Doctors Quitting - Wonderful

[hortysir]

the IRS is going to dictate what level of coverage I can afford, thereby determining the quality of care I receive.

Your income will dictate that for you.

That's not "rationing"?

 

[MarcATL]

second, why would they quit? The Affordable Care Act changes nothing for DOCTORS. It changes INSURANCE. not CARE. so its bullshit again

I'd push back on that assertion a bit. The numbers in the OP are obviously a bit absurd, but I've said it before and I'll say it again: I'm sure many doctors are somewhat worried. Many of them--not all--dislike quality measures (particularly those that are available for public inspection), they dislike patient experience surveys, they don't like the idea of smoothing out unexplained variations in care, and they certainly don't like the idea of linking their pay to their performance and the quality of the care they deliver. I'm overgeneralizing--I have particularly great hope for younger doctors.

I'm sure many current docs love an opaque market where they get paid simply for doing things, independent of results. But the trend now is toward accountability and there will no doubt be a great deal of breath-holding and foot-stomping for a bit, as the sentiment behind the OP demonstrates. It'll be an adjustment for some folks. Being held accountable for the quality of your product or the quality of your work always is.

This is one of the Most Nonsensical Rants I have ever heard. Private insurance Companies have always, and will always have Motivation to limit Bureaucracy and Maximize Profits.

These are not entirely opposing aims. The financial incentives of unregulated health insurance markets encourage more bureaucracy up to a point.

 

[Greenbeard]

the IRS is going to dictate what level of coverage I can afford, thereby determining the quality of care I receive.

Your income will dictate that for you.

That's not "rationing"?

Of course. A price tag is a rationing mechanism. You think the IRS invented prices?

 

[MarcATL]

Can't argue statistics here folks.

Just reporting the facts.

American Medicine - soon to be as efficient as the DMV.

The reason MANY, MANY Canadian doctors are working in the U.S. today.

They quit - took their degrees elsewhere.

Same now with US docs.....

Obama's fucked up royally.

This rant is nothing but an absurd and bogus talking point.

 

[Pheonixops]

Anyone with a single spark of brain activity is aware of how slanted Politifact is.

But I'll start with the second one on the linked page:
Is it true or false that the IRS is the primary enforcer of the ACA Mandate?
That is placing a government entity between me and my care.

So anything with the word "fact" in it is invalid? Factcheck is "bad" and now Politifact is "bad"?
Is the IRS going to dictate what kind of care you get from your doctor? Come on!
I'm not in favor of the mandate, but at least lets discuss it in a rational and honest manner.

Actually, I like FactCheck.


the IRS is going to dictate what level of coverage I can afford, thereby determining the quality of care I receive.

LOL, that's good to know. Here:
"“Massive government takeover of health care.” Actually, the law expands business for private insurance companies by requiring nearly everyone to have health insurance. Medicaid eligibility is also increased, but this is no government-run system, as single-payer advocates wanted. And as we’ve noted again and again, government already accounted for 43.6 percent of all health care spending before the new law was enacted, and that share is projected to rise by 3.8 percentage points by 2015, a year after the law takes full effect. Plus, much of that increase would happen anyway as more and more seniors reach Medicare age."

How is the IRS allegedly going to 'dictate what level of coverage you can afford'?

 

[hortysir]

Your income will dictate that for you.

That's not "rationing"?

Of course. A price tag is a rationing mechanism. You think the IRS invented prices?

I was just being a smartass, GB.

I'm hoping the whole ball of wax gets repealed, actually, then none of this matters.



In other words, I don't feel like bitching about it tonight.

 

[Lakhota]

I love this board. It's the greatest source of misinformation I've ever seen. Along with the totally made-up shit, it draws from all the lunatic right-wing sources.

 

[MarcATL]

I asked one of my doctors aboout this and he says he now intends to retire within two years. This is not bullshit. They work too hard and have paid their dues to not to have the rewards they have expected. He's a very skilled doctor and will be missed.

Another doctor will take his place in the market and thus the cycle continues.

