ObamaCare ruined primary care medicine

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

It doesn’t matter when people with pre-existing conditions have insurance, but now no doctors are out there who take insurance and want a $2000 per year membership club fee and cash payments for services. Right back to square 1 again, now access is impossible for all. Primary care in this region sucks so much a$$. Tons and tons of pcp are now concierge and charge ridiculous membership fees, or they’re impossible to access anyway even if you wanted to join because they take less patients.

ACA ruined primary care, so the solution is to double down with more govt medicine? Insane.

What you are complaining about was already happening. The ACA didn't create nor compound it.

The hell it didn’t. ACA made everything worse with onerous levels of paperwork, requirements/rules, and sh!tty reimbursement.

BS. It’s been that way for decades. I work in healthcare and I know firsthand.

ACA made it 10x worse. If you actually worked in healthcare you’d know this.

Don't work in healthcare--but have just been through an intensive medical issue with a family member. We are blessed with our insurance--but the prices are prohibitive. Insurance does not cover the "list price" but we don't have to pay either.

It seems the nurses have to spend more time on the computers than with patients--and we met great nurses. Saw another specialty nurse afterwards and "protocol" said she could not look at another issue (she did anyway, but could not document it.)

The doctors cannot look you in the eye unless they have a "scribe" because they are so busy writing it on the computer.

They follow "protocol" instead of using their own opinion and instinct. (We did have one who told us this is "protocol" but you might want to consider "Y" instead.......

And the GP sends everyone to a specialist--because that is also protocol.

Technology is taking over and I'm not sure it is better.

None of what you are describing is because of the ACA.

[Anonymous]

Anonymous wrote:I blame the government for having too few seats at residency programs. We simply do not have enough doctors if everyone has access to healthcare. The system worked fine before, but only because so many people couldn’t afford to see doctors

Wait, the government runs all the medical schools? Interesting theory.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'd like to know where OP lives where there are only concierge service PCPs. Here in NoVA, I can choose from among dozens that take my insurance.

I'm in MoCo, and I have several PCPs to choose from. Maybe OP lives in a *** area?

Concierge is growing in MoCo and DMV dum dum.

https://moco360.media/2022/01/10/the-rise-of-concierge-medicine/

Potomac Physicians was huge for the area and has now closed and been replaced with concierge.

The DMV sucks big time for primary care. You live in a bubble and are oblivious.

Hey dum dum, I was able to get a PCP because of ACA.

Hey dum dum, enjoy it while it lasts until they change to concierge.

hey dum dum, this is like saying that all doctors who take medicare will stop taking medicare, so we should get rid of medicare.

That’s going to be inevitable at the rate CMS is stiffing physicians.

[Anonymous]

Anonymous wrote:I blame the government for having too few seats at residency programs. We simply do not have enough doctors if everyone has access to healthcare. The system worked fine before, but only because so many people couldn’t afford to see doctors

Before the ACA, the system was not working fine. Go back and read the media articles describing the acute issues people faced at the time.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

It doesn’t matter when people with pre-existing conditions have insurance, but now no doctors are out there who take insurance and want a $2000 per year membership club fee and cash payments for services. Right back to square 1 again, now access is impossible for all. Primary care in this region sucks so much a$$. Tons and tons of pcp are now concierge and charge ridiculous membership fees, or they’re impossible to access anyway even if you wanted to join because they take less patients.

ACA ruined primary care, so the solution is to double down with more govt medicine? Insane.

What you are complaining about was already happening. The ACA didn't create nor compound it.

The hell it didn’t. ACA made everything worse with onerous levels of paperwork, requirements/rules, and sh!tty reimbursement.

BS. It’s been that way for decades. I work in healthcare and I know firsthand.

ACA made it 10x worse. If you actually worked in healthcare you’d know this.

Don't work in healthcare--but have just been through an intensive medical issue with a family member. We are blessed with our insurance--but the prices are prohibitive. Insurance does not cover the "list price" but we don't have to pay either.

It seems the nurses have to spend more time on the computers than with patients--and we met great nurses. Saw another specialty nurse afterwards and "protocol" said she could not look at another issue (she did anyway, but could not document it.)

The doctors cannot look you in the eye unless they have a "scribe" because they are so busy writing it on the computer.

They follow "protocol" instead of using their own opinion and instinct. (We did have one who told us this is "protocol" but you might want to consider "Y" instead.......

And the GP sends everyone to a specialist--because that is also protocol.

Technology is taking over and I'm not sure it is better.

None of what you are describing is because of the ACA.

