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The Great ObamaCare Debate, Part 237: Back to Court The Great ObamaCare Debate, Part 237: Back to Court

12-06-2011 , 10:43 PM
Quote:
Originally Posted by FlyWf
Fixes what? Obamacare is health insurance reform, it's not going to make your toast always land butter side up.
Obamacare is government takeover of health insurance. And we all know how efficiently government operates. lol
12-06-2011 , 10:44 PM
I have an ear infection. It cost me $5 to go to Urgent Care and $5 at the pharmacy.

This is the cost of county run health care. I suspect it will be $7 after Obamacare.

FML.
12-07-2011 , 12:27 AM
Quote:
Originally Posted by jogsxyz
Already made to medicare age. Was once sick for 36 hours.
Much cheaper to pay to have appendix removed than to pay 65 years of health insurance.
Quote:
Originally Posted by jogsxyz
Obamacare is government takeover of health insurance. And we all know how efficiently government operates. lol
12-07-2011 , 12:56 AM
Quote:
Originally Posted by renodoc
btw- since these threads are so fun.

I saw a 23 year old healthy female the other day who was referred to me for a "bullseye maculopathy." You can google if you want--this would probably fall into the 20% that the chimp/robot couldn't get right.

Anyway, I didn't find anything wrong with her. I had my partner look at her also and I called the referring doc to ask him what exactly he thought he saw. I did an OCT which was normal. I also took funds photos at no charge. I think she's got blue cross insurance. Here's a normal OCT (not hers):



So, new patient in my office for about 90 minutes. Gets some tests done and sees two doctors.

How much should I get paid for seeing this patient?

How much will I get paid for seeing this patient?
Well, if there's no diagnosis....you get paid nothing. You could bill a 99205 or 99245 (can bill this because amt of time spent with pt), but of course you must come up with a dx to support the visit. It looks like you cant/didnt so technically unless you can pull up a dx...it doesnt look good. Also, why not bill the ins for the 92250 (fund photo)? I'm sure you can find some sort of dx for this..also keep in mind that BCBS pays this twice rt/lt modifiers.

Edit..didnt see that you answered this a few posts up. I was right
12-07-2011 , 01:09 AM
Quote:
Originally Posted by suzzer99
Sheesh. Either govt isn't jacking prices to the moon or it's ruining Renodoc's life with draconian Medicare price cuts. Can govt ever get anything right?
Obviously you are ill informed of the way the medical world works for docs.

MOST docs haven't had a raise in years. YEARS. Especially if you're a single practitioner. The ins companies hold all the cards. If a single practitioner is unhappy with his reimbursement from "x" ins company, they tell him **** off and drop out if he doesnt like it. End of story...no negotiations..nothing.

This is why alot of docs are closing shop and joining larger practices. Larger practices have much more power and can successfully negotiate higher rates. Hospitals are in and out of plans all the time while they renegotiate rates.

Since the doc hasnt gotten a raise in yrs...he must see more pts to keep up with the upkeep of his practice. Have to give raises to your staff, prices go up..etc. Also, transitioning to electronic medical records (while somewhat worthwhile--but im not totally sold) adds an hour or two to a physician's day.

Most people think doctor="millionaire" and have the life. Most people=dummies.
12-07-2011 , 01:10 AM
Quote:
Originally Posted by mikeinyonkers
Well, if there's no diagnosis....you get paid nothing.
Bingo.

Again, I'll ask the resident experts--this gets "fixed" under the ACA, right?
12-07-2011 , 01:16 AM
Quote:
Originally Posted by renodoc
Bingo.

Again, I'll ask the resident experts--this gets "fixed" under the ACA, right?
The resident experts here all hail Obama. Take from the "rich" and give to the poor. This will bankrupt the states while shuffling everyone into medicaid. Wonder who's going to pay for this?

Would think that you need a dx for any visit doc...unless they scrap the current medical billing guidelines. Its extremely rare to have an instance such as you did...but it does happen from time to time.
12-07-2011 , 01:28 AM
Quote:
Originally Posted by renodoc
Again, I'll ask the resident experts--this gets "fixed" under the ACA, right?
Before Obamacare, why didn't you do better than this?
12-07-2011 , 01:34 AM
Quote:
Originally Posted by jogsxyz
Obamacare is government takeover of health insurance. And we all know how efficiently government operates. lol
Keep beating that drum. lol

Lie of the Year Winner 2010 - Government Takeover of Health Care/
12-07-2011 , 04:11 AM
Lulz: http://www.tnr.com/blog/jonathan-coh...court-standing

Quote:
The legal case against the Affordable Care Act may have just become weaker. And it’s not because of anything that happened in Washington. It’s because of something that happened in Florida: The filing of bankruptcy papers by Mary Brown, who until recently owned and operated an auto repair shop near Pensacola.

