The Villages Health Care System

[Chinook]

I'm really disappointed in the Villages. I moved here with good insurance, but I'm not 65 yet. The villages developed this wonderful health care clinic system and they only take ONE insurance and that is a Medicare Advantage Plan. ONE insurance. How nice for the rest of us that are not 65 or are 65 and do not want an HMO Medicare plan which is what it is. I know they make a bundle of money taking the capitation from the only plan they accept but the system they developed is only accessible to a few villagers. What do Villagers think about this "Villages Health Care system"?
Can anybody recommend a good family or internal medicine primary doctor?

Disappointed Villager

[Avista]

Have you been to the Medicare store in Sumter? Get your questions answered.

[vlm790]

I am 55 and I have BC/BS and they accept it.

[graciegirl]

I'm really disappointed in the Villages. I moved here with good insurance, but I'm not 65 yet. The villages developed this wonderful health care clinic system and they only take ONE insurance and that is a Medicare Advantage Plan. ONE insurance. How nice for the rest of us that are not 65 or are 65 and do not want an HMO Medicare plan which is what it is. I know they make a bundle of money taking the capitation from the only plan they accept but the system they developed is only accessible to a few villagers. What do Villagers think about this "Villages Health Care system"?
Can anybody recommend a good family or internal medicine primary doctor?

Disappointed Villager



Yeah. We can't have everything we want sometimes.




Here is a list of doctors and health care folks we see and find to be good;


Dr. Felix Agbo PCP
Dr. Judith Milstead ENT
Dr. Hamilton Fish, Endocrinologist
Dr. Caspar, Dermatologist
Dr. Han, Gastroenterologist
Drs, Rosario and Caylor, Oral Surgeons
Dr. Alex Ghazal, Endodontist
Dr. Wu, Podiatrist
Drs. Jabar and Williams, Dentists
Lake Imaging, Mammography and other imaging.
Publix, Flu Shots and Pharmacy.

[sirknor]

I really like The Villages Health. We got in at the start.Their are many health care providers in the area. Like any other city you need to find a provider that takes your insurance.

[billybye]

No need to be upset if your insurance is not accepted at Village Health.
The BEST doctors in this area are not in their system. Look around, TV area has plenty of excellent doctors, and they also do not rush you through an appointment.

[John_W]

Have you tried Premier Medical? They had a full page ad in today's Sun newspaper. My wife used them for 4 years when we came here. They have two locations, one at Lake Sumter and one on Santa Barbara by the hospital. That second location also has an urgent care and lab. Here's their website Premier Medical Associates (http://pma-physicians.com/)

http://pma-physicians.com/pmaphysicians/wp-content/uploads/2013/11/SBB_HOME.jpg

http://pma-physicians.com/pmaphysicians/wp-content/uploads/2013/11/LSL-Exterior-Home.jpg

[NotGolfer]

Could this be an example of "you can keep your insurance and also your doctors"? Folks all over the country (I know some of them) are not getting the care and coverages they'd been promised. SOME doctors even aren't accepting Medicare and/or some insurances/

[rexxfan]

they only take ONE insurance and that is a Medicare Advantage Plan.

I'm not sure that's correct. Have you called to ask them whether your insurance is accepted for those not yet Medicare eligible? Mine was (but admittedly I inquired about it last Spring when I made my first appointment, so things may have changed). That appointment is coming up next week (yes, it was a long wait but it was alright with me as I am fortunate to be generally healthy). I even received an email from them around the time of the announcement of the Medicare Advantage plan being the only plan they accept for Medicare-eligible folk that said not to worry, that that did not apply in my case. I presumed that also applied to everyone not currently eligible for Medicare. Bottom line, don't assume, call and ask.
--
bc

[perrjojo]

I'm not sure that's correct. Have you called to ask them whether your insurance is accepted for those not yet Medicare eligible? Mine was (but admittedly I inquired about it last Spring when I made my first appointment, so things may have changed). That appointment is coming up next week (yes, it was a long wait but it was alright with me as I am fortunate to be generally healthy). I even received an email from them around the time of the announcement of the Medicare Advantage plan being the only plan they accept for Medicare-eligible folk that said not to worry, that that did not apply in my case. I presumed that also applied to everyone not currently eligible for Medicare. Bottom line, don't assume, call and ask.
--
bc

I agree. I think the United Heatlh care is the only Advantage insurance they take but they do take many other insurance plans. Please check this out further, you may have been misinformed.

[villagetinker]

Call SHINE, they will give you the straight scoop. I have posted this info twice, so do a search on the word SHINE and you will get all the contact info. They are very knowledgeable and helpful.

[billybye]

Have you tried Premier Medical? They had a full page ad in today's Sun newspaper. My wife used them for 4 years when we came here. They have two locations, one at Lake Sumter and one on Santa Barbara by the hospital. That second location also has an urgent care and lab. Here's their website Premier Medical Associates (http://pma-physicians.com/)

http://pma-physicians.com/pmaphysicians/wp-content/uploads/2013/11/SBB_HOME.jpg

http://pma-physicians.com/pmaphysicians/wp-content/uploads/2013/11/LSL-Exterior-Home.jpg

Good doctors and never rushed out during appointments

[NYGUY]

I agree. I think the United Heatlh care is the only Advantage insurance they take but they do take many other insurance plans. Please check this out further, you may have been misinformed.

FOR NEW PATIENTS, they only will accept UHC Advantage plans, both HMO and PPO.

