Some South Florida docs decline to accept Obamacare


#1

From the Miami Herald:
After being without health insurance for two years, Miranda Childe of Hallandale Beach found a plan she could afford with financial aid from the government using the Affordable Care Act’s exchange.

Childe, 60, bought an HMO plan from Humana, one of the nation’s largest health insurance companies, and received a membership card in time for her coverage to kick in on May 1st.

But instead of being able to pick a primary care physician to coordinate her healthcare, Childe says she repeatedly ran into closed doors from South Florida doctors who are listed in her plan’s provider network but refused to see patients who bought their coverage on the ACA exchange.

“I just felt that I wasn’t being treated like a first-class citizen,’’ said Childe, who eventually found a doctor with the help of a Humana counselor. “Nobody, I don’t care what kind of degrees they have, should ever be treated that way.’’

The solution to this problem is simple: require all doctors to accept Obamacare or yank their medical licenses, right? :thumbsup:

Of course, there will be some who say that it is perfectly OK to yank their licenses: they’ll just retire. So maybe that won’t work.

OK, then, maybe the solution to this problem should be to require all doctors to accept Obamacare or throw them in jail…that will work, right? :thumbsup::thumbsup:

Of course, some lawyer will likely try to make the assertion that this would be unconstitutional:

Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction.

Well, the solution to that is simple: get rid of that darned old Constitution. Who needs it anyway? (After all, it’s only a charter of negative liberties and needs to be fundamentally transformed) :thumbsup::thumbsup::thumbsup: :eek:

:banghead:


#2

You know I went into respiratory arrest, and the local hospital would not treat me because I’m on medicade They put me in a ambulance with an oxagen mask and shipped me to another hospital 35 miles away.

This hospital only cares about profit and has no interest in human lives. They proudly print a profit statement in the newspaper every year.

To me at least human lives should come way before profits.


#3

Respiratory arrest is the cessation of normal breathing. Waiting the drive time for 35 miles, with only an oxygen mask, would have resulted in death.

Maybe they made you stable, *then *transferred you?


#4

Perhaps my memory of the day is pretty much a blur. The first thing I remember was waking up in an ambulance with a medic who wreaked of cigarette smoke. Great thing for a patient with breathing problems.


#5

Terrible, but it happens all the time.

We had a nurse show up at my house to take care of my dying mother. The nurse also smelled of heavy smoking. And my mother was dying of lung cancer. :frowning:

It was obvious that the nurse had been smoking right before she walking into the house. :mad:


#6

This is pretty sad. I have no idea what they can do to fix these issues with Obamacare. I am definitely not an expert on the issue. Regardless, I do hope they get the issues fixed while respecting all parties. Everyone has a right to health care. I am just grateful that I haven’t had hardly any issues with my Medicaid that I have had since 2003 or 2004 with the exception that sometimes they refuse to cover certain medicines. For example, my psychiatrist prescribed a medication to control my shoulder shrugging tic but Medicaid wouldn’t cover it. I remember they sent me some sort of letter explaining it but I didn’t understand it. The psychiatrist was moving and I was getting a new one so I decided to just let it go and bring it up with my new psychiatrist when I see him in about 3 months.


#7

You’re assuming the govt is competent enough to actually fix the problem. And also assuming that the govt isn’t the cause of the problem.

Both assumptions are wrong.


#8

So the people who keep you alive shouldn’t make money?

Do you work for free?

Businesses don’t exist without profit, and that includes non-profit businesses as well. Maybe you should be more upset at Medicaid that a hospital has to make decisions like this to stay in business. Hospitals are in the business of supplying health care services to patients. So when they have to send patients away, there is a very serious reason. In your case, Medicaid doesn’t pay them enough to cover their costs of treating you. They can’t take very many Medicaid patients or they’ll go out of business. So probably in your case, they stabilized you, and noted you were okay to be transported, so they made the decision to do so. They don’t for patients that can’t be transported.

Your anger should be directed towards the govt run program that is a train wreck, not the hospital that would love to sell services to you (as long as they don’t go out of business doing so).


#9

I don’t meany offense at all by this but what would you suggest be done?


#10

So much conservatism, so little time…

For starters, a doctor can neither accept nor decline “Obamacare.” Obamacare is a law, not an insurance plan.

From the article: “Health plans that consumers buy on the ACA exchange are private insurance, even for consumers who receive federal government subsidies.”

This bears repeating: “Health plans that consumers buy on the ACA exchange are private insurance, even for consumers who receive federal government subsidies.”

Also from the article: They … have no idea that they’ve just been signed up to participate in a plan with a patient population who are, you know, they’re probably not financially well off, and they just signed up for a plan that has a** 40 percent co-payment and potentially high deductible.**

So, under Obamacare, we have mandatory purchase of private insurance plans. In the conservative alternate universe, this is known as “socialism.” Of course, what it actually is is more corporate welfare, designed to protect insurance company profits at everyone else’s expense, as anyone on the actual left, as opposed to the pseudo-left represented by Obama and the Democratic Party, could have told you.

From the article: Insurance companies, though, say they expect physicians to honor their contracts.

Nancy Hanewinckel, a spokeswoman for Humana, which sells plans on the ACA exchange in Miami-Dade and Broward counties, said the insurer received signed consent from existing providers to participate in the new networks.

“In all cases, these providers voluntarily agreed to participate and signed an amendment to their existing contract,’’ Hanewinckel said.

Florida Blue, which sells plans on the ACA exchange in every Florida county, did not build new networks for those plans, said Paul Kluding, a spokesman.

