Everyone likes to complain about health insurance costs but none of that matters if we don’t have providers!

[Anonymous]

Anonymous wrote:Look at it this way, doctors pay is not inflation adjusted because fees for services are not inflation adjusted. Everyone got a 30% raise to cover the 30% rise in goods/services. Is it still worth becoming a doctor? Would you work in a field where your income keeps getting cut and the price of entry (student loans) has doubled? I don't think so. The consumer needs to wake up and realize doctors are being abused, patients blame them but in reality it's the insurance company that is stealing from both you and the doctors! You guys blame the docs because they're the closest to you and easiest to put blame on but that is so far from the truth. Damn the insurance companies, they peg the patient and doctor against each other all while ceo takes millions a year. They sure as hell get raises

Sign a doc

The reason we have HMOs in the first place is because doctors couldn’t be trusted not to run every test and perform every possible procedure to boost their bottom line. Doctors aren’t saints. They are just people. Also the AMA limited the spaces to ensure MD salaries stayed high.

[Anonymous]

Anonymous wrote:DH is a MD and I have worked in healthcare for 33 years. I rarely had insurance deny care that was covered a covered service in their premiums. DH and I help many family members with their medical care and no one has been denied services.
If you want to forgo conservative treatment before an MRI or surgery, yes, you will be denied. If you want to dictate what medicine you take when an off-brand is available, you may be denied. If the coding is correct- and believe me, there is a lot of hoops to jump through before demonstrating need, and you have triage the situation appropriately, usually try and conservative approach first, if there is good documentation on all of this, then you rarely see denials.

You claim insurance isn’t denying necessary care. So why do your family members needs an MD and a healthcare worker to help them get medical care?

[Anonymous]

Anonymous wrote:

Anonymous wrote:DH is a MD and I have worked in healthcare for 33 years. I rarely had insurance deny care that was covered a covered service in their premiums. DH and I help many family members with their medical care and no one has been denied services.
If you want to forgo conservative treatment before an MRI or surgery, yes, you will be denied. If you want to dictate what medicine you take when an off-brand is available, you may be denied. If the coding is correct- and believe me, there is a lot of hoops to jump through before demonstrating need, and you have triage the situation appropriately, usually try and conservative approach first, if there is good documentation on all of this, then you rarely see denials.

You claim insurance isn’t denying necessary care. So why do your family members needs an MD and a healthcare worker to help them get medical care?

Reading is fundamental.

[Anonymous]

Anonymous wrote:From the article: "Medical schools have done their part by increasing enrollment by nearly 40% since 2002. We must now expand graduate medical education so we are training more doctors to meet the nation’s health care needs."

So are there a bunch of people who got their MDs but can't get residencies? What are they doing?

It's still like a 5% acceptance rate.

[Anonymous]

Our dental office can't find enough hygienist. 3 people in our family are now 3+ months over due for our cleaning with no appointment for the future. We had appointments but the office called and said they don't have enough staff and that they would reschedule as soon as they get someone. I have searched and the closest option that takes our insurance is an hour away.

[Anonymous]

Anonymous wrote:Our dental office can't find enough hygienist. 3 people in our family are now 3+ months over due for our cleaning with no appointment for the future. We had appointments but the office called and said they don't have enough staff and that they would reschedule as soon as they get someone. I have searched and the closest option that takes our insurance is an hour away.

What city? What insurance? Liar.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:And totally agree that the healthcare system isn’t at up for preventative care, which is maddening for physicians. The insurance companies fight tooth and nail to pay for preventative care care and the. Again for much needed sick care. They are atrocious.

All the preventive care stuff is covered.

You have no idea. Doctors spend hours on the phone every week arguing with insurance companies who fight every test and medication.

If they are spending hours arguing about basic preventive care services then they aren’t coding things correctly. Either the doc or their coder isn’t very knowledgeable.

Look yes sometimes providers make mistakes. But the insurance companies intentionally make the process of getting claims paid out difficult. They lie, put people on hold, delay, all with the obvious intent of trying to get people to give up.