Healthcare costs exploded after the passing of ACA. And healthcare became much more bureaucratic as well. Coincidence? Maybe, maybe not.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP I’m happy with my primary care. Not seeing what you’re seeing. Sorry. Maybe get a better job with different insurance. Of course it’s crazy insurance is tied to an employer but until enough people say enough let’s change the system it’s what we have.

Here is the key. There are only 2 real long term choices. Retaining the connection between employer and employee is simply nuts. One option is in essence a regulated national marketplace for insurance policies, something like mortgages though more complicated. Obamacare is consistent with this approach though it is state based. Here, we can argue foreover about the balance between premium costs and minimum coverage rules. More coverage means higher premiums. Second option is a single payor system like most every developed country.

Obama adopted the GOP/Romneycare policy. In hindsight, they should have just gone single payer.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I blame the government for having too few seats at residency programs. We simply do not have enough doctors if everyone has access to healthcare. The system worked fine before, but only because so many people couldn’t afford to see doctors

Wait, the government runs all the medical schools? Interesting theory.

Residency isn't run by medical schools. Residency is run by hospitals using Medicare funding from the federal government to pay the residents.

If Congress cuts residency funding, the number of residents go down. A huge number of med school grads do not get matched to residency program each year. There's more med school grads than there are residency slots. It's an insane system.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

It doesn’t matter when people with pre-existing conditions have insurance, but now no doctors are out there who take insurance and want a $2000 per year membership club fee and cash payments for services. Right back to square 1 again, now access is impossible for all. Primary care in this region sucks so much a$$. Tons and tons of pcp are now concierge and charge ridiculous membership fees, or they’re impossible to access anyway even if you wanted to join because they take less patients.

ACA ruined primary care, so the solution is to double down with more govt medicine? Insane.

What you are complaining about was already happening. The ACA didn't create nor compound it.

The hell it didn’t. ACA made everything worse with onerous levels of paperwork, requirements/rules, and sh!tty reimbursement.

BS. It’s been that way for decades. I work in healthcare and I know firsthand.

ACA made it 10x worse. If you actually worked in healthcare you’d know this.

Don't work in healthcare--but have just been through an intensive medical issue with a family member. We are blessed with our insurance--but the prices are prohibitive. Insurance does not cover the "list price" but we don't have to pay either.

It seems the nurses have to spend more time on the computers than with patients--and we met great nurses. Saw another specialty nurse afterwards and "protocol" said she could not look at another issue (she did anyway, but could not document it.)

The doctors cannot look you in the eye unless they have a "scribe" because they are so busy writing it on the computer.

They follow "protocol" instead of using their own opinion and instinct. (We did have one who told us this is "protocol" but you might want to consider "Y" instead.......

And the GP sends everyone to a specialist--because that is also protocol.

Technology is taking over and I'm not sure it is better.

None of what you are describing is because of the ACA.

Healthcare costs exploded after the passing of ACA. And healthcare became much more bureaucratic as well. Coincidence? Maybe, maybe not.

healthcare costs were already exploding, that is why the ACA was needed. It was already bureaucratic. Sheesh, none of that is new.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Nearly every PCP in this area is now switching to concierge service. No one wants to take ObamaCare any more because if it’s horrendous reimbursement rates, paperwork, productive quotas, etc. etc. Now it has ruined access to virtually all PCPs for everyone with insurance, because doctors have decided they’ll take zero insurance. Primary care is increasingly becoming a luxury for the ultra elites who can shell out additional thousands of more dollars per year to keep a PCP on retainer while the rest of us get stuck with nothing or impossible routes to overcome to get access for simple primary care. Isn’t more government intervention in healthcare great? We can all have equal healthcare when it is crap for everyone and hardly anyone can access it. Thanks ObamaCare.

What a crock of shit. The "horrendous reimbursement rates" are among the highest IN THE WORLD. The real problem is that there is too much greed in healthcare.

Not for general practitioners. The reimbursement rates are heavily skewed towards specialists. A GP makes about as much as a 20 year UPS driver.

Doctors are not the issue. Yes, a few make real money. Vast majority do not. Moreover, even if some do, I have no issues with doctors being overpaid on the margins. I want some of our brightest students to enter medicine, and if compensation helps achieve that goal I am okay.

I don't think you read that correctly. General Practitioners are nowhere near overpaid. They make less than a cop on overtime. The system, which was set up long before Obamacare, that sets the reimbursement rates is heavily skewed towards specialists and surgeons. It is skewed so much that even a minor specialization can double a prospective doctor's income. This leads to a feedback loop whereby general practitioners are systematically financially disincentivized and costs are increased for everyone because we have orthopedic surgeons treating sprained ankles.

