Supreme Court upholds health care law - Page 11 - The Horse Forum
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post #101 of 152 Old 06-30-2012, 03:44 PM
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Originally Posted by kitten_Val View Post
Is GP "general practice" aka "family doctor"?
Ya sorry should have typed it all out. Trying to do several things and get through it all faster then I should.

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post #102 of 152 Old 06-30-2012, 03:53 PM
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Thing is that an Oral Surgeon can get away with doing this. Lets face it there are not a large call for them nor are there a lot of them out there.

Now take a GP. This is what most people are going to need. There is a large need for GP and there are not many out there. They are the first leg of defence with in the HC area. Yet they are the lowest paid the most over worked Drs out there. With this bill these are the first Drs who will be bailing out. With the cost of THEIR Ins. and cost of keeping their doors open and the cost that the Govt. wish to make they will run for the hills.
Well, luckily my insurance does not require that I have a referal from my primary doctor in order to go to a specialist. This, I am sure, saves them a lot of money. Most people figure that if their ear hurts they need to see an ENT and shouldn't need to pay to see some diagnostician (i.e., doctor) so they can "refer them" them to one. Otherwise, a diagnostician does not just "look" at someone to make a diagnosis, they have 15-25 tests order so one has to go to a diagnostics lab and have those super costly tests performed. Generally, doctors order far more tests that is necessary in order to cover themselves "legally". But, since Obama, a lawyer and all, wouldn't want to limit the BAR's ability to sue w/o limits - he has not and will not address tort reform. Bush did...but was not successful as the most all of the senate are lawyers. On and on it goes.

There is just as much horse sense as ever, but the horses have most of it.
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post #103 of 152 Old 06-30-2012, 05:15 PM
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Thing is that is part of the problem. If your ear hurts does not mean you need to go see an ENT. It is a lot less expensive to go see a GP and rule out a simple ear infection which most likely is what it is then to go see an ENT and have them tell you the same things. A GP is about $75 and a ENT is about $300+ So what is $75 when the majority of the time it is something a GP can fix for the one time they need to refer you to the ENT.

-I'm so busy... I don't know if I found a rope or lost my horse.
-An Armed Man is a Citizen an unarmed man is a subject.
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post #104 of 152 Old 06-30-2012, 05:48 PM
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Originally Posted by dbarabians View Post
STG having 27 million uninsured is better than having 59 million.
Extending coverage for adult children until they are financially able to afford their own is good legislation .
Once again you are insisting on playing the partisian politics rampant on Capital Hill.
The affordable Healthcare Act is LAW.
Upheld by all three branches of our government.
Millions will now be covered by insurance.
Funny that you neglected to bring up the 3 billion in savings that seniors have enjoyed. That is very telling.
It proves you are more willing to argue than to accept reality. Shalom
As to the first statement I bolded, Obamacare only resolves half the problem, so I assume you will agree that it is a half-assed plan.

Yes, Obamacare is law, but not for long. The first time Republicans control the White House and both houses, it will be history. Sorry 'bout that. Oh, by the way, I can't bring myself to call it "The Affordable Healthcare Act" - we can't afford it any more than you can afford to buy Israel.

As to the second statement I bolded, you have to be kidding. I am a senior, and thanks to your spendthrift radical liberal President, seniors are losing billions and billions of dollars in lost income from their investments and nest eggs. Any savings in healthcare cost, which will only be temporary in the first place once insurance and Medicare premiums go up, is a drop in the bucket compared to the lost income. Seniors can't risk their money in the stock market - you know what a CD pays these days? Less than 1%...
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post #105 of 152 Old 06-30-2012, 05:52 PM
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Originally Posted by dbarabians View Post
Now that the AFA is law we as citizens need to urge our elected officals to cooperate and enhance this legislation.
If we do not then they will do nothing. Shalom
Here, let me correct that statement for you...

Now that the AFA is law, we as citizens need to urge our elected officials to repeal this legislation. If we do not they will do nothing.