Brown’s story, which the Wall Street Journal reported in Monday’s editions, seems genuinely heartbreaking: From the sounds of things, the twin shocks of the recession and the Gulf oil spill basically killed her business. One former employee tells the Journal that Brown fought “every day” to keep the shop going. Another describers her as “professional, truthful, honest" and adds that "she really took care of us."

But Brown isn’t just any old small business owner. She’s the lead plaintiff in the lawsuit against health care reform that the National Federation of Independent Businesses (NFIB) and 26 states filed in 2010. Yes, that’s the same case the Supreme Court just agreed to hear – the case that could determine whether Obamacare, as it’s come to be known, will stand or fall.

The Journal story – the product of excellent reporting by Emily Maltby, Vanessa O’Connell, and Jess Bravin* – focuses on the new legal issue that Brown’s financial situation raises: She may no longer have the standing to sue. According to the article, the bankruptcy makes it more difficult for Brown to claim that the Affordable Care Act will harm her interests, since she can no longer claim it will damage her business. In addition, the article states, her financial situation makes it more likely she wouldn’t even be subject to the mandate – again, calling into question whether she can claim the law would harm her.

...

The legal case against the health care reform really boils down to one question: Does the government infringe upon your freedom when it demands that you obtain insurance or pay a penalty, as long as you have the money to afford it? Or is the government merely asking you to help bear the cost of medical care you will inevitably consume – a cost that, otherwise, the rest of society would have to pick up, chiefly in the form of higher taxes, higher insurance premiums, and lost income?

Brown adheres to the former point of view: “No one has the right to try to control how you spend your money,” Brown told the Journal. But the bankruptcy filing that she and her husband made, and which TNR obtained via online court records, lists among the couple's unsecured creditors several providers of medical care – a hospital and a physician group in Florida; an anesthesiology group based in Mississippi; and an eye care center in Alabama. The total, based on the court filing, appears to be a little less than $5,000. The bankruptcy filing also indicates that the couple has $400 in expected monthly "medical and dental" expenses.

...

Bankruptcy proceedings frequently leave doctors and hospitals with unpaid bills. When that happens, doctors and hospitals write off the cost as “uncompensated” care – and pass along at least some portion to the rest of society, in one form or another. Some credible estimates have suggested uncompensated care adds up to more than $40 billion a year.


Also note that Brown's creditors include providers from three different states. A key issue in the constitutional challenges to the Affordable Care Act is whether health insurance status has consequences for "interstate commerce." If nothing else, this filing is a reminder that the business of health care frequently spans state borders.

Just to be clear, I’m not blaming Brown for her bankruptcy or for her lack of health insurance. Far from it! According to the Journal story, Brown and her husband used to have health insurance -- and dropped it because the cost, more than $1,100 a month, was prohibitive.

That is all too typical of the insurance market today. Small business owners frequently struggle to find decent health benefits, particularly as they get older, because the market for both individuals buying on their own and small businesses is extremely dysfunctional. Insurers jump in and out of the market, broker fees drive up premiums, and plans tend to have spotty benefits. Most important of all, carriers are practice aggressive forms of “risk selection” – that is, altering coverage, raising premiums, or simply denying coverage to people with pre-existing conditions and other signs of medical risk.

Brown told the Journal that the costs of health care are one reason she opposes the law; if the Affordable Care Act takes effect, she said, more businesses will "close because they can't afford health care, and more people will be out of work." But I think the predicament of small business is more an argument for the Affordable Care Act than against it.
It's weird - you'd think the republicans/Obamacare foes would have found a way to keep her out of bankruptcy. Maybe all that health insurance industry lobbying money is going to work already.
12-07-2011 , 08:44 AM
Quote:
Originally Posted by mikeinyonkers
MOST docs haven't had a raise in years. YEARS. Especially if you're a single practitioner. The ins companies hold all the cards. If a single practitioner is unhappy with his reimbursement from "x" ins company, they tell him **** off and drop out if he doesnt like it. End of story...no negotiations..nothing.

This is why alot of docs are closing shop and joining larger practices. Larger practices have much more power and can successfully negotiate higher rates. Hospitals are in and out of plans all the time while they renegotiate rates.
You are not alone. This is a trend in many industries (farming, retail stores, etc.) - get the **** over it. Or at least recognize that your complaint is hardly unique and you still have a better life than the majority of other people.
12-07-2011 , 08:47 AM
Quote:
Originally Posted by jogsxyz
Obamacare is government takeover of health insurance. And we all know how efficiently government operates. lol
Once again, I'll ask for claims to back this kind of statement up. There are many other countries with more government intervention than the US that spend significantly less money for more-or-less equivalent (and sometimes better) patient outcomes. What's your explanation for this?
12-07-2011 , 09:50 AM
Quote:
Originally Posted by jjshabado
Once again, I'll ask for claims to back this kind of statement up. There are many other countries with more government intervention than the US that spend significantly less money for more-or-less equivalent (and sometimes better) patient outcomes. What's your explanation for this?
Where's your proof that your statements are accepted by all as fact?
12-07-2011 , 09:56 AM
Quote:
Originally Posted by suzzer99
The government is doing it all wrong. Instead of looking for ways to pay for medicare. They should be trying to find ways to provide health care more efficiently and more inexpensively.
12-07-2011 , 09:57 AM
I don't care if they're "accepted" as fact, but one example has already been well sourced in this thread.

