How Obamacare Will Affect Your Doctor.

[FirefightnRick]

http://online.wsj.com/article/SB124208383695408513.html

The 60% of doctors who are self-employed will be hardest hit. That includes specialists, such as dermatologists and surgeons, who see a lot of private patients. But it also includes tens of thousands of primary-care doctors, the very physicians the Obama administration says need the most help.

Doctors will consolidate into larger practices to spread overhead costs, and they'll cram more patients into tight schedules to make up in volume what's lost in margin. Visits will be shortened and new appointments harder to secure. It already takes on average 18 days to get an initial appointment with an internist, according to the American Medical Association, and as many as 30 days for specialists like obstetricians and neurologists.

Right or wrong, more doctors will close their practices to new patients, especially patients carrying lower paying insurance such as Medicaid. Some doctors will opt out of the system entirely, going "cash only." If too many doctors take this route the government could step in -- as in Canada, for example -- to effectively outlaw private-only medical practice.

Rick

[meangreendork]

" He's partner to a firm that invests in health-care companies ."

[Censored by Laurie]

" He's partner to a firm that invests in health-care companies ."

I see you...and I'll raise you:

OPINION

[meangreendork]

There really should be a restructuring of health care in America. Really, if an insurance company can't compete with a government plan, then it needs to rethink how it runs itself - and that probably means run more efficiently. For private practice doctors, they're losing money from private insurance and malpractice lawsuit coverage...there's a whole laundry list of things that need to be cleaned up in the medical insurance industry that would make it competitive (easily) with a government plan or render it entirely obsolete.

[FirefightnRick]

I see you...and I'll raise you:

I'll match and raise again:

Dr. Gottlieb, a former official at the Centers for Medicare and Medicaid Services, is a fellow at the American Enterprise Institute and a practicing internist.

Rick

[KRAM1]

Too bad the playing field will be skewed so much by Obamacare and the government that the private companies wil not have the chance to compete on a level playing field. When we actually get to see and READ the details of the Obama plan most (with any sense at all) will see it for what it is...another power grab by this administration. The Obama Administration cares absolutely ZERO about the quality of anyone's health care plan, they just want the control and the power. It is all about control and power with these guys...just like most socialists!

[greenminer]

Can anyone provide some valuable perspective on how this will effect insurance for those that are self-employed?

You can take quick, easy shots at how this will shorten visits and increase waiting times; but what about us young guns where that's not really a concern? I'm not visiting dermatology or surgery anytime soon. I need general health care (dental cleanings, yearly checkups) insurance to be as affordable as possible.

Or have I been misled to believe that getting insurance while being self-employed is ridiculously - or unfarily? - expensive? While some *cough*Rick*cough* are quick to point out what they don't like about Obama, I am under the impression that our insurance - especially options/affordability for the self-employed - need a considerable overhaul; at least a reconsideration.

[meangreendork]

Can anyone provide some valuable perspective on how this will effect insurance for those that are self-employed?

You can take quick, easy shots at how this will shorten visits and increase waiting times; but what about us young guns where that's not really a concern? I'm not visiting dermatology or surgery anytime soon. I need general health care (dental cleanings, yearly checkups) insurance to be as affordable as possible.

Or have I been misled to believe that getting insurance while being self-employed is ridiculously - or unfarily? - expensive? While some *cough*Rick*cough* are quick to point out what they don't like about Obama, I am under the impression that our insurance - especially options/affordability for the self-employed - need a considerable overhaul; at least a reconsideration.

I'm in the same shoes as you.

From what I'm gathering, the new plan is to trim down the excess of the existing private insurance industry, tossing out the needless bonuses paid to the wrong people, and making the system less cumbersome and top-heavy. It's supposed to (and that's in italics because this involves private industry working with the government) make things more affordable for those who don't want government coverage. It's also supposed to balance out in such a way that private insurance will be able to compete with government insurance, which if they want to stay in business, they will.

Both options still require that someone pays into their insurance coverage plan, it's just a matter of what you get and what you pay for it.

I'm going to do like what I'm doing now, which is take the better deal with the better office coverage. I'm about to switch to BC/BS pretty soon.

[eulesseagle]

You want to find out how great socialized medicine is? Google the health care industries in Canada and England. You can read the various papers from around the world and get into their archives and read the stories yourselves.

