Hmmm. Who could have predicted this? Doctors that have loans and big bills aren't willing to see patients that they can't make a profit on. (Making a profit=being able to pay your business costs and have enough left over to pay your school loans and have enough to live on. Not to mention that with mainly sick people buying into Obamacare they might not get paid at all...or have to accept even less money.flamingdem (26,849 posts)
(Some) Fancy pants doctors won't accept PPO from the exchange
So I'm all happy thinking that I can get great care with Blue Shield or Anthem PPO in California on the Silver plan. I used to pay these companies so much money for large deductible policies that were just a step above catastrophic coverage.
However today I called an orthopedist who was recommended to me. The receptionist admits that none of the doctors in the group will accept ACA policies because the payments to are too low. They are "in negotiations" but have pretty much made this decision.
She advises me to use Kaiser's HMO program because her sister apparently finds it great but then I don't get to see my doctors! What's the point?
Then I realize that this may be true with other specialists or expensive doctors as well and it could cause major problems. Why isn't an Anthem PPO policy bought on the exchange as good as Anthem via a business plan from before? How can they use the same name for it? This will perpetuate a two tier, multi-tier treatment program that doesn't benefit those of us who want to access the best doctors. I'm pissed.
It seems like this was an oversight, not forseen?, greed driven and unexpected? or that it was always part of the plan to have expensive specialists bow out.
Liberals are SHOCKED, SHOCKED I tell you, that the concerns and arguments against Obamacare from the beginning from Conservatives is really TRUE.
But pie in the sky liberals think that it's all the greedy insurance companies and doctors fault and if everyone had just bowed before Obama it would all be just perfect.
No Republicans voted for it. Obama didn't allow any input from Conservatives. All of the yammering liberals have done about how Obama has tried to work with Republicans=I won, live with it. That's how liberals define "bipartisanship" when they have the presidency and congress.
It's just too bad we can't limit the effects of Obamacare to liberals and democrats.
Yea, those rich greedy doctors.Star Member NYC_SKP (54,830 posts)
12. I think "many more in the system" is a red herring. I think non-PCPs are edgy about being paid.
I had an issue for which I needed elective services and cannot find a provider to save my life.
No excuses, actually one receptionist said something about insurance and then backpeddled that during a second call.
So I think they're in a "wait and see" mode.
Everybody is probably up to date on their boat and Porsche and vacation home payments.
Hoyt (14,384 posts)
3. Docs want to get their share just like other greedy participants in health care system.
Personally, I like going to doctors who take Medicaid because you know their heart is in the right place. A good number of the others are in it for more than just a decent living.flamingdem (26,849 posts)
6. Here's the crazy thing - these fancy doctors DO take Medicare
so I guess that implies that ACA is paying less than that.
I really hope they can resolve this because that should not be happening.
Does point to Medicare for all as a better solution.Yea, that's the thing. Either refuse to give anyone more than 10 minutes of your time or work 120 hours a week instead of 60-80.Star Member notadmblnd (17,753 posts)
5. Well I guess if they think the 1% will take care of them, then I say go for it Doc.
personally, if I were a Dr. I think I would want a piece of the pie that 40 million+ newly insured people are going to bring to the table. Hell with the lower payments, I'll make it up in volume.
flamingdem (26,849 posts)
24. I'm more pissed at the doctors than ACA
but I think there are many issues cropping up here.
I used to be able to see any doctor that took PPO -- almost all doctors do.
Now I'm limited to a narrower group of doctors. Not every doctor fits the
Speaking of bills, that IS the point. Why waste money on a doctor who is
NOT up on my issue when I've gotten a clear recommendation for one who
IS up on it - but I can't see him now. THUS it will cost me more CASH so
what's the point of saving money via ACA when I'll end up spending as much
because I only want to see certain specialists, not an up and coming specialist
because I know from experience that is a waste of time and money.
This is not a good thing for patients in my opinion. We'll see how it shakes out.