthcare" controlled by the state, and the wealthy will continue to obtain quality care from the best providers who aren't part of the system the state controls. Even if that means the wealthy leave the US for their healthcare needs, the wealthy WILL continue to obtain quality care.

The "reform" simply puts such care completely outside the reach of average americans. Which was the goal all along - the US can't afford to pay bennies to the population, so it behooves the state to ensure that a lot of those people die.

Note that Canada has such a two tiered system, though many Canadians will fiercely deny this reality. Canadians with means who find themselves in need of care that their state run system doesn't provide (or doesn't provide within a reasonable time frame) go outside Canada to get their care. Canadians without means to obtain care outside Canada....those folks suffer.

tangent4ronpaul
03-24-2010, 07:49 AM
re: aravoth

"If you hear hoofbeats, think horses, not zebra's"

Medical students get that drilled into their heads for years.

"Everything has become cook-book medicine right now,..You are going to go to your doctor and get what they call evidence-based medicine and that's about it . You're going to have a lot of unhappy doctors so what's the point (of universal care) will the quality of coverage be really worth it."
-- Bob, A Clarence-based doctor, calling WBEN's Hardline Sunday, last name unknown.


I don't think it addresses some of the things that were of most concern to me, and that is the cost of health care and the approach of medical liability, which does nothing to improve care and adds a huge amount of expense to care. That wasn't addressed at all. It was totally ignored as far as I can see,"
-- Dr. John Hellriegle, MD, an Amherst-based OB/GYN.

On the sunscription based approach - I like it! I think he was shut down because he was in NYC.

Also of note, NYC blood collection efforts after 9/11 were stepped on when some agency came in and said that only licenced phlebotomists could collect blood and the MD's, nurces. paramedics, etc that were doing so had to stop. The ammount of blood collected slowed to a trickle because of it.

On medical tourism, a PA I know said his practice was considering doing all surgery in another country if the bill passed. many docs are talking early retirement, and we allready have a growing shortage of docs.

-t

MsDoodahs
03-24-2010, 07:57 AM
On the sunscription based approach - I like it! I think he was shut down because he was in NYC.

I have not looked in depth at that situation, but I suspect you're right - any grief that doc was subjected to was likely a result of the fucked up laws in the area where he located his practice.


On medical tourism, a PA I know said his practice was considering doing all surgery in another country if the bill passed. many docs are talking early retirement, and we allready have a growing shortage of docs.

-t

I read that there is a supermarket chain in the NE that sends all its employees to ... maybe India? anyway, they send the employee AND a companion oversees for all hip and knee replacements.

aravoth
03-24-2010, 08:01 AM
There are a lot of stories along the lines of avaroth's, and what gets me is when people who've had those experiences are pro-bill.


I know, this confuses the hell out of me.

When I heard that the orthopedist we were going to see did not accept insurance, I breathed a sigh of relief. For one, I wouldn't have to deal with referral hassles, and two, no allegiance to an insurance company meant that he had nothing to rely on on. Which in turn meant that he stood or fell based on his professional performance.

Not surprisingly, He is continuously ranked as one of the top pediatric orthopedists on the North American Continent.

Was it spendy? Yeah, very. But then, I'm the kind of person that saves money. I don't have a credit card, nor do I have any debt. Because I made choices in life to live a certain way. It is because of those choices that my wife and I were able to pay, out of pocket, for the best treatment money can buy. We are not wealthy people, by any stretch of the imagination. My Wife stays home with the children. We are a single income family. We could afford it because we saved, instead of spent it all on useless shit.

Do I think that doctor is greedy for charging that much? No. He's the best, and he wasn't born that way. He busted his ass to have his own medical office, he busted his ass to be ranked in the top of his field, and he busted his ass to have all those hot young ladies staffing that medical office of his.

He spent two weeks in Haiti, brought all his own equipment down there during the quake aftermath. Who knows how many kids get to keep their arm or leg because of him.

