Concierge / private practice recommendations

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:well apparently then I have your Cadillac plan-oon is not covered well at all-if I pay 200 for a kids therapy session I get 70 dollars back--is that good? my coinsurance is 15% I pay over 10k/ year after two FSA plans are used up with pretax money--so 20K a year or a mix of pre and post tax cash-now agreeably I do have some conditions that most people dont.
do you have a cadillac plan? LOL

please tell me who doesnt take medicaid? all of inova docs take medicaid

Yes I do have a Cadillac plan and it pays $160 for a $200 OON session. It sounds like you don't have a Cadillac plan. Bummer.

My kid's therapist has people sign a contract that specifically says Medicaid won't reimburse for services. She is one of only a few people qualified to treat my kid's condition. There is research showing people with Medicaid have trouble finding providers. Not that there aren't any providers that take it. But when you need something specific it might not be available.

Well apparently your Cadillac is fully loaded while mine isn't-satisfied now?. I did make the 1 % disclaimer about Medicaid so it stands. BTW we found an out of the DMV therapist in network who is also MUCH better than the local OON one--so find and you shall seek for most everything.

Why would I care what kind of plan you have?

And I am glad that you found something that works for you. Some of us have children that need weekly in person therapy and we live in the DMV. So no, "seek and you shall find" is not true for many families.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:well apparently then I have your Cadillac plan-oon is not covered well at all-if I pay 200 for a kids therapy session I get 70 dollars back--is that good? my coinsurance is 15% I pay over 10k/ year after two FSA plans are used up with pretax money--so 20K a year or a mix of pre and post tax cash-now agreeably I do have some conditions that most people dont.
do you have a cadillac plan? LOL

please tell me who doesnt take medicaid? all of inova docs take medicaid

Yes I do have a Cadillac plan and it pays $160 for a $200 OON session. It sounds like you don't have a Cadillac plan. Bummer.

My kid's therapist has people sign a contract that specifically says Medicaid won't reimburse for services. She is one of only a few people qualified to treat my kid's condition. There is research showing people with Medicaid have trouble finding providers. Not that there aren't any providers that take it. But when you need something specific it might not be available.

Well apparently your Cadillac is fully loaded while mine isn't-satisfied now?. I did make the 1 % disclaimer about Medicaid so it stands. BTW we found an out of the DMV therapist in network who is also MUCH better than the local OON one--so find and you shall seek for most everything.

Why would I care what kind of plan you have?



And I am glad that you found something that works for you. Some of us have children that need weekly in person therapy and we live in the DMV. So no, "seek and you shall find" is not true for many families.

what is your point? in socialized medicine your therapist would not take any insurance so again only the "haves" would get their kids in, and even if she did have a gov job and private practice one the side there would be probably such a backlog of kids though the gov that the wait time would be months and she would see them every 6 months--so the same outcome again as you can see
you are free to set up a fund for the condition your kid has(and I hope they are getting better and better) so that kids with only medicaid can use this cash to see your therapist as well....

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:well apparently then I have your Cadillac plan-oon is not covered well at all-if I pay 200 for a kids therapy session I get 70 dollars back--is that good? my coinsurance is 15% I pay over 10k/ year after two FSA plans are used up with pretax money--so 20K a year or a mix of pre and post tax cash-now agreeably I do have some conditions that most people dont.
do you have a cadillac plan? LOL

please tell me who doesnt take medicaid? all of inova docs take medicaid

Yes I do have a Cadillac plan and it pays $160 for a $200 OON session. It sounds like you don't have a Cadillac plan. Bummer.

My kid's therapist has people sign a contract that specifically says Medicaid won't reimburse for services. She is one of only a few people qualified to treat my kid's condition. There is research showing people with Medicaid have trouble finding providers. Not that there aren't any providers that take it. But when you need something specific it might not be available.

