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Thread: Obamacare: Is a $2,000 deductible 'affordable?'

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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by Boo Radley View Post
    You assume constant numbers. Two things will prevent that: 1) more creative use of personnel which has already begun, and 2) increasing the physician pool, which the legislation encourages and demand will push along.
    Stumbling block there, since the number of additional GPs is no where's near a realistic doctor:patient ratio (being that most med students head straight for a specialty for the $$), and I was including the fact that Nurse Practitioners and the like have long since been assisting in the medical field, add to that the doctors who are retiring for whatever reason, the basis remains the same.

    A couple of million people seeking medical help in a rather stagnant pool of access points is not greater access. The Insurance Mandate MAY give an individual greater access to medical treatment, but the population as a whole, access will be reduced.
    Building block or stumbling block.... choose.

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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by GottaGo View Post
    Stumbling block there, since the number of additional GPs is no where's near a realistic doctor:patient ratio (being that most med students head straight for a specialty for the $$), and I was including the fact that Nurse Practitioners and the like have long since been assisting in the medical field, add to that the doctors who are retiring for whatever reason, the basis remains the same.

    A couple of million people seeking medical help in a rather stagnant pool of access points is not greater access. The Insurance Mandate MAY give an individual greater access to medical treatment, but the population as a whole, access will be reduced.
    As those retire, more come in. And while use of alternatives like nurse practitioners have been done before, they are seeing new attention. Creative approaches have gained new emphasis. And demand will assure adjustments. It's already begun. There is no likelihood access will be reduced. None at all.

    But lets really look at your premise, for the few to have more, we have to leave some without. A bit like "let them eat cake" don't ya think?

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by Boo Radley View Post
    As those retire, more come in. And while use of alternatives like nurse practitioners have been done before, they are seeing new attention. Creative approaches have gained new emphasis. And demand will assure adjustments. It's already begun. There is no likelihood access will be reduced. None at all.
    Sorry, I don't see that happening, nor do many in the medical field. We're not talking a couple of hundred thousand people here. The time it will take to educate the number of medical personnel to service that many people isn't going to happen over night.

    But lets really look at your premise, for the few to have more, we have to leave some without. A bit like "let them eat cake" don't ya think?
    What should have been done, was staffed clinics, immediate medical care centers, etc, to take the drain off the ERs, and expand Medicare/Medicaid. Payment via those programs for the additional people needing the care would have been less expensive in the long run than paying premiums for insurance they may or may not use. Instead of upping the cash flow for programs that do some good, those subsidized premiums will now go corporations, people aren't able to keep plans they want, and those that want Catastrophic coverage are no longer able to do so.

    It has nothing to do with 'let them eat cake', it has to do with using common sense.
    Building block or stumbling block.... choose.

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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by Erod View Post
    Obamacare: Is a $2,000 deductible 'affordable?' - Jun. 13, 2013





    So when does the "Affordable" part of the Affordable Care Act kick in? High deductibles and high co-pays were not what Obama sold us.
    That's about what my deductible is on one of those CDHP plans at work. But I only pay about $40 a month for it.
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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by GottaGo View Post
    Sorry, I don't see that happening, nor do many in the medical field. We're not talking a couple of hundred thousand people here. The time it will take to educate the number of medical personnel to service that many people isn't going to happen over night.
    I know quite a few in the field, and it's already happening. So the end game is it will increase access.

    What should have been done, was staffed clinics, immediate medical care centers, etc, to take the drain off the ERs, and expand Medicare/Medicaid. Payment via those programs for the additional people needing the care would have been less expensive in the long run than paying premiums for insurance they may or may not use. Instead of upping the cash flow for programs that do some good, those subsidized premiums will now go corporations, people aren't able to keep plans they want, and those that want Catastrophic coverage are no longer able to do so.

    It has nothing to do with 'let them eat cake', it has to do with using common sense.
    Here, we might not be too far Apart. I have not argued this is the best plan, or the best approach. But it doesn't decrease access.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by Boo Radley View Post
    I know quite a few in the field, and it's already happening. So the end game is it will increase access.
    I also know quite a few in the field, it is quite the opposite. Plus my brother is in the medical field, and he sees what's happening first hand.



    Here, we might not be too far Apart. I have not argued this is the best plan, or the best approach. But it doesn't decrease access.
    Then we're going to have to agree to disagree. There is no way quality, educated medical personnel (GPs/NPs, mainly) are going to pop out fast enough to not only replace those retiring, those choosing to retire early because of the ACA, and service an inbound couple of million people.
    Building block or stumbling block.... choose.

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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by GottaGo View Post
    I also know quite a few in the field, it is quite the opposite. Plus my brother is in the medical field, and he sees what's happening first hand.



    Then we're going to have to agree to disagree. There is no way quality, educated medical personnel (GPs/NPs, mainly) are going to pop out fast enough to not only replace those retiring, those choosing to retire early because of the ACA, and service an inbound couple of million people.
    I have been, my wife is, my sister is, my brother is, my sister in law is and so is my brother in law. Not to mention we've been working with the hospitals here doing just what I said. You can also find articles on it happening, some having already been posted.

