A fee-for-service (FFS) system, as is commonly used in the Medicare program, pays caregivers fixed amounts for each service provided to patients. According to the Congressional Budget Office, doctors and hospitals in Medicare’s FFS program have little or no financial incentive "to deliver care in an efficient, cost-effective manner." As Urban Institute economist Stephen Zuckerman said, under FFS "the incentives to over-provide services can be very strong." So "there is definitely interest in moving away from unbridled FFS as it currently exists." Congressional Democrats are proposing ways of paying for quality — rather than quantity— of care. What do you think?
The insurance overhaul may end fee-for-service care so doctors get a fixed salary from the government.
Wed Oct 21, 2009 1:31 PM EDT
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The insurance overhaul may end fee-for-service care so doctors get a fixed salary from the government.
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A salary instead of fee service? Would save millions, even billions by eliminating the review process that blocks docs from actually doing medically necessary treatment. So how about if it becomes fact?
SO..How much is that aspirin going to actually cost...I know first hand from a medical professional in my extended family that an aspirin dispensed in the ER gets the hospital around $200.
Take that line item bill with the $200 aspirin charge right into the CEO's office and demand an explanation! Truth is that while many items on the inpatient' bill are astonishingly priced - YOU, the patient, can get ridiculous charges expunged. Remember - pricing is based on whatever the market will bear.
The problem with the outrageous over charges for example "aspirin" is that usually a loved one or close friend ends up spending a lot of time making phone calls during working hours to get the charge reduced. If they are employed, that means wasting their employer's time by making personal phone calls.
With insurance companies taking their cut of 31% of premiums of the top, over testing and over prescribing by physicians, and over charging by drug manufacturers and hospitals, it's no wonder that the US pays twice as much per capita for health care as any other industrialized nation. Most nations with a REAL healthcare system, addressing the needs of ALL of it's citizens, have a single payer system is far superior to the insurance-run, profit driven health care system that Americans are plagued with. I have experience with both the US insurance run system andr the Canadian single payer system and the Canadian single payer health care system is far superior to thr insurance run US System. Every Canadian has access to a physician, while only 64% of Americans have the same access to a physician that Canadians have. Canadian physicians are paid on a fee for service basis, thus the Canadian system is NOT socialized medicine, physicians are in private practise and paid on a fee for service basis. Giving physicans a salary as opposed to a fee for service basis,m as with DOD and DVA in the US make it a socialized medicine system, which is what all these anti reform Republican politicians rely on for their treatment and surgery. All these Republican health reform obstructionists go to DVA and DOD hospitals, not for profit hospitals, for treatment and surgery.
At what cost. please look up what percent of their taxes are paid in for health care. I know it varies from province to province but its around 10% and some places more then that. If we go there I will be paying close to 45% of my wages to the government. If that happens my child will not go to college and I will not tolerate that and support that. My children come long before government forced charity. My children are more important to me then a drug addict on the streets of Chicago who has no health insurance. My child has a chance the drug addict is just another wasted and lost soul and deserves everything he has manifested unto himself. You don't pour water into a bucket with a hole in it and keep pouring water in and wonder why it keeps running out.
You think the only people who don't have insurance are drug addicts? Not to mention your total lack of understanding of addiction, which you may face with YOUR children one day, it happens to every faction of society, including normal middle class families and the rich. And one day it will be YOUR child unable to get insurance if we continue down the path we are currently on. If you knew anything at all about other countries with national health care you would not be so quick to believe the lies out there. By the way, those taxes in other countries also allow most of their citizens to GO to college. We TALK about "family values", but other countries actually LIVE them.
Holy Cow! I know the system could use fixing but do we really want the Soviet Union's health care system?
You're staking your life on an insurance company bureaucrat not rationing your care for profit. That's the worst case scenario. Having an insurance company bureaucrat decide if you live or die sounds like Soviet Union health care to me.