Well apparently your Cadillac is fully loaded while mine isn't-satisfied now?. I did make the 1 % disclaimer about Medicaid so it stands. BTW we found an out of the DMV therapist in network who is also MUCH better than the local OON one--so find and you shall seek for most everything.

Why would I care what kind of plan you have?



And I am glad that you found something that works for you. Some of us have children that need weekly in person therapy and we live in the DMV. So no, "seek and you shall find" is not true for many families.

what is your point? in socialized medicine your therapist would not take any insurance so again only the "haves" would get their kids in, and even if she did have a gov job and private practice one the side there would be probably such a backlog of kids though the gov that the wait time would be months and she would see them every 6 months--so the same outcome again as you can see
you are free to set up a fund for the condition your kid has(and I hope they are getting better and better) so that kids with only medicaid can use this cash to see your therapist as well....

But the outcomes aren't the same as you would know if you bothered to Google differences in health outcomes across developed countries.

[Anonymous]

Btw if you need therapy for a kid get ready to get on a ton of waitlists. You seem to think the US is a magical land where people can get insurance to pay for stuff and not have to wait for it. Number 1 that insurance is very expensive, number 2 you do often have to wait quite a bit and number 3 the outcomes you get are worse than countries with much cheaper socialized medicine.

I have lived in one of those countries and I know it is not perfect at all, but it was a better system than the US system which rations care based on income and ability/time to fight with the insurance company.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All slimeballs. Pay the insurance AND dr. Slimeball because they want to see 10 vs 30 patients AND earn the same amount. They don’t give a damn about you - you are just a pawn in the game of greed.

I dont know why DCUM has an issue with doctors wanting to make money,,,shouldnt lawyers work for free then too, cpa's, teachers..

Because they're bringing down the healthcare system. I don't see how you could possibly compare a public school teaching working for$65,000 with a gastroenterologist making $500k. Or a radiologist making $600k. Sure, they complain about their pay equally, but they're hardly the same.

You have no idea how mentally stressful it is being a doctor. Not everyone can do it-intellectually, mentally or physically. One radiology oversight can take someone's life. Doing gastro procedures is not easy. PCPs make 150-300 working like dogs. My teenage doctor thought she wanted to go the medical way but then sees how much her pediatrician works and changed her mind.

Your daughter stopped listing after a pediatrician speciality after she or you discovered their compensation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All slimeballs. Pay the insurance AND dr. Slimeball because they want to see 10 vs 30 patients AND earn the same amount. They don’t give a damn about you - you are just a pawn in the game of greed.

I dont know why DCUM has an issue with doctors wanting to make money,,,shouldnt lawyers work for free then too, cpa's, teachers..

Because they're bringing down the healthcare system. I don't see how you could possibly compare a public school teaching working for$65,000 with a gastroenterologist making $500k. Or a radiologist making $600k. Sure, they complain about their pay equally, but they're hardly the same.

You have no idea how mentally stressful it is being a doctor. Not everyone can do it-intellectually, mentally or physically. One radiology oversight can take someone's life. Doing gastro procedures is not easy. PCPs make 150-300 working like dogs. My teenage doctor thought she wanted to go the medical way but then sees how much her pediatrician works and changed her mind.

Your daughter stopped listing after a pediatrician speciality after she or you discovered their compensation.

It is an emotionally, mentally and physically taxing job irrespective of the (low) compensation.

[Anonymous]

Anonymous wrote:Getting back to the original topic, anyone have recommendations for an internist in the Bethesda, Friendship Heights, Chevy Chase area? We're looking b/c of our doc's retirement, and the pickings are slim. There seem to be tons of specialists, and few primary care types

FWIW I totally agree that the American health care system sucks, and we are all f*cked, even the rich.

We use Complete Concierge Care practice- primary care. Easy to talk to doctors. Easy to get appointments. When we have had issues come up they have gotten us in to specialists in timely manner. Highly rec.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Getting back to the original topic, anyone have recommendations for an internist in the Bethesda, Friendship Heights, Chevy Chase area? We're looking b/c of our doc's retirement, and the pickings are slim. There seem to be tons of specialists, and few primary care types

FWIW I totally agree that the American health care system sucks, and we are all f*cked, even the rich.

