Obamacare, what could go wrong?

[SC_RNDude]

"Let me get this straight . . .

We're going to be "gifted" with a health care plan we are forced to purchase and fined if we don't, which purportedly covers at least ten million more people, without adding a single new doctor, but provides for 16,000 new IRS agents, written by a committee whose chairman says he doesn't understand it, passed by a Congress that didn't read it but exempted themselves from it, and signed by a... President who smokes, with funding administered by a treasury chief who didn't pay his taxes, for which we'll be taxed for four years before any benefits take effect, by a government which has already bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese, and financed by a country that's broke!!!!

What the hell could possibly go wrong?'"

-Donald Trump

[MunoRN, RN]

AND all the web linked ACA's are all just a touch over 900 pages and on democrat or left sites. WHERE is the WHOLE thing?!?! They claim it is because the size of the law would be too large and cause download problems. SO,,,,,,,, why don't they post it in pieces. Those with nothing to hide....hide nothing.

Have a great day too!

Again, here's the link to all 2407 pages. It's not exactly hidden, it's the very first result for searching "ACA full text". 2407 pages does sound long, but there's only about 175 words per page, in terms of word count, it's almost half as long as Harry Potter and the Prisoner of Azkaban.

http://www.healthcare.gov/law/resources/authorities/patient-protection.pdf

[jojonavy]

What can go wrong is providers like me will quit seeing all Medicaid patients. I work in California. If I have a patient who is straight Med-Cal which is Medicaid for California I get paid $15 for the visit. I, along with the other providers I work with have severely limited the amount of straight Medicaid patients we see. If reimbursement falls lower we will quit seeing those patients all together.

If Obamacare doesn't get repealed and the reductions in payments to Medicare providers goes through I will quit seeing Medicare patients. My entire office has sent letters to our patients letting them know they will have to find another provider if reimbursement gets lowered. We will stick with cash paying and PPO patients.

15$ seems very very low. My co-payment is 15$ to see my primary MD. I don't see why there aren't any co-payments for Medi-cal and Medi-care. There should be. If they could afford a cell-phone bill, how can they not afford forking $15 for co-payment. Doesn't make sense. Also the same with ER visits. Again I can't imagine 15$ reimbursement.

[guest416560]

It is low. California has one of the lowest Medicaid reimbursement rates in the country. The majority of Medicaid patients are illegal immigrants. How they get Medicaid I will never know.

$15 is what the NP gets paid. The MD's get paid $18. The patients have a $5 co pay which most never pay. All of their prescription drugs cost them $1.20. That is their copay. Pretty sweet deal....better than what I pay for prescription drugs.

If one has ever wondered why California has billions of dollar of debt and is on the verge of bankruptcy.....here is one reason why.

[tntrn, ASN, RN]

15$ seems very very low. My co-payment is 15$ to see my primary MD. I don't see why there aren't any co-payments for Medi-cal and Medi-care. There should be. If they could afford a cell-phone bill, how can they not afford forking $15 for co-payment. Doesn't make sense. Also the same with ER visits. Again I can't imagine 15$ reimbursement.

Or hair extensions, high end Handbags (even from outlets), perfect nails. There is no reason to doubt the $15 reimbursement..which only underscores the concern of lessening them.

[guest416560]

just last week, california medical association filed a petition with cms asking that corrective action be taken to address current reimbursement rates and access standards.