You can't make a man like that into a slave. Faced with the prospect of being forced to accept government issued insurance, I think he would save his pride and retire on top. Which scares the shit out of me. Because the next time my son injures himself, who in the hell will I take him too? Some mediocre shitbag at a government hospital? We tried that already, it obviously did not work out well.

I never thought that legislation could effect a person in such a direct way.

Working Poor
03-24-2010, 08:12 AM
Whats the moral of the story?

Publicly funded Health care is not only tyrannical, it is extremely dangerous.


I hope you wrote a letter to the President.

pacelli
03-24-2010, 08:46 AM
I post this because it does not seem discussed much in the threads...

If every person is required to carry insurance, then every Doctor must accept 3rd party payments.
i.e. There are no more cash transactions (or at least insignificant percentage) of cash transactions with Medical Providers..

National Provider ID hoorah!:mad:

I knew of many Doctors who stopped accepting 3rd party, Medicare/Medicaid payments....


Furthermore, everyone now gets an entry in the Medical Information Bureau ...MIB, as well as likely a medical id number.

In order to apply to accept any form of insurance, all doctors and healthcare providers are required to get a National Provider Identification number (its called an NPI number). That's nothing new.

I don't accept insurance because I haven't applied to be on any insurance panels. If clients can't afford service, I'm ethically obligated to offer a sliding scale fee whether they are paying by cash, check, gold, or silver. I'm also ethically permitted to engage in bartering.

MsDoodahs
03-24-2010, 08:48 AM
I hope you wrote a letter to the President.

WHY?

We are sooooo far beyond the letter writing phase....

ChaosControl
03-24-2010, 08:49 AM
I won't buy insurance.
I won't go to a doctor who accepts insurance.
I won't pay the fine.

**** the gov.

Brian Defferding
03-24-2010, 08:59 AM
I know, this confuses the hell out of me.

When I heard that the orthopedist we were going to see did not accept insurance, I breathed a sigh of relief. For one, I wouldn't have to deal with referral hassles, and two, no allegiance to an insurance company meant that he had nothing to rely on on. Which in turn meant that he stood or fell based on his professional performance.

Not surprisingly, He is continuously ranked as one of the top pediatric orthopedists on the North American Continent.

Was it spendy? Yeah, very. But then, I'm the kind of person that saves money. I don't have a credit card, nor do I have any debt. Because I made choices in life to live a certain way. It is because of those choices that my wife and I were able to pay, out of pocket, for the best treatment money can buy. We are not wealthy people, by any stretch of the imagination. My Wife stays home with the children. We are a single income family. We could afford it because we saved, instead of spent it all on useless shit.

Do I think that doctor is greedy for charging that much? No. He's the best, and he wasn't born that way. He busted his ass to have his own medical office, he busted his ass to be ranked in the top of his field, and he busted his ass to have all those hot young ladies staffing that medical office of his.

He spent two weeks in Haiti, brought all his own equipment down there during the quake aftermath. Who knows how many kids get to keep their arm or leg because of him.

You can't make a man like that into a slave. Faced with the prospect of being forced to accept government issued insurance, I think he would save his pride and retire on top. Which scares the shit out of me. Because the next time my son injures himself, who in the hell will I take him too? Some mediocre shitbag at a government hospital? We tried that already, it obviously did not work out well.

I never thought that legislation could effect a person in such a direct way.

I really really wish there were more doctors out there like this, that don't accept insurance or Medicaid/Medicare.

I really hope these doctors continue to buck the system and not accept insurance anyway. This UHC bill is already bad enough, but the mandate is the worst part of it, because of the situation you just spoke about in detail on.

hopeforamerica
03-24-2010, 09:19 AM
More docs will change their practices over to concierge medicine and avoid the entire mess.

That's exactly what my doctor did one year ago. He saw the writing on the wall.

ChaosControl
03-24-2010, 10:10 AM
Speaking of all this, does anyone know a good resource for finding both medical doctors and dentists who don't accept insurance and just go on a direct pay approach?

MsDoodahs
03-24-2010, 12:34 PM
Try a google search using "concierge care" and your city.

:)