    Professionals are not retiring for the first time. This is on going, and their replacements already on board. The small number retiring early is insignificant.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by Boo Radley View Post
    Wring again. If we simply refused to treat those who can pay, there illnesses. And decaying health would bleed over in others. One way or another, the health of the community effects more than just the individual who can't pay.

    Again, I ask you to define too much. I can't respond without knowing how you're defining too much.
    I don't know how else to explain it such that you and others understand the inherent theoretical flaw in health insurance which gives us nearly perfectly inelastic demand for medical care and hence runaway inflation in prices.

    In a sense, you see the solution as the problem and vice versa.

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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by Neomalthusian View Post
    I don't know how else to explain it such that you and others understand the inherent theoretical flaw in health insurance which gives us nearly perfectly inelastic demand for medical care and hence runaway inflation in prices.

    In a sense, you see the solution as the problem and vice versa.
    I think you're trying to apply a theory that really doesn't play with medicine. Medicine is not a normal market service. A lot of our problem is trying to treat it like it is.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Obamacare: Is a $2,000 deductible 'affordable?'

    Quote Originally Posted by Boo Radley View Post
    As those retire, more come in. And while use of alternatives like nurse practitioners have been done before, they are seeing new attention. Creative approaches have gained new emphasis. And demand will assure adjustments. It's already begun. There is no likelihood access will be reduced. None at all.

    But lets really look at your premise, for the few to have more, we have to leave some without. A bit like "let them eat cake" don't ya think?
    With 30 million new people expected to enter the health-care system in 2014 under the Patient Protection and Affordable Care Act, experts say a looming doctor shortage isn’t a chance—it’s a fact.
    “These 30 million new patients have either not gone to the doctor or [have been] going to the emergency room so that is putting pressure into the system. You have a foundational supply and demand shift,” says Mitch Rothschild, CEO of Vitals, a consumer tool physician evaluation company.
    He expects the shortage to hit the primary care physician (PCP) arena the hardest and explains that there is approximately one PCP for every 1,500 people in the U.S. but come 2020, there will be about 70,000 less doctors available to consumers as a direct result of the law, according to Deloitte.
    In fact, a recent Deloitte 2013 survey of U.S. physicians found 57% doctors view changes in the industry under health-care reform as a threat, and six in 10 physicians report it’s likely that many will retire earlier than planned in the next two to three years, fueling the shortage.

    Here’s the Doctor, You Have 6 Minutes
    Here’s the problem: the number of people in the patient pool will increase 12% next year, but the supply of doctors will hold steady. Patients are already waiting longer to see their physicians and spending less time with them than they have in the past, according to Rothschild. On average, Vitals found patients are waiting 6% longer to see their doctors and spending only six minutes in the exam room.
    “You’re going to wait longer and spend less time with doctors,” he says.


    Read more: Obamacare Reality: Doctor Shortage on the Way | Fox Business
    Over half of physicians surveyed have reached a tipping point
    and plan to make changes to their practices. Many intend to
    take one or more steps likely to reduce patient access to their
    services
    , limiting physician availability at a time when doctors
    already are in short supply.

    Over 60 percent of physicians would retire today if they had the means.

    Over 52 percent of physicians have limited the access Medicare patients have to their practices or are
    planning to do so.

    Over 59 percent of physicians indicate passage of the Patient Protection and Affordable Care Act (i.e.,
    “health reform”) has made them less positive about the future of healthcare in America.

    Close to 92 percent of physicians are unsure where the health system will be or how they will fit into it
    three to five years from now.

    http://www.physiciansfoundation.org/...ial_Survey.pdf
    The Affordable Care Act isn’t scheduled to be fully implemented until next year, but some doctors already are viewing it as dead on arrival. The medical rumor mill is abuzz with stories about physicians girding for Mr. Obama’s signature domestic policy achievement by limiting their exposure to Medicare and Medicaid, selling their practices, converting to fee-for-service approaches, or even retiring from medicine altogether.
    “Every single day, people are talking about retiring early, getting out of clinical medicine, or going into hospital administration, where you don’t have to think about patient care anymore,” said Dr. Richard Armstrong, a Michigan surgeon and chief operating officer of Docs 4 Patient Care, which opposes the Affordable Care Act.
    Not all doctors agree. The American Medical Association endorsed the health care legislation at the time of its passage in 2010, although the group now is pushing for the elimination of the Independent Payment Advisory Board, the cost-control organization at the heart of the president’s plan that became known to critics as the “death panel.”


    Read more: 'Obamacare' health care reform ALREADY forcing doctors to close practices - Washington Times
    Follow us: @washtimes on Twitter
    Doctor Shortage Likely to Worsen With Health Law

    http://www.nytimes.com/2012/07/29/he...ties.html?_r=0
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