Patients Pay Before Seeing Doctor as Deductibles Spread

jmotivator said:

Look at it this way Maggie:

A woman who works two part time jobs makes $15,000 annually. Because of the ACA she gets bronze health insurance with, say, a $5000 deductible.

This woman gets the flu, but the doctor wants payment up front for the visit. She doesn't have the money to pay the doctor.

Now tell me how this is any different than her life before Obamacare?

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She pays a measly $95 penalty and is in no worse shape than she was before. And if her premiums would be more than 8% of her salary? She faces no penalty at all. If a woman is working two part-time jobs and earning $15,000 annually? She's got more vacation time than you have. Perhaps she needs three. Not all uninsured will face fines under Affordable Care Act | ksl.com

Let's get real here.

jmotivator said:

Everyone has insurance, less people get care. It's a great system....

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That's nonsense.

jmotivator said:

Look at it this way Maggie:

A woman who works two part time jobs makes $15,000 annually. Because of the ACA she gets bronze health insurance with, say, a $5000 deductible.

This woman gets the flu, but the doctor wants payment up front for the visit. She doesn't have the money to pay the doctor.

Now tell me how this is any different than her life before Obamacare?

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It sort of depends on how the deductible has to be applied. IIRC, from way back when I had insurance, certain maintenance appointments are paid for with a reasonable co-pay, it's the catastrophic and chronic issues that get the deductible treatment. So a person having known chronic issues shouldn't get a $5000 deductible, and a person with a catastrophic issue should be damn glad his costs will be limited to about $5000, plus what 20% of everything else with no limits, lifetime or annual.

trfjr said:

you are going to have a lot of pissed off the Obama voters which most are miss or uniformed that will sign up pay that one monthly premium and go to the doctor demanding treatment to find out it will cost them a few thousand to get that treatment

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I don't think that will happen, no. Unless that person is completely unaware of the concept of a deductible, for some reason. But someone that ignorant was going to run into problems regardless of the ACA.

MaggieD said:

That's nonsense.

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You said yourself that under the new system fewer people will be going to see the doctor and that that is a good thing. Less doctors visits = less care.

MaggieD said:

She pays a measly $95 penalty and is in no worse shape than she was before. And if her premiums would be more than 8% of her salary? She faces no penalty at all.

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So in your "better" system she has no medical insurance but doesn't have to pay a penalty? You mean just like BEFORE Obamacare?

If a woman is working two part-time jobs and earning $15,000 annually? She's got more vacation time than you have. Perhaps she needs three.

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If she is making $8 an hour she is working full time.

Not all uninsured will face fines under Affordable Care Act | ksl.com

Let's get real here.

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Yes, let's get real here: You have just shown that the people that the Affordable Care Act was meant to help have been EXCUSED FROM THE AFFORDABLE CARE ACT BECAUSE THEY CAN'T AFFORD IT.

jmotivator said:

So in your "better" system she has no medical insurance but doesn't have to pay a penalty? You mean just like BEFORE Obamacare?



If she is making $8 an hour she is working full time.



Yes, let's get real here: You have just shown that the people that the Affordable Care Act was meant to help have been EXCUSED FROM THE AFFORDABLE CARE ACT BECAUSE THEY CAN'T AFFORD IT.

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Look, if people are going to pick worst cases and make up ****, then Obamacare is a piece of ****. But it's not. How many adults do you know who earn minimum wage? I sure don't know any. And if they are, chances are they're on Medicaid anyhow.

If it is the piece of crap folks seem to think it is? Then why is Barack Obama a second term president? I support Obamacare (though I think it needs work) and I didn't vote for him.

MaggieD said:

Look, if people are going to pick worst cases and make up ****, then Obamacare is a piece of ****. But it's not. How many adults do you know who earn minimum wage? I sure don't know any. And if they are, chances are they're on Medicaid anyhow.

If it is the piece of crap folks seem to think it is? Then why is Barack Obama a second term president? I support Obamacare (though I think it needs work) and I didn't vote for him.

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Obamacare was designed to save the worst case scenarios. Now it excuses them from participating.

Cardinal said:

I don't think anyone is entirely happy with PPACA, it's just meant to be better than what came before it. At least it expands coverage to 16 million more people (so I read), and eliminates cutting people off for pre-existing conditions as well as eliminating kicking people off for getting sick, all real problems.

