Nurses laid off - Thanks to Obamacare

dansamy · Aug 8, 2013

Neither does private insurance necessarily result in short waits. I had to wait 3 months for a CT abd to rule out serious pathology.

What caused your delay?

allnurses Guide · Aug 8, 2013

Neither does private insurance necessarily result in short waits. I had to wait 3 months for a CT abd to rule out serious pathology.

There is either more to that story or it is grossly inexcusable.

I order a half dozen CTs a week and I have never had a patient wait more than 24 hours. .

Mindful, RN · Aug 8, 2013

You all southern boys and girls voted for Bush in 2000... that's where all the money went :yuck:

uRNmyway, ASN, RN · Aug 8, 2013

You all southern boys and girls voted for Bush in 2000... that's where all the money went

Yes of course laborer, only southerners voted for Bush, and remarkably, that was enough for him to win the election. Jesus... insert eye roll right here...

Guests · Aug 8, 2013

What caused your delay?

There is either more to that story or it is grossly inexcusable.
I order a half dozen CTs a week and I have never had a patient wait more than 24 hours. .

I don't quite understand how the insurance program works... it appears that I'm capitated to specific medical group and the hospital with which they're affiliated. It further seems to have been complicated by the fact that the c/c originated in an ER unrelated to "my" medical group. Approval for the CT seems not to have been through the insurance company but rather through the medical group, though apparently not with my PCP who actually ordered the CT and made the GI referral.

After several weeks of waiting to hear, I finally called the insurance company who directed me back to "member services" of the medical group who promised an answer within a few days. They finally approved it and gave me a 7-day window in which the scan had to be performed which was about 6 weeks out and which could only be done in the small regional facility affiliated with the medical group.

All that and I got hit with a $500 MD bill for the original ED visit because it wasn't my 'preferred' ED.

It's very different than the other insurance coverage that I've had (Kaiser and Anthem PPO) and I don't seem to get how to navigate it.

dansamy · Aug 8, 2013

Wow! That's heinous insurance. I'd be taking the FT no benefits option & buying my own.

LadyFree28, BSN, LPN, RN · Aug 8, 2013

In my experience, buying your own insurance can be reasonable and has a flexibility better than employer sponsored insurance...sometimes employer-sponsored insurance has this "capitation" that is ridiculous and should be done away with...unless you have a pre-existing condition; which has been eliminated due to ACA...a great thing... :yes:

I never waited for diagnostic testing, had to go to only one hospital, etc. With the private insurance I had I paid 50% LESS than the employer I was with at the time.

I would love to see less capitation and more portability...no one should have to wait for treatment, diagnostic or otherwise.

wooh, BSN, RN · Aug 9, 2013

Waited over 2 months for an MRI, then another month and a half for the results. Blue Cross Blue Shield. Respected MD ordered it. In the good ole US of A. (And huge copay to go along with that wait.)

MunoRN, RN · Aug 9, 2013

There is either more to that story or it is grossly inexcusable.
I order a half dozen CTs a week and I have never had a patient wait more than 24 hours. .

I've had many patients who've gone through this, with the most recent being just a few weeks ago. Pt had intractable abdominal pain, his GP ordered a CT, he then waited 6 weeks for approval from his insurance company until he thought he was going pass out from pain and he showed up in our ED, abdominal CT showed metastasized pancreatic cancer.

allnurses Guide · Aug 9, 2013

I've had many patients who've gone through this, with the most recent being just a few weeks ago. Pt had intractable abdominal pain, his GP ordered a CT, he then waited 6 weeks for approval from his insurance company until he thought he was going pass out from pain and he showed up in our ED, abdominal CT showed metastasized pancreatic cancer.

That's the provider's err. It's very unfortunate, awful disease, I know all too well from having lost a parent to it.

MunoRN, RN · Aug 9, 2013

That's the provider's err. It's very unfortunate, awful disease, I know all too well from having lost a parent to it.

If providers can get around insurance company rules regarding approval of outpatient referrals and tests I'd be interested in hearing how, I've thrown out my back a couple of times and my preferred fix is Physical Therapy. Both times I was 6 or 7 visits in before my insurance finally approved me, and they don't cover retroactively. Out of about 15 PT sessions I think I've only had 2 or 3 covered, I paid for the rest out of pocket.

BrandonLPN, LPN · Aug 9, 2013

*** Let's also consider that the federal government runs some of the finest health care in the country. Have you ever been a patient in a military hospital? I have as both a patient and a nurse and they are top notch.

I work at a state run nursing home, and I can say withouth the slightest hesitation that our residnts recieve care that's heads and shoulders above anything any privately run nursing home provides in my area. Even the posh medicare-only ones. There's no comparison.

And I don't really understand the "inefficient government" argument. Yes, we have an extra layer of bureaucracy, but we are more efficient than the private sector in other ways. We don't waste money on showy dispalys to dazzle families into admitting grandma. There's no CEO collecting absurd amounts of money. Our highest ranking person at the top recieves a relatively modest salary, compared to the plutocrats running private LTC chains.

For every instance of government waste in health care delivery, I could counter with an equally wasteful instance from the private sector.