We use Complete Concierge Care practice- primary care. Easy to talk to doctors. Easy to get appointments. When we have had issues come up they have gotten us in to specialists in timely manner. Highly rec.

Thank you. Your advertising payment has been sent to your account.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All slimeballs. Pay the insurance AND dr. Slimeball because they want to see 10 vs 30 patients AND earn the same amount. They don’t give a damn about you - you are just a pawn in the game of greed.

I dont know why DCUM has an issue with doctors wanting to make money,,,shouldnt lawyers work for free then too, cpa's, teachers..

Because they're bringing down the healthcare system. I don't see how you could possibly compare a public school teaching working for$65,000 with a gastroenterologist making $500k. Or a radiologist making $600k. Sure, they complain about their pay equally, but they're hardly the same.

Lol, no.

Healthcare policy and the insurance companies it has enabled are doing that. Not doctors.

DP I agree with you. But "good" healthcare policy also means less money for doctors.

PP, and I probably agree with that.

Countries that pay their docs less have more concierge practice so the pay evens out for the doctors(sorry dcum) but you end up creating even more a two tier system for the haves and have nots--look at England, eastern Europe, Canada...actually just listened to this happening right now in canada---need elective surgery(it may be medically called elective but when you cant walk because your knee hurts like hell you will probably call it something else)--pay 10 K canadian to have the doc do it next week or waitch 18 months for free
ultimately what DCUM cant understand it is all about supply and demand....we dont have a demand for middle mgmt (most of the DCUM peeps here) but we do always have a demand for someone to fix illness...

I feel like you are implying the US is not a "two tier" system. Which I guess is correct, there are multiple tiers - the people with no access to any care except emergency care, people with Medicaid, people with high deductible ACA plans, and people with Cadillac PPO plans with out of network bennies.

-I work with Medicaid patients every day ---for 99 percent of illnesses they have the BEST insurance.=everything covered and paid for, the only time where their insurance may be not the best is for the 1 percent of illness'that is so rare only a doc at Hopkins can treat it but for example they have VA medicaid-but even then then we send them to UVA(trip also paid for by Medicaid) most of the time poor outcomes are due to lack of keeping appts--OK?
What Cadillac plans are you referring to? this absolutely doesnt exist--and the better the plan the more your coinsurance is, if you make 150K or less you couldnt even afford the coinsurance of you have a complex medical chronic illess
The only people who have it bad is when they only have Medicare-then medications are really unaffordable...
My sibling is poor-just above medicaid so they pay for aca-has great insurance but doesnt use it when they need it--I cant fix that

Wow, none of what you are saying matches the reality.

People on DCUM love to think Medicaid is "the best" insurance and it does have some advantages, but people with Medicaid often have trouble finding providers because the reimbursement rates are lower and the administrative hassle is better.

Cadillac plans do exist. They are great for the people who have them. Low copays, low coinsurance, good reimbursement rates for out of network. Often available for local government workers.

And are you really pretending uninsured people don't exist, or that health outcomes are better in the US than other places? Seriously? GTFOOH.

When people talk like this that's when I know to stop listening to them because they clearly have a huge chip on their shoulders and a strong partisan bias.

I've lived in other countries, both first and developing worlds, and have had a range of healthcare experiences. But focusing on the US, what the PP pointed out is correct. A great deal of the problems with health care for poorer Americans is the inability to follow through with recommendations. Not sure why this is so problematic for you to understand or grasp. There's only so much a system or doctors can do if patients blow off appointments or don't keep up with medications or abuse the medications.

[Anonymous]

It would be a mistake to assume that other countries have more and cheaper access to mental health therapy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All slimeballs. Pay the insurance AND dr. Slimeball because they want to see 10 vs 30 patients AND earn the same amount. They don’t give a damn about you - you are just a pawn in the game of greed.