The difference between Soviet Era care and Insurance care is YOU actually can make a choice of who covers you IF you don't just cover yourself! Why depend on a government who cant maintain Medicare without 60 billion in fraud?
ALSO, insurance providers generally have anywhere from 2-6% profit margin. That isnt a HUGE margin. Heck, I know our margin's are a LOT higher then that for the work we do.
I am one of the evil doctors, so I realize that my opinions don't count for much. That being said, government involvement should frighten us all. This entire charade will lead to one thing - the government running health care. The "public option" is the way for this to happen. Supporters of this say that it is a way to drive down costs of insurance, but it is much more than that. It is a way to drive the insurance companies out of business. It is foolish to think otherwise. After all, how can a company compete with the government when the government can treat us as a piggy bank, taking whatever percentage of our income they see fit to fund their ideology?
Once they have driven their competition out of business, then they will move on to limiting compensation for health care providers. Since Obama rode class warfare into the White House, this seems obvious to me. Despite the debt I have incurred in my training, the hours I spend away from my family, the time I spend worrying about frivolous lawsuits, and the time I spend caring for and worrying about my patients, I have learned that a lot of people feel I do not deserve my salary. Or, even if I do deserve it, I deserve to be taxed at an ever-increasing rate so that the "working families" do not have to pay for their entitlements. This is what a lot of people see as fair.
My only warning is this - if my compensation goes down, and my taxes continue to go up, I will not work twice as hard for half as much. And I am not alone. You may have "free", government health insurance, but it will not do you much good when all of the doctors in this country cut back to a 40 hour work week. No more late appointments, returning phone calls at all hours of the day, stopping by patients' homes after clinic to check on them (which I still do), or squeezing people into an already cramped schedule so that they do not have to wait for care. If that is your idea of an ideal health care system, let Obama have his way. But hey, at least that will close that income gap, which is what Obama and his socialist friends want more than anything. I love my job, but it is a lot of work. I can justify the time away from my family, so long as I can provide a good life for them. Take that away, however, and you will soon find that there is no one willing to go into the field anymore. What good will your "free" insurance be then?
Well said. Hope people actually hear what you are saying and think about the consequences of the future. Thank you for saying what so many are just not seeing.
do you understand that socialism is for the rich in america and democracy free-enterprise is for the rest of us? what is wrong with providing universal healthcare to all americans? why can't we get the level of care that is offered in other,less prosperous countries? why should there be a profit motive in healthcare? americans are truely not free unless we have universal healthcare.
AMEN!!
r
To joe paraceratherium
I am one of the evil doctors, so I realize that my opinions don't count for much.
Self-deprecating sarcasm is a strangely dubious way to begin one’s defense anad is unlikely to elicit much sympathy.
That being said, government involvement should frighten us all.
It doesn’t scare most patients who now are turned away from doctors’ offices for lack of medical insurance or money to pay directly. What scares them is the possibility that even though they are in physical distress, they are told they are not “entitled” to care and may get a lot more ill.
This entire charade will lead to one thing - the government running health care.
No, Doctor, this is not a charade, it is the genuine reaction of people bringing home as little as $1,500 per month being told that they are not good enough to have health care unless they “pay” out more than half of their income to health care providers, whether directly or through health insurance, more like blackmail than a charade.
The "public option" is the way for this to happen.
Not necessarily. All the public wants is reasonably priced access to being medically cared for when necessary, and if that be a public option, so be it..
Supporters of this say that it is a way to drive down costs of insurance, but it is much more than that. It is a way to drive the insurance companies out of business.
We have a triangular system [hospitals, doctors and insurance companies] with each segment justifying raising their prices unchecked to try to stay ahead of the other two financially benefit themselves. If the insurance company segment of the triangle is the first to go, the other two will fall into line.
It is foolish to think otherwise.
I do not believe I or my colleagues are fools.
