|
Post by safetildecember on Oct 18, 2009 19:41:13 GMT -4
Makes sense. Thanks for the enlightenment. For the record, I am in no way for the Obama Healthcare Plan.
|
|
|
Post by stephadele on Oct 19, 2009 9:08:45 GMT -4
falgar...This is the myth of managed care...You dont really have much of a choice because they all operate the same way and your change from one plan to another doesnt matter...If you choose from one to another, they will all still jack up your premiums and deny you care while they make a profit...It can look good for the first 6 months or so...Then before you know it, you are changing from plan to plan to avoid the inevitable.....Ive worked with over 20 managed care companies over 20 years and they all work the same way ...They all took turns being on the hot seat....Their aim is to ration and deny you care so they can make profits.....they are just very good at hiding that fact from the public.. Their reimbursements were all pretty similar for providers also so any problems with beaurocracies and wait times will just follow you from one plan to another....They use selling tactics to bait and switch, make things look appealing, and throw the public off into thinking they are getting something better than what you switched from.. Providers could drop out of managed healthcare plans but then they would be hard pressed to find many referrals since most people are on some kind of managed care plan...It would be very difficult to have any kind of part time private practice much less a full time private practice...I did have a private practice several years ago where I bypassed managed care but it was very small part time and very difficult to get referrals as most people want to use their health insurance and not pay out of pocket...And my rates were very reasonable, about 10 dollars more than what I was forced to make under managed care....Benefits were they were given 100% confidentiality and my ability to speak with them freely inbetween sessions for outside referrals and crisis calls.....One cant make a living doing that..You are also competing with other healthcare providers who use managed care and have more clients available to them... Which brings up another point...FFS clinician arent really independent contractors if they work with managed care because then they dont set their own rates....Managed care determines what your reimbursement will be...Its usually about 3/70, with 30% of what the client pays going to you the provider and 70% going to the managed care company.
Accepting to see providers at a lower cost has its disadvantages....First of all, most of your money is going to managed care, not the provider......Underpaying providers makes them overbook and cause problems with you the consumer getting appointments...Since underpaid providers have to book clients every hour, all paperwork and phone calls you need must be done in session..That means your session time for mental health providers is cut short because of administrative work...In private practice without managed care, the provider can do this outside of your session since she controls her schedule and doesnt need to overbook appointments because of low reimbursement...making her available to return your phone calls and find other resources and services you may need.....If you are under a managed care plan and are suicidal or your family is in crisis, you will be hard pressed to find your provider is available to speak with you immediately....You often have to wait several hours or even days if you provider isnt working that day.....Better off going to the ER...And we all know that jacks up their prices there as well as over clogging the wait rooms.....This is very bad healthcare for the vets of wars and their families as well as people who have experienced trauma in car accidents, post 9/11 trauma, fires, rapes, natural disasters......In short, managed care may look like cheaper care for the consumer upfront in terms of initial fees but also results in lower quality care for the consumer. Lastly, your healthcare decisions under managed care are made by an administrator, not your provider....They always have the final say in healthcare and they can quickly ration and nix any treatments you or your doctor may want to try....My decisions as a healthcare provider were frequently monitored and nixed if they were not deemed "medically neccessary" to an untrained paperpusher......I had to watch while managed care refused critical services for clients only to have them deteriorate and get worse, then making it MORE expensive to seek out an emergency care for them, passing this expense down to you the consumer by increasing your premiums...In other words, you also pay for their mistakes.....Your doctor has to get permission from managed care to authorize the best and newest medications, tests, equiptment, social services when you are homebound....Do you really want your healthcare decisions made by a administrator instead of your licensed and credentialed provider just because it "looks" cheaper upfront? Would you hire an accountant to fix your car?
Im all for small businesses thriving.....My father was a small business owner for 50 years, selling truck parts.....I owned my own small private practice business before the power of managed care nixed that....This isnt like buying a car or truck or AC where one just loses money on a bad deal and looks elsewhere for a better one...They have no business playing with peoples lives like that...Id have to question the loyalty of some here towards local small businesses if they so readily support giant corporation managed care companies such as Kaiser, Cigna and BCBS and giant pharm companies like Glaxo Smith Klein and Pfizer that are located hundreds , even thousands of miles from them....
|
|