We use a couple of out of network providers for our child who needs weekly therapy so we submit the claims ourselves. I spent hours on the phone with our insurance provider with people insisting, sending me documents, putting me on hold to "check", claiming that we were required to get prior authorization for the services. I had chosen this plan specifically because my coworker whose child has similar needs uses it and had never had any trouble getting claims paid out.

I had to make a big stink with my employer and then finally the insurance company called me to apologize. I wanted to curse at them because they had been lying to me over and over again and they knew it. I was venting about this to my physician friend and she basically said yep, they are just trying to get people to give up. These companies are psychopathic.

This isn’t preventive care.

Okay, see the thread about the 365 day waiting period some plans have for annual physicals. You know, so each year you have to schedule it a little bit later, sometimes more than a little bit depending on schedules. And good forking luck if your PCP retires and no PCP will take you on until you do a physical with them. Thank goodness my plan didn't have this rule because my PCP announced retirement after my October physical and I have prescriptions for two chronic health conditions that I need and need blood work monitored for.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Well, we all are going to die anyway. Why even bother with healthcare?

We don’t have healthcare, we have sickcare. Our current system is doing tremendous harm.

The vast majority of wellness is beholden to the ‘patient’ - learn to eat well, be active and exercise, have good relationships and practice gratitude (or something to provide mental stability, there are many options ), and don’t do any risk taking behaviors.

[Anonymous]

Anonymous wrote:Our dental office can't find enough hygienist. 3 people in our family are now 3+ months over due for our cleaning with no appointment for the future. We had appointments but the office called and said they don't have enough staff and that they would reschedule as soon as they get someone. I have searched and the closest option that takes our insurance is an hour away.

Ours has the same problem. . Our dentist is excellent- so much so that people move away and fly back twice a year for the appointments. We're talking flying to Chicago from Seattle. The best hygienist was about 10 years out from retiring but suffered a career-ending shoulder overuse injury. They have brought in rotating temporary hygienists who are basically semi-retired travel hygienists who they pay a fortune in order to cover the appointments that are scheduled a year out. He has said that he cannot hire hygienists and there aren't enough skilled hygienists to go around who do the kind of work he does in his practice, which isn't crazy extensive but is more than just the basics. When the last 3 of his permanent hygienists retire, we're in trouble.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:DH is a MD and I have worked in healthcare for 33 years. I rarely had insurance deny care that was covered a covered service in their premiums. DH and I help many family members with their medical care and no one has been denied services.
If you want to forgo conservative treatment before an MRI or surgery, yes, you will be denied. If you want to dictate what medicine you take when an off-brand is available, you may be denied. If the coding is correct- and believe me, there is a lot of hoops to jump through before demonstrating need, and you have triage the situation appropriately, usually try and conservative approach first, if there is good documentation on all of this, then you rarely see denials.

You claim insurance isn’t denying necessary care. So why do your family members needs an MD and a healthcare worker to help them get medical care?

Reading is fundamental.

Do you work for or with the insurance industry, PP? You seem oddly determined to defend them.

You wrote that that getting insurance to approve care is so tough it requires help from an MD and an unspecified “healthcare worker.” So you admit that patients who navigate the process on their own are thrown to the insurance wolves.

[Anonymous]

Anonymous wrote:Everyone hates the insurance companies, but no one wants a single payer

It's a complex issue, and I think insurance companies are a big part of the problem - they are the middle man, in-between you and your doctor, taking their cut.

And, malpractice rates are sky high (needs to be, because when a doc makes a mistake, it can be life-altering in horrendous ways, in which case your medical needs should be taken care of forever, but there's also lots of needless lawsuits by those hoping for a quick payout).

The fear of malpractice also causes docs to order unnecessary tests, "just to make sure." That adds up to millions, if not billions of wasted healthcare dollars

There's pharmacy benefits managers also taking cuts and setting prices

And, we are all to blame for the amount we choose to spend on extraordinary measures to prolong end of life care, when we should not. Keeping people alive in vegetative state, why? So a machine can keep blood pumping through your comatose body? And other crazy things I've seen

I've lived in countries with single payer systems like the UK, and believe me when I point out there is no shortage of complaints and criticism of dysfunctional bureaucracies and overburdened doctors and waiting six months for a basic appointment.

