Actuary here again. PP who lost coverage is on the right track. Here's the thing, right now insurance companies can exclude pre-existing conditions because it's always been that way outside employer coverage, if one company tomorrow decided not to, all the people with high cost conditions flock to that company and it will go bankrupt which helps no one. All the companies need to be forced to start covering all people with pre-exisiting. Young people need to buy into the system (forced or else why would they) and support the older and sicker people in society. In the future those younger will subsidize them. If they get in a car wreck they won't go bankrupt. If you can afford a cell phone you should have health insurance.

Hello Obamacare, that's a good step and should happen. I don't think Obamacare is great and it's caused some increases in costs, but fundamentals of it are necessary or else we are talking rationing of care very soon. We are out of $$ as a country. It forces the healthy to pay in NOW and gets those exlcuded from coverage in at an appropriate price. Insurers want more people covered. They especially want young people and even families like yours. Yes, COBRA is actually $2000, your employer is just no longer paying the majority of the cost. COBRA rates are maybe only 2% higher than what your employer is paying now for families. Believe me, insurance companies lose money on COBRA, and guess who decides to stay and pay $2000 a month, the already very sick and heavy utilizers. Average claims for a family of 4 can easily be $2000, people just don't realize how much the employer is covering beyond your copays and deductions.

Anonymous wrote:

PP who changed to an internist who does not take insurance. The main difference I noticed is not so much the quality of care but things like getting an non-urgent care appointment for our annual physical. I can make an appointment a week in advance instead of at least three months in advance for our in-network doctor. Our new internist will prescribe lower cost meds or generics if they are available which makes up for the higher cost of seeing him. We've been healthy and see the internist once or twice a year so the extra cost is negligible and worth it for the convenience.

This is exactly the issue and you don't even see it.

This lovely system only works if you are have no health issues and make enough money to make this extra cost nothing to you. Just wait. One day, you will be laid off, or divorced, or diagnosed with a serious illness, or facing some other sort of circumstances that changes how you feel about the availability and cost of health care. It will happen to you, or someone you love. Odds guarantee it.

The first time your insurance refuses to pay for a medication or a test you and your doctor believe you need, you will understand how dire health care really is in this country. The first time an insurance company refuses you due to a preexisting condition, you will understand and you will see how these charges further erode the quality of health care in this country.

Of course, until then, you'll continue to be the young, rich or stupidly naive people who think this is a good idea.

+1
We are now on Medicaid b/c we both got laid off and can't afford COBRA (2k per month? Really?) and we were rejected from private insurers due to a preexisting condition that I had (which was not serious, and was resolved two years ago). We have three kids. We earned decent salaries, have advanced degrees, etc. etc. We are ONE serious illness or injury away from financial ruin. So yeah, this whole concierge thing gets me pretty pissed off. Just give me the same health care benefits as the Members of Congress have (I'm pretty sure that the Republicans accept those nice Federal health care benefits) and I'll be happy. Bring on Obamacare - because if you think the current system is working, you are beyond naive.

Concierge does discriminate against the poor but why should doctors bear the brunt of this fucked up healthcare system? Nobility doesn't pay the bills. Welcome to capitalism. Furthermore, since when did the poor ever get equal service...how about public defenders as opposed to a high priced defense lawyer like Johnny Cochrane?

I am a health care actuary, we set rates and reserves for health insurance including Medicaid and Medicare. Many of you are way off base.

The one poster was right that the profit margins made on health insurance are pretty small. Many insurance companies are not for profit entities. Profit is heavily regulated. Sure some executives make very large salaries, but it is quite literally a drop in the bucket when you look at your premium. Insurance companies make small profit in return for taking on risk and in health insurance they often lose money on products, health costs have a lot of variables. You win some and lose some. They are not the underlying problem, most people who understand how the system works see that.

Most of the Fed insurance is administered by insurance companies, but they simply pay the claims. The insurance company makes a small fee for that and having a network with contracts, they aren't raking in the profits on it. The reason insurance companies have resorted to low reimbursements, squeezing the doctors and having the endless paperwork to save money is to keep the claims down (which determines premium) and prevent fraud/waste/abuse. If they didn't do that, premiums would sky rocket and no employer, state or federal gov't could pay them, they barely can now. Fraud, waste and abuse in the system is huge. Health care costs are increasing at alarming rates as people have developed more cancer, diabetes etc. and demanded more prescription drugs and treatment. That is a result of a society with growing health concerns and new technology. A person may need $300,000 annually for some treatments and someone has to pay for it. Insurance companies could care less if in the future a doctor was paid $200 for a visit vs. $50. If it's high though, you bet premiums will be higher and people complain about that too. Someone besides the insurer must sponsor and pay for it. It is not sustainable to keep increasing costs, someone needs to pay for it. Insurance companies want to pay less to keep premium down, otherwise they won't have anyone using their services. Insurance companies are the middleman only.

One way out of this mess is keeping the waste down and increasing the health of the people in this country. Until then it will be a constant pull between big pharma, government, insurance companies and people. We need more consolidation and pooling of risk, there is a lot of red tape and people employed in the industry to set up and administer complicated uneccessary benefit plans. I'd start with the Feds and their open season, you all do realize those fairs, gifts and choices all jack up your premium. Some choice is okay and keeps costs down, but most of it creates waste. Making insurance the boogyman only allows us to skip past the real issues.