After all, how can a company compete with the government when the government can treat us as a piggy bank, taking whatever percentage of our income they see fit to fund their ideology?
How do you like having the shoe on the other foot, Doctor? Imagine that dirty public deciding how much your services are worth, you know, like they do for policemen, firemen, etc.?
Once they have driven their competition out of business, then they will move on to limiting compensation for health care providers.
Oh, no. Imagine taking that blank checkbook away from medical providers?
Since Obama rode class warfare into the White House, this seems obvious to me.
Class warfare! Finally you’ve got it! Imagine that you sacred “class” making ten or twenty times as much money as your child’s teacher be threatened. How classless of us!
Despite the debt I have incurred in my training, the hours I spend away from my family, the time I spend worrying about frivolous lawsuits, and the time I spend caring for and worrying about my patients, I have learned that a lot of people feel I do not deserve my salary.
You’re on a salary? How much? Lawsuits? Your insurance company takes care of that, just like, you know, our auto insurance companies do.
Or, even if I do deserve it, I deserve to be taxed at an ever-increasing rate so that the "working families" do not have to pay for their entitlements.
. . . “working families” do not have to pay for their entitlements? What on earth does that mean? To what “entitlements” are you referring. You don’t make any sense to me on this one.
This is what a lot of people see as fair.
Yes, doctor. It is fair. Sorry about that. When over 75% of an AMA national meeting addressed tax sheltered investments for physicians’ investment, yes, it is fair that we don’t think this is fair.
My only warning is this - if my compensation goes down, and my taxes continue to go up, I will not work twice as hard for half as much.
We’ll miss you, dear doctor.
And I am not alone. You may have "free", government health insurance, but it will not do you much good when all of the doctors in this country cut back to a 40 hour work week.
Not “free” government health insurance, just insurance at an affordable price. A 40-hour work week? Just how much do you make (bill) per hour? It would really bring you down in “class” if you were to be paid ONLY $200 per hour, now wouldn’t it. Poor baby.
No more late appointments, returning phone calls at all hours of the day, stopping by patients' homes after clinic to check on them (which I still do), or squeezing people into an already cramped schedule so that they do not have to wait for care.
Do you practice in the USA?
If that is your idea of an ideal health care system, let Obama have his way. But hey, at least that will close that income gap, which is what Obama and his socialist friends want more than anything.
Equity is a terrible thing to experience in a time of deep recession when so many have lost their insurance coverage, isn’t it? Imagine having to squeeze your belt in too.
I love my job, but it is a lot of work.
Your children/grandchildren’s teachers, your mechanic, your wife’s housekeeper also have to do “a lot of work.”
I can justify the time away from my family, so long as I can provide a good life for them.
Have you decided to be a long distance truck driver? A fireman? A bridge inspector in all 48 states?
Take that away, however, and you will soon find that there is no one willing to go into the field anymore.
Long distance truck drivers seem very grateful to have their work and wages and don’t expect anything for free, just like firemen and bridge inspectors, none of whom make a paltry $200 per hour.
What good will your "free" insurance be then?
My guess is that it will be so refreshing to be treated by doctors, who are truly devoted to their patients and not only their wallets, you know, like the dedicated doctors who are on staff at the public hospitals where good medical care is their only motivation.
Joe, thank you for being the Dr. you are. I believe that you work hard and have been smart leveraging your skills to provide a good living for your family. I believe that is the American Dream. We are also living that dream even though my husband is not a Dr. If we are still allowed to live that dream, people like us would pay you to take care of us outside of the public system because other than yearly exams/screenings/vaccinations, we only go to the Dr. when we absolutely need to ex. abraded cornea, diverticulitis, strep, broken bones, torn ligaments and we wouldn't be willing to wait for months to get fit into someone's schedule to get antibiotics, bones set, or physical therapy we would be willing to pay more to be seen sooner.