[looneycat]

FOR NEW PATIENTS, they only will accept UHC Advantage plans, both HMO and PPO.

unfortunately that is why I can't use them. I have had too many issues requiring hospitalization, if I was on an advantage plan last year, with villages health care, I would be bankrupt now.

[Avista]

unfortunately that is why I can't use them. I have had too many issues requiring hospitalization, if I was on an advantage plan last year, with villages health care, I would be bankrupt now.

Well there is max out of pocket of $4500.
Their other plan 's out of pocket is about half of that.

[RickeyD]

Well there is max out of pocket of $4500.

Their other plan 's out of pocket is about half of that.


Max out of pocket will prevent a bankruptcy in just about all cases.

[Carla B]

A friend just told me he was accepted by The Villages Health system just before the cut-off date. His wife, who is on the same insurance policy, was denied acceptance since she did not apply by that date. So, The Villages Health says what they mean and they mean what they say.

[RickeyD]

A friend just told me he was accepted by The Villages Health system just before the cut-off date. His wife, who is on the same insurance policy, was denied acceptance since she did not apply by that date. So, The Villages Health says what they mean and they mean what they say.


Considering they were on the same policy together their decision is heavy handed. If I were the husband I'd withdraw and shop elsewhere. It's not like they're the platinum standard. Are they giving out vanity plates so the members can showboat?

[cquick]

I am 55 and I have BC/BS and they accept it.

we do too.
no problem.

[RickeyD]

we do too.

no problem.


Sounds like you're grandfathered in.

[Pegamyheart]

Full page articles in the Sunday paper are working hard to move people into the UHC Advantage Plan which employs The Villages Health PCPs, specialists and services. It is a very lucrative profit center for TV. That being said, the calibre of docs being brought into TV are better than before. Note that insurance companies take about 17% right off the top of the medical dollar, and compete hard for your business, as do docs, usually. TV is becoming a captive market. I'm continuing to choose my physician/specialists, especially in travel by purchasing a supplement plan and a Part D, which is quite easy to do by calling Medicare. Rather have alittle more control.

[Number 6]

Considering they were on the same policy together their decision is heavy handed. If I were the husband I'd withdraw and shop elsewhere. It's not like they're the platinum standard. Are they giving out vanity plates so the members can showboat?

If it were me I would appeal that decision to upper management. Finally if Villages Health is not the "platinum standard", what's the big deal?

[graciegirl]

Consulting the Villages Health System is a choice just like what car you drive and what restaurant you choose.


I wish they would take my insurance. I would use them in a heartbeat. Health care in Central Florida is not as good as where I came from. We lived near to a large teaching hospital with tons of research grant money and doctors who were prestigious in their fields.


I think, because I am really taken in by the Morse family and think they are great, that they were trying to provide good health care for Villagers, and make money too. That is how it works. It would finish off their fine idea place very well.


But me, I am just a hick from Ohio, what do I know?

[looneycat]

Well there is max out of pocket of $4500.
Their other plan 's out of pocket is about half of that.

check the hospitalization coverage and medical tests outside the routine. the max out of pocket is for medicare covered services and not for tests, treatments or other services not covered by medicare...those you will still pay for after max out of pocket is reached.

[rexxfan]

FOR NEW PATIENTS, they only will accept UHC Advantage plans, both HMO and PPO.

Yes, but is that for ALL new patients, or only those who are old enough to be eligible for Medicare?
--
bc

[NYGUY]

Yes, but is that for ALL new patients, or only those who are old enough to be eligible for Medicare?
--
bc

Since they only accept UHC Medicare Advantage Plans they will only accept new patients who are eligible for Medicare (I can only think of two categories that are eligible, age 65 and those younger but are on Social Security Disability).

[MoeVonB61]

Dr. Delbakhsh and his new partner, Dr. Lorenzo are excellent...smart, thorough, follow-through and an office staff to support the practice!!

[golfing eagles]

I'm too tired from unpacking to make a long dissertation on all the disinformation posted so far, so I'll just say this: If you are under 65 and interested in TV Health, call and ask if they accept your insurance. I very much doubt they are not accepting patients under 65. If you are medicare eligible, they will only accept UHC advantage for NEW patients. If you don't understand $4500 out of pocket max, and some apparently don't, call UHC and ask.

[theorem painter]

Call SHINE, they will give you the straight scoop. I have posted this info twice, so do a search on the word SHINE and you will get all the contact info. They are very knowledgeable and helpful.

According to the description of SHINE in the Recreation News they only deal with Medicare issues. If that is so they would not be able to help the OP because she is younger than 65.

[perrjojo]

I'm too tired from unpacking to make a long dissertation on all the disinformation posted so far, so I'll just say this: If you are under 65 and interested in TV Health, call and ask if they accept your insurance. I very much doubt they are not accepting patients under 65. If you are medicare eligible, they will only accept UHC advantage for NEW patients. If you don't understand $4500 out of pocket max, and some apparently don't, call UHC and ask.

:agree:

[rexxfan]

I'm too tired from unpacking to make a long dissertation on all the disinformation posted so far, so I'll just say this: If you are under 65 and interested in TV Health, call and ask if they accept your insurance. I very much doubt they are not accepting patients under 65. If you are medicare eligible, they will only accept UHC advantage for NEW patients. If you don't understand $4500 out of pocket max, and some apparently don't, call UHC and ask.