 

[Pheonixops]

So anything with the word "fact" in it is invalid? Factcheck is "bad" and now Politifact is "bad"?
Is the IRS going to dictate what kind of care you get from your doctor? Come on!
I'm not in favor of the mandate, but at least lets discuss it in a rational and honest manner.

Actually, I like FactCheck.


the IRS is going to dictate what level of coverage I can afford, thereby determining the quality of care I receive.

Hence the need for so many new agents.

FactCheck.org : IRS and the Health Care Law, Part II

 

[Vidi]

Which rights are those??

The inalienable ones. like Life

Citing that as a source, wouldn't that give the Fed the capability of "taxing" me if I don't buy broccoli?

Our government's job is to protect my inalienable rights. On that we agree.

The way they should protect them is the difference.
They should protect my right to life by prosecuting those that would try to take it.
Not by funding an effort to extend it, according to their standards.

No. Your "life" is not dependant on your purchasing and eating broccoli. But thats thinking backwards about this whole issue anyway.

You refusing to purchase health insurance isnt really the issue. The issue is the health insurance companies denying coverage or refusing to pay for legitimate claims made by paying customers.


now if you needed broccoli to stay alive and the broccoli growers refused to sell it to you or sold you cabbage when you asked for broccoli, then that would be a better anology.

So they changed the law to protect your rights, rather than prosecute and deal with years of courtroom battles and high priced lawyers finding every loophole in the book to protect your rights.

personally I do not believe that the ACA will actually protect those rights. I think only a single payer system will do that effectively.

 

[hjmick]

No, doctors consider quitting...

 

[MarcATL]

The Daily Caller is a far right extremist non-mainstream rag.

Precisely!

And look how all these rabid extremist RWers on this board are bitterly clinging to that story for dear life.

It's sad really.

*SMH*

 

[hortysir]

So anything with the word "fact" in it is invalid? Factcheck is "bad" and now Politifact is "bad"?
Is the IRS going to dictate what kind of care you get from your doctor? Come on!
I'm not in favor of the mandate, but at least lets discuss it in a rational and honest manner.

Actually, I like FactCheck.


the IRS is going to dictate what level of coverage I can afford, thereby determining the quality of care I receive.

LOL, that's good to know. Here:
"“Massive government takeover of health care.” Actually, the law expands business for private insurance companies by requiring nearly everyone to have health insurance. Medicaid eligibility is also increased, but this is no government-run system, as single-payer advocates wanted. And as we’ve noted again and again, government already accounted for 43.6 percent of all health care spending before the new law was enacted, and that share is projected to rise by 3.8 percentage points by 2015, a year after the law takes full effect. Plus, much of that increase would happen anyway as more and more seniors reach Medicare age."

How is the IRS allegedly going to 'dictate what level of coverage you can afford'?

Okay, Pheonix, you've convinced me.

The reason I just told Greenbeard that I didn't feel like bitching about it tonight is because I just lost my job.

So, rather than trying to work and keep up with any COBRA payments I'm going to have to worry about, I'm just going to let your tax dollars take care of me.



I feel MMMUUUUUCH better now. Thanks.

 

[Vidi]

I asked one of my doctors aboout this and he says he now intends to retire within two years. This is not bullshit. They work too hard and have paid their dues to not to have the rewards they have expected. He's a very skilled doctor and will be missed.

Another doctor will take his place in the market and thus the cycle continues.

Indeed. Demand will cause an increase in supply.

 

[Harry Dresden]

SHIT ! Gotta call my doc. This thread makes my ass hurt.
Cost ? ZERO.

tell your boyfriend to ease up a bit.....

 

[Charles_Main]

Can you please cite the provision in the ACA that the government is the one that pays them and that the government is the one that decides to pay him? Thanks in advance!

Have you ever read the bill shit for Brains, one of the ways they cover all the uninsured now, is by Asking the States to Expand access to MC. You do know who pays for MC right?

Wow I mean you guys run around like Experts on the ACA, and do not even understand the basics of it.