“Based on the contracts our providers have signed with Florida Blue, they have agreed to treat our members regardless of how they obtained their insurance coverage,’’ Kluding said. "

The problem is not between physicians and the government, but between physicians and private insurance companies, who are, as anyone on the actual left can tell you, the only entities who will profit from Obamacare. The problem is a violation of contract law, not the ACA.

As far as this goes: " Eduardo Martinez, an internist and vice president of the Dade Medical Association, said doctors in private practice sometimes don’t have the resources to verify a patient’s benefits, or to be burdened with collecting high deductibles from patients.

Martinez said his office staff has spent as much as 35 minutes on the phone trying to verify a patient’s benefits under an ACA exchange plan, and, he said, “you don’t always get the correct information.’’

Well, this is exactly what happens with any insurance plan, ACA or not. This is what your physician’s staff has been doing for years. And it works in reverse for patients as well.

I can’t be the only one who has spent hours on the phone with an insurance company explaining to a CSR that my terminally ill mother’s enteral supplies ARE covered, and that there is a significant difference between “permitted to eat” and “able to eat.” Unless, of course, she got that GI port as elective surgery? Maybe she thought she was spending way too much time eating meals the old-fashioned way?

Neither have I spent hours sorting out bills from a “mystery doc” who turned out to have been an out-of-network doc who popped in to check on one of my children during an ER visit or hospital stay. Now that’s always fun… as if you demand to see each individual doctor’s credentials before they examine your child, even though you have already gone to an in-network hospital.

Good thing I didn’t have to deal with a “faceless bureaucracy” in any of that.

If you want to argue that Obamacare is a bad law, I would agree with you. Our disagreement would be over why it is a bad law. Now, one last thing from the article:

“It’s unknown how many of the 983,775 Floridians who selected a private plan have been turned away by doctors in their network but Florida’s Department of Financial Services reported receiving 63 complaints from consumers who bought a plan on the ACA exchange but could not get in to see a physician in their network.”

OK, so 63 divided by 983,775 = .0064%. So these figures are underwhelming, to say the least. Even so, If you want to argue that Obamacare is a bad law, I would agree with you. Our disagreement would be over why it is a bad law.


#11

I think that medical care to make a buck is against the churches moral teaching, and just plain immoral period.

Not wealthy-you die?

Why must everything in the USA be done with the sole purpose of chasing the almighty dollar?

I serve almighty God, not the almighty dollar.


#12

Citation from the CCC? I’ll wait.:wink:

Not wealthy-you die?

Is that in their profit statement?

Why must everything in the USA be done with the sole purpose of chasing the almighty dollar?

I serve almighty God, not the almighty dollar.

But you don’t mind complaining that someone else has the almighty dollar. Go figure.

Peace

Tim


#13

Get the govt out of healthcare. Increase freedom so that people can purchase the insurance they want instead of what politicians deem is best for them. Make private insurance policies tax deductible. Allow purchasing of insurance across state lines. Pass tort reform to take greedy lawyers out of healthcare.

Most importantly, work to re-link the purchaser of the service to at least a portion of the cost of the service, so that the purchaser makes better and more rational decisions.

ALL of these have been pushed by the GOP in multiple forms, and ALL have been flat-out rejected. It’s an endless march to socialized medicine by the President.


#14

I seem to remember something about “the laborer deserves his wages”.

Funny how we have no problem with people earning money from an endless supply of worthless professions, but some people lose their mind over someone devoting decades of their time studying and working to learn how the heal people, and that person wishing to make a profit and earn money doing so. Seems to me that making money by doing such good work should be encouraged.

Sad how we view selling computers to make good profit is more noble than making good profit while healing people.


#15

It’s very easy to be charitable with other people’s money.


#16

Obamacare is a stepping stone to destroying the private insurance market and govt control of health care. Yes, the insurance companies supported it because they thought is was going to force millions of customers into their arms, guaranteeing huge profits. And like all govt “solutions” they won’t see it when the train hits them, and the profits are fantasy, and the losses are in the billions. Very shortly, as more the law is implemented, losses will mount, and they will demand greater subsidies and bailouts, otherwise they will go under. And they may get them, and be completely controlled by govt, or they will not get them, and will fold, and govt will create their own “masterpiece” insurance plans.

And just as it has in every other place it has existed, socialized medicine will lead to longer waits, subpar medicine, denied service, higher suffering, greater costs, and huge human tolls. But the champions of this will call themselves “compassionate”.

And many Catholics will champion it, completely in contradiction to Church teaching on socialism.


#17

Thank you for your statement. My husband is a retired MD now, but we used to hear complaints about rich Drs. all of the time. He accepted California welfare patients when we were in California and we were swamped my them because most Drs. did not. When was this.1970! Many times it would be over six months before he was paid. Glad we finally left there.


#18

Our former health insurance was cancelled, so we needed to get another plan.

After going through different options, we considered a plan through the exchange, (aka the Obamacare plan.)

Not one of our doctors (mine, my husband’s or children’s plus specialists) accepted the plans from the exchange. We had to get another plan from a private company. All our prescriptions increased, especially my son’s asthma meds. I just filled a script that cost me 10 dollars before, now it’s 70 dollars.

We don’t live in Florida.


#19

What money? I have not been able to work since I had a crippling stroke nine years ago? Perhaps you think should die from starvation, or lack of medical care? That way I would not be stealing from the rich via taxation.

I do not hate or even envy the rich, but I think that some become wealthy by their own hard work, some by inheritance, and a few by immoral means.

It is only the last group I dislike. My own Father worked his backside off honestly in a far right town until he died poor. He never became wealthy.

I think more has to be considered than just chasing the almighty dollar. My Father died of a coronary chasing the almighty dollar.


#20

This is a tangent but I’m curious. Why are you seeing a psychiatrist for a shoulder shrugging tic and not a neurologist?


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