I agree, it doesn't make sense to me that they would not accept new patients under 65, although it is possible, so a clear statement from them on this would be helpful. I'm going in Monday for my first appointment. I'll ask.
--
bc

[dbussone]

For those on this thread who think the insurance companies are just out to get every penny they can out of your pocket, the following might surprise you:

"UnitedHealth Group has lost $425 million from health plans sold on the Affordable Care Act's marketplaces, which forced the company to lower its profit projections for the rest of the year. The company suggested it may exit the exchanges altogether by 2017.

It's a potentially huge blow to President Barack Obama's healthcare reform law. The exchanges have been viewed as the primary conduit to expand health coverage to middle-class Americans. If a major publicly traded insurer bows out, others may follow and destabilize the entire individual market.

“We cannot sustain these losses,” UnitedHealth CEO Stephen Hemsley said on an investor call Thursday.

The $425 million shortfall from exchange products includes $275 million that UnitedHealth expects to lose from its 2016 plans. There's also another $200 million to $225 million in potential exchange losses that can't be booked until next year, the Minnetonka, Minn.-based health insurer and services conglomerate said.

UnitedHealth will evaluate its public exchange status during the first half of next year before deciding if it will leave the market. It has also “pulled back” significantly on marketing its 2016 plans and cut commissions to insurance brokers to minimize enrollment growth.

It's a swift turn of events for the nation's largest health insurer, which only a month ago touted its exchange strategy and said it was expanding into 11 new markets next year.

Healthcare stocks have been taking a beating Thursday morning in light of UnitedHealth's announcement. UnitedHealth's shares were down 3.6%. Anthem's stock plummeted 6.8%, while Aetna lost 4%. Hospital chains HCA and Community Health Systems were down 5.2% and 8.3%, respectively."

Just released by Modern Healthcare.

[RickeyD]

For those on this thread who think the insurance companies are just out to get every penny they can out of your pocket, the following might surprise you:

"UnitedHealth Group has lost $425 million from health plans sold on the Affordable Care Act's marketplaces, which forced the company to lower its profit projections for the rest of the year. The company suggested it may exit the exchanges altogether by 2017.

It's a potentially huge blow to President Barack Obama's healthcare reform law. The exchanges have been viewed as the primary conduit to expand health coverage to middle-class Americans. If a major publicly traded insurer bows out, others may follow and destabilize the entire individual market.

“We cannot sustain these losses,” UnitedHealth CEO Stephen Hemsley said on an investor call Thursday.

The $425 million shortfall from exchange products includes $275 million that UnitedHealth expects to lose from its 2016 plans. There's also another $200 million to $225 million in potential exchange losses that can't be booked until next year, the Minnetonka, Minn.-based health insurer and services conglomerate said.

UnitedHealth will evaluate its public exchange status during the first half of next year before deciding if it will leave the market. It has also “pulled back” significantly on marketing its 2016 plans and cut commissions to insurance brokers to minimize enrollment growth.

It's a swift turn of events for the nation's largest health insurer, which only a month ago touted its exchange strategy and said it was expanding into 11 new markets next year.

Healthcare stocks have been taking a beating Thursday morning in light of UnitedHealth's announcement. UnitedHealth's shares were down 3.6%. Anthem's stock plummeted 6.8%, while Aetna lost 4%. Hospital chains HCA and Community Health Systems were down 5.2% and 8.3%, respectively."

Just released by Modern Healthcare.


Getting real tired of this argument. Health care may not be a right, but it is a necessity. Water, electricity, law enforcement, fire protection, sanitation are all necessities. In many areas of our country these are all public services. Health care needs to be nationalized so as to provide ALL of us with affordable services unencumbered by shareholder greed. Medicare for all and let's see if these companies "pull out". They'll always be money that will operate out of the system but the remaining 98% of us will still generate an effective and productive health care system.

[Chi-Town]

Agree that healthcare needs to be a Medicare for all model.. The ACA was a compromised step in that direction.

[fredthefisherman]

Anyone go to Dr. Qamar in Ocala?
Lawsuit continues against Ocala's Dr. Asad Qamar after judge denies motion to dismiss | Ocala.com (http://www.ocala.com/article/20151116/ARTICLES/151119797?tc=ar)

[Buckeyephan]

Happy Friday morning to me. At 8:00 this morning, I received a call from the Villages Health Care telling me that they will no longer accept my insurance. After over 2 years with them, I now have to find a new PCP. It is difficult to wade through the qualifications of so many physicians who were not educated in our country. Changing plans is not an option since mine is provided by my retirement system. Wish me luck.

[Blessed2BNTV]

Have you tried Premier Medical? They had a full page ad in today's Sun newspaper. My wife used them for 4 years when we came here. They have two locations, one at Lake Sumter and one on Santa Barbara by the hospital. That second location also has an urgent care and lab. Here's their website Premier Medical Associates (http://pma-physicians.com/)

http://pma-physicians.com/pmaphysicians/wp-content/uploads/2013/11/SBB_HOME.jpg

http://pma-physicians.com/pmaphysicians/wp-content/uploads/2013/11/LSL-Exterior-Home.jpg

Mom uses Dr. Shah at Premier. She likes him, as I do (I take her to all visits).

Hubby and I prefer a holistic approach so we use Healthcare Care Partners and see Dr K - Contact Us | HealthCare Partners Family Medicine, LLC (http://www.lifefamilypractice.com/contact-us)

He accepts our insurance with is United Healthcare.

[fredthefisherman]

You can go here to look up doctors background
https://appsmqa.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP

[fredthefisherman]

Dr. K went to medical school in the Phillipines - UNIV OF THE EAST, RAMON MAGSAY from 1982-86. That's where he met his wife Dr. Villa.

