Is America Headed to Two Separate and Unequal Healthcare Systems?

Discussion in 'Politics, Religion, Social Issues' started by Southern Dad, May 8, 2014.

  1. Southern Dad macrumors 65816

    Southern Dad

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    #1
    Will concierge doctors bring about a two level medical system in the United States? I thought about this as I wrote out the annual check to my daughter’s pediatrician for membership. Is the future of medicine two levels of care? Concierge Medicine for those that can afford it and waiting rooms for those that are on subsidized plans?

    There are a lot of misconceptions about concierge doctors. While most of them do not take medical insurance, you can usually submit the paid bills to your healthcare insurance company and be reimbursed at the out-of-network levels.

    Concierge doctors don’t want you to be unhappy. They are in competition. There is a less expensive alternative. If you aren’t happy, you won’t continue to pay the annual retainer. These doctors know you on a personal level. It’s not an hour wait, followed by a five minute visit. Many of these will make house calls.

    Are you willing to pay an annual fee to have more access to your doctor? Could this lead to a shortage of doctors taking the ACA?

    Why concierge medicine will get bigger - Marketwatch

    Is Concierge Medicine The Correct Choice For You? - Forbes
     
  2. iBlazed macrumors 68000

    iBlazed

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    The ACA is not an insurance plan. There have always been people willing to pay cash for doctors that don't take insurance. Unfortunately for concierge doctors, it's a pretty small demographic. And it will continue to be small as long as the individual mandate is in place. Why would you pay a doctor when you're paying insurance premiums already anyway?
     
  3. VulchR macrumors 68020

    VulchR

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    Socialised medicine is the way to go. Everybody gets care according to their need, not their wallet. If people pay taxes toward the socialised system, but then want to pay extra for private care then that is fine with me. However, if the rich lobby against the taxes needed to fund an adequate health care system (rather like they do for education), then that is not fine with me.

    At any rate, America already has had a two-tier health care system for ages. Some were sufficiently well off to get insurance or provide for their own care, the rest lived with untreated illness and died ill.
     
  4. iBlazed macrumors 68000

    iBlazed

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    No. And I won't. I have health coverage. I am entitled to see my doctor as I see fit. Why would I need "more access"? What does "more access" even mean? My wait is only 5-10 minutes in the waiting room as it is...
     
  5. Eraserhead macrumors G4

    Eraserhead

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    #5
    I'm sure healthcare has always worked like this...
     
  6. Michael Goff macrumors G3

    Michael Goff

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    #6
    Now there will be a two tiered instead of a three tiered. That's a step in the right direction in my book. ;)
     
  7. Macky-Mac macrumors 68030

    Macky-Mac

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    we've already had two separate and unequal healthcare systems for some time.

    But as for concierge doctors; sure some people who are well off will pay the extra money for the added attention and access, but this isn't something that's going to be affordable for most of the middle class. Concierge doctors will be a niche market, and while that niche will grow some, the potential market is limited.

    No
     
  8. Southern Dad thread starter macrumors 65816

    Southern Dad

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    You are correct, the ACA isn't a healthcare plan but it is a governance of healthcare plans. Many of which are subsidized by the government. My daughter's pediatrician is a concierge doctor. I joined the membership when I found out that 24/7, I would be able to reach him or someone from his office. A friend of mine, was a member, we are getting ready to start our third year of membership.

    The goal of the ACA is to increase the number of people using doctor's offices rather than emergency rooms. This could change that wait time as the doctors load increases. One thing the ACA doesn't do is increase the number of doctors.

    More access, can mean house visits, 24 hour access via telephone.

    ----------

    Why, do you think that it will be unaffordable? The ACA plans have deductibles. The Bronze Plan has a ridiculous deductible. The membership fees range from $1k to $5k. My daughter's pediatrician charges $1200. I don't have to pay anything for routine visits, sick visits or physicals. It's included in that price.
     
  9. Happybunny macrumors 68000

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    Just a question don't you yourself have government subsidised health care?

    If so what is your problem, that somebody else is getting a helping hand from the US government. :confused:
     
  10. rdowns macrumors Penryn

    rdowns

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  11. Southern Dad, May 8, 2014
    Last edited: May 8, 2014

    Southern Dad thread starter macrumors 65816

    Southern Dad

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    $1099 this year. I believe he also has a $99 per month option. The first year, I got a discount, as did the person who referred me.
     
  12. rdowns macrumors Penryn

    rdowns

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    #12

    So $1,100 only for physician visits?
     
  13. Southern Dad thread starter macrumors 65816

    Southern Dad

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    We can reach the doctor by Skype or phone pretty much any time. It works out. My insurance company will reimburse me at the out-of-network rate for some services. It isn't always the best choice but for some it may become a better alternative. My question is if this could lead to two different standards of healthcare in the USA? One for those willing to pay for it and one on socialized medicine (if we ever get there)
     
  14. vrDrew macrumors 65816

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    There have always been (at least) two standards of healthcare in the United States. Rich people, or at least those willing to pay more money, get access to better services and facilities.