What has the government run sucessfully and you want them to run health care??? what the heck for??? Currently, England and France are telling Obama not to get into socialized health care. Of course you will not read this in American newspapers.

That is why it is important to read the papers of other countries. You will find out more about what is happening here in their "rags" than what the "red star newspapers" in the US give you.

[KRAM1]

Can anyone provide some valuable perspective on how this will effect insurance for those that are self-employed?

Sure, it will SUCK just like it will for everyone else. Socialized medicine costs too much and provides poor overall care. What elese do you need to know? You will get HOSED along with everyone else. Count on it.

[greenminer]

Sure, it will SUCK just like it will for everyone else. Socialized medicine costs too much and provides poor overall care. What elese do you need to know? You will get HOSED along with everyone else. Count on it.

I'm certainly not advocating for/against Socialized medicine. I'm glad to know where you stand, though.

I was just looking for some perspective from others self-employed.

How do you get your insurance? Does it come with sawlt awn it?

[GreenBat]

Sure, it will SUCK just like it will for everyone else. Socialized medicine costs too much and provides poor overall care. What elese do you need to know? You will get HOSED along with everyone else. Count on it.

Another typical reponse from KRAM. What about the military medical care. It is a socialistic system. People are always saying that the Military deserves the best of everything. I agree and grew up a dependant of a father, who proudly served his country, so I can speak about the socialized military medical care. It was great. I had to spend less time waiting to see a doctor in this socialized system than I do in having private insurance.

Is, as you call it, Obamacare the answer? I do not know. But I do know that something needs to be changed in the healthcare industry, where people die in the emergency room because the hospital can't get approval to treat from someone.

[FirefightnRick]

Steve,

I might suggest you send Harry a P.M. about some info on it. After all, Health Insurance is his business. I know after speaking with him recently that he's keeping up with the latest journals and information on a daily basis and perhaps he can give you some insight as to what independants can expect for the future. I spoke with two doctors yesterday about the various arguements concerning the socialized health rationing that's coming, and it is coming. Both said that if they are squeezed to the point that they cannot make it affordable that they will go private, which may also be an option for independants like yourself? Of course, in the journal article linked above it's mentioned that Canada has prevented that from happening there.

Rick

[Green Gas]

All you have to do is ask a Canadian. It sucks.

The typical scenario is the good docs won't take the crappy pay they receive from a government plan and go private. Then the people say well thats not fair because just about no one will take that government plan and then Congress will make it law that all Doctors have to except the Nation program. Then people will say but those that pay for themselves get better care, next you have the Canadian system where there is no private care by law.

[UNTflyer]

There really should be a restructuring of health care in America. Really, if an insurance company can't compete with a government plan, then it needs to rethink how it runs itself

When the government has every citizen as a customer, how CAN you compete?

[UNTflyer]

Another typical reponse from KRAM. What about the military medical care. It is a socialistic system. People are always saying that the Military deserves the best of everything. I agree and grew up a dependant of a father, who proudly served his country, so I can speak about the socialized military medical care. It was great. I had to spend less time waiting to see a doctor in this socialized system than I do in having private insurance.

You have GOT to be kidding me. I grew up a Navy brat, and it was horrible... BTW, the military went to a PPO-type plan for dependents to save money. SO much for that theory.

[Harry]

Health Insurance as we know it will be reformed and it probably needs to be. Rewind back to 1993, when President Clinton and Hillary tried to reform healthcare and faced major obstacles from groups representing hospitals, health-insurance companies, doctors, pharmaceuticals, medical devices and labor unions. Some of us older fans remember the "Harry and Louise" commercials that used scare tactics to sway the masses against the proposed changes. These were funded by the AMA and Health Insurance Association. At the time, I was employed by a large health carrier and was against reform and recall being quite pleased that it never came to fruition.

Monday's press conference with President Obama and the major healthcare players standing side by side was a clear indication that they realize reform is inevitable and you are better off having a seat at the table versus being on the outside looking in. They are talking big dollars, like a savings of 2 trillion over 10 years. The specifics on how this will actually be achieved remain murky. Having been on that side of the world, I have my doubts. It's hard to have a doctor and an insurance guy in the same room without a fistfight or verbal exchange in my experience.

