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Post by JP5 on Nov 1, 2013 3:26:06 GMT
Top Hospitals Opting Out of Obamacare. "Most of the top hospitals will accept from just one or two companies operating under Obamcare." If Obamacare stays in place, our healthcare will see a serious decline from what we had as a country. "The Obama Administration has been claiming that insurance companies will be competing for your dollars under the Affordable Care Act, but apparently they haven't surveyed the nation's top hospitals. Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare. [CHART: Which Top Hospitals Take Your Insurance Under Obamacare?] "This doesn't surprise me," said Gail Wilensky, Medicare advisor for the second Bush Administration and senior fellow for Project HOPE. "There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money." Regulations driven by the Obama White House have indeed made insurance more affordable – if, like Health and Human Services Secretary Kathleen Sebelius, you're looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered. Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well. The result of our investigation: Many top hospitals are simply opting out of Obamacare. Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio." health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/10/30/top-hospitals-opt-out-of-obamacare |
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Post by ShivaTD on Nov 2, 2013 14:49:26 GMT
An interesting claim but this appears to be a problem with state law as opposed to "Obamacare" from what I can see. While I haven't checked Washington law I'm a native Californian and I did have occasion in the past to check California law.
Under California law it is illegal for any hospital to deny medical services to any person that either has insurance or the ability to pay cash for services at the time they are offered. I believe the only hospitals excluded were HMO's where only subscribers were treated and they did not accept the general public.
It is a simple matter resolved by state law that would require hospitals to accept the coverage of any insurance company and then bill the patient for costs not covered by the insurance like California has.
Additionally I'm thinking that those hospitals that claim they won't provide services are going to find themselves at the wrong end of a civil rights lawsuit because this appears to be a case of unjustifiable discrimination that serves no legitimate interest of the enterprise.
Of course if the person chooses to pay cash and then submit the bill to the insurance provider for reimbursement these hospitals can't deny services at all so the person is still covered by the insurance. They just don't have the convenience the hospital performing the billing service to the insurance company. This was actually how health insurance worked when I grew up. The providers didn't bill the insurance companies then and the person paid for the service and then submitted the bill to the insurance company for reimbursement.
Actually having the person pay and then submit the bill to the insurance company dramatically reduces the administrative costs of the hospitals lowering the costs of health care so it's not necessarily a bad thing. Between 20% and 50% of the costs of medical services in America are due to the administrative costs of insurance by the providers and few are aware of that fact. This is why I opposed the insurance coverage of routine medical services because they can be budgeted for and that would eliminate the overhead costs of insurance resulting in reduced cost for medical services.
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Post by JP5 on Nov 3, 2013 2:58:31 GMT
While that is true for some state laws......it is not true for all. And I truly believe that since the U.S. Supreme Court ruled that the federal gov't cannot force states to take Medicaid away if they don't expand it per Obamacare.....I doubt very seriously that the federal gov't can FORCE hospitals and doctors to accept all their insurance carriers. And can you blame them? They get paid far less than a private insurer pays them....one that is not part of either Obamacare or Medicare.
"The result of our investigation: Many top hospitals are simply opting out of Obamacare.
Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.
And that's not because their exchanges don't offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states' premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks.
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers.
"Many companies have selectively entered the exchanges because they are concerned that (the exchanges) will be dominated by risky, high-using populations who wanted insurance (before Obamacare) and couldn't afford it," said Wilsensky, who is also on the board of directors of UnitedHealth. "They are pressed to narrow their networks to stay within the premiums."
Consumers, too, will struggle with the new system. Many exchanges don't even list the insurance companies on their web sites. Some that do, like California, don't provide names of doctors or hospitals."
health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/10/30/top-hospitals-opt-out-of-obamacare
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Post by ShivaTD on Nov 3, 2013 12:56:35 GMT
Here is the problem if we remove any political spin.
A hospital that provides services to the general public should not be allowed to refuse service to a person that can pay for services with cash or with a combination of cash and insurance.
All states should have a law that addresses this so that a hospital providing services to the public doesn't discriminate by denying medical services to a person that can afford to pay for services either with cash or a combination of cash and insurance.
The reason the states need a law so that a hospital isn't be allowed to discriminate are two-fold. First of all they are all receiving government subsidies either directly as payments or indirectly as special tax breaks. The acceptance of the government subsidies provides the authority for the government to dictate that the must accept patients that will pay cash or use a combination of cash and insurance to pay for services. Next is simply a moral issue that a hospital should never refuse medical services to a person will pay for those services either with cash or a combination of cash and insurance.