RN-My husband paid for his college degree entirely on his own and worked his A-- off by putting in 60+hours/week EVERY week for over 20 years (even while we were supposed to be on vacation). The democracy free-enterprise system worked for us. Now we are considered rich and "everything was just a gift". And no, we have never made a million dollars in one year, nor has his company gotten a bailout from anyone. But yes we will be paying more in taxes or a lot less in taxes because he won't be ALLOWED to make more than 20% of our current income. All so that someone who I've never met can get unlimited 24/7 private nursing care needed for a disease that should have killed them years ago, hasn't yet. If I had the same disease, my cure would be a pine box buried 6ft in the ground.
Just be aware that in order for people to take risks there has to be some reward. Other countries are perfectly willing for us to take all the risk and refuse to pay any reward. You can't tell me that the medication that I have taken for 20+ years now costs 5x's as much to manufacture (when the generic costs about what I was paying for the name-brand then). The companies have to pay for R&D somehow. One reason U.S. health care is so expensive is because the other countries aren't willing to pay up to develop new treatments and drugs - plain and simple. We have been subsidizing universal healthcare for the rest of these other less prosperous countries. A profit motive absolutely has a role in healthcare otherwise there will be little (if any) viable innovation.
Amen to that! I think you deserve every penny if it will help to keep the best and the brightest in the field. Since when did compassion mean you have to forgo compensation?
Just and Lucia - Also a medical provider for nigh these 30 years, I agree with you and with Joe, (doc dinotopia {(:->)}
All of this began in my dad's era of physicians and surgeons. Those guys (dad and his colleague surgeons 1960s-late seventies) were literally the Kings of their day. They did superlative surgery and their patients were completely enamored of them. People used to stop my mother in the A&P and stare at her, saying, ".....you are HIS wife?"...He SAVED my LIFE! God Bless him - and your family!" Seriously, these were guys who did it ALL. They had very lucrative practices and were their OWN bosses. There were NO case managers or case managers hovering over their treatment plans. Whatever they wanted for their patients is what their patients GOT. No bean counters told them 'yes' or 'no' vis a vis the surgery they planned to do for Mr. Hotcholey or Ms. Ouchygut. The hospital admin types practically genuflected before them because as surgeons, they brought in the ca$h. They charged what they deemed fit (once they all agreed with each other) but often charged a pittance to an inpoverished patient and much more to the patient known to have Big $$$. No, it was not 'fair', and YES, they took big gifts from big pharma (not called that back then) which included tickets to the circus at MSG or to the live 'Wonderama" audience on Sunday mornings in the city for rxing placidyl AND paid trips to Vegas for he and mom to see Frank Sinatra at the Sands for four days (I didn't care for those, got left home with sibs) and lots of other freebie stuff which now relegated to medical history. Their names were well known and they were skilled practitioners of surgery. BUT they didn't have any bosses or regulators. Nor were their offices ever robbed by street junkies. They were a tight group and they protected each other from slander. But EVERY Sat. AM my dad would take me on his rounds, explaining medical diagnoses and surgical plans as he would sit in his pts' rooms while he chatted with them and their families and their lives (since he knew them all) and would then leave me in the hosp. library while he and his fellows attended their M&M meeting. There they'd would rip each other new excretory pathways for any surgical errors. No non surgeon EVER attended those meetings because these guys were vicious when ANY of their membership goofed. Mind you - this info would never leave the room - but God help the guy who left a sponge in their pt.s belly, or had too many post op infections, or worse, had a post op demise related to the surgery itself. They would NOT soon get over the censure of their fellow surgeons. These macho men (seriously) didn't have to deal with the ICD-9 or ICD-10 now dreaded by one and all. There were no modifiers or bundling of services. These guys did house calls ALL THE TIME and never thought twice about getting called away from family dinner or add ons to the OR sked because it was WHAT THEY DID. Excessive regulations changed everything in the late 80s with DRG and in the 90s with managed care and 'gatekeeping' HMOs. The excessive wealth of the last generation of physicians and surgeons IS still, however, what today's patient population STILL things is the norm. They do NOT realize how vastly the life of physician/surgeons has changed (for the worse) compared to dad's. So remember this when you discuss current practice constraints with your patients or patients in general. They are not seeing the forest for the trees. For many of them - our lives are still locked in 1960s-70s and early 80s standards. So while I have made an honest effort to clear the air here on Newsvine vis a vis the DIFFERENCE, I have found the battle to be in vain. For this and other reasons - we are not seen in the clear light of day here. Better off to stay on Medpage, journals of our specialties, Sermo, and the like. I appreciate your efforts to explain, nonetheless.
