You are the only person I have heard stating that Obamacare does not cut Medicare $700B. That goes for the talking heads on the left. We can debate which method, Obama's or Ryan's, of cutting Medicare is better but to state Obama is not cutting is dishonest.

 

That said, cutting what doctors will be reimbursed has a threshold. There will be a basement and when Medicare digs through the basement floor the doctors are going to tell them to take a hike. There is a reason your last bill was $196 instead of $96. The doctor said $409, the insurance said $50 and they ended up agreeing on $196. Had your insurance stood their ground on a lower rate you would have received a letter stating your doctor no longer excepted your insurance.

 

I don't think it is at all dishonest since there is no change to the care received. If I go into a car dealer to buy a car and the dealer says $30,000, I say $26,000 and we settle on $28,000, there is no cut to the car. The only cut is in what is being paid. You believe that the reimbursement rates to providers will be so low that everyone will quit. I don't. There is NOTHING in the ACA that reduces the services provided under Medicare or private insurance. That is a fact.

I think to truly reform health insurance you have to start with overall costs of health care. And I don't mean you tell doctors what their gonna make but the whole process has to be more transparent and realistic. At the same time people have to be smarter with health care. They have to make better choices. I think health care is much like taxes. People would care alot more if they had to write the checks directly. With health care people don't think about what is being spent because their insurance pays the bill and normally the premiums comes direct out of their check (just like taxes). How many unneeded trips to the ER or unneseccary procedures would be avoided if the you had to write the check? I have a friend who is a mailman. Everytime you turn around his wife is taking one of their kids to the ER. They get a fever and it's off to the ER.

 

Secondly you have to allow insurance to be sold across statelines.

I agree with all of that.. Let me give you a scenario that happened to us. My 11y.o. son had an MCL sprain in football a couple of years back. I didn't go to the ER because I have friends that help me circumvent that junk. No offense to ER docs, (ask LRCW if you want to know how that whole ball of yarn spins) but I get a digital film that you can't really read, get charged for the visit, the digital xray and the radiologists interpretation. I bypassed all that crap and went straight to the orthopod who of course wanted an MRI. My friend is the director over the imaging center so I got to bypass some more there, but still had to pay for the radiologists interpretation of the MRI. (by the way, the single-most overrated, unnecessary position in healthcare in my humble opinion)

I went back to the orthopod who not only didn't read my son's MRI (I mean didn't even look at it) but simply regurgitated the radiologists opinion (which I had courtesy of the my imaging director friend). Needless to say, I left with my son, the MRI disk and went to another hospital where the ORTHOPOD read the MRI, said that the stuff the radiologist had included in the report wasn't there (I mean wasn't even evident on the image at all) we got a knee brace and he lived happily up to now without surgery that the other dork was ready to perform without exam or MRI result.

 

You may say that all of that is just example of inept care from the physicians. And I would agree to a point. Sadly, with the way the hospitals have taken the insurance licks over time, they pile on a multitude of unnecessary charges and simply retarded treatment. And as long as they all make money, no one says a peep.

I don't think it is at all dishonest since there is no change to the care received. If I go into a car dealer to buy a car and the dealer says $30,000, I say $26,000 and we settle on $28,000, there is no cut to the car. The only cut is in what is being paid. You believe that the reimbursement rates to providers will be so low that everyone will quit. I don't. There is NOTHING in the ACA that reduces the services provided under Medicare or private insurance. That is a fact.

If you think that the quality of care won't diminish, I think you're sadly mistaken.

What it's going to do is close medical schools because why in the frig would I want to subject myself to that torture and ridiculous student loan burden for the "reward" at the end? As a young man of good conscience I want to help people, but that only goes so far, I want to get paid!!! At that rate, law schools will be so overcrowded with the cream of the crop students all battling to pass the bar so they can go into politics.

 

I don't believe that you are correct, but I suppose we will find out. Doctors deserve to be paid. They represent the best and brightest. I think that public pressure will make sure that happens.

If you think that the quality of care won't diminish, I think you're sadly mistaken.

 

I really am interested in why you think quality will diminish.

As a matter of fact, maybe someone close to the King's Daughter drama (like LRCW) could expound on why the hospital was doing heart cath's on every one who passed through the place with gas pains. Huge inquiry that included federal agencies. Why? Because with the reduced payments you have to keep everyone happy somehow. Bill that medical card all you can, the reimbursement sucks, so you pile on additional charges to make it worth your while. Is this health care bill going to stop that?

I don't believe that you are correct, but I suppose we will find out. Doctors deserve to be paid. They represent the best and brightest. I think that public pressure will make sure that happens.

 

I'd like to know how you think it won't? How are physicians going to continue to be reimbursed at the rate they are now? Do you not think that the AMA would be hush hush about all of this if their contingency was satisfied that they'll maintain their lifestyle?

Well, I can say without much reservation, that the AMA and it's members are fairly tightly knit (not to mention wealthy). I'd guess that you'll see a blanket movement within the profession, whatever that may be. It's a very strong lobby.

 

But I'm a new doctor or a doctor whose practice isn't doing as well as I hoped. Why wouldn't I take your customers that you're turning away?

But I'm a new doctor or a doctor whose practice isn't doing as well as I hoped. Why wouldn't I take your customers that you're turning away?

 

Why are you not doing well? If your a new doctor that no one else wants to see, then sign me up.

So would I be wrong to assume that if a good number of existing doctors quit taking Medicare patients that some other doctors would accept them? In other words, the "market" would work like it always does when there's a need?

 

Possibly for a while anyway. The problem is what doctors will be taking them? Will they be as good? Will they be as convenient? Will overall health care slip?

Isn't there a correlation to doctors not accepting medicaid? Seems to me I've heard thats been happening. If true, how has that worked out?

But I'm a new doctor or a doctor whose practice isn't doing as well as I hoped. Why wouldn't I take your customers that you're turning away?

You have enormous debt. You may have a lease on a bldg and staff you have to maintain. Many a practice has gone asunder because you can't collect enough to make ends meet. Get online and see the hot item practices for sale and you'll see "no managed care" in there somewhere. They don't teach you much business when you are in med school, however, it's common knowledge that managed care is not the way to build a productive practice.

You have enormous debt. You may have a lease on a bldg and staff you have to maintain. Many a practice has gone asunder because you can't collect enough to make ends meet. Get online and see the hot item practices for sale and you'll see "no managed care" in there somewhere. They don't teach you much business when you are in med school, however, it's common knowledge that managed care is not the way to build a productive practice.

 

This, plus if nobody want to be treated by you then you suck at doctoring. I don't want a cheap deal on parachutes, life vest, fire extinguishers, or medical care.

 

Here is something never said at the hospital:

 

"Who do you want to do your surgery?"

 

"Whoever charges the least"

Medicare patients will have to settle for what physicians they can get in to see just like Medicaid patients do now.

I read today (and I think someone alluded to this in another thread) that the reported "gutting of Medicare" by the President is not a CUT of $700B as claimed but rather a decrease in the rate of increase. In other words, Medicare spending would continue to rise but at a slower rate than previously planned.

 

So this begs the question.

 

When Gov Romney and his supporters say it's a $700B cut ie gutting Medicare do they a)not fully understand or b)they're playing a game of semantics?