BTW Politically this is interesting because the number of people that would be affected probably represents less than 1/10th of 1% of Americans. It is a hugely insignificant number overall. Additionally these people that might be excluded from health care services by one hospital will be able to obtain them at another hospital while without "Obamacare" they wouldn't receive any medical services at all.
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Post by dangermouse on Nov 3, 2013 13:52:07 GMT
It all goes to keeping the fear alive, right up to when the ACA is actually up and running, and the lies are exposed.
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Post by ShivaTD on Nov 3, 2013 14:42:23 GMT
I'm going to state one more time that I disagree with many of the provisions in "Obamacare" but I cannot disagree with it's purpose or the eventual results. "Obamacare" is going to address the problem of tens of millions of Americans that didn't have the financial means for obtaining quality health care services they needed. These were individuals and families that couldn't afford private insurance and, in many cases, couldn't even afford a minimal payment for private insurance.
Excluding the roughly 5 million Americans that are going to be left out because of (Republican)16 states refusing to place them under Medicaid expansion fully funded initially by the federal government (ignoring the fact that the funding is supposed to be co-paid for by a federal-state partnership) it is going to accomplish the goal of providing quality health care, often life-saving, to millions of Americans.
Republicans present arguments like "a couple million Americans might have to purchase superior new heath insurance to what they had and that it is probably subsidized so they end up paying less out of pocket" or "a few hundred thousand might have to drive a few miles farther to obtain medical services (while closing abortion clinics so women often have to drive hundreds of miles or even to another state to obtain an abortion) while at the same time ignoring that millions of Americans will actually receive medical services is rather absurd.
The Congress acknowledgement that the United States had a serious "health care" crisis goes back to 1948 from what I understand. It was 17 years before it was first addressed by Medicaid but because the federal government and states refused to adequately fund Medicaid so that it would solve the health care crisis it continued. When Medicaid failed to fulfill it's Mission Statement it was another 28 years until 1993 a Congressional proposal (Hillarycare) was rejected predominately by Republicans claiming there was a better way to address the health care crisis that they did not deny existed. For 15 years, even when they had a Republican President for 8 of those years, they sat on their hands even though the Republican Party Platform calls for "quality health care" for Americans. They had 15 years to present a proposal that would provide quality health care for the millions of Americans that couldn't afford the health care or the insurance to pay for it........ and they did nothing.
Today they condemn "Obamacare" because it has some very bad provisions, and I agree that it does have some very bad provisions, but they still haven't offered any proposal that would provide quality health care to tens of millions of Americans that can't afford the health care or the insurance to pay for it. The complain about the "Obamacare" affects for a few hundred thousand here and perhaps a million or two there while ignoring the tens of millions of Americans that will receive quality health care because of "Obamacare" at the same time. Why don't Republicans submit a proposal that addresses the problems for those few hundred thousand here or that million or so there that still ensures that the tens of millions that will receive quality health care will continue to receive quality health care that "Obamacare" was designed to provide?
BTW November is the annual re-enrollment for my private health insurance and guess what. It didn't go up one dime for 2014.
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Post by JP5 on Nov 3, 2013 15:45:24 GMT
Here is the problem if we remove any political spin.
A hospital that provides services to the general public should not be allowed to refuse service to a person that can pay for services with cash or with a combination of cash and insurance.
All states should have a law that addresses this so that a hospital providing services to the public doesn't discriminate by denying medical services to a person that can afford to pay for services either with cash or a combination of cash and insurance.
The reason the states need a law so that a hospital isn't be allowed to discriminate are two-fold. First of all they are all receiving government subsidies either directly as payments or indirectly as special tax breaks. The acceptance of the government subsidies provides the authority for the government to dictate that the must accept patients that will pay cash or use a combination of cash and insurance to pay for services. Next is simply a moral issue that a hospital should never refuse medical services to a person will pay for those services either with cash or a combination of cash and insurance.
BTW Politically this is interesting because the number of people that would be affected probably represents less than 1/10th of 1% of Americans. It is a hugely insignificant number overall. Additionally these people that might be excluded from health care services by one hospital will be able to obtain them at another hospital while without "Obamacare" they wouldn't receive any medical services at all.
So, you admit Obamacare is bad....but like many Democrats, you expect someone else to fix it. Sorry....but it's Obama's baby; let him and his minions fix it. The dictator has already made some 14 changes to the law all on his own anyway. You can feel how much better he's made it.....right??? |
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Post by ShivaTD on Nov 3, 2013 16:12:44 GMT
That's right. They don't have to go to the top Tier hospitals; just go to the ones where their Obamacare insurance is accepted. BTW, Obama promised all this was going to be so much better for the citizens.....so they should just sit back and accept his word. It's good, isn't it???