Well , I asked a fucking question. Secondly shit for brains not everyone who is uninsured will qualify for MC, and yeah the states will pay for MC. That certainly IS NOT "the government" paying for everyone's health care, now is it?

In so far as the states will have to pay for the MC expansion, and they are part of our government, Yes it is. And don't be Naive, the states will have to come Begging for Bail outs again, and then we will be back passing another bill to Bail them out.

You can claim what ever you want. Facts are Facts.

2 well 3 Things in the ACA will increase federal and State liabilities massively.

First the MC expansion,

Second and Third the Tax Credits to help people buy Insurance, and Tax Credits to Encourage Business to Offer Insurance. Those are Direct Pay outs of Government Money, to Business and People to encourage people to get Insurance.

How you guys can ignore that, and pretend the ACA is not going to massively Increase the Amount State and Fed government spends on peoples health Care is simply Funny, and frankly Very dishonest.

 

[PixieStix]

Why Physicians Oppose The Health Care Reform Bill - Forbes.com

What physicians knew then and certainly know now is that instead of fixing these issues, the government will be forced to take the path of least resistance to save money (that is to say the path with the least special interest resistance). That means reducing physician reimbursement, just as the country is counting on even more physicians to be available.

Physicians knew the health care bill had a "gotcha" buried deep inside. The only way it could be called "budget-neutral" was to implement significant reductions in physician payments. So just as we are hoping more physicians become available to treat the influx of 31 million more patients, the government is implementing a massive reduction in physician reimbursement (a 21% reduction in physician reimbursement went into effect April 1 after several years of no adjustments for inflation, meaning physician reimbursement has been declining for several years already).

In a moment of complete legislative hypocrisy, the proponents were touting one health care bill that included cost estimates that assumed a massive reduction in payments while another bill moved its way through Congress that would reverse those cuts (the bill reversing the cuts was ultimately defeated, meaning the cuts did go into effect). At some point, basic supply and demand will kick in, and there will be insufficient physician resources for treating patients.

 

[Vidi]

Have you ever read the bill shit for Brains, one of the ways they cover all the uninsured now, is by Asking the States to Expand access to MC. You do know who pays for MC right?

Wow I mean you guys run around like Experts on the ACA, and do not even understand the basics of it.

Well , I asked a fucking question. Secondly shit for brains not everyone who is uninsured will qualify for MC, and yeah the states will pay for MC. That certainly IS NOT "the government" paying for everyone's health care, now is it?

In so far as the states will have to pay for the MC expansion, and they are part of our government, Yes it is. And don't be Naive, the states will have to come Begging for Bail outs again, and then we will be back passing another bill to Bail them out.

You can claim what ever you want. Facts are Facts.

2 well 3 Things in the ACA will increase federal and State liabilities massively.

First the MC expansion,

Second and Third the Tax Credits to help people buy Insurance, and Tax Credits to Encourage Business to Offer Insurance. Those are Direct Pay outs of Government Money, to Business and People to encourage people to get Insurance.

How you guys can ignore that, and pretend the ACA is not going to massively Increase the Amount State and Fed government spends on peoples health Care is simply Funny, and frankly Very dishonest.

The tax credit offsets a portion of the employer’s federal income tax liability for the year. Tax-exempt employers receive the credit as a refund, with the provision that the refund cannot exceed the amount of federal income tax and Medicare payroll tax that the employer withholds from the employees’ wages, plus the Medicare tax paid by the employer

Here's the specifics:

•The tax credit decreases as the number of employees approaches 25 and as average annual wages approach $50,000.
•To qualify for the credit, an employer must pay at least half the premium for each employee. The percentage paid by the employer should generally be uniform for all employees, although special provisions will apply when a small employer offers its workers a choice of health plans. Since the law was enacted in March 2010, and employers may not have had time to adjust their policies, the Internal Revenue Service (IRS) in 2010 allowed employers who paid at least half the premium to qualify, even if the percentage of premium paid was not uniform across their entire work force.
•From 2014 on, the maximum credit will increase to 50 percent (35 percent for taxexempt employers). However, coverage will have to be purchased through one of the new state-based health insurance exchanges. The credit will only be available to any employer for two consecutive tax years after 2013.


