unintended consequences of owebamacare....

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  1. #1

    unintended consequences of owebamacare....

    and these consequences might actually be a good thing...
    i'm not a believer in drugging the elderly out of their minds...
    i think getting them off some of these drugs is going to help alot of people...

    http://cnsnews.com/news/article/rati...icaid-patients

  2. #2
    SpankyNek's Avatar
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    Originally Posted by 87sooner View Post
    and these consequences might actually be a good thing...
    i'm not a believer in drugging the elderly out of their minds...
    i think getting them off some of these drugs is going to help alot of people...

    http://cnsnews.com/news/article/rati...icaid-patients
    Either we are serious about cutting costs or we aren't.

  3. #3
    Originally Posted by SpankyNek View Post
    Either we are serious about cutting costs or we aren't.
    people are gonna **** about this and try to use it against owebama....
    which is fine
    but i hate the drug companies with a passion...
    they've been pushing these useless drugs on old people and they cost an arm and a leg...
    they need to get back to producing drugs that people need...like cancer drugs and new antibiotics...
    instead of milking the system...

  4. #4
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    Originally Posted by 87sooner View Post
    people are gonna **** about this and try to use it against owebama....
    which is fine
    but i hate the drug companies with a passion...
    they've been pushing these useless drugs on old people and they cost an arm and a leg...
    they need to get back to producing drugs that people need...like cancer drugs and new antibiotics...
    instead of milking the system...
    Cialis reference?

  5. #5
    zevogolf's Avatar
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    Originally Posted by 87sooner View Post
    people are gonna **** about this and try to use it against owebama....
    which is fine
    but i hate the drug companies with a passion...
    they've been pushing these useless drugs on old people and they cost an arm and a leg...
    they need to get back to producing drugs that people need...like cancer drugs and new antibiotics...
    instead of milking the system...
    What is the connection of "old people" and MEDICAID with drugs???
    The following users like this post: soonerintn


  6. #6
    Originally Posted by zevogolf View Post
    What is the connection of "old people" and MEDICAID with drugs???
    damn....got so excited i thought it said medicare...
    well....it's a good start anyway...

  7. #7
    SoonerLibertarian's Avatar
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    The problem is this bill won't cut costs. It might cut healthcare though. People that want or get care will pay more.

    Sent from my SGH-T679 using Tapatalk 2
    Last edited by SoonerLibertarian; July 31st, 2012 at 11:56 AM.

  8. #8
    Anyone know how I can get some cannabis oil? My dad has been diagnosed with bladder cancer.

  9. #9
    Rationing won't happen. The President said so.

  10. #10
    Originally Posted by TIMB0B View Post
    Anyone know how I can get some cannabis oil? My dad has been diagnosed with bladder cancer.
    I haven't seen any in decades or I would help you out...but then again, if it was available, I would probably do it myself...

  11. #11
    zevogolf's Avatar
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    Originally Posted by SoonerLibertarian View Post
    The problem is this bill won't cut costs. It might cut healthcare though. People that want or get care will pay more.

    Sent from my SGH-T679 using Tapatalk 2
    I thought it was against the law for ANY doctor to take cash payments from patients if he/she takes Medicare.....

  12. #12
    Originally Posted by zevogolf View Post
    I thought it was against the law for ANY doctor to take cash payments from patients if he/she takes Medicare.....
    You are correct.

  13. #13
    SoonerLibertarian's Avatar
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    Originally Posted by zevogolf View Post
    I thought it was against the law for ANY doctor to take cash payments from patients if he/she takes Medicare.....
    The problem is the only way it'll save costs is that it'll basically limit what care those people get.

  14. #14
    zevogolf's Avatar
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    I read an article the other day that by 2020 there would be a huge shortage of doctors. The problem will not be coverage, it will be treatment capability....

  15. #15
    IcanzIIravor's Avatar
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    Originally Posted by zevogolf View Post
    I read an article the other day that by 2020 there would be a huge shortage of doctors. The problem will not be coverage, it will be treatment capability....
    I doubt there will be a huge shortage. What you probably will see if US doctors get out of the field is more doctors and students from overseas going to our schools and happily taking their places. I guess that would be considered outsourcing to a degree, or would that be considered in-sourcing since they are taking jobs in the USA?