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Granted those are all improvements. Still, as it turns out, the ACA is bringing the pain. Will this prompt people to shift support to single payer or will trust in big government be so damaged that that goal becomes impossible? In my opinion it will be the latter.

MaggieD said:

Are you posting this as if it's bad news? That would be good news. Emergency rooms are ridiculously over-used. If people have to pay up in advance, they'll make an appointment with their doctor -- or, YIKES! get a family doctor.

I've had the misfortune of having to use the ER on four occasions in the last six years...for genuine pain-threshhold-ten emergencies. Somebody's there because his foot cast itches...a kid with a sore throat who's running around the waiting area...dozens of people looking just fine patiently waiting for ER care. More convenient at night is my guess. That's simply GOT to change.

Large deductibles are a good thing.

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I think they are a bad thing especially when premiums exceed what they were with low deductables. He sends a bad message to the middle class that has maintained coverage all their lives. People with low deductibles take better care of themselves with preventative care.

jmotivator said:

Obamacare was designed to save the worst case scenarios. Now it excuses them from participating.

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And it harmed every person that has maintained coverage all their lives.

Deuce said:

I don't think that will happen, no. Unless that person is completely unaware of the concept of a deductible, for some reason. But someone that ignorant was going to run into problems regardless of the ACA.

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It's not that the person is unaware of deductibles...but the person is not aware that their doctor wants full payment BEFORE the doctor will see them. When they are confronted with that situation...and don't have the ready cash to pay $500-$1000 just so the doctor will take a look at them...they will be surprised and, eventually, pissed off. My guess is that their anger will be directed at their doctor and at Obamacare.

Are we complaining that Obamacare does not go far enough in mandating what insurance options are available? You want fewer buying choices? Before ACA you could buy insurance with deductibles as high as you can imagine. After ACA, we have the maximum out of pockets of $6,350 per individual. If you buy insurance with a $6,350 deductible don't act all surprised when someone expects you to actually pay them for services received. If you wanted a lower deductible, you have that option too. Just pay the extra money for it. ACA can't fix people not reading what they're buying.

trfjr said:

Patients Pay Before Seeing Doctor as Deductibles Spread - Bloomberg

wasn't Obama care supposed to keep the uninsured from flocking to the emergency rooms for any little illness?
Now it will be the insured and uninsured doing just that because they cant afford the deductibles and co-pay
so there goes another liberal talking point down the drain

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Yeah, you have to do something called shopping around. A high deductable low cost insurance plan is great for a healthy person. It is good that it is there because it will get people who would normally go without to sign up because they do not have to pay in as much. I do not know what you are complaining about, this is absolutely normal for insurance. It happened before Obamacare also. obamacare did not make this happen. Part of the lies spread by the right which any person who has ever shopped for health insurance knows has always been the case.

Mycroft said:

It's not that the person is unaware of deductibles...but the person is not aware that their doctor wants full payment BEFORE the doctor will see them. When they are confronted with that situation...and don't have the ready cash to pay $500-$1000 just so the doctor will take a look at them...they will be surprised and, eventually, pissed off. My guess is that their anger will be directed at their doctor and at Obamacare.

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That is not Obamacare. That is a product of people skipping out on bills. That is also a product of insurance companies. Yes, doctors have been asking for deductable payment up front for a while now, and it has nothing to do with obamacare. if you had insurance you would know that. The only doctor I know that you can walk into and not pay first is the ER. Look how often they get screwed. Actually most doctors already have payment plans for people who know they will be going over their deductible. Friends of mine who have been having children set up a payment system where they go through their deductible over the course of the pregnancy for the hospital care at the end. This is not new. Please stop lying about that. This is insurance and how it works. Of course doctors want payment up front now. Too many of them have been screwed on payment in the past. However, there are credit options that have been developed for people to handle their deductible through a loan and have that loan company absorb the risk rather than the doctor.

tererun said:

That is not Obamacare. That is a product of people skipping out on bills. That is also a product of insurance companies. Yes, doctors have been asking for deductable payment up front for a while now, and it has nothing to do with obamacare. if you had insurance you would know that. The only doctor I know that you can walk into and not pay first is the ER. Look how often they get screwed. Actually most doctors already have payment plans for people who know they will be going over their deductible. Friends of mine who have been having children set up a payment system where they go through their deductible over the course of the pregnancy for the hospital care at the end. This is not new. Please stop lying about that. This is insurance and how it works. Of course doctors want payment up front now. Too many of them have been screwed on payment in the past. However, there are credit options that have been developed for people to handle their deductible through a loan and have that loan company absorb the risk rather than the doctor.

