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Supreme Court upholds health care law

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        06-30-2012, 09:28 PM
      #111
    Trained
    Quote:
    Originally Posted by RunSlideStop    
    Did anyone watch the video I posted? ... Anyone at all?
    I had to look back and find it...sorry I missed it the first time. It is rather long, I can't watch it in one sitting. BUT, what I have seen so far....

    THANKS FOR SHARING!
         
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        07-01-2012, 09:08 AM
      #112
    Trained
    I question these dire prediction some have about our future.
    Especially when made about a program that has yet to be fully implemented.
    \Obama was elected with the promise of implementing reform in the industry.He made good on the promise.
    Most american like all but the individual mandate that requires them to purchase insurance.
    67% of the voters approve of the rest. That is telling.
    Yes this legislation needs to be adjusted. It is not perfect.
    But allowing insurance companies to choose who and when they will cover paying customers only benefited them. Not the public.
    I must withdraw from this debate until later.
    A serious matter has required my attention concerning my family.
    I would like to address certain post but sadness has clouded my judgement and perhaps I can reply to them later.
    If not enjoy the debate and thank you for distracting me for 30 minutes or so whilke reading yesterdays post. Shalom
         
        07-01-2012, 10:26 AM
      #113
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    Quote:
    Originally Posted by Missy May    
    People shouldn't go to the dr unless they have to, either.
    I very much agree (except the preventing services like blood tests, screening, and alike, which I think should be done as they are recommended and be paid by insurance).

    BTW, talking about "have to" I know at least one family doctor in my area who make people on Medicaid/Medicare to come to his office at least once/month for "check up". And I'm talking about those who are NOT sick. I think that's something that should be traced and stopped, because it's nothing but pure making money from nothing.
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        07-01-2012, 10:32 AM
      #114
    Trained
    That is part of the problem and one that is not being addressed. Whe need REAL HC reform not this. This does nothing to addess the under lieing problems. Of which there are many.

    As the end of the day if the Govt. Ends up running HC in the US we are all in big trouble.
         
        07-01-2012, 10:35 AM
      #115
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    Quote:
    Originally Posted by nrhareiner    
    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.
    nrhr, I agree and disagree with you in same time. My insurance doesn't require a referral for me to go to the specialist (thank God!). I do go to one specialist a lot (because I have no choice) and asking a referral every time would be a nightmare. In my experience GP doctors are quite useless when you have a real problem (and so far I never went to the family doctor with something simple - it always required a specialist and just went directly). Moreover we had a bad experience with my mom when she went to family doctor (instead of going to the specialist as I tried to push her), and the diagnose given was wrong giving us all kinds of problems several months later when she had to go to specialist anyway and it got much worse than it should. Frankly I'd much rather to get an advice from the specialist when I feel something is really off than some "general" doctor not knowing much (and just to add, I do NOT go to the doctor unless there is a real need for it). But it's just me.
         
        07-01-2012, 10:40 AM
      #116
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    Quote:
    Originally Posted by nrhareiner    
    I do under stand why you would want to go to the ENT but in reality it is hurting everyone.
    Well, but more often than not you can NOT schedule the appointment like for tomorrow. So you have to schedule one with FD (family doctor) in 2 weeks (or month), and then have to schedule other one with the specialist (which can take even couple months or more). When you have something that can't wait that long, it doesn't sound like a smart way to go.
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        07-01-2012, 10:59 AM
      #117
    Trained
    Quote:
    Originally Posted by kitten_Val    
    nrhr, I agree and disagree with you in same time. My insurance doesn't require a referral for me to go to the specialist (thank God!). I do go to one specialist a lot (because I have no choice) and asking a referral every time would be a nightmare. In my experience GP doctors are quite useless when you have a real problem (and so far I never went to the family doctor with something simple - it always required a specialist and just went directly). Moreover we had a bad experience with my mom when she went to family doctor (instead of going to the specialist as I tried to push her), and the diagnose given was wrong giving us all kinds of problems several months later when she had to go to specialist anyway and it got much worse than it should. Frankly I'd much rather to get an advice from the specialist when I feel something is really off than some "general" doctor not knowing much (and just to add, I do NOT go to the doctor unless there is a real need for it). But it's just me.
    I am not talking about every time. Beleive me I have 5 specilaist and only 1 do I need a referal everytime and it also has to be Oked through my Ins. I am talking about either the first time or if it is something simple like your ear hurts. As that was the example given. Most of the time it is just an infection. So why would you need an ENT for that? Also there are times that you do not know what is going on so how could you know what specialist to go to? I have been there.

