Giantaxe

Remember that many doctors are vehemently opposed to the ACA, so I would not take everything they say as an unbiased picture of reality. Having said that, it's certainly true that in some states, at least, insurers have kept costs down by limiting the doctors on specific exchange plans.

As to the claim that ACA reimbursements are lower than Medicaid, count me sceptical. I'd like to see some evidence of this from an unbiased source.

notshipman

Not sure where you got the idea the US docs want to get the best for the overall populace since they have never done this in the past. Given a lot of things they do are revenue based such as operating on people for no reason, giving people coronary stents when they dont even have heart disease, over investigation etc I doubt they give a fig about the overall populace as long as their revenue streams are maintained. Getting the best for the populace would drop their income and defo. not be savvy in their eyes!

scrubbedexpat099

We are in agreement, I had a friend in the UK, it has been a few years, a GP, he might have called it quits by now.

When Labour did there big switch up he did very well financially out of it, he was slightly embarrassed, when you are a small cog what do you do.

The local Doctor sold out last year to a mini group, I knew her husband quite well so we had chatted, I think we had sort of similar view as to the illogicality of what was going on, how much effort and resources the 'system' wasted.

I doubt if it can be changed fundamentally, or put it another way not without the revolution.

Pulaski

Well if people could get away from the "well I've paid for the insurance, I might as well use it" attitude, and also the belief that there is a miracle cure for every perceived ailment, we could do a lot. Insurance is paying a lot for "lifestyle issues", and at the moment I can't see a way to get out of subsidizing other people's obesity treatments and viagra prescriptions. Give me an opportunity to sign up for insurance for diseases and conditions that are (i ) life threatening and (ii) beyond my control, and I'd jump at it. I suspect that between the doctors and the drug companies, such a commonsense CHOICE to sign up for such a plan will never be permitted. .... So, Boiler, I guess I do agree with you after all!

notshipman

Even the NHS doesnt pay for Viagra am amazed if stringent US insurance subsidizes someone to get a boner. Also very difficult to get obesity treatment in the UK on the NHS. They make you go through so many impossible hoops you give up trying.

In the US should be simple case of maths - you cant pay a 3 figure monthly sum for insurance and expect to get 5-6 figure treatment on a regular basis. Thats why deductibles etc are there. The insurance companies have factored in the inherent problems with ACA into the plans they offer through them.

scrubbedexpat099

Not really an ACA issue, more of a general issue.

Although if you expect a lot of treatment you can buy down the deductible etc with a more expensive plan.

Thinking about it what seems to be happening.

Young and healthy are not bothering.

Young and sick can get cover which is not too expensive.

Old and healthy can now get high deductible cover.

Old and sick can get get low deductible expensive cover. But may be better off reducing their income and going Medicaid.

Poor can get Medicaid. Poor in this case means income, out of work but still have good savings qualify.

I do not understand how it makes sense, whats new.