Small Business Tax Credits Under the ACA Examined

Additionally, States can choose to NOT expand MC and therefore NOT take the Federal money provided for that purpose.

Although participating states will distribute the funds, the funds themselves come from the Federal revenue. At least thats my understanding. If you can provide a link disputing that, I am open to new information.

 

[Greenbeard]

Why Physicians Oppose The Health Care Reform Bill - Forbes.com

What physicians knew then and certainly know now is that instead of fixing these issues, the government will be forced to take the path of least resistance to save money (that is to say the path with the least special interest resistance). That means reducing physician reimbursement, just as the country is counting on even more physicians to be available.

Physicians knew the health care bill had a "gotcha" buried deep inside. The only way it could be called "budget-neutral" was to implement significant reductions in physician payments. So just as we are hoping more physicians become available to treat the influx of 31 million more patients, the government is implementing a massive reduction in physician reimbursement (a 21% reduction in physician reimbursement went into effect April 1 after several years of no adjustments for inflation, meaning physician reimbursement has been declining for several years already).

In a moment of complete legislative hypocrisy, the proponents were touting one health care bill that included cost estimates that assumed a massive reduction in payments while another bill moved its way through Congress that would reverse those cuts (the bill reversing the cuts was ultimately defeated, meaning the cuts did go into effect). At some point, basic supply and demand will kick in, and there will be insufficient physician resources for treating patients.

Meanwhile, back on planet Earth: Medical News: CMS Proposes Primary Care Pay Raise for 2013 - MedPage Today

Published: July 06, 2012

WASHINGTON -- The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would give family physicians a 7% pay boost in 2013.

The proposal released Friday also would increase Medicare payments to other primary care practitioners by between 3% and 5%.

Physician payments aren't governed or affected by the ACA. Arguably they should be, since the law that governs them (the Balanced Budget Act of 1997) sucks.

 

[Vidi]

Why Physicians Oppose The Health Care Reform Bill - Forbes.com

What physicians knew then and certainly know now is that instead of fixing these issues, the government will be forced to take the path of least resistance to save money (that is to say the path with the least special interest resistance). That means reducing physician reimbursement, just as the country is counting on even more physicians to be available.

Physicians knew the health care bill had a "gotcha" buried deep inside. The only way it could be called "budget-neutral" was to implement significant reductions in physician payments. So just as we are hoping more physicians become available to treat the influx of 31 million more patients, the government is implementing a massive reduction in physician reimbursement (a 21% reduction in physician reimbursement went into effect April 1 after several years of no adjustments for inflation, meaning physician reimbursement has been declining for several years already).

In a moment of complete legislative hypocrisy, the proponents were touting one health care bill that included cost estimates that assumed a massive reduction in payments while another bill moved its way through Congress that would reverse those cuts (the bill reversing the cuts was ultimately defeated, meaning the cuts did go into effect). At some point, basic supply and demand will kick in, and there will be insufficient physician resources for treating patients.

Meanwhile, back on planet Earth: Medical News: CMS Proposes Primary Care Pay Raise for 2013 - MedPage Today

Published: July 06, 2012

WASHINGTON -- The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would give family physicians a 7% pay boost in 2013.

The proposal released Friday also would increase Medicare payments to other primary care practitioners by between 3% and 5%.

Physician payments aren't governed or affected by the ACA. Arguably they should be, since the law that governs them (the Balanced Budget Act of 1997) sucks.

Agreed. The ACA does precious little to effect Health Care costs. It tries to address health Insurance costs, but without dealing with CARE costs, the price of insurance MUST rise.

However, one must consider the fact that Medicaid itself DOES restrict costs through the amount they will payout. And THAT is most likely what the detractors are failing to express when they speak of lower reembusments.

And damn them for not articulating that point so I didnt have to