Name:	MartiniMan -	Reply
Subject:	Obamacare coops dropping like flies
Date:	10/16/2015 12:16:53 PM

What a shocker.  The ones that are cratering owe the federal government almost a billion in loans that will almost certainly never be paid back.  And the reason they are all stating for their demise?  Decision by HHS to only pay 12.6% of their requested low risk corridor payments, better known as profit props for insurers losing money.  As I predicted, as a result of Obamacare costs will continue to soar, especially in 2016 when insurers realize and adjust for the lack of profit payments from the government.  There is talk that average premium increases will be on the order of 50%, and that doesn't even begin to address the increased cost for copays and deductibles.  Rationing is not far behind as costs soar.  I have been right about everything else associated with Obamacare so don't doubt me.

What is even more laughable is I saw a study recently that indicated that 32 million Americans are still uninsured.  Lie after lie after lie.  But i am sure left wing nuts are still supporting this worthless piece of crap legislation.

Name:	wix -	Reply
Subject:	Where is that Archypoo?
Date:	10/17/2015 3:01:59 PM

Where, oh where could he be.  The great defender of all that is o-BAMMIEcare....where is he?  

Name:	lucky67 -	Reply
Subject:	Where is that Archypoo?
Date:	10/17/2015 5:50:24 PM

friend in Montgomery told me at least 3 Dr.'s there have sent out letters to all patients telling them no more medicare//medicaid; they estimate they will eliminate treatment for about 7500 current patients; also they are limiting treatment to max 400 patients & you have to sign a contract agreeing to pay them { auto debit] $75.00-$100.00 monthly

Name:	Talullahhound -	Reply
Subject:	That is a Trend
Date:	10/18/2015 10:52:05 AM

Drs. are fed up with low/slow Medicare payments, so they are making their practice a "subscription" affair.  Supposedly, you get long with the Dr., and have email access.  This has been going on for a while in other more affluent areas - it's just getting to AL now. 

With the threat of a sharp increase in Medicare premiums, it is going to be interesting to see what people do.  i have wondered if it isn't  a ploy to thin out the Medicare roles, since a lot of people will not be able to afford the increase and will probably drop out of medicare and go uninsured. 

Name:	MartiniMan -	Reply
Subject:	It's called concierge practices
Date:	10/19/2015 12:16:03 PM

My internest switched to this type of practice three years ago.  Their practice hired a consultant to study their business and the gist of it was they needed to spend no more than five minutes with a patient and had to see some ridiculous number of them every day for it to make sense financially given the reimbursement rates (both govt and private insurance).  Also told them they needed to restrict Medicare/Medicaid patients to a very low percentage of their overall patient makeup because of the much lower reimbursement rates.  

So he decided to go concierge and changes between $1,200 and $1,600 per year which is paid out of pocket.  Interesting side note, I asked him how it was going and he said the one thing they did not consider adverse selection with the relatively healthy patients electing not to sign up and the more illness prone patients signing on.  I am a low maintenance patient and negotiated a lower annual fee.

Name:	GoneFishin -	Reply
Subject:	It's called concierge practices
Date:	10/20/2015 5:47:11 PM

"he said the one thing they did not consider adverse selection with the relatively healthy patients electing not to sign up and the more illness prone patients signing on." I hope he didn't pay the consultant. even a right wing nut who wants to eliminate Obamacare should understand adverse selection. 

Name:	MartiniMan -	Reply
Subject:	It's called concierge practices
Date:	10/21/2015 9:24:26 AM

The consultant didn't advise him on the concierge practice and if I implied that they did that was my error.  As I understood it, they advised him on how to make the practice work as an ordinary one.  When they got the recommendations he and another doctor in the practice elected to go out on their own with the concierge concept.  And to be fair to him, he indicated that he underestimated the adverse selection and I take that to mean he considered it but was surprised at its extent.  It's why he gives me a discount because most years the only time he sees me is when I have my annual physical where he tells me I need to lose 20 pounds, give up my small business because of the stress and get more exercise.  It's our annual goat dance although last year I was down 10 pounds from prior years but no luck on the other recommendations as yet.  Given the increased health care costs because of Obamacare I will probably end up selling the business so that would take care of number 2.