@Blickers,
Blickers wrote:Yet I've known people on Medicaid who were referred to a cardiologist for a cardiac catheter. I've known some who spent over a week in the hospital when on Medicaid.
A single referral for a common procedure is one thing. Getting an HMO to authorize multiple referrals when the first specialist failed to diagnose the problem is quite different.
Blickers wrote:How much more are you going to try to push this fantasy that if a patient needs a referral, they don't get one?
The ravages that Medicaid inflicts on the poor is not a fantasy.
Blickers wrote:HMOs and PPOs can be sued for the malpractice of a doctor on their network. But the doctor on the network who refuses to refer a case to the appropriate specialist absolutely is on the hook for malpractice if something bad happens as a refult of lack of referral. So your theory goes out the window.
All I know is HMOs have been denying referrals to people from the day that the first HMO opened for business, and they've been getting away with it.
Blickers wrote:I don't think General Practitioners perform cardiac catheter operations, so my friend on Medicaid must have gotten a referral.
A single referral for a common procedure is one thing. Getting an HMO to authorize multiple referrals when the first specialist failed to diagnose the problem is quite different.
Blickers wrote:You are making stuff up,
No. Medicaid really is a bad deal.
Blickers wrote:if a serious problem comes up from the lack of a referral, the doctor for sure is on the hook for malpractice and the HMO or PPO can be.
I don't know how HMOs get away with denying referrals without being sued. But somehow they do.
PPOs don't deny referrals. People on a PPO can see any specialist they want so long as that specialist is in the network.
Unfortunately Medicaid doesn't have PPOs. It has HMOs (and bad HMOs at that).
Blickers wrote:You are struggling to make it seem that Medicaid is not much different from the Doctors Without Borders physicians who do the best they can to bring modern medicine to impoverished residents of places without electricity or roads.
Not much of a struggle. All I am doing is pointing out facts.
Blickers wrote:Medicaid is a comprehensive modern medical system that works, contrary to what you are claiming.
Well, it doesn't work if you want cosmetics more modern than the 1800s. It doesn't work if you want to avoid unpleasant side effects that are unnecessary. It doesn't work if you have an especially difficult health problem. And it doesn't work if you want to pass an inheritance to your children.
Blickers wrote:Actually, Medicaid is pretty good health care from what I can see, but if you have a plan for improvement, let's hear it.
Give the poor enough money to pay for real insurance.
Blickers wrote:79% of employers offered PPOs in 2010, years before the ACA went into effect.
That doesn't change the fact that the ACA ended traditional insurance (where there were no networks), and forced people who had been on traditional insurance to get a form of insurance where they would be confined to a network.
Blickers wrote:Medicaid does allow necessary cosmetics, it does not allow the deluxe version. Nor do private health care plans, in many cases.
Medicaid allows cosmetics from the 1800s. It does not allow cosmetics from the 20th (or 21st) century.
Private health plans allow cosmetics from the 21st century presuming the cosmetics are cheap.
Blickers wrote:And since your alternative is Trumpcare,which the people being thrown off Medicaid by Trumpcare cannot afford, you are downgrading Medicaid, so that the people being thrown off it won't seem to be losing much.
Well, it's a pretty bad deal that they'll be missing out on.
Blickers wrote:The people I knew on Medicaid had regular visits to the doctor and got referred for various procedures, some of them quite expensive. While everyone knows that all halth care plans prefer generic meds to brand name drugs, I haven't seen any evidence that Medicaid doctors are denying the expensive generic drugs to keep their jobs. And I've known at least one Medicaid patient who got Abilify before it went generic.
Actually Medicaid denies even cheap generics if there is a more ancient alternative with lots of unpleasant side effects that they can force people to endure.
Blickers wrote:Most plans, Medicaid or private, require a case to be made by the prescribing doctor for name brand drugs instead of a generic. What I don't see is any evidence that it takes a long process to get slightly more expensive generics.
The generics that are denied are not necessarily any more expensive at all.
The problem isn't the length of the process. If someone can't come up with a good reason why they can't just put up with unpleasant side effects, the denial comes swiftly.
Blickers wrote:And even if what you said was true, it would still be far better than being thrown off Medicaid and going without treatment because Trumpcare will not be affordable to people who make between $9K and $18K yearly.
I don't know. Seems like a pretty bad scenario either way.
But why not make Trumpcare affordable to the poor?
Blickers wrote:Yes, public hospitals and those connected to universities accept Medicaid.
They may be willing to accept Medicaid, but do the Medicaid HMOs include them in their network?
If an HMO does not have a given hospital in their network, it doesn't matter how willing that hospital is.
Blickers wrote:If you pay more than a 100 percent rebate, you are talking about subsidies, and Trumpcare is supposed to get rid of subsidies.
I am talking about a more than 100% rebate.