[Anonymous]

Anonymous wrote:Nearly every PCP in this area is now switching to concierge service. No one wants to take ObamaCare any more because if it’s horrendous reimbursement rates, paperwork, productive quotas, etc. etc. Now it has ruined access to virtually all PCPs for everyone with insurance, because doctors have decided they’ll take zero insurance. Primary care is increasingly becoming a luxury for the ultra elites who can shell out additional thousands of more dollars per year to keep a PCP on retainer while the rest of us get stuck with nothing or impossible routes to overcome to get access for simple primary care. Isn’t more government intervention in healthcare great? We can all have equal healthcare when it is crap for everyone and hardly anyone can access it. Thanks ObamaCare.

ACA single handedly got rid of exclusions for pre-existing conditions. That is one of the biggest wins in healthcare.

ACA isn't perfect. But lbh, healthcare was already going in the direciton you describe. And there have been, what? 20? years since ACA was passed for Republicans to come to a table and negotiate further revisions to that law. They have not. They tried 40'ish times to repeal with nothing to replace it with.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:it was already going that way. the ACA simply provided a safety net particularly for people with pre-existing conditions who were rejected or exempted coverage in the prior version of health insurance

what we need is single payer/universal- our healthcare system has been horrible since the deregulation of the Reagan era

It doesn’t matter when people with pre-existing conditions have insurance, but now no doctors are out there who take insurance and want a $2000 per year membership club fee and cash payments for services. Right back to square 1 again, now access is impossible for all. Primary care in this region sucks so much a$$. Tons and tons of pcp are now concierge and charge ridiculous membership fees, or they’re impossible to access anyway even if you wanted to join because they take less patients.

ACA ruined primary care, so the solution is to double down with more govt medicine? Insane.

What you are complaining about was already happening. The ACA didn't create nor compound it.

The hell it didn’t. ACA made everything worse with onerous levels of paperwork, requirements/rules, and sh!tty reimbursement.

BS. It’s been that way for decades. I work in healthcare and I know firsthand.

ACA made it 10x worse. If you actually worked in healthcare you’d know this.

Don't work in healthcare--but have just been through an intensive medical issue with a family member. We are blessed with our insurance--but the prices are prohibitive. Insurance does not cover the "list price" but we don't have to pay either.

It seems the nurses have to spend more time on the computers than with patients--and we met great nurses. Saw another specialty nurse afterwards and "protocol" said she could not look at another issue (she did anyway, but could not document it.)

The doctors cannot look you in the eye unless they have a "scribe" because they are so busy writing it on the computer.

They follow "protocol" instead of using their own opinion and instinct. (We did have one who told us this is "protocol" but you might want to consider "Y" instead.......

And the GP sends everyone to a specialist--because that is also protocol.

Technology is taking over and I'm not sure it is better.

None of what you are describing is because of the ACA.

Healthcare costs exploded after the passing of ACA. And healthcare became much more bureaucratic as well. Coincidence? Maybe, maybe not.

Health care costs were exploding prior to the passage of the ACA. In fact, health care cost inflation has consistently trended downward since the passing of the ACA. Coincidence? Maybe, maybe not.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I blame the government for having too few seats at residency programs. We simply do not have enough doctors if everyone has access to healthcare. The system worked fine before, but only because so many people couldn’t afford to see doctors

Before the ACA, the system was not working fine. Go back and read the media articles describing the acute issues people faced at the time.

The ACA tried to fix problems, but as if often the case, the road to hell is paved with good intentions. ACA increased the amount of reporting, imposed onerous rules and regulations, and continues to reimburse less and less. It has now added millions of new people to the system while the number of doctors stays the same. It has blown up our entire healthcare system.

Doctors are fed up and are ditching all insurance, so now you have thousands and thousands of people paying out the a$$ for insurance they can’t even use anymore and are being asked to fork out thousands more for an exclusive membership just to keep docs on retainer. It squeezes many more people towards the remaining docs that do take insurance, which are fewer and far between. Just because you can look on your insurance website and find PCPs thst accept the insurance doesn’t mean you’ll get access. So many don’t even take new patients anymore, or it is impossible to schedule an appointment, rendering your insurance worthless. Too bad for you if you don’t have an extra $2000+ per year per person in your household to pay for a membership fee. You’re screwed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I blame the government for having too few seats at residency programs. We simply do not have enough doctors if everyone has access to healthcare. The system worked fine before, but only because so many people couldn’t afford to see doctors

Before the ACA, the system was not working fine. Go back and read the media articles describing the acute issues people faced at the time.