I do expect AI to revolutionize everything in healthcare pretty soon. Need to have a mole checked out? Upload a photo to AI and it'll tell you it's benign and you've saved yourself the hassles of scheduling a visit with a dermatologist only to pay $230 for pre-deductible copay for a 10 minute visit and 5 second glance and being told it's fine.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Our dental office can't find enough hygienist. 3 people in our family are now 3+ months over due for our cleaning with no appointment for the future. We had appointments but the office called and said they don't have enough staff and that they would reschedule as soon as they get someone. I have searched and the closest option that takes our insurance is an hour away.

What city? What insurance? Liar.

My dentist had a hygienist quit on her and when I tried to reschedule an appointment back in February due to work conflicts, I was told the next available appointment was in September. That's how bad it is.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Everyone hates the insurance companies, but no one wants a single payer

It's a complex issue, and I think insurance companies are a big part of the problem - they are the middle man, in-between you and your doctor, taking their cut.

And, malpractice rates are sky high (needs to be, because when a doc makes a mistake, it can be life-altering in horrendous ways, in which case your medical needs should be taken care of forever, but there's also lots of needless lawsuits by those hoping for a quick payout).

The fear of malpractice also causes docs to order unnecessary tests, "just to make sure." That adds up to millions, if not billions of wasted healthcare dollars

There's pharmacy benefits managers also taking cuts and setting prices

And, we are all to blame for the amount we choose to spend on extraordinary measures to prolong end of life care, when we should not. Keeping people alive in vegetative state, why? So a machine can keep blood pumping through your comatose body? And other crazy things I've seen

I've lived in countries with single payer systems like the UK, and believe me when I point out there is no shortage of complaints and criticism of dysfunctional bureaucracies and overburdened doctors and waiting six months for a basic appointment.

I do expect AI to revolutionize everything in healthcare pretty soon. Need to have a mole checked out? Upload a photo to AI and it'll tell you it's benign and you've saved yourself the hassles of scheduling a visit with a dermatologist only to pay $230 for pre-deductible copay for a 10 minute visit and 5 second glance and being told it's fine.

No one is going to pay inflated insurance premiums to use ChatGPT or Gemini. Consumers already use AI to triage themselves for free. If someone is seeking care, they want to see a physician.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Anecdotally, every single one of my doctors works only 2-3 days/week, and they are all young- in their 30s and 40s. My older doctors have all retired, save for one in her 50s who quit medicine abruptly. She was the best doctor I’ve ever had.

I think we either need more medical school slots and residencies or some kind of requirement of working 5 days/week for x number of years if you’re going to take a US residency slot.

Agree. The AMA restricts the number of people in medical schools to keep the salaries high.

Meanwhile fake crying about the physician shortage to hide the fact that they are doing this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everyone hates the insurance companies, but no one wants a single payer

It's a complex issue, and I think insurance companies are a big part of the problem - they are the middle man, in-between you and your doctor, taking their cut.

And, malpractice rates are sky high (needs to be, because when a doc makes a mistake, it can be life-altering in horrendous ways, in which case your medical needs should be taken care of forever, but there's also lots of needless lawsuits by those hoping for a quick payout).

The fear of malpractice also causes docs to order unnecessary tests, "just to make sure." That adds up to millions, if not billions of wasted healthcare dollars

There's pharmacy benefits managers also taking cuts and setting prices

And, we are all to blame for the amount we choose to spend on extraordinary measures to prolong end of life care, when we should not. Keeping people alive in vegetative state, why? So a machine can keep blood pumping through your comatose body? And other crazy things I've seen

I've lived in countries with single payer systems like the UK, and believe me when I point out there is no shortage of complaints and criticism of dysfunctional bureaucracies and overburdened doctors and waiting six months for a basic appointment.

I do expect AI to revolutionize everything in healthcare pretty soon. Need to have a mole checked out? Upload a photo to AI and it'll tell you it's benign and you've saved yourself the hassles of scheduling a visit with a dermatologist only to pay $230 for pre-deductible copay for a 10 minute visit and 5 second glance and being told it's fine.

No one is going to pay inflated insurance premiums to use ChatGPT or Gemini. Consumers already use AI to triage themselves for free. If someone is seeking care, they want to see a physician.

Maybe for lonely people.