@Betz:
Really? So, ~155 million people are turned away from doctors' offices throughout the country, huh?
Depends on the set-up... either way, most doctors are responsible for carrying hundreds of thousands, if not millions of dollars in personal liability insurance, which means they pay for their premiums.
Completely ridiculous comparison... none of the above listed professions require anything like the level of education or training that being a doctor requires, even more so if they are any sort of specialist. Furthermore, almost everyone with the inclination could be a truck driver, etc. ... but not everyone with the inclination could be a doctor, or a specialist.
Again, another ignorant assumption on your behalf... living around D.C. I know a number of med-school students... and every single one of them that I know list the potential income as one of their top reasons for career choice... that aside, even private practice doctors are concerned about their patients well-being... or I'd guess they would have become lawyers...
Look, I think there will be less doctors, and medial support people once the money making is taken out of the equation. (I also doubt better care will come with it) In a utopian world it would great that only people that want to be caregivers go into the medical field. But that's not the way of the world. It costs a lot of money to become a doctor and that's because there should be a big payoff if you are a good doctor. Do you think brain surgeons are not well paid?
Money! that's what this is all about. People want free health care... Ummm no that's not possible. It costs money to fix people. It costs money to run a hosipital. It costs money to pay someone to change a bedpan.
I would like affordable health care... not free healthcare. Do you know how much bad debt hospitals write down a year? It costs a lot to care for people who will never have money to pay for service. I beleive in careing for others but where do you draw the line as a state? You can't afford to pay for everyone's care. Can you?
I guess you could take some of the profit out of making drugs... some of the profit out of other medical device makers... but in the end that's going to cause more people to loose thier job... and that's no fix.
I don't think this would be as big a problem as it is if basic stuff didn't cost so much. Houses are too expensive then they should be. Cars are way to expensive then they need to be. Food is more then it should be. With all those basic needs taken into equation you'r going to have a problem paying for medial costs.
Work on that rather then just medial costs. Get people jobs. Help create new things that make jobs. that's what we need to do. This cost cutting is the same as companies have been doing for the last two years.. cost savings don't cause growth.
Maybe find some ways to make people more fit and healthy. Work on taking things out of the air and water that make us all sick. Make fast food make healthy food that is cheap and make the unhealthy food more expensive. Force people to do good things for their bodies that cost less.
I think if we impose salaries on doctors, we should impose fixed salaries on ALL professionals and ALL other workers. Real estate agents, car repairmen, salesmen, bankers, investors, stock brokers, plumbers, electricians, lawyers, corporate officers, etc....everyone should share in the new system of fixed salaries that disregards the kinds and quality of services provided. I do not believe that in our society, doctors should be singled out to be the only ones who cannot be paid fairly according to their education, training, experience, and services provided. The last time that the wealthy, intellectual "elite" were singled out for persecution was under nazi germany....