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Oh, I agree with you that Obamacare is not causing this situation. Didn't you read my first post in this thread? Heck, I don't even blame the insurance companies like you do.

However, people are people. They will blame whoever is prominent in their minds. In this case, I think the doctors and Obamacare will be the targets.

I've been to the E.R. once.

It happened at 10pm on a Friday night. I slipped and fell out of the shower. I had hurt my back and I had a horrible stabbing pain. There were no regular doctor's offices open. There were no urgent care offices open. The only thing open was the E.R. Now I was pretty sure it wasn't an emergency since I could drive but I was genuinely worried that something was "broken", possibly a rib or something. I didn't know but it hurt so ****ing bad and it was hard to breath. I had to drive in excrutiating pain to the hospital because it's the only care I could get. It's just another anectodal story to add to how and why people go to the E.R. I'm sure if I could have just gone to an urgent care or even some doctor who had their lights on that would have been fine but those weren't options.

BTW it was a sprain and I was on light duty for a week.

Mycroft said:

Oh, I agree with you that Obamacare is not causing this situation. Didn't you read my first post in this thread? Heck, I don't even blame the insurance companies like you do.

However, people are people. They will blame whoever is prominent in their minds. In this case, I think the doctors and Obamacare will be the targets.

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I can see where you are coming from there. I think it has more to do with the blame game and pointing them in that direction while they forget what they already know, but complaining people do tend to migrate to other complaining people which is why Obamacare will continue to be a good rallying cry for the right. I just wish the right would recognize that people are tending to remember how crappy no regulation on insurance was, and how they were dropping people for getting sick, and how you got stuck in your job if you got sick because you would never get a new policy with a new job. Here is what I wanted with the right. I actually wanted an alternative proposal to the healthcare mandate. If the alternative to Obamacare was not nothing I am pretty sure republicans would have actually been popular. Obamacare sucks, but it is better than nothing. It was just such a smack in the face that republicans wanted nothing when it was clear the american public as a majority was screaming for health care reform. That sent a clear FU to everyone where they could have come up with an alternative and been an alternative.

tererun said:

I can see where you are coming from there. I think it has more to do with the blame game and pointing them in that direction while they forget what they already know, but complaining people do tend to migrate to other complaining people which is why Obamacare will continue to be a good rallying cry for the right. I just wish the right would recognize that people are tending to remember how crappy no regulation on insurance was, and how they were dropping people for getting sick, and how you got stuck in your job if you got sick because you would never get a new policy with a new job. Here is what I wanted with the right. I actually wanted an alternative proposal to the healthcare mandate. If the alternative to Obamacare was not nothing I am pretty sure republicans would have actually been popular. Obamacare sucks, but it is better than nothing. It was just such a smack in the face that republicans wanted nothing when it was clear the american public as a majority was screaming for health care reform. That sent a clear FU to everyone where they could have come up with an alternative and been an alternative.

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I will blame Obamacare for what it deserves to be blamed for...and there is a lot it deserves to be blamed for.

But, you know, if what you want from the Republicans is a government controlled alternative to Obamacare, you won't get it and you should know that. Republicans don't believe government is able to control health care costs...nor do they believe government should attempt to do that. Republicans believe the best thing the government can do is get out of the way so people can make their own decisions.

You see, not everyone in the US thinks the government is the solution to every problem. A lot of people think the government is the problem. Obamacare is just one example of government being the problem.

btw, there IS no alternative to the mandate. Obamacare can't work without it.

Mycroft said:

I will blame Obamacare for what it deserves to be blamed for...and there is a lot it deserves to be blamed for.

But, you know, if what you want from the Republicans is a government controlled alternative to Obamacare, you won't get it and you should know that. Republicans don't believe government is able to control health care costs...nor do they believe government should attempt to do that. Republicans believe the best thing the government can do is get out of the way so people can make their own decisions.

You see, not everyone in the US thinks the government is the solution to every problem. A lot of people think the government is the problem. Obamacare is just one example of government being the problem.

btw, there IS no alternative to the mandate. Obamacare can't work without it.

