Health Care Reform Sticks It to Connecticut Children

[ABC]

Here in Indiana Anthem is the only stand alone child policy now. The updated their rates to 9/23 and increased that policy by about 50%. I was writing those policies for about $80+ a month on an HSA. Now they are $150 for the same plan.

Going forward Anthem stated that they would stay in that market all other carriers said they will not.

So with just one carrier writing kids policies i expect the preferred premium to be around $200 a month.

 

[somarco]

The theory is people want to see "their doctor" when they need treatment.

Of course they do. And if they liked their plan they could keep it.

This was the world before Obamacrap.

Not any more . . .

 

[Norwayguy]

The theory is people want to see "their doctor" when they need treatment. However, we've opted for places like Patient First and Nighttime Pediatrics because the trend with the doctor we used to see was pawning us off to the nurse practitioner.

In fact, fool me three times, my son was complaining of headaches a few weeks ago so we decided to give "his pediatrician" one more shot. Called and they told us to come in the same day. So, do we see his doctor? No, we see the nurse practitioner. This, of course, is after waiting 45 minutes in the waiting room and another 20 in the patient room. Remember, the entire point was for him to see "his doctor."

So that's strike three. All of his care moving forward will be at places like Nighttime and Patient First.

It seems this is happening all over and I think we can expect 5 - 10 years down the road your PCP will be a Nurse Practiciner or Physicians Assistant. My child rarely sees "their" doctor but sees the on call Dr at the practice, its become more of an issue for me. My Drs practice was bought by the local hospital so now when you call for an appointment they don't even try to fit you in any more its at least a week and the attitude is "if you don't want to wait, the ERs right around the corner". I was in serious back pain back in febuary but stuck it out over the weekend called in on Monday and they where able to fit me in on Wednesday after noon...Wednesday morning they called they were closing the office for the day and would reschedule, I asked if I could reschedule now they said no they would call to reschedule...well screw that I suffered through a 45 minute drive to Lewiston and went to an Urgent care, normally its first come first serve but when they saw I couldn't sit or stand they got me right in...$95 later I had the scripts I needed and a referral appointment to a specialist....A week later they called to reschedule the appointment....More recently I called for an appointment on friday and they couldn't get me in till next friday...I knew I had an ear and sisus infection...they also put me on the on call list for people that cancel...Obviously they don't scrub those lists because the wednesday after my appointment they called to get me in....Now on the one hand this is probably good business for the practice...on the other hand it sucks as patient care...For me I've been looking around but all the local practices are not taking new patients and I would have to go to Lewiston.

 

[Crabcake Johnny]

Yep - total failure. Months ago when my son had an ear infection he said that it was throbbing pain.

Choices:

A) Call his pediatrician. They would have seen him within the hour. Get there, wait 45 minutes, another 15 to 20 in the room. Nurse practitioner comes in, says he has an ear infection, writes a script for antibiotics then it's off to CVS or Rite Aid.

B) Go to Nighttime Pediactrics. Walk in, get seen in around 20 minutes, doctors says "yep...ear infection" then we fill the script right there - no CVS - and drive home.

B wins and we need more options like this. It's especially nice that places like this are open until midnight. Try calling your doctor at 9pm.

 

[Norwayguy]

Yep - total failure. Months ago when my son had an ear infection he said that it was throbbing pain.

Choices:

A) Call his pediatrician. They would have seen him within the hour. Get there, wait 45 minutes, another 15 to 20 in the room. Nurse practitioner comes in, says he has an ear infection, writes a script for antibiotics then it's off to CVS or Rite Aid.

B) Go to Nighttime Pediactrics. Walk in, get seen in around 20 minutes, doctors says "yep...ear infection" then we fill the script right there - no CVS - and drive home.

B wins and we need more options like this. It's especially nice that places like this are open until midnight. Try calling your doctor at 9pm.

Oh I'm all for more of this...I know my local Walgreens is doing Flu Shots every day, I wish they would be able to bump it up to having a NP in place for other things, Its more an issue for me and the wife right now then the kids because the Pediatrics practice is running smoothly normally a 5 minute waiting room wait then a assistant doing height weight notes etc another 5 minute wait and we get a Dr...because there is the chance it might be more than just the ear infection.

But I think these innovations are due to the private market seeing an opportunity and need and fulfilling it, and not based on Obama crap.

 

[Crabcake Johnny]

Here's one of the current problem with health care and it's a great analogy.

Someone trains to become one of the foremost auto mechanics. They can build engines, transmissions, etc...They can work on high tech sports cars and it took them 6 years of training to attain their level of expertise.

Now, I need brake pads, but he's charging $350 because he's an "auto expert." Guess what - I don't need an auto expert to change the pads...I need someone who knows how to change pads and charge me $99. It's great that his education cost $150,000 and he's got student loans up the wazoo. But I still just need the pads changed.

I think it's great that my son's pediatrician is capable of diagnosing him with some rare brain disease. And that would be fine, but I just need antibiotics for his ear infection.

 

[ABC]

What I am seeing in my area is the hospitals groups are buying up all the outpatients practices they can get their hands on. Once they buy them then they use their coding for procedures which sometimes is double.

THe medical groups no longer want to lose revenues to outpatient facilities. I just witness a local diagnostic center with about 4 location get bought by a hospital. An MRI at the outpatient was $289-$350. They are now charging hospital rates for that procedure which is $1,400+.

 

[ksigmtsu]

Some markets work better than others for KP. They have been here 20 years and slowly gaining traction. They are expanding their clinics beyond just the usual "big" clinics to smaller ones incorporated into strip malls. Changes in health care delivery, some trigged by the onslaught of Obamacare, have caused more docs to align with KP.

Their model makes a lot of sense and will continue to grow in some areas.

I really appreciate the concept of the HMO model, it just doesn't appear to work in practice as well as it works in theory.

 

[Post Quartermaster]

What I am seeing in my area is the hospitals groups are buying up all the outpatients practices they can get their hands on. Once they buy them then they use their coding for procedures which sometimes is double.

THe medical groups no longer want to lose revenues to outpatient facilities. I just witness a local diagnostic center with about 4 location get bought by a hospital. An MRI at the outpatient was $289-$350. They are now charging hospital rates for that procedure which is $1,400+.

I have seen alot of that in my area as well. I liken it to an "arms race" between the 4 major hospitals in our metro area.

I just priced out a colonoscopy with a client yesterday, and it is staggering. A doctors office will do it for $950, contracted rate. The hospital wants $4150 in facility charges alone, in addition to physicians fees.

It gets better, though,the client is on a $5k HDHP, with $300/yr in preventative covered.....however, the carrier is telling us that the contract actually pays 100% of facility charges under the preventative benefit (this was news to me), which is completely asinine IMO.....

 

[somarco]

Doc office may do it with a local while the hospital with a general anesthetic. Given the choice, I would opt for the one with the general too.