[fredthefisherman]

Villages Health accepted insurance
Accepted Insurance by The Villages Health (http://www.thevillageshealth.com/insurance.php)

[rexxfan]

Getting real tired of this argument. Health care may not be a right, but it is a necessity.
It really all boils down to who do you trust more to run the health system, private industry or the government. Private industry has a profit motive. Government has a power and control motive. They both have bureaucracy issues. Tough choice. I prefer to have the freedom to choose for myself.
--
bc

[rexxfan]

Villages Health accepted insurance
Accepted Insurance by The Villages Health (http://www.thevillageshealth.com/insurance.php)
Quoting from the website:

If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by UnitedHealthcare®.

... which does nothing to clear up the confusion regarding those who are not (yet) eligible for MediCare.
--
bc

[fredthefisherman]

My daughter has BCBS. She has been a patient there since 2013.

[dbussone]

Getting real tired of this argument. Health care may not be a right, but it is a necessity. Water, electricity, law enforcement, fire protection, sanitation are all necessities. In many areas of our country these are all public services. Health care needs to be nationalized so as to provide ALL of us with affordable services unencumbered by shareholder greed. Medicare for all and let's see if these companies "pull out". They'll always be money that will operate out of the system but the remaining 98% of us will still generate an effective and productive health care system.


I'm sorry you're tired of the argument. But I'm as entitled to my opinion as you are yours. I respect your opinion but disagree with it.

I have no interest in the Feds running our healthcare system. They've proven they can't even provide adequate care to our veterans for goodness sake. And a single payer system would mean the Feds would control our healthcare system. Try reading the 2200 pages of the ACA if you want to see what to expect.

[JoMar]

....

[Carla B]

Quoting from the website:

If you are eligible for Medicare, we want you to know that the only Medicare Advantage plans The Villages Health participates in are those offered by UnitedHealthcare®.

... which does nothing to clear up the confusion regarding those who are not (yet) eligible for MediCare.
--
bc

Exactly, there are at least two very relevant questions their website doesn't address:

1) If UHC is the only Medicare Advantage plan they accept, do they accept insurances that are not Advantage plans (i.e., supplemental plans)?
2) Do they accept patients not of Medicare age and, if so, what insurance plans are accepted for those patients?

Why should it be so hard for them to address these issues on their website?

[NYGUY]

Exactly, there are at least two very relevant questions their website doesn't address:

1) If UHC is the only Medicare Advantage plan they accept, do they accept insurances that are not Advantage plans (i.e., supplemental plans)?
2) Do they accept patients not of Medicare age and, if so, what insurance plans are accepted for those patients?

Why should it be so hard for them to address these issues on their website?

Because they know you will not like the answers...it's a shell game!!

BTW, the answer to both of your questions (for NEW patients) is no!! Those that say they have it were existing patients who were grandfathered in.

[graciegirl]

I'm sorry you're tired of the argument. But I'm as entitled to my opinion as you are yours. I respect your opinion but disagree with it.

I have no interest in the Feds running our healthcare system. They've proven they can't even provide adequate care to our veterans for goodness sake. And a single payer system would mean the Feds would control our healthcare system. Try reading the 2200 pages of the ACA if you want to see what to expect.



Amen.

Most people think the government running healthcare would equate to the same quality of healthcare that most Americans are used to and they are wrong. I have a pen pal (email) in The Netherlands that had to wait six months for her mastectomy. Meanwhile the cells are growing, growing, growing. My husband worked for the same company and endured some pretty horrible bosses because the insurance was excellent and our daughter had some serious health issues. I am so grateful to him and to the wonderful health care she had over the years, saving her life again and again. Socialistic medicine is not as good, in my view, especially for those whose life is in the balance. We could search for the best doctors and the insurance paid for them. All insurance is o.k. as long as you aren't fighting a deadly disease.

[golfing eagles]

Amen.

Most people think the government running healthcare would equate to the same quality of healthcare that most Americans are used to and they are wrong. I have a pen pal (email) in The Netherlands that had to wait six months for her mastectomy. Meanwhile the cells are growing, growing, growing. My husband worked for the same company and endured some pretty horrible bosses because the insurance was excellent and our daughter had some serious health issues. I am so grateful to him and to the wonderful health care she had over the years, saving her life again and again. Socialistic medicine is not as good, in my view, especially for those whose life is in the balance. We could search for the best doctors and the insurance paid for them. All insurance is o.k. as long as you aren't fighting a deadly disease.

Unfortunately, it's worse than that. Currently, there are about 900,000 practicing clinicians in the US; those are projected to shrink by as many as 250,000 over the next 5 years due to early retirement and alternative non patient care careers. Who is going to replace them? With a growing and aging population, demand will increase as supply shrinks. One of the main reasons for physician dissatisfaction is burdensome government regulation---and we all know what happens if the feds take over health care---just look at the VA.
When I applied to medical schools in 1979, there were 128,000 applicants for 17,000 seats overall; due to multiple applications, each school with 100-200 seats received 8-10,000 applications. You could randomly toss 90% in the trash and still have a great pool to choose from. Five years ago there were 23,000 applicants for the same 17,000 seats---choices have dwindled. Already, teaching hospitals cannot fill their positions with American graduates. At his rate, soon you can just walk in the front door and have a seat. It is no longer, if the left will pardon my foul language, "competitive" But then again, why bother with diplomas and licenses---just show your "participant" trophy. I'm sure we all would get that warm and fuzzy feeling when visiting a doctor who hangs a "Certificate of Participation" on their wall above their desk.
For the "grass is greener" crowd that idolizes European style health systems--just try living there--anyone who can afford to opt out of their system generally does so. It is fine for preventative care and routine minor illness, beyond that, make sure your affairs are in order.
And for those who believe the skewed and biased WHO rankings of world health care that places the US in 28th place and Luxembourg in 1st, consider this: We all know that when world leaders , royalty, and billionaires get sick, they flock to "Luxembourg"--not NY or Boston, right?