    Why this should be a cause for concern for anyone, least of all a conservative, is frankly beyond me. The ACA, despite Republican claims to the contrary, isn't some sort of plot to turn the USA into a Socialist People's Republic. So please don't act all surprised when it doesn't,
     
  15. miloblithe macrumors 68020

    miloblithe

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    #15
    I think this question is misleading because we already have far more than two separate and unequal healthcare systems based around who can afford to pay for what.

    ----------

    Not exactly. That's a theory about what may happen if people have more access to healthcare. Unfortunately, that's not the result seen in the Oregon study:

    http://www.nber.org/oregon/

    The ACA is about increasing access to health care, improving population (and individual) health, and reducing financial risks of ill-health, not about reducing emergency room visits.
     
  16. Macky-Mac, May 8, 2014
    Last edited: May 8, 2014

    Macky-Mac macrumors 68030

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    you've just told us about 75% Americans Living Paycheck-to-Paycheck so where do you think they're going to get the money for the additional cost.

    Your daughter's pediatrician's plan, does it cover anybody in the family besides your daughter? You? Your wife? Does it pay her hospital room or just the doctor's visit? Lab costs? The cost of other doctors and specialists? Prescriptions? Or do you have to pay for those from something other than the pediatrician's plan?

    And it sounds like your daughter is getting a bargain price as other concierge plans run up to $5000 or more. (My former doctor started a plan 12 years ago that cost a minimum of $6000 at the time, and typical of concierge practices it primarily provided convenient access to the doctor)

    So in figuring the cost for your daughter's healthcare, it isn't really just the cost of the pediatric doctor's plan. You also need to add in the cost of additional insurance.
     
  17. Southern Dad thread starter macrumors 65816

    Southern Dad

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    #17
    If you take the ACA Bronze Plan, you have to come out of pocket for the $5k deductible and the 30% copay. If you take the Silver you've got $3k. Healthcare isn't free.
     
  18. bradl macrumors 68040

    bradl

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    The bold is the problem. Especially, because we see how wonderful it works in other places around the world, and that people don't have to pay a bloody cent for it. The UK is doing great with theirs. Australia is as well.

    We're one of the few countries that thinks that healthcare should be a business to make money off of, when without our health, we wouldn't be alive to make money at all. That is really sad.

    But to answer the question in the title of the thread: I would say no, because the moment that happens, expect one healthcare system to sue the other because of segregation, citing Brown v. Board of Education as precedence. ;) :rolleyes:

    BL.
     
  19. rdowns macrumors Penryn

    rdowns

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    #19


    [​IMG]
     
  20. Southern Dad thread starter macrumors 65816

    Southern Dad

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    What are the tax rates in those countries? Does everyone pay? How is the healthcare? Canada has a wonderful plan from what I hear but Pennsylvania has more MRI machines than their whole country. Here is a side concern… In a single payer system who do the lawyers sue?
     
  21. Macky-Mac macrumors 68030

    Macky-Mac

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    yes but the ACA Bronze Plan also covers all those other costs that your child's pediatrician's concierge plan doesn't cover.

    the average daily cost of a hospital stay for a child aged 1 to 17 was $8,200 in 2010.....your pediatrician's concierge plan only covers the cost of the pediatrician's visits, so you're going to be paying those deductibles and co-pays for all the rest as well.....or ALL of it if you don't also have insurance that covers it....as you say, healthcare isn't free.

    The reality is that you're going to have to provide healthcare insurance coverage for your daughter anyway (even if the bulk of it is paid by your employer)
     
  22. bradl macrumors 68040

    bradl

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    #22
    http://en.wikipedia.org/wiki/Health_care_in_Australia

    So 1.5% tax on the people for free healthcare, and well above the US on quality of care, pre-ACA, post-ACA, or otherwise.

    BL.
     
  23. thekev macrumors 604

    thekev

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    #23
    Australia's system is a bit more complex than that. They pay a fine if they don't purchase a basic level of private insurance over a certain age and make over a certain annual amount. Private insurance also cuts wait times on certain things, but it still works out better than what we have here.
     
  24. miloblithe macrumors 68020

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    What's the optimum number of MRI scanners per capita? Canada has 4.6 per million people. The U.S. has 19.5. I'd wager the ideal number is somewhere in between (in terms of cost benefit compared to other things that money could be spent on).

    http://en.wikipedia.org/wiki/Comparison_of_the_health_care_systems_in_Canada_and_the_United_States

    That last line is key there. If 30% are unnecessary in Canada, what percentage do you think are unnecessary in the U.S?

    MRIs and CT scans can be life saving if they provide useful information, but they are always expensive and CT scans result in effective radiation dose from 2 to 10 mSv.
     
  25. FreemanW, May 8, 2014
    Last edited: May 8, 2014

    FreemanW macrumors 6502

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    #25
    SD, you truly are indefatigable when it comes to defending the indefensible.

    Spectacular!

    You are at once, the Black Knight standing on his own stumps, not a leg to stand on, while yelling, "it's only a silly squirrel rabbit!"

    Thanks for the laughs. ;)
     

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