At my agency, we are constantly battling on behalf of individual and small to midsized companies who often fall victim to rising premiums, double digit renewal increases and poor service. We also see unfair underwriting practices, like refusing to cover individuals with pre-existing conditions or charging women higher rates than men. I have a client who tried to get family coverage and could not get her husband covered on the plan because of a very minor issue even though the rest of the family was 100% healthy. I am talking about a complete denial, no rate loads or anything. This guy is really quite healthy, no surgeries no ongoing diseases or conditions. It's not right, insurance should not only be available to the very healthy and I sense that there are a lot of people, especially small companies and self employed individuals who need it but get lost in the complicated system required to purchase a policy. This is not meant as an indictment of every health care plan, there are some good ones that I work with on a daily basis, but many of them face tremendous pressures from their stockholders to produce outrageous profit margins and ROI's.

Healthcare executives are actually inviting Congress to mandate Universal coverage, i.e. coverage for all Americans and are even willing to accept strong federal regulation of the entire industry which would have been unheard of 3-5 years ago. These landmark concessions are - in my opinion - based on their fear of the possible addition of a public insurance plan option, something Obama has been supportive of and the democrats covet. A public health plan option would be offered alongside the private insurance options and would be priced more competitively, pulling much of the membership and associated revenues with it. Insurers fear this public plan option could drive them out of business and eventually would lead to a single payor option which could essentially eliminate the entire industry. This is not an outcome that I support, as it would put us in a nationalized healthcare situation and I think it could affect the quality of care we have become renowned for in the world. I am becoming resigned to the fact that a public insurance plan option may become a reality and I hope that if that happens, they will create a structure in which private plans could survive and compete favorably against it. It won't be easy.

I am following the developments quite closely both from a business perspective as it impacts my clients, and from a historical perspective as there have been attempts to reform this juggernaut dating back to the Nixon and Carter terms. The country is quickly becoming tired of the ever expanding Obama budget and bailouts at the taxpayer's expense. This proposed healthcare reform will be very costly, regardless of any savings are being promised by this about face from the industry. It will be interesting to see how it all plays out.

[The Fake Lonnie Finch]

I've seen government run health care in my wife's home country of Mexico. Trust me, it will suck.

The rich will still be able to pay to get the care they need. What will happen is the middle class will be folded into the same pathway as the lazy and irresponsible. The level of care will not be brought up, but dragged down.

It's really, really sad. Those of us who have responsibly shopped and chosen our own health care plan for years are the ones who will screwed the worst. It's a big sacrifice in our budget, but we do it because it's the right thing to do.

I thought I'd never say this, but if this is what America comes to - hard work and responsible living rewarded with outright government thievery on behalf of the lazy and drug-addled - I will never say the Pledge of Allegiance again. I will not pledge allegiance to the flag of a socialist or communist country, not even my own.

[SilverEagle]

I've seen government run health care in my wife's home country of Mexico. Trust me, it will suck.

The rich will still be able to pay to get the care they need. What will happen is the middle class will be folded into the same pathway as the lazy and irresponsible. The level of care will not be brought up, but dragged down.

It's really, really sad. Those of us who have responsibly shopped and chosen our own health care plan for years are the ones who will screwed the worst. It's a big sacrifice in our budget, but we do it because it's the right thing to do.

I thought I'd never say this, but if this is what America comes to - hard work and responsible living rewarded with outright government thievery on behalf of the lazy and drug-addled - I will never say the Pledge of Allegiance again. I will not pledge allegiance to the flag of a socialist or communist country, not even my own.

I don't pretend to understand all (or any for that matter) of the complexities of the Insurance industry. But I do know that the vast majority of people who don't have insurance coverage are children. And I'm sick to death of hearing children being lumped into the broad (and convenient) catagory of the "lazy" and "irresponsible".

[KRAM1]

Another typical reponse from KRAM. What about the military medical care. It is a socialistic system. People are always saying that the Military deserves the best of everything. I agree and grew up a dependant of a father, who proudly served his country, so I can speak about the socialized military medical care. It was great. I had to spend less time waiting to see a doctor in this socialized system than I do in having private insurance.

Is, as you call it, Obamacare the answer? I do not know. But I do know that something needs to be changed in the healthcare industry, where people die in the emergency room because the hospital can't get approval to treat from someone.