[Villageswimmer]

Unfortunately, it's worse than that. Currently, there are about 900,000 practicing clinicians in the US; those are projected to shrink by as many as 250,000 over the next 5 years due to early retirement and alternative non patient care careers. Who is going to replace them? With a growing and aging population, demand will increase as supply shrinks. One of the main reasons for physician dissatisfaction is burdensome government regulation---and we all know what happens if the feds take over health care---just look at the VA.
When I applied to medical schools in 1979, there were 128,000 applicants for 17,000 seats overall; due to multiple applications, each school with 100-200 seats received 8-10,000 applications. You could randomly toss 90% in the trash and still have a great pool to choose from. Five years ago there were 23,000 applicants for the same 17,000 seats---choices have dwindled. Already, teaching hospitals cannot fill their positions with American graduates. At his rate, soon you can just walk in the front door and have a seat. It is no longer, if the left will pardon my foul language, "competitive" But then again, why bother with diplomas and licenses---just show your "participant" trophy. I'm sure we all would get that warm and fuzzy feeling when visiting a doctor who hangs a "Certificate of Participation" on their wall above their desk.
For the "grass is greener" crowd that idolizes European style health systems--just try living there--anyone who can afford to opt out of their system generally does so. It is fine for preventative care and routine minor illness, beyond that, make sure your affairs are in order.
And for those who believe the skewed and biased WHO rankings of world health care that places the US in 28th place and Luxembourg in 1st, consider this: We all know that when world leaders , royalty, and billionaires get sick, they flock to "Luxembourg"--not NY or Boston, right?

Thank you for your educated, unemotional post. I'm glad you participate in this forum.

[fredthefisherman]

Unfortunately, it's worse than that. Currently, there are about 900,000 practicing clinicians in the US; those are projected to shrink by as many as 250,000 over the next 5 years due to early retirement and alternative non patient care careers. Who is going to replace them? With a growing and aging population, demand will increase as supply shrinks. One of the main reasons for physician dissatisfaction is burdensome government regulation---and we all know what happens if the feds take over health care---just look at the VA.
When I applied to medical schools in 1979, there were 128,000 applicants for 17,000 seats overall; due to multiple applications, each school with 100-200 seats received 8-10,000 applications. You could randomly toss 90% in the trash and still have a great pool to choose from. Five years ago there were 23,000 applicants for the same 17,000 seats---choices have dwindled. Already, teaching hospitals cannot fill their positions with American graduates. At his rate, soon you can just walk in the front door and have a seat. It is no longer, if the left will pardon my foul language, "competitive" But then again, why bother with diplomas and licenses---just show your "participant" trophy. I'm sure we all would get that warm and fuzzy feeling when visiting a doctor who hangs a "Certificate of Participation" on their wall above their desk.
For the "grass is greener" crowd that idolizes European style health systems--just try living there--anyone who can afford to opt out of their system generally does so. It is fine for preventative care and routine minor illness, beyond that, make sure your affairs are in order.
And for those who believe the skewed and biased WHO rankings of world health care that places the US in 28th place and Luxembourg in 1st, consider this: We all know that when world leaders , royalty, and billionaires get sick, they flock to "Luxembourg"--not NY or Boston, right?


Golfing Eagles,

Thank you for you insight. It's helpful to have another perspective.

This exactly the reason there are so many foreign doctors here; foreign medical grads (FMGs) pay next to nothing for medical school in their home country, then come to US to make money because their home country doesn't pay! While at the same time US medical school graduates pay upwards of $300,000 in tuition (with 8% interest).

Example:
Romania $5,000 per year for medical school.
US $60,000 per year for medical school.
....Additionally we have an oral surgeon in the family, by the time he finished up at UF he had spent close to $500,000 in tuition (undergrad + dental school + additional training).

Why hasn't the US built more medical schools to accommodate for the physician shortage the government predicted 20 years ago? Did the AAMC have a role in this? We produce roughly the same amount of doctors per year as we did when you graduated Golfing Eagles.

This is why there are so many foreign doctors in The Villages. They are here to attain their Visa and then either stay in the area or move away after they have completed their 3 year service commitment.

AAMC shares all the statistics for medical school applications etc., current figures are available. Just go to their website. The entrance exam known as the MCAT is taken after a student earns an undergraduate degree ($$ for tuition). The MCAT is now a 7.5 hour test. If a candidate earns a competitive score and has a GPA of 3.6-4.0 (on average) they can apply to medical school. After paying for another 4 years of tuition in medical school, they move onto residency. Foreign doctors do their residency here and have no student loans. So while American trained doctors are scraping by financially, foreign docs are laughing all the way to the bank.

Another advantage foreign doctors have is time, they do not need to get a 4 year degree before they apply/attend medical school. So they spend less time in school. Example: India you go straight to medical school out of high school. Romania you go to med school straight out of high school. America high school + undergrad + medical school.

Our system is so broken.