“what we’re seeing now, is that medi-cal patients are already having a tough time getting access to care,” james t. hay, m.d., cma president said. “with these cuts, physicians will only be reimbursed $11 per medi-cal patient visit, when it costs the physician several times that to provide. physicians will be forced to reduce the number of medi-cal patients they accept, if they can continue to see any at all. we want to be able to treat these patients and we regret that the federal government is making it impossible.”

like i said earlier.....just because all of these people now have obamacare doesn't mean anybody is going to treat them. i know i'm not for $9,35 for an office visit. nps get paid 85% of what a md does for an office visit.

obamacare alienates providers.

cms approves california

[tntrn, ASN, RN]

just last week, california medical association filed a petition with cms asking that corrective action be taken to address current reimbursement rates and access standards. “what we’re seeing now, is that medi-cal patients are already having a tough time getting access to care,” james t. hay, m.d., cma president said. “with these cuts, physicians will only be reimbursed $11 per medi-cal patient visit, when it costs the physician several times that to provide. physicians will be forced to reduce the number of medi-cal patients they accept, if they can continue to see any at all. we want to be able to treat these patients and we regret that the federal government is making it impossible.”like i said earlier.....just because all of these people now have obamacare doesn't mean anybody is going to treat them. i know i'm not for $9,35 for an office visit. nps get paid 85% of what a md does for an office visit.obamacare alienates providers.

that's just pathetically criminal.

[MunoRN, RN]

It is low. California has one of the lowest Medicaid reimbursement rates in the country. The majority of Medicaid patients are illegal immigrants. How they get Medicaid I will never know.

$15 is what the NP gets paid. The MD's get paid $18. The patients have a $5 co pay which most never pay. All of their prescription drugs cost them $1.20. That is their copay. Pretty sweet deal....better than what I pay for prescription drugs.

If one has ever wondered why California has billions of dollar of debt and is on the verge of bankruptcy.....here is one reason why.

Low reimbursement rates for primary care pre-dates obamacare. Obamacare actually increases reimbursement rates for both MD and NP primary care providers. It should have been more than the 10% increase that was in the final bill, but like the inclusion of the individual mandate there were too many concessions to the GOP reform platform, which in terms of medicare/medicaid included cuts and a switch to a fixed budget, which means no reimbursement at all for the remainder of the fiscal year after the budget is exhausted.

[tntrn, ASN, RN]

Ooh, i bet that extra $1.50 makes FNP2B1 feel waaay better.

[MunoRN, RN]

"Death Panels"....a overly dramatic term. But yes, a team of gov't administrators is going to make cookie-cutter policies regarding healthcare. You already see Medicare taking healthcare decisions out of patient and doctors' hands. And, how about core measures in hospitals? Physicians have to follow them, or document why they do not, or the hospital doesn't get paid. As gov't healthcare grows, this type of from the top down healthcare is only going to increase.

The "death panel" actually came about in reference to a proposal to reimburse providers for discussing end of life wishes and filling out POLST's with patient's, which as an ICU nurse my view is that this should not only be reimbursed, but mandatory.

Core measures don't actually come from government administrators, they come from reliable EBM sources such as Cochrane and professional practice organizations such as the AMA and ACC/AHA. CMS refers to these EBM principles to define what they expect for their (our) money. Core measures represent the basic things that should be expected of someone billing for the treatment of certain condition. It's like saying if you're going to pay someone for building you a house, it should include a roof and walls, do you really think that's unreasonable?

[MunoRN, RN]

Ooh, i bet that extra $1.50 makes FNP2B1 feel waaay better.

So you support raising reimbursements even more? I never would have pegged you as a democrat tntrn.

[tntrn, ASN, RN]

So you support raising reimbursements even more? I never would have pegged you as a democrat tntrn.

You are at least correct on that....not a Democrat although i have a couple of moderate viewpoints. My comment was sarcasm, pure and simple.

[BlueDevil,DNP, DNP, RN]

Whoa now, the Medi-Cal debacle goes back to when Obama was about a high school sophomore, lol. Honestly, I don't know when it began or whom is responsible, but I do know that my uncle, whom retired from practicing medicine in California over 10 years ago, had to sue the state for 20 years of back pay from Medi-Cal. He won a very large judgement but he still hasn't been paid because the state treasury is insolvent. What a cluster. He basically worked for free for 20 years! He doesn't blame Obama, rather for some reason he thinks it is Schwarzenegger's fault.