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Not everyone in the US is under the delusion that the free market actually works for people, and therefor that is a flaw of the republican party. If they do not wish to change that is fine, but we have learned over the existence of the US that when you do not have regulations bad things happen. Yes, we have also discovered that government does provide services much better than the private sector especially when funded. I have to say that if your purpose is to have no government programs you are pretty much outvoted as people do appreciate things like schools, cops, firemen, roads, social security, welfare, CDC, EPA, FCC, and many other government organizations that provide services to all of us. They may need a good fine tuning, but you will find few people who would not find things the government is useful for. BTW the republicans are all for government programs. they do like their corporate welfare, government contracts, military industrial complex, private prison systems, police, fire departments, DEA, FBI, CIA, Military, and many other systems that are run by the government. They are most certainly not for smaller government so they should get their asses in gear and start recognizing government programs people want and get with making them better rather than trying to funnel every bit of money they can into their corporate friends pockets.

But if you want to pretend republicans are not about government you can feel free to pretend that. It just means you are blind to the future and you will help guide the party into oblivion.

Mycroft said:

It's not that the person is unaware of deductibles...but the person is not aware that their doctor wants full payment BEFORE the doctor will see them. When they are confronted with that situation...and don't have the ready cash to pay $500-$1000 just so the doctor will take a look at them...they will be surprised and, eventually, pissed off. My guess is that their anger will be directed at their doctor and at Obamacare.

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I think people are misinterpreting this article.

If you go to the doctor, and your policy has a $30 co-pay, the doctor wants that co-pay right then and there. If you have a $1,000 deductible, the doctor is STILL going to want that $30 co-pay right then and there. The doctor is NOT going to collect your $1,000 deductible for a $125 office call. What's HE going to do with it? You don't owe it to him. This is nothing new.

Use your heads, folks.

Summerwind said:

We didn't need to have that so much. In Boise, all the IBMers which were few, lived in the same neighborhood. It was a lot like EDS in Plano with my uncle and his co-workers, except EDS was on a much larger scale taking up blocks and blocks of neighborhoods.

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IBM people stick together. My retired parents still travel around in fifth wheel-motor home IBM caravans.

MaggieD said:

I think people are misinterpreting this article.

If you go to the doctor, and your policy has a $30 co-pay, the doctor wants that co-pay right then and there. If you have a $1,000 deductible, the doctor is STILL going to want that $30 co-pay right then and there. The doctor is NOT going to collect your $1,000 deductible for a $125 office call. What's HE going to do with it? You don't owe it to him. This is nothing new.

Use your heads, folks.

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You are mistaken Maggie. The docs want the entire deductible up front. That is what my mom just told me anyway. She has been doctor shopping since her old doc won't take Medicare patients which obamacare forced her onto and is being told this constantly.


EDIT: To be more precise they want the entire deductible up front before they accept you as a new patient. If you are already a patient it may be different, I truly don't know.

MaggieD said:

I think people are misinterpreting this article.

If you go to the doctor, and your policy has a $30 co-pay, the doctor wants that co-pay right then and there. If you have a $1,000 deductible, the doctor is STILL going to want that $30 co-pay right then and there. The doctor is NOT going to collect your $1,000 deductible for a $125 office call. What's HE going to do with it? You don't owe it to him. This is nothing new.

Use your heads, folks.

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Ah...no, Maggie.

What the article is saying is that when you go to your doctor's appointment, they will ask you for the co-pay and the cost for the blood test and any other treatment they expect to do until your deductible has been met...before the doctor will even see you.

You, on the other hand, came there expecting to pay only the co-pay, getting all the other stuff done and then getting a statement from your insurance company saying they were not going to pay for the treatment and stuff because your deductible had not been met and getting a bill from the doctor for the rest. By that time, payday has come and you have the cash on hand without having to dip into your savings to cover it.

sawyerloggingon said:

You are mistaken Maggie. The docs want the entire deductible up front. That is what my mom just told me anyway. She has been doctor shopping since her old doc won't take Medicare patients which obamacare forced her onto and is being told this constantly.

EDIT: To be more precise they want the entire deductible up front before they accept you as a new patient. If you are already a patient it may be different, I truly don't know.

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This cannot be true. Period.

Think about it. You go to the doctor. The doctor visit is $125. You have a $5,000 deductible. The doctor is NOT going to collect $5,000 from you. Use your head. And, in this case, assume your mom has her facts absolutely 100% wrong. How on earth would your DOCTOR know whether or not you'd paid your deductible or not??

The doctor wants his co-pay.