Buh-bye Obama-care?

[drusso]

https://www.washingtonpost.com/nati...s-affordable-care-act/?utm_term=.453651fa7b95

"In a significant shift, the Justice Department now says that it backs a full repeal of the Affordable Care Act, the signature Obama-era health law."

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[Ligament]

Fingers crossed Obamacare is erased. I had given up hope on it.

 

[Ducttape]

why? Americans like Obamacare.

Fox News poll: Voters like Obamacare more than GOP tax cuts

 

[SSdoc33]

im no fan of obamacare, but what, all of a sudden of obamacare goes away we get paid more? our national health system improves? no chance. you just have more patients not covered and hospitals get more write offs for indigent care.

in particular ligament and drusso, how would this be good for your business?

 

[drusso]

in particular ligament and drusso, how would this be good for your business?

Healthcare Reform Creates Provider Monopolies | The Lund Report

 

[SSdoc33]

Healthcare Reform Creates Provider Monopolies | The Lund Report

well, i walked right into that one, didnt i?

without a plan for any replacement, how is dumping more patients into medicaid or going without insurance at all going to help your practice?

 

[drusso]

well, i walked right into that one, didnt i?

without a plan for any replacement, how is dumping more patients into medicaid or going without insurance at all going to help your practice?

Don't confuse coverage with access. Erasing the terrible mistake of the ACA will allow us to "reset" the conversation on promoting access. So, so much dirty shenanigans caused by ACA--it's ruined countless small, independent medical practices. This is an opportunity for doctors to get back in the driver's seat.

CHI Franciscan settles antitrust lawsuit with Washington

"According to emails obtained by the attorney general's office and included in the complaint, CHI Franciscan executives said that WestSound would allow CHI Franciscan to grow its surgery cases, which was the "fastest way to increase its bottom line." The redacted complaint cites contracts between CHI Franciscan and a major payer that allege double-digit percentage price increases for arthroscopic shoulder, ACL and knee surgeries following the deal.

As for the Doctors Clinic, the state claims that CHI Franciscan and the clinic are separate economic entities that entered into an agreement to fix prices.

CHI Franciscan acquired the clinic's ambulatory surgery center, imaging and laboratory services and has since closed its imaging services and a large portion of the ASC, shifting care to CHI Franciscan's Harrison Medical Center, according to the complaint. Unlike the WestSound transaction, CHI Franciscan did not acquire TDC's medical practices.

A Doctor Clinic executive wrote in an internal email obtained by the attorney general office that he "can't wait to hear how CHI messages the addition of TDC to (Franciscan Medical Group). 'You can now get your outpatient care in a complex, relatively unsafe and vastly more expensive location. You are welcome, Kitsap County."

 

[SSdoc33]

Don't confuse coverage with access. Erasing the terrible mistake of the ACA will allow us to "reset" the conversation on promoting access. So, so much dirty shenanigans caused by ACA--it's ruined countless small, independent medical practices. This is an opportunity for doctors to get back in the driver's seat.

CHI Franciscan settles antitrust lawsuit with Washington

"According to emails obtained by the attorney general's office and included in the complaint, CHI Franciscan executives said that WestSound would allow CHI Franciscan to grow its surgery cases, which was the "fastest way to increase its bottom line." The redacted complaint cites contracts between CHI Franciscan and a major payer that allege double-digit percentage price increases for arthroscopic shoulder, ACL and knee surgeries following the deal.

As for the Doctors Clinic, the state claims that CHI Franciscan and the clinic are separate economic entities that entered into an agreement to fix prices.

CHI Franciscan acquired the clinic's ambulatory surgery center, imaging and laboratory services and has since closed its imaging services and a large portion of the ASC, shifting care to CHI Franciscan's Harrison Medical Center, according to the complaint. Unlike the WestSound transaction, CHI Franciscan did not acquire TDC's medical practices.

A Doctor Clinic executive wrote in an internal email obtained by the attorney general office that he "can't wait to hear how CHI messages the addition of TDC to (Franciscan Medical Group). 'You can now get your outpatient care in a complex, relatively unsafe and vastly more expensive location. You are welcome, Kitsap County."

of course the business is dirty. we know that.

but your rationale is circuitous. bc/bs wont all of a sudden pay you more if the ACA goes away. i really dont think the ACA moved the needle all that much. the right feels as though if obamacare goes away, the problems will be solved. i really just dont see that. there will be an even bigger political will for the hospitals to take care of the (now larger) indigent population with no coverage. i know you are an anti-hospital guy, and removing the ACA may hurt a hospital's bottom line, but that doesnt necessarily HELP the private practice. it is not a zero-sum game

 

[lonelobo]

Fingers crossed Obamacare is erased. I had given up hope on it.

How does it effect your practice?