There...much, much better...
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post #106 of 152 Old 06-30-2012, 06:52 PM
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Thing is that is part of the problem. If your ear hurts does not mean you need to go see an ENT. It is a lot less expensive to go see a GP and rule out a simple ear infection which most likely is what it is then to go see an ENT and have them tell you the same things. A GP is about $75 and a ENT is about $300+ So what is $75 when the majority of the time it is something a GP can fix for the one time they need to refer you to the ENT.
Point taken, however, in this specific example it is heavily dependant on the individual GP, the actual problem, and individual dr's rates. And, there is no real reason for a GP to have all the instrumentation an ENT does. In the end, it is probably better to go to the ENT.

There is just as much horse sense as ever, but the horses have most of it.
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post #107 of 152 Old 06-30-2012, 07:02 PM
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Maybe I can help with a couple of clarifying comments.

A family doctor (who could be a general practitioner, or of the specialty of internal medicine or family medicine doctor, or - for children - a pediatrician) generally is agreed upon by all to be the most effective healthcare provider for routine primary care. An earache is routine primary care. A draining and bleeding ear from a kid sticking a pointed object in his ear canal is maybe not routine and then an ENT is advisable. NHRA is right about the costs; it is under $100 versus over $250 in the KC area for primary care versus specialists. A family doctor (especially in the new patient centered medical home model) is going to organize your meds, your shots, your other illnesses, etc. A specialist is going to deal with just the one thing in front of him that is in scope for his specialty and at most, tell you to go somewhere else for the other conditions. A primary care doctor is going to try to work with you until and unless it is totally out of his scope and experience, and then he should coordinate with the other physicians he advises you to see. Some are better than others about this, I agree.

Oral surgeons are generally not covered under medical insurance policies except for trauma or birth defects. For run of the mill wisdom teeth extractions or root canals, the insurance they will file for you is your dental insurance, not your medical insurance. Some of the citizens of the US do not have dental insuranace, surprise, surprise. These guys are not as much affected by the Obamacare law, therefore. They get their money up front because if they don't, they have to spend money on collecting their fees and the collection agencies take a huge chunk of the money.
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post #108 of 152 Old 06-30-2012, 07:56 PM
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Originally Posted by Ladytrails View Post
Maybe I can help with a couple of clarifying comments.

A family doctor (who could be a general practitioner, or of the specialty of internal medicine or family medicine doctor, or - for children - a pediatrician) generally is agreed upon by all to be the most effective healthcare provider for routine primary care. An earache is routine primary care. A draining and bleeding ear from a kid sticking a pointed object in his ear canal is maybe not routine and then an ENT is advisable. NHRA is right about the costs; it is under $100 versus over $250 in the KC area for primary care versus specialists. A family doctor (especially in the new patient centered medical home model) is going to organize your meds, your shots, your other illnesses, etc. A specialist is going to deal with just the one thing in front of him that is in scope for his specialty and at most, tell you to go somewhere else for the other conditions. A primary care doctor is going to try to work with you until and unless it is totally out of his scope and experience, and then he should coordinate with the other physicians he advises you to see. Some are better than others about this, I agree.

Oral surgeons are generally not covered under medical insurance policies except for trauma or birth defects. For run of the mill wisdom teeth extractions or root canals, the insurance they will file for you is your dental insurance, not your medical insurance. Some of the citizens of the US do not have dental insuranace, surprise, surprise. These guys are not as much affected by the Obamacare law, therefore. They get their money up front because if they don't, they have to spend money on collecting their fees and the collection agencies take a huge chunk of the money.
Not all insurances work the same way. A primary, as you said, may not be a general practitioner, however, some, not all, insurance companies require that one is refered to a specialist by whoever it is that one identifies as their primary. BC/BS does not work this way, but others do. I rarely ever go to the doctor, so I am not an expert. But, I have noticed that doctors are not always available the same day or even within the week. I am a full believer in specialized instrumentation as well as getting out of pain as soon as possible. There is a risk in delaying care and doubling bills by going to a primary first and not an ENT, if one has seriouse earache - or other "ear symptom"..... which was only given as an example.

Many, not all, medical insurance plans cover some percentage of almost all the procedures one might go to an oral surgeon for as well as many one would go to the dentist for. Most oral surgeons and dentist will file first with your medical and then with your dental insurance. I can assure you this is not an "opinion", it is a fact.