  16. #16
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    Originally Posted by IcanzIIravor View Post
    or would that be considered in-sourcing since they are taking jobs in the USA?
    Most often it would be called illegal aliens.

  17. #17
    Originally Posted by zevogolf View Post
    I thought it was against the law for ANY doctor to take cash payments from patients if he/she takes Medicare.....
    Where did you get that idea? Are you implying taking cash from a Medicare patient for a Medicare covered procedure or any patient paying cash if the doctor also takes Medicare? Because all doctors will take a cash payment(credit card or check) for a non covered procedure. Granny wants a boob job, lipo or bariatric surgery and the surgeon takes some form of cash.

  18. #18
    Originally Posted by IcanzIIravor View Post
    I doubt there will be a huge shortage. What you probably will see if US doctors get out of the field is more doctors and students from overseas going to our schools and happily taking their places. I guess that would be considered outsourcing to a degree, or would that be considered in-sourcing since they are taking jobs in the USA?
    You will see a shortage in areas most affected by obamacare.

  19. #19
    Originally Posted by soonerintn View Post
    Where did you get that idea? Are you implying taking cash from a Medicare patient for a Medicare covered procedure or any patient paying cash if the doctor also takes Medicare? Because all doctors will take a cash payment(credit card or check) for a non covered procedure. Granny wants a boob job, lipo or bariatric surgery and the surgeon takes some form of cash.
    I'm trying really hard not to imagine the last part of your post.

  20. #20
    Originally Posted by soonerintn View Post
    Where did you get that idea? Are you implying taking cash from a Medicare patient for a Medicare covered procedure or any patient paying cash if the doctor also takes Medicare? Because all doctors will take a cash payment(credit card or check) for a non covered procedure. Granny wants a boob job, lipo or bariatric surgery and the surgeon takes some form of cash.


    Medicare patients cannot pay cash for care. A 1997 law (Balanced Budget Act, section 4507) forbids private contracts between patients and doctors. With few exceptions, Medicare recipients cannot pay cash for a Medicare-covered service that Medicare denies until the doctor has opted out of Medicare. Most physicians cannot afford to opt out, so the law essentially prohibits private contracting between elderly patients and their doctors. Obamacare cut $500 billion from Medicare and enacted two administrative panels that are expected to advance rationing: the Independent Payment Advisory Board (IPAB) and the Patient-Centered Outcomes Research Institute (PCORI).

    http://www.cchfreedom.org/cchf.php/308

  21. #21
    Originally Posted by SoonerPT View Post
    Medicare patients cannot pay cash for care. A 1997 law (Balanced Budget Act, section 4507) forbids private contracts between patients and doctors. With few exceptions, Medicare recipients cannot pay cash for a Medicare-covered service that Medicare denies until the doctor has opted out of Medicare. Most physicians cannot afford to opt out, so the law essentially prohibits private contracting between elderly patients and their doctors. Obamacare cut $500 billion from Medicare and enacted two administrative panels that are expected to advance rationing: the Independent Payment Advisory Board (IPAB) and the Patient-Centered Outcomes Research Institute (PCORI).

    http://www.cchfreedom.org/cchf.php/308
    the original statement was that doctors could not take cash payments if they take Medicare. It is a blatantly false statement. A plastic surgeon can take Medicare and take care of Medicare patients while accepting all sorts of cash payments from 22 year old strippers for boob jobs. Plus, if granny wants a facelift, granny can pay for a facelift. Happens every day. In addition, doctors take all sorts of payments from uninsured while they accept Medicare.

    What you are sourcing is a completely different statement. In addition, balance billing would fit into something you can't do with Medicare.

    I know the point you are trying to make, but that wasn't the original statement.

  22. #22
    Originally Posted by soonerintn View Post
    the original statement was that doctors could not take cash payments if they take Medicare. It is a blatantly false statement. A plastic surgeon can take Medicare and take care of Medicare patients while accepting all sorts of cash payments from 22 year old strippers for boob jobs. Plus, if granny wants a facelift, granny can pay for a facelift. Happens every day. In addition, doctors take all sorts of payments from uninsured while they accept Medicare.

    What you are sourcing is a completely different statement. In addition, balance billing would fit into something you can't do with Medicare.

    I know the point you are trying to make, but that wasn't the original statement.
    Maybe he can confirm but I thought we were talking about Medicare patient's not some other group.