healthcare professionals with direct patient contact are not the cause of out of control healthcare costs. It is the administrative costs and all the other hanger-ons in healthcare that has driven up the cost. It is the business of healthcare that has driven up the costs. healthcare is not suppose to be a business. the emphasis is not suppose to be profit but patient care and a healthy populace
When fee for service was introduced, it was viewed as a means of improving the pay of doctors, which it was. The problem is that it became a monster: I am told that currently there are some 4 milion people working on billing. There are major billing companies with a huge and well paid administration I get everyday in the e-mail information on what codes to use to get a better payback. There are College degrees in billing. And I las when they are allowed to bill and tnreaten a poor citizen for three times what they would get from an Insurance company. And beware of their mistakes, because you and not they will have to pay for the consequences. These people are parasites of the medical system. Their beaurocracy is so large that it would put to shame any government system.
well said, joan304175
Lets not have an ins company, but a govt bureaucrat making medical decision on our behalf! Be careful what you ask for. Oh, and insurance cos taking their 30% right off the top. You have no idea what you are talking about
healthcare professionals will make the healthcare decisions they are trained to make - not MBAs and accountants
Fixed salaries for all professionals? What for? All anyone needs is a roof, food, water, and clothes. You will be required to provide the essential services the government declares are necessary, and in return the government will provide you the essentials of life. Worked just fine in the Soviet Union for 60-70 years.
The government already provides food stamps, low and no income housing, and possibly unlimited unemployment (insurance-ha ha) payments, now free health care. Why would anyone need to work at all? What's the incentive, when I can go to the beach every day? You folks who live in the snow belt need to move further south, like me.
The Reid-Pelosi proposals are not health care reform. Read it. They're not reforming health care at all. This is health insurance reform. The actual costs of healthcare will keep going up, and in fact the Senate just repealed the Medicare savings bill passed by Bill Clinton. This is the Democrats plan. Barney Franks has said it. They want the system to fail in 10-30 years so they can go to government imposed price controls.
My Doctors have expressed great concern over having to accept a salary instead of running their own businesses.
If all claims went to one source with one set of billing rules, Drs. could cut down on paperwork and staff==Money saved. Problems with hiring and firing, benefits for the extra employees, personality problems, etc. would also be cut back.
One pay would level the playing field. A GP has to know a little bit about everything, yet gets less insurance reimbursement than a specialist.
We have been under supply and demand for ever, but that was back when it took a wagon train thirty days or more to go across country. ( Not anymore ). Hospitals for profit should never have happened. Hospitals should be made to lower their GREED and charge more reasonable prices. Doctors should be made to charge more reasonable prices also. Insurance company's should also be made to lower prices. Some Hospital's, Doctors, and insurance co. will threaten to close their doors, let them. Than maybe more reasonable people will step up and reopen under better conditions. All charges from hospital and doctors to insurance companies should go through a review board if challenged my the patent. We are the best country on this planet but a lot of places don't like us because of what they see as our greed. I served this country as a young man and I am prould of it, and GOD BLESS our young troops that are in the thick of it so this country can remain the best there is. Health care has to get better but it will take us all to fix it and take away greed. I have more to say but maybe I will take it up later if this great country is willing to work for it. Thanks
Larry I will never understand why anyone single person believes they should be able to decide what one persons services is worth. You and I and anybody else do not have that right. If you don't like what they are charging find somebody cheaper but I'll take my chances with somebody who is motivated to help me because they are being compensated for their services.
Oh, so anything the government decides is an essential service should be provided at the price the government dictates. Today it's doctors and nurses. Tomorrow it's farmers. Next it's landlords. Then construction workers, then power companies, then coal miners. We've seen the results of that thinking. That's why our profit-motivated farmers had to sell the Soviet Union and now North Viet Nam wheat year after year to prevent mass starvation.
Not even mainland China believes in that kind of government control any more, only loons like Kim Jong Il.
In Europa many have a card with a chip. With a few simplified codes, it determines the payment due, any copays and completes the fee-for-service billing on the spot, without the billing office of the doctor (with more billers than doctors), without the billing company to which the doctor subscribes for good money, without the counter-billing bureaucracy of the insurance and certainly without the many medical collection agencies with their threats and insults. The doctor does get a reasonable fee-for service and there is no need to pay a salary to everybody.