 

[hyperalgesia]

well, i walked right into that one, didnt i?

without a plan for any replacement, how is dumping more patients into medicaid or going without insurance at all going to help your practice?

It's not gonna have any bearing on my practice. But ACA was a crooked Christmas gift to Big Insurance, at the expense of patients and small businesses.

I'm sure there were a few pts who benefitted from it and will lose from its demise but the country and most people will be much better off in the long run.

The polls mean absolutely nothing. They only follow fake news.

 

[Ducttape]

Obamacare Has More Support Than GOP Alternative, Poll Finds - Morning Consult

 

[lobelsteve]

Obamacare Has More Support Than GOP Alternative, Poll Finds - Morning Consult

https://projects.fivethirtyeight.com/2016-election-forecast/

 

[lonelobo]

https://projects.fivethirtyeight.com/2016-election-forecast/

So the polls got 2016 wrong....so that invalidates any other poll taken?

Nate Silver's model gives Trump an unusually high chance of winning. Could he be right?

 

[hyperalgesia]

So the polls got 2016 wrong....so that invalidates any other poll taken?

Nate Silver's model gives Trump an unusually high chance of winning. Could he be right?

Following polls is like chasing our tail.

 

[lonelobo]

Following polls is like chasing our tail.

Polls Are Still As Accurate As They Were 75 Years Ago | Smart News | Smithsonian

 

[hyperalgesia]

Polls Are Still As Accurate As They Were 75 Years Ago | Smart News | Smithsonian

I think they can be accurate as a snapshot. I just don't think they should be used to guide policy because they are ephemeral and whimsical and sometimes symbolic.

When CNN is running a headline non-stop with experts saying Trump is a KGB agent, then a poll asks if you support Trump, people are evaluating the character in the prevailing narrative at the moment. Same with polls on Obamacare. In both cases, it's not particularly relevant.

I just think polls should only be used as a metric of the current, whimsical prevailing wisdom.

 

[drusso]

of course the business is dirty. we know that.

but your rationale is circuitous. bc/bs wont all of a sudden pay you more if the ACA goes away. i really dont think the ACA moved the needle all that much. the right feels as though if obamacare goes away, the problems will be solved. i really just dont see that. there will be an even bigger political will for the hospitals to take care of the (now larger) indigent population with no coverage. i know you are an anti-hospital guy, and removing the ACA may hurt a hospital's bottom line, but that doesnt necessarily HELP the private practice. it is not a zero-sum game

Insuring the Uninsurable | Manhattan Institute

"High-risk pools are the best way to direct subsidies at those who need them most, while freeing the marketplace from the unwieldy, dysfunctional, and anti-competitive system of cross-subsidies."

 

[Ducttape]

https://projects.fivethirtyeight.com/2016-election-forecast/

Still living in 2016....

 

[lobelsteve]

Still living in 2016....

Was posting just in case you were too old to remember your Hilary was going to win in a landslide.

 

[drusso]

of course the business is dirty. we know that.

but your rationale is circuitous. bc/bs wont all of a sudden pay you more if the ACA goes away. i really dont think the ACA moved the needle all that much. the right feels as though if obamacare goes away, the problems will be solved. i really just dont see that. there will be an even bigger political will for the hospitals to take care of the (now larger) indigent population with no coverage. i know you are an anti-hospital guy, and removing the ACA may hurt a hospital's bottom line, but that doesnt necessarily HELP the private practice. it is not a zero-sum game

Medicaid Expansion Boosts Hospital Bottom Lines — And Prices

"He said the state report shows how hospitals in heavily consolidated markets don’t have to cut prices as their bottom lines improve. “They can charge whatever the market will bear.”

Democrats were reckless and relentless in their efforts to pass the ACA despite the fact that many, many economists told them that it would lead to market consolidation, risk monopolistic control on prices, and drive a stake into the heart of small independent private practice businesses (the historic backbone of our health care industry). How can anyone take money from them?

 

[emd123]

Fingers crossed Obamacare is erased. I had given up hope on it.

One lingering problem: Roberts is still there to stab us in the back, again.

 

[emd123]

Was posting just in case you were too old to remember your Hilary was going to win in a landslide.

I'm old enough to remember when "the walls were closing in" on Trump, cuz CNN told me so.

 

[lonelobo]

Someone please tell me how doing away with the ACA tomorrow would change your practice?

 

[drusso]

How does it effect your practice?

Here's an excellent analysis of how the ACA created & accelerated perverse incentives in the marketplace. Besides stacking the deck against independent MD's, it also accelerated narrow networks (limiting choice) and drove UP prices.

The opioid crisis is partly fueled by insurers' approach to back pain - STAT

"This dynamic was accelerated by the Affordable Care Act’s Medical Loss Ratio, which requires that 80 percent of insurance premium dollars pay for medical expenses and that carriers pocket only 20 percent. It doesn’t take much to see that the higher the premium, the more they make from that 20 percent."