  23. #23
    Conversely, Medicaid patients are supposed to pay a cash copay.

  24. #24
    It's time for a super virus that takes the population down a little.

  25. #25
    IcanzIIravor's Avatar
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    Originally Posted by soonerintn View Post
    You will see a shortage in areas most affected by obamacare.
    For a very short time I'd wager. Plenty of medical students within the USA that would eventually shore up such a shortage and others coming from outside the USA to practice via visas. I'm not sure there will be a mass defection of doctors. I suppose some will retire early, but what will the rest do? Go into the I.T. field or something?

  26. #26
    Originally Posted by IcanzIIravor View Post
    For a very short time I'd wager. Plenty of medical students within the USA that would eventually shore up such a shortage and others coming from outside the USA to practice via visas. I'm not sure there will be a mass defection of doctors. I suppose some will retire early, but what will the rest do? Go into the I.T. field or something?
    There is already a shortage of doctors available, some will retire, some will go into other fields rather than deal with this monstrosity. The big winners are PA's and NP's while the big losers are the people who are satisfied with their doctor and current care.

  27. #27
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    Originally Posted by SoonerPT View Post
    There is already a shortage of doctors available, some will retire, some will go into other fields rather than deal with this monstrosity. The big winners are PA's and NP's while the big losers are the people who are satisfied with their doctor and current care.
    That's life for you. Those other fields will benefit from the new blood and the fields they left will give others a chance to step up and replace them.
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  28. #28
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    Unreason on Health Care

    Or take the health care law's creation of the Independent Payment Advisory Board, known as IPAB. It's a 15-member body charged with finding ways of cutting the costs of treatment under Medicare. Congress would have the final say, but through a fast-track process.
    Would it?

  29. #29
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    I am awaiting to see how much more my insurance can cost and what I have to buy. I currently have an emergency only plan with a $3K deductible.. This covers ER, broken bones, and hospital stay only ... Costs me $95.46 per month. I can easily hit up the ready clinic should I get a sinus infection or something and buy a $4.00 antibiotic at the local RX...I pay the female doc for my yearly exam and test, this costs me about $185.00.. I don't need BC because I had my tubes tied, I get mamograms at a clinic downtown for $75.00 and even though I am only 34 is get them yearly because my dad, his mother and my mom's mother all had breast cancer. I see this as fitting for me. My ex carries my son on his plan as he gets it through work. I personally don't need a full plan at my age. I have no trouble coming up with the money for the yearly, the mamogram, or the ready clinic visit (which I have not been sick enough for a doctor in 2 years). I gladly pay my monthly fee for my emergency insurance as to make sure I am not 100% screwed if I need hospital services.

  30. #30
    .
    Last edited by soonerintn; July 20th, 2013 at 01:14 AM.

  31. #31
    .
    3 users like soonerintn's post: DRminimega67, Jenn and tonic, ThievingMagpie

    Last edited by soonerintn; July 20th, 2013 at 01:13 AM.

  32. #32
    zevogolf's Avatar
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    I just moved to Florida and most doc's are heavy into using NP's and PA's. Much more than what was seen in Texas. Also, there are no doc's that draw their own blood for lab tests. No problem with these things as the PA's so far are much better looking and younger than the doc's, plus centralized blood draws have a better chance for central lab result depositories.

  33. #33
    .
    Last edited by soonerintn; July 20th, 2013 at 01:13 AM.

  34. #34
    zevogolf's Avatar
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    Originally Posted by soonerintn View Post
    Pretty uncommon for a md(other than a resident or intern or anesthesiologist) to draw blood. Most blood draws are by nurses or phlebotomists.

    Get used to nps and pas. Nobody is going into primary care unless they don't have any other options. The nashville area is very concerned about the current shortage and impending depletion of primary care doctors. So much so, that they are starting their own family practice in hopes that they can attract or keep family docs in the area.
    Of all the Texas doc's I saw when living there, their nurses ALL drew blood, my Primary would stick me when her nurses were unsucessful.

  35. #35
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    Our New Obamacare Masters

    • By January 15 each year, the Independent Payment Advisory Board must submit a proposal to Congress and the president for reaching Medicare savings targets in the coming year. The majority leaders in the House and Senate must introduce bills incorporating the board’s proposal the day they receive it.