[RickeyD]

Unfortunately, it's worse than that. Currently, there are about 900,000 practicing clinicians in the US; those are projected to shrink by as many as 250,000 over the next 5 years due to early retirement and alternative non patient care careers. Who is going to replace them? With a growing and aging population, demand will increase as supply shrinks. One of the main reasons for physician dissatisfaction is burdensome government regulation---and we all know what happens if the feds take over health care---just look at the VA.
When I applied to medical schools in 1979, there were 128,000 applicants for 17,000 seats overall; due to multiple applications, each school with 100-200 seats received 8-10,000 applications. You could randomly toss 90% in the trash and still have a great pool to choose from. Five years ago there were 23,000 applicants for the same 17,000 seats---choices have dwindled. Already, teaching hospitals cannot fill their positions with American graduates. At his rate, soon you can just walk in the front door and have a seat. It is no longer, if the left will pardon my foul language, "competitive" But then again, why bother with diplomas and licenses---just show your "participant" trophy. I'm sure we all would get that warm and fuzzy feeling when visiting a doctor who hangs a "Certificate of Participation" on their wall above their desk.
For the "grass is greener" crowd that idolizes European style health systems--just try living there--anyone who can afford to opt out of their system generally does so. It is fine for preventative care and routine minor illness, beyond that, make sure your affairs are in order.
And for those who believe the skewed and biased WHO rankings of world health care that places the US in 28th place and Luxembourg in 1st, consider this: We all know that when world leaders , royalty, and billionaires get sick, they flock to "Luxembourg"--not NY or Boston, right?

What you are seeing is the decline of the American model of healthcare. It does not address how are we going to provide affordable health care for our population. Rising medical costs have more to do with people living longer, people eating fast foods instead of healthy foods, medical malpractice suits, the misuse of healthcare services by patients and by fraud mostly by health care practitioners. Also, advanced technologies in radiology and medicine come at a cost. People want to live longer and healthier yet maintain the lifestyles they are accustomed to but at what cost ? The model no longer works. Please don't blame the Feds for this misfortune, they are but a small part of it. The solution is not a leftist solution or a progressive one it is the only one. We may have reached the tipping point at which we have to decide do we want a healthier population or a smaller population. The longer we live the more of a burden we put on those in their working years. If the average life expectancy keeps growing the system will become increasingly unsustainable. IMHO we as humans need to lower our expectations and realize that in order to provide for all, we need to choose between what we can achieve and what is practical. Not withstanding, technology will move forward in all the sciences but the health sciences must realize there is a cost in moving forward that must be met with affordable solutions which can only be implemented and managed by efficiency of scale, otherwise the system will implode. National health care is our only solution. I am not a leftist, just thinking practically is all.

[fredthefisherman]

I think you make some really good points.

Fast food and sedentary lifestyle play a large role in cardiovascular disease and cancer, as well as many autoimmune diseases.

And as your Mother said: you are what you eat so eat your vegetables.

But the question still remains, why do we have a shortage of American trained doctors and why didn't the system plan for this? We all knew this day would come as the population aged.

[dbussone]

I think you make some really good points.

Fast food and sedentary lifestyle play a large role in cardiovascular disease and cancer, as well as many autoimmune diseases.

And as your Mother said: you are what you eat so eat your vegetables.

But the question still remains, why do we have a shortage of American trained doctors and why didn't the system plan for this? We all knew this day would come as the population aged.


A basic fact that is important to recognize. It is the Feds that have caused much of the problem by restricting the number of residency positions that it would support.

I would also note that while the government was predicting an aging population it was also pressuring hospitals to reduce beds and services. IMO the government has created many of the difficulties we now face in our healthcare system.

[fredthefisherman]

A basic fact that is important to recognize. It is the Feds that have caused much of the problem by restricting the number of residency positions that it would support.

I would also note that while the government was predicting an aging population it was also pressuring hospitals to reduce beds and services. IMO the government has created many of the difficulties we now face in our healthcare system.

Insurance companies tell hospitals when to empty their beds and send patients home before patients are ready.

Insurance companies and big pharma have profited off all of us. The government didn't regulate them enough.

Our prescription drug prices are the most expensive in the world. And insurance companies dictate deductibles, co-pays and infringe on doctors plan of care. Any physician will admit they are pressured by insurance companies when making medical decisions.

[fredthefisherman]

AAMC knew that Babyboomers were aging therefore leaving a two-fold problem:
1. Boomers will be aging and need increased healthcare
2. Boomers will be retiring which decreases the number of overall healthcare practitioners.

Example: government list of areas of critical need
1. shortage of physicians, dentists, psychiatrists...these professions have been listed for over 15 years.
2. Registered nurses where taken off that list in 2008.

Shortage Designation: Health Professional Shortage Areas & Medically Underserved Areas/Populations (http://www.hrsa.gov/shortage/)
(215)

Or

https://www.aamc.org/download/100598/data/
(2012)

[dbussone]

Insurance companies tell hospitals when to empty their beds and send patients home before patients are ready.



Insurance companies and big pharma have profited off all of us. The government didn't regulate them enough.



Our prescription drug prices are the most expensive in the world. And insurance companies dictate deductibles, co-pays and infringe on doctors plan of care. Any physician will admit they are pressured by insurance companies when making medical decisions.


While we disagree about the need for more regulations I appreciate your opinion. It would be interesting to have GolfingEagles weigh in on this as far as physician practices go. But I can tell you, as far as hospitals are concerned, the Feds exert at least as much pressure as insurers.