I dont know why DCUM has an issue with doctors wanting to make money,,,shouldnt lawyers work for free then too, cpa's, teachers..

Because they're bringing down the healthcare system. I don't see how you could possibly compare a public school teaching working for$65,000 with a gastroenterologist making $500k. Or a radiologist making $600k. Sure, they complain about their pay equally, but they're hardly the same.

Lol, no.

Healthcare policy and the insurance companies it has enabled are doing that. Not doctors.

DP I agree with you. But "good" healthcare policy also means less money for doctors.

PP, and I probably agree with that.

Countries that pay their docs less have more concierge practice so the pay evens out for the doctors(sorry dcum) but you end up creating even more a two tier system for the haves and have nots--look at England, eastern Europe, Canada...actually just listened to this happening right now in canada---need elective surgery(it may be medically called elective but when you cant walk because your knee hurts like hell you will probably call it something else)--pay 10 K canadian to have the doc do it next week or waitch 18 months for free
ultimately what DCUM cant understand it is all about supply and demand....we dont have a demand for middle mgmt (most of the DCUM peeps here) but we do always have a demand for someone to fix illness...

I feel like you are implying the US is not a "two tier" system. Which I guess is correct, there are multiple tiers - the people with no access to any care except emergency care, people with Medicaid, people with high deductible ACA plans, and people with Cadillac PPO plans with out of network bennies.

-I work with Medicaid patients every day ---for 99 percent of illnesses they have the BEST insurance.=everything covered and paid for, the only time where their insurance may be not the best is for the 1 percent of illness'that is so rare only a doc at Hopkins can treat it but for example they have VA medicaid-but even then then we send them to UVA(trip also paid for by Medicaid) most of the time poor outcomes are due to lack of keeping appts--OK?
What Cadillac plans are you referring to? this absolutely doesnt exist--and the better the plan the more your coinsurance is, if you make 150K or less you couldnt even afford the coinsurance of you have a complex medical chronic illess
The only people who have it bad is when they only have Medicare-then medications are really unaffordable...
My sibling is poor-just above medicaid so they pay for aca-has great insurance but doesnt use it when they need it--I cant fix that

Wow, none of what you are saying matches the reality.

People on DCUM love to think Medicaid is "the best" insurance and it does have some advantages, but people with Medicaid often have trouble finding providers because the reimbursement rates are lower and the administrative hassle is better.

Cadillac plans do exist. They are great for the people who have them. Low copays, low coinsurance, good reimbursement rates for out of network. Often available for local government workers.

And are you really pretending uninsured people don't exist, or that health outcomes are better in the US than other places? Seriously? GTFOOH.

When people talk like this that's when I know to stop listening to them because they clearly have a huge chip on their shoulders and a strong partisan bias.

I've lived in other countries, both first and developing worlds, and have had a range of healthcare experiences. But focusing on the US, what the PP pointed out is correct. A great deal of the problems with health care for poorer Americans is the inability to follow through with recommendations. Not sure why this is so problematic for you to understand or grasp. There's only so much a system or doctors can do if patients blow off appointments or don't keep up with medications or abuse the medications.

Correct, and furthermore this is actually being addressed in the US system by increasing patient engagement through health coaches (which is really I believe the way to influence the "social determinants of health" in regards to health inequity) and in my position as an MD i only work in places that provide this(or can influence these programs being created ), because contrary to what the PP (with the better "Cadillac" policy than mine) implied some MDs think that healthcare can be improved without political posturing and actually creating concrete plans and following through on them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All slimeballs. Pay the insurance AND dr. Slimeball because they want to see 10 vs 30 patients AND earn the same amount. They don’t give a damn about you - you are just a pawn in the game of greed.

I dont know why DCUM has an issue with doctors wanting to make money,,,shouldnt lawyers work for free then too, cpa's, teachers..