Canada:
1) Greater intervention by the Government (not sourced - but I assume you'll accept this)
2) Significantly Lower per-capita spending (approximately half as much as the US)
3) No significant differences in patient outcomes (noted in a number of studies but I linked to one particular one earlier in this thread).

The same can be said for a number of other countries in the world.
12-07-2011 , 10:27 AM
Quote:
Originally Posted by suzzer99
Quote:
The legal case against the Affordable Care Act may have just become weaker.
Is the author of this article a lawyer?

Well he answers my question with this:
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I’m not a lawyer, so I’m really in no position to adjudicate the standing question.
.
Enough said.

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It's weird - you'd think the republicans/Obamacare foes would have found a way to keep her out of bankruptcy. Maybe all that health insurance industry lobbying money is going to work already.
We don't know a thing about any future bankruptcy filing, what kind of business entity she had vis-a-vis IRS tax code rule and such. I'm no expert on bankruptcy law but it's conceivable to me that a business reorganization (chapter 11) may be harder due to obligations stemming from Obamacare.
12-07-2011 , 10:50 AM
What on earth are you basing that on?

Also you're ignoring the two major points of the article:

1) Her bankruptcy filing might weaken the SCOTUS case (click through to the WSJ article if that makes you feel better).

2) Medical bills are part of the reason she's going bankrupt. The US is the only even semi-wealthy country on earth where medical care is a major cause of bankruptcy.

People with good corporate or govt insurance don't go bankrupt over medical bills. Obamacare will provide the self-employed and small businesses (particularly those with older owners/workers) with that kind of insurance, instead of the dysfunctional private and small business insurance market hey have to deal with now.
12-07-2011 , 10:57 AM
My prediction is that for a lot of small business owners and self-employed like the woman in the law suit - Obamacare is going to be like smoking bans were to bar owners and bar patrons.

IE - "No way! This will not stand! It's not about smoking/healthcare - it's about Freedom!!!" ... years later ... "Oh hey, this is kind of nice."

And soon the next generation will go on to forget how nasty, disgusting and unhealthy bars ever were--so as to be completely unfettered in their belief that the gubmint can do nothing right. It is the cycle of life.
12-07-2011 , 11:25 AM
edit n/m i shouldnt hijack
12-07-2011 , 01:29 PM
Quote:
Originally Posted by mikeinyonkers
Most people think doctor="millionaire" and have the life. Most people=dummies.
I know 90% of people would gladly trade places with them.
12-07-2011 , 01:50 PM
I never understood why people don't support healthcare for everyone. It just never made sense.

You already have to wait so long for care in the ER so who gives a crap if you have to wait a little longer. I had to sit there for an hour while my heart was racing. And another time I chopped my finger off and sat there while it gushed blood waiting. I really don't think it could be much worse.

It's funny doesn't Cuba have like the best healthcare in the world? oh but they're communist...
12-07-2011 , 02:13 PM
Quote:
Originally Posted by Bluffzorz
I never understood why people don't support healthcare for everyone. It just never made sense.
This will be fun

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You already have to wait so long for care in the ER so who gives a crap if you have to wait a little longer.
lol definitely will be fun
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I had to sit there for an hour while my heart was racing.
Probably because you weren't actually in trouble

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And another time I chopped my finger off and sat there while it gushed blood waiting.
Bull****.
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I really don't think it could be much worse.
Try going to:

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It's funny doesn't Cuba have like the best healthcare in the world? oh but they're communist...
Because you'll find out quickly how wrong you are.
12-07-2011 , 02:22 PM
Quote:
Originally Posted by jogsxyz
The government is doing it all wrong. Instead of looking for ways to pay for medicare. They should be trying to find ways to provide health care more efficiently and more inexpensively.
Yeah. They did that
12-07-2011 , 02:31 PM
Quote:
Originally Posted by dinopoker
I know 90% of people would gladly trade places with them.
LOL..sure you do. But 100% of that 90% couldnt or wouldnt do ONE % of what it takes to be successful in this life. Looking at the clock waiting for 5pm....waiting for friday...refusing to learn something new unless paid for it....basically wishing/wasting your life away. A great recipe for success for those 90%. All you guys do is bitch, moan and complain and point your fingers at the "rich" as if you're entitled to something.

No worries though...if obama gets reelected, he'll certainly balance the tables for you.
12-07-2011 , 02:37 PM
lol.

Welcome to 2011 where most of what you said applies to a lot of different jobs (especially having to work long hours and constantly learning new skils on your own time).

      
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