[fredthefisherman]

While we disagree about the need for more regulations I appreciate your opinion. It would be interesting to have GolfingEagles weigh in on this as far as physician practices go. But I can tell you, as far as hospitals are concerned, the Feds exert at least as much pressure as insurers.

Thank you, I also appreciate your perspective.

I'm afraid I am missing something, how are the Feds exerting pressure? By regulations?

[RickeyD]

I may be a tiny bit off subject here but I have observed something. Considering the disproportionate number of seniors in The Villages as opposed to the general senior population who are not retired public servant employees there seems to be an overwhelming number of self described conservatives who are dipping into the self insured public service retirement well but are unwilling to share this well with the general population. They themselves are benefiting from the efficiency of scale at the state level but are opposed to others benefiting at the federal level. Am I wrong ?

[dbussone]

Thank you, I also appreciate your perspective.



I'm afraid I am missing something, how are the Feds exerting pressure? By regulations?


Regulations are a large part of it. However don't forget that both the federal and state governments are also payers (insurers) through Medicare, Medicaid, TriCare, etc. And there is no negotiation with them. Their payment is determined by unilateral action on their part. Federal law also obligates hospitals to provide (appropriately so) care to those requiring urgent and emergent treatment.

I've frequently wondered why the Feds don't also require grocery stores to give food away for free to those who cannot afford to pay. It's as necessary to eat as it is to get healthcare isn't it. (Just being facetious. But it is an interesting question.)

[dbussone]

I may be a tiny bit off subject here but I have observed something. Considering the disproportionate number of seniors in The Villages as opposed to the general senior population who are not retired public servant employees there seems to be an overwhelming number of self described conservatives who are dipping into the self insured public service retirement well but are unwilling to share this well with the general population. They themselves are benefiting from the efficiency of scale at the state level but are opposed to others benefiting at the federal level. Am I wrong ?


What is the "self insured public service well" ?

[RickeyD]

I think you make some really good points.

Fast food and sedentary lifestyle play a large role in cardiovascular disease and cancer, as well as many autoimmune diseases.

And as your Mother said: you are what you eat so eat your vegetables.

But the question still remains, why do we have a shortage of American trained doctors and why didn't the system plan for this? We all knew this day would come as the population aged.

Why do we have a shortage of American trained doctors ? Probably the same reason there is a shortage of engineers and mechanics. Young people are taking the path of least resistance, they don't want to study hard, they don't want to work with their hands. Doctors are in fact anatomy mechanics and the work requires too many hours and much hard intensive work. Laziness comes to mind, living at home with Mom and Dad till their 35 doesn't help. Mom and Dad refuse to kick their sorry butts out.:censored:

[RickeyD]

What is the "self insured public service well" ?

Medical insurance provided to public service retirees funded by taxpayer (public) dollars as opposed to the private sector which is funded by the retirees themselves or in the case of the dwindling number of corporations that provide medical insurance to retirees themselves, funded by (private) dollars.

[fredthefisherman]

Good point RickeyD. I will be interested to see what others like Chatbrat say in response to your point.

[dbussone]

Medical insurance provided to public service retirees funded by taxpayer (public) dollars as opposed to the private sector which is funded by the retirees themselves or in the case of the dwindling number of corporations that provide medical insurance to retirees themselves, funded by (private) dollars.

Ok. Thanks for the explanation.

[fredthefisherman]

Why do we have a shortage of American trained doctors ? Probably the same reason there is a shortage of engineers and mechanics. Young people are taking the path of least resistance, they don't want to study hard, they don't want to work with their hands. Doctors are in fact anatomy mechanics and the work requires too many hours and much hard intensive work. Laziness comes to mind, living at home with Mom and Dad till their 35 doesn't help. Mom and Dad refuse to kick their sorry butts out.:censored:


There is a physician shortage for these reasons:

1. Growing and aging population in need of healthcare
2. Large segment of the population retiring / leaving the workforce
3. Medical schools have not significantly increased the number of graduating physicians per year in 30+ years

Lastly, for many attempting to further their education, cost becomes a factor. To become a nurse practitioner will cost $60,000 minimum (after you have already paid years of tuition to become a RN). Not everyone can come up with the money to pay for these programs even if they are accepted.

Kindly, I have to say, the majority of young people are not lazy. Many return home after college secondary to student loan payments. Payments can be $250 a month or far above $1500 per month. Student loan interest is 8% on average; so its best to pay them ASAP.

Additionally as you pointed out before, these folks have to pay for health insurance because few companies take on the entire cost. Example: my youngest daughter is a RN, at a local hospital she is paid between $18-20/hour and pays an additional $180 per paycheck (every 2 weeks) for health insurance thru her employer. Now add in co-pays and deductibles...

[fredthefisherman]

Medical insurance provided to public service retirees funded by taxpayer (public) dollars as opposed to the private sector which is funded by the retirees themselves or in the case of the dwindling number of corporations that provide medical insurance to retirees themselves, funded by (private) dollars.

Rickey D, I think this is a great point and one I have not considered.

Many of the people who have Medicare or some other form of healthcare insurance provided as a retirement benefit (i.e. Veterans benefit) do not want socialized medicine...yet they are utilizing a form of socialized medicine already.

I don't have the answers, but this is an excellent point.

[fredthefisherman]

U.S. medical school applications since 2003 -

https://www.aamc.org/download/321470/data/factstable7.pdf

In 2014 20,300 students accepted in U.S. medical schools.
In 2003 there were 16,500 students entering U.S. medical schools.