Because they're bringing down the healthcare system. I don't see how you could possibly compare a public school teaching working for$65,000 with a gastroenterologist making $500k. Or a radiologist making $600k. Sure, they complain about their pay equally, but they're hardly the same.

Lol, no.

Healthcare policy and the insurance companies it has enabled are doing that. Not doctors.

DP I agree with you. But "good" healthcare policy also means less money for doctors.

PP, and I probably agree with that.

Countries that pay their docs less have more concierge practice so the pay evens out for the doctors(sorry dcum) but you end up creating even more a two tier system for the haves and have nots--look at England, eastern Europe, Canada...actually just listened to this happening right now in canada---need elective surgery(it may be medically called elective but when you cant walk because your knee hurts like hell you will probably call it something else)--pay 10 K canadian to have the doc do it next week or waitch 18 months for free
ultimately what DCUM cant understand it is all about supply and demand....we dont have a demand for middle mgmt (most of the DCUM peeps here) but we do always have a demand for someone to fix illness...

I feel like you are implying the US is not a "two tier" system. Which I guess is correct, there are multiple tiers - the people with no access to any care except emergency care, people with Medicaid, people with high deductible ACA plans, and people with Cadillac PPO plans with out of network bennies.

-I work with Medicaid patients every day ---for 99 percent of illnesses they have the BEST insurance.=everything covered and paid for, the only time where their insurance may be not the best is for the 1 percent of illness'that is so rare only a doc at Hopkins can treat it but for example they have VA medicaid-but even then then we send them to UVA(trip also paid for by Medicaid) most of the time poor outcomes are due to lack of keeping appts--OK?
What Cadillac plans are you referring to? this absolutely doesnt exist--and the better the plan the more your coinsurance is, if you make 150K or less you couldnt even afford the coinsurance of you have a complex medical chronic illess
The only people who have it bad is when they only have Medicare-then medications are really unaffordable...
My sibling is poor-just above medicaid so they pay for aca-has great insurance but doesnt use it when they need it--I cant fix that

Wow, none of what you are saying matches the reality.

People on DCUM love to think Medicaid is "the best" insurance and it does have some advantages, but people with Medicaid often have trouble finding providers because the reimbursement rates are lower and the administrative hassle is better.

Cadillac plans do exist. They are great for the people who have them. Low copays, low coinsurance, good reimbursement rates for out of network. Often available for local government workers.

And are you really pretending uninsured people don't exist, or that health outcomes are better in the US than other places? Seriously? GTFOOH.

When people talk like this that's when I know to stop listening to them because they clearly have a huge chip on their shoulders and a strong partisan bias.

I've lived in other countries, both first and developing worlds, and have had a range of healthcare experiences. But focusing on the US, what the PP pointed out is correct. A great deal of the problems with health care for poorer Americans is the inability to follow through with recommendations. Not sure why this is so problematic for you to understand or grasp. There's only so much a system or doctors can do if patients blow off appointments or don't keep up with medications or abuse the medications.

I just had to do hand to hand battle with Caremark for a med my doc prescribed. Their proposed “alternatives” demonstrated that they had not read my file at all. They were inappropriate because I lack the organ they target.

Ultimately, after a process involving US mail and fax (!!!) they approved it. It took two months. I paid nothing. Cost without insurance: $5613/month. Same drug can be gotten via a Canadian pharmacy for $100/mo, but that’s not legal.

You tell me whose fault it is that patients don’t “keep up” with medications. And get bent while you’re at it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All slimeballs. Pay the insurance AND dr. Slimeball because they want to see 10 vs 30 patients AND earn the same amount. They don’t give a damn about you - you are just a pawn in the game of greed.

I dont know why DCUM has an issue with doctors wanting to make money,,,shouldnt lawyers work for free then too, cpa's, teachers..