May I also suggest that somebody checks the salaries of non-profit hospital directors and the cost of the administration? One could save many milions without cutting services to the patients or payment to the doctors. Just get rid of parasites!
So your saying hospitals don't need administrators. Good to know DA!
What happened to our health care?? Doctors & Nurses went into Medical practice because they wanted to HELP the sick get better. They did not go into the field because they wanted to get rich. They usually earned a respectable salary but it was not the main reason for becoming a Doctor or Nurse. Just like Teachers, the Military, Social workers, Firemen, and Policemen these professions were suppose go into those fields because the person wanted to better thier community and help or protect its fellow citizens. Now everyone is just after the dollar. The respect given to these professionals was also greatly valued, but now that respect has been taken in wake of the fact that they sometimes provide thier services only because they want to make extensive $$$ at no thougt how this has affected those they are suppose to help. How can Medicine or the Health Care help if one cannot afford it, so many do without or wait too long. The insurance companies also deny care in a timely manner thus treatment is provided at a higher cost because of the delays. What ever is passed should be mandatory for our dear Government represenatives no more that the general puplic can receive or afford, since we pay for thier health care package.
There's more money wasted on government (un)supervised insurance fraud than there is profit in all the private health insurance companies combined.
Last night's 60 Minutes says there's $60 Billion of fraud in Medicare alone, and Medicare only spends 25-30 cents of every health care dollar in the U.S. The top 13 private insurance companies combined only made $33 Billion in profit (from CNNMoney), and maybe another $1 Billion on CEO and executive pay.
The Reuters story this morning says that wellness programs might only save $30-$50 Billion a year.
The proposed health insurance reform bills, with or without the 'public option,' will not save nearly as much as just eliminating the fraud in Medicare, SCHIP and other government programs. Politicians don't have to upset their constituents the way they are doing if their goal is to save money and cover all Americans, just reform existing programs. Either they don't see this publicly available information, or savings and universal coverage aren't their goals. Perhaps taking over the health care system is their real goal.
One thing that could help is to remove the doctor get's sued thing... Make it a hell of a lot harder to sue the hospital and doctor. (you still need to have a system to catch bad doctor's) but it's got to be something other then someone getting a huge payout.
The more you can do to remove the Insurance racket from medicine the better off we all will be.
Betz: WELL SAID!!!! I know my doctor allots 10-15 minutes per patient, so that means he makes approximately $784-980 per hour!
First time I saw him= 10 minutes $196.00!! And that was just a first consultation. We have such a high deductible that ALL of this is owed by me. I can't afford it! I'm supposed to see him every three months, and blood work every 3 months. I begged him to let me only have to see him twice a year because I just can't afford his fees, he lets me do this as long as I do my labs every 3 months.
This just makes me sick. SOMETHING does need to be done to get the greedy insurance companes out of our pockets, but FORCING us to buy into THEIR program or get FINED is ludicrous to say the least.
HOW can they enforce this? People that live on $684 a month Social Security won't be able to pay into this or afford to pay a huge fine, plus their Medicare will be cut back? GIVE ME A FREAKING BREAK!!!! People that are homeless won't be able to do either, what do they intend to do with those that do not have the money? Prison camps?
Why can't they just ORDER the insurance companies to stop ROBBING us and to STOP denying us coverage and to STOP making us pay astronomical deductibles!!!! ORDER them to go back to when we only had to pay $46 a month for two people and $20 co-pays and low prescripion costs.
FORCE everyone in Government to have to do what the rest of us have to do also.
The Government needs to STAY OUT OF OUR POCKETS also and QUIT QUIT QUIT telling us what we can and cannot do. QUIT taking our FREEDOMS away, i.e., smoking bans in bars for instance. It's NONE OF THEIR BUSINESS. Federal or State.!!!!!!!! AND to QUIT TAXING US TO DEATH!!!