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 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

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.

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.

NP here. My parents are both physicians. One who owns a private practice. One who works for a hospital. A lot of healthcare workers' perceptions of the ACA are driven by the business structure of their employment. Initially my hospital-employed parent was much happier with ACA because it meant that patients came in for preventive care. Private practice parent resented that the ACA accelerated the trend of insurance telling them how to treat patients and also reduced reimbursements.

Now they are both unhappy, because the profit-motive has sucked whatever remaining life there was out of practicing medicine in the US. ACA may have been an accelerant to some issues, but the issue is that insurance for something you have to use (and actually would reduce lifetime costs if you do use it) doesn't make any actuarial sense. And also, for a wealthy country not to guarantee a basic level of healthcare is barbaric and frankly bad economic policy. I don't think healthcare is a basic right in the way freedom of speech and movement are, but I think it's really stupid not to ensure a basic level for our citizens.

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.

MAGAs are becoming increasingly ludicrous. What was the GOP alternative to the ACA?

GOP have given up killing ACA because they realize even many of their constituents support it. Rs are now even pushing for it.

A push led by House Republicans to allow insurers offering the plans to cover more expenses than they do now is gaining momentum in Congress and dividing Democrats.

The proposed changes reflect the new state of play on health care for Republicans, who have turned away from efforts to repeal Obamacare but see high-deductible plans as a way to boost market forces in the system.

https://www.politico.com/news/2023/08/18/lawmakers-high-risk-health-plans-00111735

There are, of course, flaws in ACA, but even the Rs now see that ACA is going nowhere. So, we need to fix it.

OP, you should move to where there is better healthcare choices.

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.

CMS has a 3.34% pay cut in 2024 for physicians dum dum. And that’s despite Biden’s inflation.

Anonymous wrote:Insurance in general ruined the healthcare industry. I lived in another country where everything was paid out of pocket (not universal health care). The cost was reasonable and care availability was quick. A specialist could get me in the same or next week. He prescribed a CT scan and I drove 10 min down the street to the nuclear medicine place and had it done within an hour of leaving the original doctor appointment. This experience is not possible in the US anymore.

This. Other systems in the modern world are much better and affordable than our insurance-industry-driven crap system.

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.

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.

MAGAs are becoming increasingly ludicrous. What was the GOP alternative to the ACA?

Anonymous wrote:Insurance in general ruined the healthcare industry. I lived in another country where everything was paid out of pocket (not universal health care). The cost was reasonable and care availability was quick. A specialist could get me in the same or next week. He prescribed a CT scan and I drove 10 min down the street to the nuclear medicine place and had it done within an hour of leaving the original doctor appointment. This experience is not possible in the US anymore.

I am a Senior citizen. When I was a child, that is pretty much the way it worked. The only insurance my parents carried (when they could afford it) was "hospitalization." Everything else was "out of pocket" and affordable. And, even then, doctors were considered wealthy.

The prices of pharmaceuticals is also ridiculous.

Not sure what the answer is, but I don't think it is universal health care.

Doctors do also have to pay for malpractice insurance which is ridiculously expensive. Pretty sure the insurance companies usually "settle" even though the case may not be strong. Cheaper than going to trial.

Insurance in general ruined the healthcare industry. I lived in another country where everything was paid out of pocket (not universal health care). The cost was reasonable and care availability was quick. A specialist could get me in the same or next week. He prescribed a CT scan and I drove 10 min down the street to the nuclear medicine place and had it done within an hour of leaving the original doctor appointment. This experience is not possible in the US anymore.

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.

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.

No, Cletus, it didn't.
Kindly tell the class what your position in healthcare is.

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.

Jobs don’t matter nitwit when all PCPs ditch insurance and you gotta pay additional money out of pocket know to access primary care because they all have gym membership like models.

Jesus you’re dumb.

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.