The ACA tried to fix problems, but as if often the case, the road to hell is paved with good intentions. ACA increased the amount of reporting, imposed onerous rules and regulations, and continues to reimburse less and less. It has now added millions of new people to the system while the number of doctors stays the same. It has blown up our entire healthcare system.

Doctors are fed up and are ditching all insurance, so now you have thousands and thousands of people paying out the a$$ for insurance they can’t even use anymore and are being asked to fork out thousands more for an exclusive membership just to keep docs on retainer. It squeezes many more people towards the remaining docs that do take insurance, which are fewer and far between. Just because you can look on your insurance website and find PCPs thst accept the insurance doesn’t mean you’ll get access. So many don’t even take new patients anymore, or it is impossible to schedule an appointment, rendering your insurance worthless. Too bad for you if you don’t have an extra $2000+ per year per person in your household to pay for a membership fee. You’re screwed.

So your solution is to let those millions clog up emergency rooms with what otherwise should have been preventative issues that became acute. THAT is why the pre-ACA system was failing. For whatever flaws currently exist, blame the GOP for not being a partner in helping to fix it. They would rather the whole system collapse with no replacement and only the oligarchs in our country able to afford healthcare.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I blame the government for having too few seats at residency programs. We simply do not have enough doctors if everyone has access to healthcare. The system worked fine before, but only because so many people couldn’t afford to see doctors

Before the ACA, the system was not working fine. Go back and read the media articles describing the acute issues people faced at the time.

The ACA tried to fix problems, but as if often the case, the road to hell is paved with good intentions. ACA increased the amount of reporting, imposed onerous rules and regulations, and continues to reimburse less and less. It has now added millions of new people to the system while the number of doctors stays the same. It has blown up our entire healthcare system.

Doctors are fed up and are ditching all insurance, so now you have thousands and thousands of people paying out the a$$ for insurance they can’t even use anymore and are being asked to fork out thousands more for an exclusive membership just to keep docs on retainer. It squeezes many more people towards the remaining docs that do take insurance, which are fewer and far between. Just because you can look on your insurance website and find PCPs thst accept the insurance doesn’t mean you’ll get access. So many don’t even take new patients anymore, or it is impossible to schedule an appointment, rendering your insurance worthless. Too bad for you if you don’t have an extra $2000+ per year per person in your household to pay for a membership fee. You’re screwed.

Imagine how people without insurance felt, then, when they couldn't go to the doctor when they were sick because they had no insurance. And no, medicaid doesn't pay for such people. These people are too "rich" for medicaid, but too poor to get private insurance.

The subsidies ACA provided helped millions of people get insurance, and many who went to see a PCP for the first time in their lives.

ACA is not perfect, but without a viable alternative, it's here to stay. And like I posted earlier, even some Rs have given into ACA and want it shored up with more people signing up for it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I blame the government for having too few seats at residency programs. We simply do not have enough doctors if everyone has access to healthcare. The system worked fine before, but only because so many people couldn’t afford to see doctors

Before the ACA, the system was not working fine. Go back and read the media articles describing the acute issues people faced at the time.

The ACA tried to fix problems, but as if often the case, the road to hell is paved with good intentions. ACA increased the amount of reporting, imposed onerous rules and regulations, and continues to reimburse less and less. It has now added millions of new people to the system while the number of doctors stays the same. It has blown up our entire healthcare system.

Doctors are fed up and are ditching all insurance, so now you have thousands and thousands of people paying out the a$$ for insurance they can’t even use anymore and are being asked to fork out thousands more for an exclusive membership just to keep docs on retainer. It squeezes many more people towards the remaining docs that do take insurance, which are fewer and far between. Just because you can look on your insurance website and find PCPs thst accept the insurance doesn’t mean you’ll get access. So many don’t even take new patients anymore, or it is impossible to schedule an appointment, rendering your insurance worthless. Too bad for you if you don’t have an extra $2000+ per year per person in your household to pay for a membership fee. You’re screwed.

So your solution is to let those millions clog up emergency rooms with what otherwise should have been preventative issues that became acute. THAT is why the pre-ACA system was failing. For whatever flaws currently exist, blame the GOP for not being a partner in helping to fix it. They would rather the whole system collapse with no replacement and only the oligarchs in our country able to afford healthcare.

How is what we have post-ACA helping anyone now. Not only do the poor have dog poop healthcare, now everyone else does too.

Thank god we all now equally garbage healthcare thanks to ACA, isn’t more govt so much better?