So, you admit Obamacare is bad....but like many Democrats, you expect someone else to fix it. Sorry....but it's Obama's baby; let him and his minions fix it. The dictator has already made some 14 changes to the law all on his own anyway. You can feel how much better he's made it.....right???
Why would health care be any different that a college education with the "minor" exception of the fact that not being able to obtain health services can result in death?
Do Republicans propose that the authorized expenditures for the private health insurance issued under "Obamacare" be increased so that every "Top Tier" hospital would fight over getting the business? That could be done but of course it just raises the costs even more.
So let's see, we have Democrats that actually addressed the health care crisis in America where millions of Americans were not receiving quality health care and they created "Obamacare" to address that. President Obama and the Democratic leaders in Congress have both expressed the desire to address problems with "Obamacare" and I would expect them to try and accomplish that. As noted where President Obama believed it was supported under the law he's already issued 14 executive orders to address problems. Whether they can actually fix problems with the law itself is dependent upon bipartisan support so it's questionable that they can fix problems but I believe they want to.
Then we have Republicans that have never proposed anything to address the fact that millions of Americans couldn't obtain quality health care services and they just sit around and complain about the Democrats that actually did something about this problem.
The Republicans haven't offered any proposals to fix the problems with "Obamacare" and had expressed the position that they have no interest whatsoever in fixing any of the problems so I seriously doubt that they will make any proposals or support any Democratic proposals that would fix any of the numerous problems.
I can only state that the Republicans should propose something positive that would provide quality health care for the tens of millions of American that would not have access to quality health care if it were not for "Obamacare" but what Republicans should do and what Republicans actually do are mile apart. I can't do anything about Republicans being completely irresponsible on the issue of providing quality health care for all Americans that is even a part of the Republican Platform. Why have something in the Party Platform if the members of the Party have no intention of every addressing it?
What I do expect from Republicans is that they will continue to be irresponsible whether we refer to providing quality health care for all Americans or related to being fiscally responsible because they're the Party of Do Nothing on both issues.
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Post by JP5 on Nov 3, 2013 16:33:23 GMT
Oh....so now it's dependent on bi-partisan support, eh? Obama, Pelosi, and the Democrats didn't care one bit about that back when they shoved this down the throats of Americans who wanted a say....and they basically told them, "Shut up.....you're just a bunch of terrorists and racists."
No this president is anything BUT bi-partisan. Had he been so, he would have purposefully involved Republicans.....listened to them.....included them....and NOT passed a massive social program of this magnitude without any bi-partisan support. You need to have at least some bi-partisan support in order for something to be successful. Obama should have been more like Bush who asked specific Democrats to help him actually write the things he wanted to enact when he first came in to office.......Ted Kennedy (No Child left Behind), and other Democrats to help with the tax cuts he wanted. It's how he got both passed and in a Bi-partisan manner. It's what good leaders do!!
I think now, however, its coming back to bite Obama. THIS Obamacare IS the topic for months; probably years to come. And it's what each and every election is going to be about for many elections in the future.
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Post by fugazi on Nov 3, 2013 17:49:37 GMT
With not being an American and fully expecting to be told to "butt out" I for one cannot see how any reasonable human being would deny health care to ALL it's people regardless of their income or insurance status. It borders on barbaric to deny someone health care based on the lack of dollars they have in their bank account.
In the UK we have the NHS, not perfect by any means, but it at least provides medical care for any person in the population regardless of their income .. sure we also have private hospitals, but they exist without government funding.
I find it extremely distasteful that people want to profit from the illnesses of others.
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Post by JP5 on Nov 3, 2013 23:21:50 GMT
With not being an American and fully expecting to be told to "butt out" I for one cannot see how any reasonable human being would deny health care to ALL it's people regardless of their income or insurance status. It borders on barbaric to deny someone health care based on the lack of dollars they have in their bank account. In the UK we have the NHS, not perfect by any means, but it at least provides medical care for any person in the population regardless of their income .. sure we also have private hospitals, but they exist without government funding. I find it extremely distasteful that people want to profit from the illnesses of others.