Because they're bringing down the healthcare system. I don't see how you could possibly compare a public school teaching working for$65,000 with a gastroenterologist making $500k. Or a radiologist making $600k. Sure, they complain about their pay equally, but they're hardly the same.

Lol, no.

Healthcare policy and the insurance companies it has enabled are doing that. Not doctors.

DP I agree with you. But "good" healthcare policy also means less money for doctors.

PP, and I probably agree with that.

Countries that pay their docs less have more concierge practice so the pay evens out for the doctors(sorry dcum) but you end up creating even more a two tier system for the haves and have nots--look at England, eastern Europe, Canada...actually just listened to this happening right now in canada---need elective surgery(it may be medically called elective but when you cant walk because your knee hurts like hell you will probably call it something else)--pay 10 K canadian to have the doc do it next week or waitch 18 months for free
ultimately what DCUM cant understand it is all about supply and demand....we dont have a demand for middle mgmt (most of the DCUM peeps here) but we do always have a demand for someone to fix illness...

I feel like you are implying the US is not a "two tier" system. Which I guess is correct, there are multiple tiers - the people with no access to any care except emergency care, people with Medicaid, people with high deductible ACA plans, and people with Cadillac PPO plans with out of network bennies.

-I work with Medicaid patients every day ---for 99 percent of illnesses they have the BEST insurance.=everything covered and paid for, the only time where their insurance may be not the best is for the 1 percent of illness'that is so rare only a doc at Hopkins can treat it but for example they have VA medicaid-but even then then we send them to UVA(trip also paid for by Medicaid) most of the time poor outcomes are due to lack of keeping appts--OK?
What Cadillac plans are you referring to? this absolutely doesnt exist--and the better the plan the more your coinsurance is, if you make 150K or less you couldnt even afford the coinsurance of you have a complex medical chronic illess
The only people who have it bad is when they only have Medicare-then medications are really unaffordable...
My sibling is poor-just above medicaid so they pay for aca-has great insurance but doesnt use it when they need it--I cant fix that

Wow, none of what you are saying matches the reality.

People on DCUM love to think Medicaid is "the best" insurance and it does have some advantages, but people with Medicaid often have trouble finding providers because the reimbursement rates are lower and the administrative hassle is better.

Cadillac plans do exist. They are great for the people who have them. Low copays, low coinsurance, good reimbursement rates for out of network. Often available for local government workers.

And are you really pretending uninsured people don't exist, or that health outcomes are better in the US than other places? Seriously? GTFOOH.

When people talk like this that's when I know to stop listening to them because they clearly have a huge chip on their shoulders and a strong partisan bias.

I've lived in other countries, both first and developing worlds, and have had a range of healthcare experiences. But focusing on the US, what the PP pointed out is correct. A great deal of the problems with health care for poorer Americans is the inability to follow through with recommendations. Not sure why this is so problematic for you to understand or grasp. There's only so much a system or doctors can do if patients blow off appointments or don't keep up with medications or abuse the medications.

I just had to do hand to hand battle with Caremark for a med my doc prescribed. Their proposed “alternatives” demonstrated that they had not read my file at all. They were inappropriate because I lack the organ they target.

Ultimately, after a process involving US mail and fax (!!!) they approved it. It took two months. I paid nothing. Cost without insurance: $5613/month. Same drug can be gotten via a Canadian pharmacy for $100/mo, but that’s not legal.

You tell me whose fault it is that patients don’t “keep up” with medications. And get bent while you’re at it.

yes pharmaceuticals hold both the R and D by the...however this was about all of the US med problems due to doctors not being paid the same salary as teachers....

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All slimeballs. Pay the insurance AND dr. Slimeball because they want to see 10 vs 30 patients AND earn the same amount. They don’t give a damn about you - you are just a pawn in the game of greed.

I dont know why DCUM has an issue with doctors wanting to make money,,,shouldnt lawyers work for free then too, cpa's, teachers..