 

[Ligament]

Someone please tell me how doing away with the ACA tomorrow would change your practice?

Pre-auths would improve over time.

Once the ACA passed and pre-existing conditions were mandated to be covered (how stupid), and a whole pool of super sick people were added to the panel who should not have been were added, the insurance companies universally made pre-auths 300% worse. Denial denial denial. Of course they did so.

If you are required to "insure" people who are guaranteed financial losses, its no longer insurance.

Once the ACA passed, people who previously had plans they were somewhat happy with had plans they hated as premiums and co-pays SKYROCKETED. It got so bad here in Seattle Regence blue cross completely eliminated their individual pay market.

Once the ACA passed, I personally had my individual insurance plan premiums skyrocket and eventually my insurance itself was CANCELLED as my insurer left the market.

For those of you who are employed you may be insulated from pre-auths and insurance messes. As a clinic owner I see it first hand.

The ACA's goal was to destroy private practice by making it impossible to survive, and drive us into socialized medicine. It was designed as a cancer.

I hate the insurance companies and am not on their side. However I hate government control even more.

 

[Ducttape]

Was posting just in case you were too old to remember your Hilary was going to win in a landslide.

She won the popular vote, in case you forgot. Unfortunately she lost the electoral college.

 

[VA Hopeful Dr]

She won the popular vote, in case you forgot. Unfortunately she lost the electoral college.

The Rams had more punt return yards than the Patriots.

Why didn't they win the Super Bowl?

 

[Ducttape]

Your analogy lacks connection. Bad analogy.


A better one would have been if hillary’s team loses a game 21-20, out scores the other team 20-0, but allows a punt, a kickoff, and a pass interception return for touchdowns...


And yes, she still lost.

 

[VA Hopeful Dr]

Your analogy lacks connection. Bad analogy.


A better one would have been if hillary’s team loses a game 21-20, out scores the other team 20-0, but allows a punt, a kickoff, and a pass interception return for touchdowns...


And yes, she still lost.

It was literally the only thing the Rams did better than the Patriots that game.

But no, your analogy doesn't make sense in regards to your post that I was responding to. The popular vote doesn't matter, and in fact has never mattered. Maybe something like if the Rams had more total yardage but still lost because they were outscored by the Patriots.

 

[Gauss]

Don't confuse coverage with access. Erasing the terrible mistake of the ACA will allow us to "reset" the conversation on promoting access. So, so much dirty shenanigans caused by ACA--it's ruined countless small, independent medical practices. This is an opportunity for doctors to get back in the driver's seat.

lol, this coming from the fool practicing in Oregon which is only going to march faster towards socialized medicine now

 

[lobelsteve]

Must have been the dems did not know the EC is how presidents are selected. If only there were prior elections and a constitution where someone could have known.

Smh

 

[hyperalgesia]

I think we have to tackle different parts of "Healthcare" separately.

Most people don't require an implanted chip with their medical records as they go from doc to doc. But some do

 

[Ligament]

There is so much ignorance in these comments and I fear some of y’all will actually be allowed to practice medicine. Disgusting.

I guess you are right, what do we know. Someday we'll be able to practice medicine...once we finish our training. And when we do...look out!

 

[hyperalgesia]

Someday we'll be able to practice medicine...once we finish our training. And when we do...look out!

Thats assuming we gravitate from high school and get into med school... Yee haw!

 

[Ligament]

Thats assuming we gravitate from high school and get into med school... Yee haw!

What amazes me is laypeople cannot fathom doctors are against Obamacare. They've been fed so much propaganda from CNN they assume doctors are the ones that asked for this disaster.

 

[cowboydoc]

What amazes me is laypeople cannot fathom doctors are against Obamacare. They've been fed so much propaganda from CNN they assume doctors are the ones that asked for this disaster.

It is not a big leap. The ama was a huge supporter.

 

[Ligament]

It is not a big leap. The ama was a huge supporter.

The AMA does not represent doctors, it represents itself and how it can make money with the insurance companies.

 

[cowboydoc]

The AMA does not represent doctors, it represents itself and how it can make money with the insurance companies.

Of course it does, but Joe six pack thinks the AMA is the doctors union. If they are behind legislation, the average person thinks doctors support the issue.

 

[Ducttape]

What amazes me is laypeople cannot fathom doctors are against Obamacare. They've been fed so much propaganda from CNN they assume doctors are the ones that asked for this disaster.

remember that we are a subspecialty.

our FM and IM colleagues feel much differently about the ACA than we do. the AMA doesn't matter in that regard.

 

[VA Hopeful Dr]

remember that we are a subspecialty.

our FM and IM colleagues feel much differently about the ACA than we do. the AMA doesn't matter in that regard.