    • Congress cannot “consider any bill, resolution, amendment, or conference report  …  that would repeal or otherwise change the recommendations of the board” if such changes fail to meet the board’s budgetary target.

    • By April 1, the committees of jurisdiction must complete their consideration of the proposal. Any committee that fails to meet the deadline is barred from further considering the bill.

    • The secretary of health and human services must implement the Independent Payment Advisory Board’s proposal, as passed by Congress and signed by the president, on August 15 of the year in which the proposal is submitted.

    • If Congress does not pass the proposal or a substitute plan meeting the Independent Payment Advisory Board’s financial target before August 15, or if the president vetoes the proposal passed by Congress, the original Independent Payment Advisory Board recommendations automatically take effect.

    Further demonstrating the Star Chamber-like powers of the Independent Payment Advisory Board, Congress cannot consider any bill or amendment that would repeal or change this fast-track congressional consideration process without a three-fifths vote (60) in the Senate. Not only that, but the implementation of the board’s remedy is exempted from administrative or judicial review.

  36. #36
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    Employers Must Offer Family Care, Affordable or Not

    Under the rules, employers must offer coverage to employees in 2014 and must offer coverage to dependents as well, starting in 2015.

    The new rules apply to employers that have at least 50 full-time employees or an equivalent combination of full-time and part-time employees. A full-time employee is a person employed on average at least 30 hours a week. And 100 half-time employees are considered equivalent to 50 full-time employees.

    Thus, the government said, an employer will be subject to the new requirement if it has 40 full-time employees working 30 hours a week and 20 half-time employees working 15 hours a week.

  37. #37
    I have a client that currently offers insurance to about 400 of the 1500 full time employees they have. The 400 are generally skilled, the 1100 not so much. This change is more than likely going to force my client to move those 1100 to part time or take it on the chin for about 2 million annually after you factor in payroll and corporate taxes as well.

    Rest assured my client is not taking the 2 million on the chin, they are raising their prices on everything if they keep those employees full time.

    This thing is such a cluster. Our actuaries, attorneys, cpa, doctors and RX consultants have been looking at this thing for 30 months now in great detail. Every way we have sliced and diced it the employee is going to get killed and the employer too.
    Last edited by htownSOONER; January 1st, 2013 at 11:13 PM.

  38. #38
    SpankyNek's Avatar
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    Originally Posted by htownSOONER View Post
    I have a client that currently offers insurance to about 400 of the 1500 full time employees they have. The 400 are generally skilled, the 1100 not so much. This change is more than likely going to force my client to move those 1100 to part time or take it on the chin for about 2 million annually after you factor in payroll and corporate taxes as well.

    Rest assured my client is not taking the 2 million on the chin, they are raising their prices on everything if they keep those employees full time.

    This thing is such a cluster. Our actuaries, attorneys, cpa, doctors and RX consultants have been looking path this thing for 30 months now in great detail. Every way we have sliced and diced it the employee is going to get killed and the employer too.
    According to the post above yours, making the employees go part time would not exempt them.

  39. #39
    Originally Posted by SpankyNek View Post
    According to the post above yours, making the employees go part time would not exempt them.
    The IRS, HHS and DOL have not confirmed rules for equivalency between full time and part time employees right now. As it stands right now there is no regulation on the part time employees. I will take my firm that is one of the largest in the world and specializes in this over a newspaper article. There is a ton of misinformation out there still on this. That is more of it.

    Now there may be perhaps industry relief where restaurants, hotels, hospitality would not be subject to the FTE requirements, but right now those are rumors via the lobbyists.

  40. #40
    Originally Posted by SpankyNek View Post
    According to the post above yours, making the employees go part time would not exempt them.
    Initially I thought the calculation they use was to determine the number of full time employees...50 full timers or equivalent employees or more and you must offer insurance to the full timers...now, I am not so sure...I am so confused...

    Are part time employees working for a company with more than 50 "full time" employees (based on the calculation) going to be provided with healthcare?

  41. #41
    Part time employees under current law will not be have to be offered healthcare. They will still have to buy insurance though due to the individual mandate.

  42. #42
    Originally Posted by htownSOONER View Post
    Part time employees under current law will not be have to be offered healthcare. They will still have to buy insurance though due to the individual mandate.
    Thanks...so the part time/full time calculation is only used to see if a company has 50 "full time" employees?

