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Ok, this'll be short, but to get more mileage out this diary, I'll continue below the cheese doodle of death.

I've been arguing elsewhere online with some individuals of the wingnut variety about the dreaded Obamacare. One of the more nutbaggy ones said this: ObamaCare has limited providers and many local hospitals and doctors do not accept them. I challenged him to back up that assertion (which obviously is pretty bold, considering the law hasn't fully kicked in yet) and another winger offered up two links as "evidence", one of them being this one:

Docs resisting ObamaCare

Ok, it's from a Murdoch rag, that's a big strike against it right there. Also, the sample size strikes me as a bit small to really be significant.

Thing is, though, reading this article did bring to mind a question which I haven't been able to find an answer for:

Will doctors even know if a patient is using insurance through the healthcare exchanges?

Apparently, according to that that stupid article, some doctors are saying they won't accept "Obamacare" patients because they don't know if they'll get paid. Seems to me that as long as one's insurance is paid up (with or without a subsidy) there should be no legit concern on a doc's part about getting the money.

But I digress. The main thing I want to know is if there's even any way that doctors would even know that patients got their insurance through ACA exchanges.

Any other tidbits of debate material would be welcome, though.


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Comment Preferences

  •  Tip Jar (10+ / 0-)

    Crap, I just realized how out-of-date my sig is. I'll come up with something else later.

    by Erik the Red on Thu Oct 31, 2013 at 01:40:17 PM PDT

  •  Well, unless these are time traveling doctors, (14+ / 0-)

    they're lying. Or fictional. Or or or! Murdoch has a time-traveling voicemail hacker on his payroll? I bet that's it.

    “OBAMACARE is a disaster. I have already seen denial of medication, denial of referrals,” one doc said.

    Check out my progressive tshirts & gear: or my hand-drawn reproduction of Rachel's Excelsior Poster from Friends available on cards, stickers, curtains etc.

    by Eileen B on Thu Oct 31, 2013 at 01:52:32 PM PDT

  •  Maybe the expanded Medicaid (1+ / 0-)
    Recommended by:

    Medicaid does not pay enough for the doc to keep the doors open.  Costs must be shifted to other payers.

    The commercial policies on the exchanges should be less of a problem for the gut plumbers than the current mess is.

  •  You could spend forever (5+ / 0-)

    Trying to disprove their lies and then they'll move to fling the next one against the wall.

    Republicans: Taking the country back ... to the 19th century

    by yet another liberal on Thu Oct 31, 2013 at 01:55:37 PM PDT

    •  Oh, I know (3+ / 0-)

      This particular issue just stuck out, so I was hoping to get some help with it.

      Besides, it doesn't hurt to get more informed on this complicated law, anyway.

      Crap, I just realized how out-of-date my sig is. I'll come up with something else later.

      by Erik the Red on Thu Oct 31, 2013 at 01:59:56 PM PDT

      [ Parent ]

      •  i agree. i check the post every day... (0+ / 0-)

        cause of the horoscopes and the "horror" scope -- there is an anti-obamacare story EVERY DAY. (yesterday was the LIE headline) if you look at their webpage..." obamacare" is actually a recurring, top of the page topic each and every day. i agree with the author of this diary. i would like to know how to refute these claims. they are getting widespread viewing -- and with that might come traction.

        Change is inevitable. Change for the better is a full-time job. -- Adlai E. Stevenson (GOTV)

        by marzook on Thu Oct 31, 2013 at 07:52:36 PM PDT

        [ Parent ]

  •  There Are Many Conservative Doctors, and (9+ / 0-)

    conservatives routinely lie.

    It's commercial insurance, they'll have the same delightful time getting paid next year as they do this year.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Thu Oct 31, 2013 at 01:55:46 PM PDT

  •  But again, I ask... (4+ / 0-)
    Recommended by:
    suesue, MRA NY, marzook, Tonedevil anyone who can answer:

    Will doctors even know if a patient is using insurance through the healthcare exchanges?

    Crap, I just realized how out-of-date my sig is. I'll come up with something else later.

    by Erik the Red on Thu Oct 31, 2013 at 02:06:58 PM PDT

  •  Partly true and partly not true (6+ / 0-)

    Theoretically, a doctor can tell if a particular insurance plan is an exchange plan.

    If there is a doctor who says he won't accept "Obamacare patients," he or she is probably a moron and should be avoided.  Exchange policies are issued by insurance companies, and if a doctor is in network, he or she must accept the contracted for amount, and if out of network, the prevailing rules regarding payment apply.

    Exchange plans can have limited networks--as can non-exchange plans.  However, limiting a network is a way of reducing cost, so exchange plans probably have more limited networks.  That is a potential problem if a provider you want isn't in network.  In the long run--and particularly when exchanges start offering large group policies (which I think is in 2015 or 2016), the differences will likely narrow.

    "Well, I'm sure I'd feel much worse if I weren't under such heavy sedation..."--David St. Hubbins

    by Old Left Good Left on Thu Oct 31, 2013 at 02:09:18 PM PDT

  •  Some media are reporting a potential problem: (2+ / 0-)
    Recommended by:
    Erik the Red, marzook
    •  Ok, thanks (1+ / 0-)
      Recommended by:

      If these sources give any credence to this particular wingding's claim, I'd rather know than shout "Bullshit!" and be proven wrong.