AAMC refused for years to allow the building of new medical schools to compensate for the physician need.

Foreign doctors have filled physician jobs in places where there have been extreme shortages, like The Villages was several years ago. Please don't misinterpret this tho, many foreign doctors give excellent care.

[rexxfan]

Exactly, there are at least two very relevant questions their website doesn't address:

1) If UHC is the only Medicare Advantage plan they accept, do they accept insurances that are not Advantage plans (i.e., supplemental plans)?
2) Do they accept patients not of Medicare age and, if so, what insurance plans are accepted for those patients?

Why should it be so hard for them to address these issues on their website?

I just got back from my first appointment. Here's what I learned.They are really, truly not accepting any new patients who are not eligible for Medicare. The only way I got in was that I made my initial appointment last May so I was grandfathered in.

As to Medicare plans, my understanding is that the only plan they accept is the United HealthCare Medicare Advantage plan.

So, there you have it.

For what its worth, I got the impression that The Villages Health folks weren't especially happy about it, so perhaps there are external factors that drove the imposition of the new requirement.
--
bc

[NYGUY]

....For what its worth, I got the impression that The Villages Health folks weren't especially happy about it, so perhaps there are external factors that drove the imposition of the new requirement.
--
bc

My guess is you are right, and that the external factor is United Healthcare!!

[golfing eagles]

I just got back from my first appointment. Here's what I learned.They are really, truly not accepting any new patients who are not eligible for Medicare. The only way I got in was that I made my initial appointment last May so I was grandfathered in.

As to Medicare plans, my understanding is that the only plan they accept is the United HealthCare Medicare Advantage plan.

So, there you have it.

For what its worth, I got the impression that The Villages Health folks weren't especially happy about it, so perhaps there are external factors that drove the imposition of the new requirement.
--
bc

That is absolutely fascinating, and somewhat unfathomable. Let me be blunt for a minute, and just give a reality of life. If you only accept patients 65 and over, the men , on average, will be with you for 13 years and the women 16 years. Sorry, but that's the reality. You need to replace those patients with younger people to sustain a practice. You may conclude you can just replace those no longer with us with 65 year olds in a 15 year cycle, but that is likely to fail. Since many move here in their 50's, they would have to seek out area physicians. Those patients are not likely to leave that doctor after, say 10 years, to join TV Health when they turn 65, so this policy is one of long term spiraling failure. In addition, private insurance generally pays a little better than medicare, so this makes no financial sense in the short term either.
My first appointment is in 3 weeks, I literally signed up 3 days before that change was made (I'm 56). Phew! I'll also check this out a bit further, because after 30 years of running a practice, this still makes no sense to me.

[RickeyD]

That is absolutely fascinating, and somewhat unfathomable. Let me be blunt for a minute, and just give a reality of life. If you only accept patients 65 and over, the men , on average, will be with you for 13 years and the women 16 years. Sorry, but that's the reality. You need to replace those patients with younger people to sustain a practice. You may conclude you can just replace those no longer with us with 65 year olds in a 15 year cycle, but that is likely to fail. Since many move here in their 50's, they would have to seek out area physicians. Those patients are not likely to leave that doctor after, say 10 years, to join TV Health when they turn 65, so this policy is one of long term spiraling failure. In addition, private insurance generally pays a little better than medicare, so this makes no financial sense in the short term either.

My first appointment is in 3 weeks, I literally signed up 3 days before that change was made (I'm 56). Phew! I'll also check this out a bit further, because after 30 years of running a practice, this still makes no sense to me.


You may be "grandfathered" in now or you may simply be a transition patient depending on how well the new business model works. I would feel uneasy in your position. You don't have a contract with them do you ? When a business trashes customers the way they have I wouldn't give them the time of day, let alone my money.
Because they use the trademark "The Villages" doesn't make them special, IMHO

[golfing eagles]

You may be "grandfathered" in now or you may simply be a transition patient depending on how well the new business model works. I would feel uneasy in your position. You don't have a contract with them do you ? When a business trashes customers the way they have I wouldn't give them the time of day, let alone my money.
Because they use the trademark "The Villages" doesn't make them special, IMHO

I would find it even more inexplicable if they dump all patients under 65, it would be tantamount to professional suicide as a business venture. I don't feel uneasy--I have a 30 year relationship with my doctor there, but that is a special circumstance that does not apply to everyone else. I'm still scratching my head over this new policy, but I'll find out, although I may not be able to share confidential information with everyone. And being "The Villages" does not in and of itself make them special, but without going into details, I am familiar with the practice model and planning that went into TV Health, and it IS cutting edge and "special", which is what makes their new policy so confusing

[fhiggi]

Here is my understanding as a patient under the age of 65 (been a patient since inception). If you are under 65 and currently a patient and have insurance they accept, you are okay. If your insurance changes to a plan they do not accept (like Aetna), you can no longer be a patient. Although they accept cash, they will not let you pay cash if you have insurance. I spoke with five different people, including upper management CEO types, and if you have insurance they do not accept, you are out of luck. I questioned the logic because using them would only mean out of network for me, so I would pay cash and then submit the claim to the insurance company. They told me their policy is to not accept cash from a patient with insurance. Didn't matter what my argument was; didn't matter that I've been a patient since inception. If my plan changes to something they don't take, I have to find a new primary care doctor. I'm not happy about this because I love my doctor, but that's they way it is for those of us under 65 who do not have insurance they accept. Unless, of course, I drop my insurance completely and pay cash for my visits.