  43. #43
    SpankyNek's Avatar
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    Originally Posted by htownSOONER View Post
    Part time employees under current law will not be have to be offered healthcare. They will still have to buy insurance though due to the individual mandate.
    If this is the case, what are the calculations for?

    If a company only employs 100 part timers, eliminating their exemption, who gets the legally required benefits? Would employers have to pay some sort of fine in this scenario?

  44. #44
    Originally Posted by SpankyNek View Post
    If this is the case, what are the calculations for?

    If a company only employs 100 part timers, eliminating their exemption, who gets the legally required benefits? Would employers have to pay some sort of fine in this scenario?
    That is my question...if the 100 part timers add up to at least 50 full timers the full time associates would get healthcare...but if they are all part time then no one gets healthcare...

    That was my understanding on the way the thing works but with thousands upon thousands of pages I doubt anyone, outside the three subject experts in the country, really knows the answer....

  45. #45
    Right now they have a ton of FTE with no healthcare offering. They either don't offer and pay 2000 per FTE not offered, offer them minimum essential coverage on their dime or move them all part time. Offering minimum essential benefits is tax deductible, paying a penalty is not. All this impacts the corporate tax rate as well as soft cost on employee morale, turnover and retention.

  46. #46
    Originally Posted by pphilfran View Post
    That is my question...if the 100 part timers add up to at least 50 full timers the full time associates would get healthcare...but if they are all part time then no one gets healthcare...

    That was my understanding on the way the thing works but with thousands upon thousands of pages I doubt anyone, outside the three subject experts in the country, really knows the answer....
    If the employer only has part time employees there is no penalty, period end of story. There is an individual mandate. If that part timer does not get coverage on their own accord then they are required to pay a penalty.

  47. #47
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    Shared Decision Making to Improve Care and Reduce Costs

    The International Patient Decision Aid Standards Collaboration has developed evidence-based guidelines for certification indicating that decision aids should include questions to help patients clarify their values and understand how those values affect their decisions; information about treatment options, presented in a balanced manner and in plain language; and up-to-date data from published studies on the likelihood of achieving the treatment goal with the proposed intervention and on the nature and frequency of side effects and complications. In addition, it would be helpful to include validated, institution-specific data on how often the specified procedure has been performed, the frequency of side effects and complications, and the cost of the procedure and any associated medication and rehabilitation regimens. We believe that decision aids should be written at an eighth-grade level and should be brief.

    [ ... ]

    Many decision aids have already been rigorously evaluated, so CMS could rapidly certify these tools and require their use in the Medicare and Medicaid programs. To give such a requirement teeth, full Medicare reimbursement could be made contingent on having documentation in the patient's file of the proper use of a decision aid for these 20 procedures. Providers who did not document the shared-decision-making process could face a 10% reduction in Medicare payment for claims related to the procedure in year 1, with reductions gradually increasing to 20% over 10 years. This payment scheme is similar to that currently tied to hospital-readmissions metrics.

  48. #48
    zevogolf's Avatar
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    There is a severe shortage of Brest Pumps, it has been noted that Obamacare requires insurance companies to provide needed Brest Pumps for FREE to doctors treating women in need of such!!!!

  49. #49
    Originally Posted by Aurora View Post
    I am awaiting to see how much more my insurance can cost and what I have to buy. I currently have an emergency only plan with a $3K deductible.. This covers ER, broken bones, and hospital stay only ... Costs me $95.46 per month. I can easily hit up the ready clinic should I get a sinus infection or something and buy a $4.00 antibiotic at the local RX...I pay the female doc for my yearly exam and test, this costs me about $185.00.. I don't need BC because I had my tubes tied, I get mamograms at a clinic downtown for $75.00 and even though I am only 34 is get them yearly because my dad, his mother and my mom's mother all had breast cancer. I see this as fitting for me. My ex carries my son on his plan as he gets it through work. I personally don't need a full plan at my age. I have no trouble coming up with the money for the yearly, the mamogram, or the ready clinic visit (which I have not been sick enough for a doctor in 2 years). I gladly pay my monthly fee for my emergency insurance as to make sure I am not 100% screwed if I need hospital services.
    For someone who is only 34 $95.00 seems pretty high, as a former insurance agent I remember selling these type of catastrophic health policies for around $35 per month with a 1,500 deductible (about 18 month ago). You might want to shop around if you have not already done it.

  50. #50

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