It is obviouse why oral surgeons collect up front. My point was not that they collect up front in an effort to eliminate unnecessary visits, but rather that as a result of this practice, "unnecessary" visits are all but eliminated. Perhaps you have never met, known, or heard of anyone that went to the doctor if they stubbed their left toe or got a sniffle...I have. However, as I pointed out..doctors would never want to collect up front b/cit would reduce the number of "unnecessary visits" which dr's are, YeS... paid for by insurance....which was the point.

There is just as much horse sense as ever, but the horses have most of it.

Last edited by Missy May; 06-30-2012 at 07:58 PM.
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post #109 of 152 Old 06-30-2012, 08:42 PM
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Did anyone watch the video I posted? ... Anyone at all?

I have said what I have said. I have not said what I have not said.
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post #110 of 152 Old 06-30-2012, 09:19 PM
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Not all insurances work the same way. A primary, as you said, may not be a general practitioner, however, some, not all, insurance companies require that one is refered to a specialist by whoever it is that one identifies as their primary. BC/BS does not work this way, but others do. I rarely ever go to the doctor, so I am not an expert.

This is the case with most Ins any more. You do not need to see a primary to see a specialist but there is a reason to have and use a primary. One is they are a clearing house to keep everything straight. I have 5 specialist that I see on a reg. bases. I also have a primary who I do not see all that often but he is CCed on everything that is done all test all meds. He is the one who can see if there are any cross overs that might not be good. I do not need to see him to get into any of the other Drs. However IF my ear hurts which it does from time to time I go see my primary even though I have an ENT in speed dial. Why? B/C is it less expensive for me my Ins company and so on.

But, I have noticed that doctors are not always available the same day or even within the week. I am a full believer in specialized instrumentation as well as getting out of pain as soon as possible. There is a risk in delaying care and doubling bills by going to a primary first and not an ENT, if one has seriouse earache - or other "ear symptom"..... which was only given as an example.

Again most specialist will take sometimes months to get into and a GP maybe a day. So really is a Specialist any faster? I have not found this to be true. I normally have to schedual appointments months in advance. Normally I have the next one set when I leave their office.

Many, not all, medical insurance plans cover some percentage of almost all the procedures one might go to an oral surgeon for as well as many one would go to the dentist for. Most oral surgeons and dentist will file first with your medical and then with your dental insurance. I can assure you this is not an "opinion", it is a fact.

It is obviouse why oral surgeons collect up front. My point was not that they collect up front in an effort to eliminate unnecessary visits, but rather that as a result of this practice, "unnecessary" visits are all but eliminated. Perhaps you have never met, known, or heard of anyone that went to the doctor if they stubbed their left toe or got a sniffle...I have. However, as I pointed out..doctors would never want to collect up front b/cit would reduce the number of "unnecessary visits" which dr's are, YeS... paid for by insurance....which was the point.
So again lest do the math and I will use your ear as in this example. Lets say 5 people ear hurts. Out of those 5, 4 are simple ear infection which is the norm. Lets say they all went to an ENT at $300 each. That is $1500 an Ins company now has to pay out. Not to mention that it sets people back who NEED to see the ENT from getting in faster. Now lest say those same 5 people went to see their family Dr. Since 4 where just simple ear infections they got the same script that the ENT gave them and went home. The cost to the Ins comp. is, on the high side, $400 then lets take the 5th person. This person was something that did need an ENT. So now we have the $100 for the GP and he goes to see an ENT for $300. So now we have a totel of $800 to the ins comp vs $1500. Not to mention the difference in Co Pays. I know mine is more for a specialist vs a GP. No wonder Ins cost so much if people are doing this a lot.


I do under stand why you would want to go to the ENT but in reality it is hurting everyone. I people where more aware of what they where doing and the cost it might help. This is why I said in an earlier post that Drs need to list their prices like you would see at Mc D's This would help people make informed choices.

-I'm so busy... I don't know if I found a rope or lost my horse.
-An Armed Man is a Citizen an unarmed man is a subject.
-Where ever free speech is stifled Tyranny will reign.
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