Bottom line is that Americans like choice; we don't like the federal government telling us what we can....and can't.....have. Sad, though....that with Obama, much of that is going away. |
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Post by fugazi on Nov 4, 2013 9:59:49 GMT
With not being an American and fully expecting to be told to "butt out" I for one cannot see how any reasonable human being would deny health care to ALL it's people regardless of their income or insurance status. It borders on barbaric to deny someone health care based on the lack of dollars they have in their bank account. In the UK we have the NHS, not perfect by any means, but it at least provides medical care for any person in the population regardless of their income .. sure we also have private hospitals, but they exist without government funding. I find it extremely distasteful that people want to profit from the illnesses of others.
Bottom line is that Americans like choice; we don't like the federal government telling us what we can....and can't.....have. Sad, though....that with Obama, much of that is going away. Profit based on the medical needs of others is dirty money. I don't really see the relevance of what "race" the first child born each year is, as far as I am aware we all belong to only one race - the human one - this fascination by some of skin colour or creed is really baffling, almost like seeking anything in order to justify prejudice. SOME Americans may like choice, it is a shame that-that choice doesn't extend to all people in the case of abortion for example .. right-wing conservatives have no issue with trying to remove that choice and are quite happy to have government involvement to do it. |
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Post by ShivaTD on Nov 4, 2013 12:13:08 GMT
Oh....so now it's dependent on bi-partisan support, eh? Obama, Pelosi, and the Democrats didn't care one bit about that back when they shoved this down the throats of Americans who wanted a say....and they basically told them, "Shut up.....you're just a bunch of terrorists and racists."
I remember the discussions and debates from 2009 and the Republicans didn't offer a single proposal that would ensure that ALL Americans would receive quality health care. Not a single one!! They did offer some limited proposals, some good and some not so good, but didn't offer a single proposal that would ensure that ALL Americans would receive quality health care.
The problem was and had always been the tens of millions of Americans that couldn't afford health care services either directly or indirectly by purchasing insurance. "Fixing" problems with insurance doesn't do anything for those that can't afford the insurance.
So Republicans had the opportunity to work on a bi-partisan solution the ensure that ALL Americans would receive quality health care services when they required them but never made any proposals that would accomplish that. Republicans didn't offer anything to fix the problem in 2009 and today they're not offering anything to fix the problem.
Democrats didn't "reject" any Republican proposal to "fix the problem" but did reject the Republican proposal to "ignore the problem" in 2009.
BTW - Here's an added twist from my perspective. Under our "dual sovereignty" where the Federal Government is supposed to be responsible for the Welfare of the States while the State Governments are supposed to be responsible for the Welfare of the People it was actually the failure of State Governments to ensure that ALL residents of the State would receive quality health care. Mitt Romney actually did quite well with Romneycare that was a State initiative to ensure that everyone in Massachusetts received quality health care. Unfortunately we had 49 other States that didn't do this. In a very real sense if the States actually fulfilled their responsibilities related to providing for the Welfare of the People virtually ALL federal "welfare" programs would disappear. Federal welfare programs address the failure of the States to Provide for the General Welfare of the People. The States are failing in their Responsibilities to the People.
Right now we have 16 (Republican) State that have refused to accept the federally funded expansion of Medicaid to provide health care for the residents of their States and those States have a responsibility to their citizens and residents to ensure that every single one of them as access to quality health care. Let's see if those State step up to the plate and ensure that the 5 million that will not receive quality health care under the expansion of Medicaid receive the medical services they require. If they don't then every one of those States has failed in it's responsibility to ensure the general Welfare of the People in their State and should be condemned for that. If they do provide that health care then they should be commended but if not then they deserve condemnation.
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Post by niff on Nov 5, 2013 15:47:39 GMT
I'd like to see some examples of a person showing up at one of these hospitals and saying: "Don't worry. I'll pay you the forty thousand in cash AFTER you've treated me". More likely the hospital says: "Hand over the forty thousand in advance and what we don' charge you we'll refund".
What person in their right mind would hand over cash then send the bill to the insurance company? What are the odds the insurance company will find some 'small-print' that means they don't have to pay the poor sap? Like 110%.
The whole Obamacare fiasco is a fitting legacy for a President who never ran anything but his mouth.
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Post by ShivaTD on Nov 5, 2013 18:44:30 GMT
I'd like to see some examples of a person showing up at one of these hospitals and saying: "Don't worry. I'll pay you the forty thousand in cash AFTER you've treated me". More likely the hospital says: "Hand over the forty thousand in advance and what we don' charge you we'll refund".
But let's look at another case. A person requires $200,000 in medical services, also a large and rare medical expenditure, and they have the very best 80/20 medical insurance in America. They would have the same $40,000 personal obligation so how many hospitals would refuse the medical service?
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