    The things is also that YOU need to take some responsibility for your health care too. If you go and they treat you and you do not start feeling better then you need to talk to them and say maybe I need to see a specialist for this or that.
         
        07-01-2012, 11:03 AM
      #118
    Trained
    Quote:
    Originally Posted by kitten_Val    
    Well, but more often than not you can NOT schedule the appointment like for tomorrow. So you have to schedule one with FD (family doctor) in 2 weeks (or month), and then have to schedule other one with the specialist (which can take even couple months or more). When you have something that can't wait that long, it doesn't sound like a smart way to go.

    Must be the area or somthing. I can get into my GP wiht in a day 2 at the most. All my specialist take 4-6 weeks with the exception of my Pulmanologest who sees me every 3-6 months. If I called and said I was not feeling very well and my breathing was getting worse. She would fit me in tomorrow but then again I have been seeing her for about 6 years. However if It had nothing to do with my breathing if I thaught I had a cold or somthing like that I would call my GP not her. I am not going to take up her time which she has very little of for somting that my GP could handle.
         
        07-01-2012, 11:11 AM
      #119
    Trained
    Depends on the time of year and what is going one and what you need to see the GP/PC here for. Some times I can get in same day with ours, and sometimes its a couple of weeks wait if nothing serious.

    Everything other then the GP/PC must have referrals or prior authorizations unless it is an emergency for our insurance to cover it, otherwise we pay out of pocket. I can't complain though... We don't have copays, don't have to pay monthly for it, and have extremely minimal med costs (hubby pays nothing for his meds)... What insurance is this you ask? Military/TriCare. The "we are going to drown you and your doctors in paperwork" insurance.
         
        07-01-2012, 11:12 AM
      #120
    Trained
    Quote:
    Originally Posted by nrhareiner    
    So again lest do the math and I will use your ear as in this example.

    I do under stand why you would want to go to the ENT but in reality it is hurting everyone. .
    I agree with you in part. I made an assumption that I should not have made. I did not mean to say that some insurances require a referal from their primary to see a specialist in order for the insurance to "allow" any of the charges. I assumed, incorrectly, that it would be taken for granted in a discussion about insurance that I meant a referal is required by some companies in order to ensure the charges would be fully covered to the extent allowable, I.e., not be penalized for "self refering". Lets do the math for the word "some", it is taken, universaly, to mean "not all", which means greater than 0%.

    In your example you left out multiple variables. To begin with, there are 50 states and umpteen hundred counties,and not everyone has a general practitioner as their primary physician. It is not more expensive for me, for example, to go to an ENT than it is to go to my primary physician for the identical treatment, it is LESS. So, I absolutely agree, a schedule of their charges should be posted - and it should be mandatory that they be posted.

    Lost in all of this "cost savings" to go to a primary (which is not always a general practitioner) was my point...which was that a lot of people go to the doctor that do not need to be going, period. Cost? It does not seem to be one of those things they wish to quantify...but I would guess it is a high multiple of billions. Incentive not to go when not necessary - not much that I know of for the insured. One rather widely discussed piece of evidence of this (people going to an md when unnecessary) is - resistant strains of bacteria.

    If I have a tooth ache, I go to the dentist. The distinction between dentistry and medicine as they pertain to humans is an arbitrary one. If it were included as part of the medical world...the price of medical care would simply go up over all due to additional training and instrumentation costs, yet there would still be "dental specialist". And, if I had a tooth ache in that "hypothetical" - I would go to the specialist, not my primary physician who is not a general practitioner.

    BTW, most cities, not towns...and I said most, which does not mean all...have "urgent care centers" with what I assume to be general practitioners. Since most people live in cities...the availability of a general practitioner in cases where one needs immediate care, but not an ER, is already established.

    Like I said, I almost never go to the doctor. If everyone went to the doctor as much as I do, insurance would not even be an issue. But, from that, should I then assume that all those that go more frequently than I, do so b/c they simply don't understand something? I say this b/c you made the assumption that people such as myself drive up insurance costs by going to a specialist. I guess I should have qualified what I said w "when necessary", but since my main point was the cost of the vast number of "unnecessary" visits people make, I mistakenly assumed that that was a given.
         

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