I'm getting this forced down my throat by my doctor too. It's $60/month for "Gold" membership, $80 for "Platinum". I'm trying to decide whether to go with it or tell him to shove it up his colon.

Anonymous wrote:

Anonymous wrote:I am sorry some of you have to deal with this issue. It seems very wrong. I love my doctors who take my insurance, see me the same day if needed, take all the time needed to help with the problem, and call or email me personally. Doesn't cost extra, they are just wonderful people.

My GP practice is just like this as well.

Mine too. So are my peds, OB, and dentist. I would accept nothing less. But then again I live out in those gosh-awful suburbs. Maybe that is the difference.

My Dr. (Taweel) Offers a similar program from a company called Privia. When I first got the packet I was pissed but after discussing with him figured it made sense. The treatment I get from him is no different but I do now have access to a nutritionist - fitness trainer - and nurse (24/7) whenever I need them. It's not my Drs. fault that my insurance (tricare) which i consider one of the best does not even cover those things that seem like no brainers to me. Think you folks may blaming the wrong people... but like I said before I looked Into it more I was pissed too.

Privia is actually charging a monthly service for access to telephone-Mayo-clinic-nurses and also allows emailing your own doctor a certain number of times a year. To me this sounds like less personal service for a higher fee. I would run away from this practice ASAP

Dr. Correnty's office has about 6 or 7 doctors with a new office in McLean with the two conventional offices in Virginia Hospital. In my opinion, the monthly charge of Privia is a combination of both Obamacare with respect to Medicare AND also the fact that the McLean office is finacially unstable. I believe Dr. Correnty's office has too many doctors and too many patients and too many offices and not enough personal service. If you have medicare i would find a new doctor. I would also have been willing to pay a monthly or yearly fee directly to the doctor's office as opposed to having Privia. My health insurance already offers a similar website to Privia.

I do really enjoy Dr. Papas tho and will probably book him a year in advance just to make sure I can see him. He's very popular and friendly. He's not a super conservative guy either and gets that I know myself and what works best for me.

Anonymous wrote:^^^
curious what you're unhappy about ... she is not my dr but I've found that office to be pretty decent in my experience (3 yrs or so)....

It's really just her - she's perpetually unhappy, never smiles ever. And she offered to do an OB exam on me to save me time. Big mistake! She literally could not find my cervix. It was one of the weirdest things I've ever experienced! Also the girl who does the prescription refill requests from the pharmacy is unbelievably rude. She yells at my pharmacist and once hung up on her over and over until I called the office manager.
I try to roll with the changes but those incidents were really absurd.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is normal with the advent of all the damn lawyers driving up malpractice insurance and obamacare.

+1

Yes, Obamacare has pinned the doctors to a wall. They are suffering from all of the horrible changes that have been put upon them.

Now can you tell me what provisions are actually directed at doctors?

There is no Obama care. That has not pinned doctors to the wall.
Too many arrogant docs, but really, I think this one falls on the legal profession trying to sue everything in sight. So we've got out of control insurance fees, to cover the out of control law suits.
Got nothing to do with the current president. This started to escalate in the early 70s and has grown insanely since. It is not possible to have a small corner practice anymore.

Monthly fee for better service is disgusting. Reduce the lawsuit risk, you reduce the insurance risk. No sign of anyone passing up an opportunity to win a suit..there you go.

--Hoping I keep my job long enough to cover my health insurance.

^^^
curious what you're unhappy about ... she is not my dr but I've found that office to be pretty decent in my experience (3 yrs or so)....

My Dr.s office just started Privia - Dr. Correnty like the other poster. I have been going there since it was just Dr. Ryan's office. Roughly 30 years. I go once a year. Lately I have been really dissatisfied with the Dr.s there - especially Kimberly Houde. I don't want to see her ever anyway so the shorter the better! Was just considering switching Dr.s anyway and will not be paying the fee. This new form of "healthcare" has me considering trying to get my medication on the internet and just dropping my insurance altogether. Risky but tired of paying for nothing.

PP who changed to an internist who does not take insurance. The main difference I noticed is not so much the quality of care but things like getting an non-urgent care appointment for our annual physical. I can make an appointment a week in advance instead of at least three months in advance for our in-network doctor. Our new internist will prescribe lower cost meds or generics if they are available which makes up for the higher cost of seeing him. We've been healthy and see the internist once or twice a year so the extra cost is negligible and worth it for the convenience.

This is exactly the issue and you don't even see it.

This lovely system only works if you are have no health issues and make enough money to make this extra cost nothing to you. Just wait. One day, you will be laid off, or divorced, or diagnosed with a serious illness, or facing some other sort of circumstances that changes how you feel about the availability and cost of health care. It will happen to you, or someone you love. Odds guarantee it.

The first time your insurance refuses to pay for a medication or a test you and your doctor believe you need, you will understand how dire health care really is in this country. The first time an insurance company refuses you due to a preexisting condition, you will understand and you will see how these charges further erode the quality of health care in this country.

Of course, until then, you'll continue to be the young, rich or stupidly naive people who think this is a good idea.