Because they're bringing down the healthcare system. I don't see how you could possibly compare a public school teaching working for$65,000 with a gastroenterologist making $500k. Or a radiologist making $600k. Sure, they complain about their pay equally, but they're hardly the same.

Lol, no.

Healthcare policy and the insurance companies it has enabled are doing that. Not doctors.

DP I agree with you. But "good" healthcare policy also means less money for doctors.

PP, and I probably agree with that.

Countries that pay their docs less have more concierge practice so the pay evens out for the doctors(sorry dcum) but you end up creating even more a two tier system for the haves and have nots--look at England, eastern Europe, Canada...actually just listened to this happening right now in canada---need elective surgery(it may be medically called elective but when you cant walk because your knee hurts like hell you will probably call it something else)--pay 10 K canadian to have the doc do it next week or waitch 18 months for free
ultimately what DCUM cant understand it is all about supply and demand....we dont have a demand for middle mgmt (most of the DCUM peeps here) but we do always have a demand for someone to fix illness...

I feel like you are implying the US is not a "two tier" system. Which I guess is correct, there are multiple tiers - the people with no access to any care except emergency care, people with Medicaid, people with high deductible ACA plans, and people with Cadillac PPO plans with out of network bennies.

-I work with Medicaid patients every day ---for 99 percent of illnesses they have the BEST insurance.=everything covered and paid for, the only time where their insurance may be not the best is for the 1 percent of illness'that is so rare only a doc at Hopkins can treat it but for example they have VA medicaid-but even then then we send them to UVA(trip also paid for by Medicaid) most of the time poor outcomes are due to lack of keeping appts--OK?
What Cadillac plans are you referring to? this absolutely doesnt exist--and the better the plan the more your coinsurance is, if you make 150K or less you couldnt even afford the coinsurance of you have a complex medical chronic illess
The only people who have it bad is when they only have Medicare-then medications are really unaffordable...
My sibling is poor-just above medicaid so they pay for aca-has great insurance but doesnt use it when they need it--I cant fix that

Wow, none of what you are saying matches the reality.

People on DCUM love to think Medicaid is "the best" insurance and it does have some advantages, but people with Medicaid often have trouble finding providers because the reimbursement rates are lower and the administrative hassle is better.

Cadillac plans do exist. They are great for the people who have them. Low copays, low coinsurance, good reimbursement rates for out of network. Often available for local government workers.

And are you really pretending uninsured people don't exist, or that health outcomes are better in the US than other places? Seriously? GTFOOH.

When people talk like this that's when I know to stop listening to them because they clearly have a huge chip on their shoulders and a strong partisan bias.

I've lived in other countries, both first and developing worlds, and have had a range of healthcare experiences. But focusing on the US, what the PP pointed out is correct. A great deal of the problems with health care for poorer Americans is the inability to follow through with recommendations. Not sure why this is so problematic for you to understand or grasp. There's only so much a system or doctors can do if patients blow off appointments or don't keep up with medications or abuse the medications.

I just had to do hand to hand battle with Caremark for a med my doc prescribed. Their proposed “alternatives” demonstrated that they had not read my file at all. They were inappropriate because I lack the organ they target.

Ultimately, after a process involving US mail and fax (!!!) they approved it. It took two months. I paid nothing. Cost without insurance: $5613/month. Same drug can be gotten via a Canadian pharmacy for $100/mo, but that’s not legal.

You tell me whose fault it is that patients don’t “keep up” with medications. And get bent while you’re at it.

yes pharmaceuticals hold both the R and D by the...however this was about all of the US med problems due to doctors not being paid the same salary as teachers....

No, the immediate preceding argument was that US health outcomes are worse because patients don’t comply with the meds prescribed in our amazing system.

The system for getting the drugs we are supposed to comply with sucks, is my (unrebutted) point.

[Anonymous]

Anonymous wrote:What location do you prefer? I love mine in NW dc/Sibley hospital office building.

Can you give the name?