We do?

 

[SSdoc33]

We do?

yeah. most of them. especially the younger crowd. I realize you are a PCP (with a very independent/PP bias) but the tide is turning to support the ACA. Again, I don't, but it still remains better than the alternative before the aca was put into place

 

[VA Hopeful Dr]

yeah. most of them. especially the younger crowd. I realize you are a PCP (with a very independent/PP bias) but the tide is turning to support the ACA. Again, I don't, but it still remains better than the alternative before the aca was put into place

Must be a regional thing, because that's not what I'm seeing on the ground here. And I now work for a large hospital system so those are the people I interact with these days.

I mean, I don't see a lot of open hatred but its not a popular thing.

 

[SSdoc33]

Must be a regional thing, because that's not what I'm seeing on the ground here. And I now work for a large hospital system so those are the people I interact with these days.

I mean, I don't see a lot of open hatred but its not a popular thing.

taking care of the poor rarely is.

i hate obamacare. but do you think DJT can come up with a better alternative? no chance.

 

[VA Hopeful Dr]

taking care of the poor rarely is.

i hate obamacare. but do you think DJT can come up with a better alternative? no chance.

Don't be a dick. Its not about taking care of the poor, its about some aspects of the law that suck.

Honestly Trump probably could. He's had a few meetings with some folks I respect who do have good ideas so he's got some good information.

But both Congress and his own ego would get in the way.

 

[lonelobo]

Pre-auths would improve over time.

Once the ACA passed and pre-existing conditions were mandated to be covered (how stupid), and a whole pool of super sick people were added to the panel who should not have been were added, the insurance companies universally made pre-auths 300% worse. Denial denial denial. Of course they did so.

If you are required to "insure" people who are guaranteed financial losses, its no longer insurance.

Once the ACA passed, people who previously had plans they were somewhat happy with had plans they hated as premiums and co-pays SKYROCKETED. It got so bad here in Seattle Regence blue cross completely eliminated their individual pay market.

Once the ACA passed, I personally had my individual insurance plan premiums skyrocket and eventually my insurance itself was CANCELLED as my insurer left the market.

For those of you who are employed you may be insulated from pre-auths and insurance messes. As a clinic owner I see it first hand.

The ACA's goal was to destroy private practice by making it impossible to survive, and drive us into socialized medicine. It was designed as a cancer.

I hate the insurance companies and am not on their side. However I hate government control even more.

Having run my own practice for the last 10 years and private practice for 15 yrs your experience has been a lot different than mine. Most of these things were taking place long before ACA.
Look at the Insurers profits....yes some may have pulled products out of markets where they could no longer make obscene returns after ACA... but don't see any of them filing for bankruptcy

 

[Doctodd]

yeah. most of them. especially the younger crowd. I realize you are a PCP (with a very independent/PP bias) but the tide is turning to support the ACA. Again, I don't, but it still remains better than the alternative before the aca was put into place

Do you think people now support the ACA? That’s proof that if you tell someone a lie enough times, they will eventually believe it as fact and try to spread same. Common sense says the govt can’t do anything efficiently, but you ignore it time and again.

The CEO of the biggest hospital in Miami loves govt run healthcare. Why do you think that is?

 

[SSdoc33]

Do you think people now support the ACA? That’s proof that if you tell someone a lie enough times, they will eventually believe it as fact and try to spread same.

then clearly, you are lacking common sense

KFF Health Tracking Poll: The Public’s Views on the ACA

New Fox News Poll: Obamacare’s Popularity Is at an All Time High

that second link is to a fox news poll on the ACA.

 

[lonelobo]

Do you think people now support the ACA? That’s proof that if you tell someone a lie enough times, they will eventually believe it as fact and try to spread same. Common sense says the govt can’t do anything efficiently, but you ignore it time and again.

The CEO of the biggest hospital in Miami loves govt run healthcare. Why do you think that is?

Wow....... wonder what administration this applies to

 

[SSdoc33]

Don't be a dick. Its not about taking care of the poor, its about some aspects of the law that suck.

Honestly Trump probably could. He's had a few meetings with some folks I respect who do have good ideas so he's got some good information.

But both Congress and his own ego would get in the way.

it is difficult for me, but i'll try.

the ACA is a behemoth. there is a ton of stuff in it. the overarching theme is subsidies (call it a tax on the wealthy or a credit for the indigent if you want) so that the poor can afford to be insured. there is a lot of other stuff in there (all of the extra mandated EHR crap) which is obviously a PITA.

I am all for updating the ACA. changing it. improving it. Schumer and the democrats ran on that message, but the only tangible thing to come out of the GOP was GET RID OF THE ACA!!!

give me an alternative. that does not exist right now

 

[Doctodd]

Wow....... wonder what administration this applies to

Trump lives in your head 24/7.....we get it.