Well, you obviously know little to nothing about the current military health system. Check out how dependents are handled today...then tell us all how great it is...and, buy the way...military health care is something I have a good bit of interest in these days...I have a married nephew serving his third (THIRD) overseas tour at the moment (2 in Iraq and this one in Afghanistan). Ask him how his wife and two little girls are handled in the military system today...AND, my son and daughter-in-law are both Navy Doctors currently. So, GreenBat.....don't know about you, but I am fairly well "up" on the current state of the military health care system.

Oh, but, just another typical response from GreenBat.

[oldguystudent]

I don't pretend to understand all (or any for that matter) of the complexities of the Insurance industry. But I do know that the vast majority of people who don't have insurance coverage are children. And I'm sick to death of hearing children being lumped into the broad (and convenient) catagory of the "lazy" and "irresponsible".

Pfft. Those children are the most drug addled of them all. Besides, they've got CHIP. As for the guy Harry mentioned who got denied for health insurance, he should've just shopped around more. A quick internet search from any GMG member would supercede Harry's years of experience and find him excellent health care for only pennies a day! The guy obviously is not putting in enough of his own hard work. Otherwise he would be completely immune to any of life's misfortunes.

So before I get accusations of wanting some totally socialist government health care written up by the ghost of Stalin, I'll reiterate that I just want to see something available, but not mandatory for everyone. I think the current system of insurance companies, who already try very hard to dictate what procedures will and will not be approved, is every bit as corrupt as a government run system would be ineffecient.

I think many here simply don't believe in consumer protection of any kind. All regulation comes from government so it must therefore all be bad. Maybe in the long run that's true, but to quote a famous economist with whom most of you vehemently disagree, in the long run, we're all dead anyways.

Meh. What do I know? I'm gonna' go teach some Chinese whores how to drink responsibly now.

Edited May 13, 2009 by oldguystudent

[KRAM1]

Meh. What do I know? I'm gonna' go teach some Chinese whores how to drink responsibly now.

Can I help????? PLEASE PLEASE!!!!!

[GreenMachine]

Another typical reponse from KRAM. What about the military medical care. It is a socialistic system. People are always saying that the Military deserves the best of everything. I agree and grew up a dependant of a father, who proudly served his country, so I can speak about the socialized military medical care. It was great. I had to spend less time waiting to see a doctor in this socialized system than I do in having private insurance.

Is, as you call it, Obamacare the answer? I do not know. But I do know that something needs to be changed in the healthcare industry, where people die in the emergency room because the hospital can't get approval to treat from someone.

I was in the military as well and I can say the few times I had to use the military hospital to see a dr it was a horrendous experience. On the other hand, I had friends that had good experiences with military medical care. I guess this socialized medical plan is kinda like a box of chocolates, you just never know what you are going to get.

[UNTflyer]

I don't pretend to understand all (or any for that matter) of the complexities of the Insurance industry. But I do know that the vast majority of people who don't have insurance coverage are children. And I'm sick to death of hearing children being lumped into the broad (and convenient) catagory of the "lazy" and "irresponsible".

Please. First off, according to the Kaiser Commission on Medicaid and Uninsured, the "vast majority" of uninsured are childless adults (25.5 million out 44 million uninsured).

Second, 3/4 of the 8 million uninsured children are eligible for Medicaid or SCHIP. Of those 8 million children, 11% are ineligible for public assistance but they have family incomes less than 300% of the federal poverty level. That leaves 15% in families who can afford health insurance but choose not to purchase it.

In other words, of the 44 million uninsured people in the country, only 880,000 are children in families who cannot afford it and cannot get public assistance. But even then the Kaiser Institute points out that 52% of these are in transitional families moving from poverty to middle class.

So in the end, we're talking about 422,400 children who truly need help.

Edited May 13, 2009 by UNTflyer

[oldguystudent]

Please. First off, according to the Kaiser Commission on Medicaid and Uninsured

Kaiser Commission? As in Kaiser the massive HMO known for it's stalwart gatekeeper system in health care denial?

the "vast majority" of uninsured are childless adults (25.5 million out 44 million uninsured).

So 58% is a vast majority? Is the remaining 42% an insignificant minority of outliers?

OK. Now that we're done needlessly picking apart syntax...

So in the end, we're talking about 422,400 children who truly need help.

Is this acceptable collateral damage for the profit motive?