      Crap, I just realized how out-of-date my sig is. I'll come up with something else later.

      by Erik the Red on Thu Oct 31, 2013 at 02:22:02 PM PDT

      [ Parent ]

      •  It has nothing to do with Obamacare (4+ / 0-)
        Recommended by:
        smrichmond, barbwires, marzook, Mortifyd

        From one of those links:
        "And that's not because their exchanges don't offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states' premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks."

        Hospitals are often affiliated with specific healthcare networks or only work with certain plans.  This has often been the case.  They usually work with each other over emergency/critical care issues, but for anything else, you are almost always routed to an in-plan facility.

        The only impact the exchanges has is that only certain insurers are operating through the exchanges, so if you absolutely want to be able to go to XXX hospital and they don't accept any of the providers offered on the exchange, you're SOL.

        This isn't any different that it was before, however, and it has nothing explicitly to do with Obamacare.

  •  Consumer Reports has a good summary (5+ / 0-)

    Health Reform: Seven Things You Need to Know Now

    Consumer Reports has developed this brief guide to help you understand how the changes brought about by health reform, the Affordable Care Act (ACA) of 2010, will affect you and your family, now and in the future. Providing easy-to understand comparative information to help consumers make the best decisions in the marketplace has been the mission of Consumer Reports .......

    The ACA keeps in place many parts of the existing private insurance system, but it makes other major changes as well. The Supreme Court has ruled on the constitutionality of the law, upholding all but one important part of the legislation.

    Ref. Link:
  •  I can see no way that a doctor would know (3+ / 0-)

    when treating you, that you are covered by an exchange plan per se, nor do I see doctors discriminating on that basis. And what does that even mean? Are they claiming they won't handle people on individual insurance plans? All policies have been affected by ACA.

    Some of them may not become preferred providers in certain plans. No doctor is such for every plan in America.

    Fry, don't be a hero! It's not covered by our health plan!

    by elfling on Thu Oct 31, 2013 at 03:11:07 PM PDT

  •  This blog (2+ / 0-)
    Recommended by:
    True North, marzook

    from the American College of Physicians has interesting articles written by Bob Doherty about the ACA.

    The one dated July 25 talks about the ethics of doctors who oppose the law.  Professional ethics don't require doctors to accept any sort of insurance though.  Obamacare isn't the payer so it isn't clear to me how these New York doctors would identify an exchange policy. The insurance company payer would be a loser and the big ones could conceivably drive a practice out of business if it came to that.  I grew up in New York and I'd expect public pressure on those doctors too.

    If the Post story can't be refuted, it can be countered with this group which takes the opposite position and supports the ACA.

    There is no existence without doubt.

    by Mark Lippman on Thu Oct 31, 2013 at 04:15:14 PM PDT

  •  They won't know if we get ins through exchanges (2+ / 0-)
    Recommended by:
    marzook, Mortifyd

    Insurance as we've all known and loved (loathed) it has not changed.  

    In my state (Washington), I'll be paying my premium to the state exchange, and that exchange will send the premium plus subsidy to the insurance company.  The insurance company'll still pay out just like before.

    Perhaps docs are saying they won't accept new Medicare patients (in states that accepted the Medicare expansion), but the rest of us are still buying private insurance policies.

    Of course, there are always those docs who'll bitch because they're ideologically opposed to "Obamacare", but since the ACA is not and has never been "government-run healthcare", their worries are all in their imagination.

    (aka NobleExperiments). ‎"Those who make a peaceful revolution imposible make a violent revolution inevitable" ~ John F. Kennedy

    by smrichmond on Thu Oct 31, 2013 at 05:17:45 PM PDT

  •  I assume it will work much like Medicare. (2+ / 0-)
    Recommended by:
    smrichmond, marzook

    I am over 65 and my Medicare is through Humana.  Choosing an insurance company is required.

    When I get medical care all they see is my Humana card and my credit card for the copay.  And I assume the Md. sends charges to Humana who then gets reimbursed by Unk. Sam.

    I don't like being forced to use an insurance company.  However a lot of doctors would not take Medicare patients or would limit the number they took.  The way it is now, when I contact a new Md.s office for an appointment they don't know I am on Medicare they only know I have Humana..

    •  you're on a Medicare Advantage plan, right? (0+ / 0-)

      Regular fee-for-service Medicare doesn't (visibly) run through any insurance company.

      The parenthetical (visibly) is because Medicare actually farms out the processing of claims to private-sector contractors. They used to be called Fiscal Intermediaries (for Part A) and Carriers (Part B), but they've now been consolidated under the Medicare Administrative Contractor rubric.

      MACs, and FIs/Carriers before them, are usually health insurance companies, such as Cigna, Noridian, and National Heritage. The MACs don't control reimbursement amounts, but they do have some small influence in interpretation of whether specific procedures are reimbursable. Their medical directors can deny reimbursement, but not on the vast majority of situations.

      Labor is prior to, and independent of, capital. Capital is only the fruit of labor, and could never have existed if labor had not first existed. Labor is the superior of capital, and deserves much the higher consideration. -- K.Marx A.Lincoln

      by N in Seattle on Thu Oct 31, 2013 at 09:50:49 PM PDT

      [ Parent ]

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