Way, way, way too early for THAT:a20:

Golfing Eagles, I appreciate the negative information you have presented on the ACA and it's management by our mega insurance companies.

As I understand it, the US is one of the few developed nations that does not have a single payer system. Are they all wrong? I worked in the bay area with RNs from Canada who would not get US citizenship because they do not want to give up their excellent medial insurance in Canada. Why would that be?

While traveling in Australia, the people we met were all very happy with their universal health care.

No "death committees" in either country. Health care is considered a right in those countries as well as in the many other developed countries who rank above us in quality and outcomes.

I don't understand how that works. If universal health care is such a bad idea, why has it been so successful and well received in so many other nations? And why have we consistently ranked so low in outcomes?

Costs have increased dramatically during my years working as a RN, the pay....not so much. The Hospital corporations are flush with cash, HCA for example, (Governor Rick Scott's former "ATM card") where I worked for the last 10 years has made record profits year after year. Their hospitals are 12 of the top 25 in profits year after year.

Some one is making a lot of $$ on the back of the health care industry, it's healthcare providers, and patients alike.

Please enlighten me? No sarcasm intended. I really want to hear your reasoning for the situation here compared to the other 1st world countries.

I do enjoy your posts and respect your opinions.

Wow, there's a lot in there, I could write a book! So I'll try to be short and answer point by point---but while I back this with facts, it is still only my opinion and I'm sure others will disagree.

Golfing Eagles, I appreciate the negative information you have presented on the ACA and it's management by our mega insurance companies.

Actually, I believe the only negative part (that I mentioned) was the cost and how it was misrepresented as well as the lack of scope in addressing the true problems in healthcare

As I understand it, the US is one of the few developed nations that does not have a single payer system. Are they all wrong? I worked in the bay area with RNs from Canada who would not get US citizenship because they do not want to give up their excellent medial insurance in Canada. Why would that be?

I guess the tongue in cheek answers would be yes, and dementia. However, part of the problem is comparing apples and oranges. At the risk of the ire of the right, I would have developed a single payer system in the US as well, but I just wouldn't let our government run it. There is a big difference between how our government works and that of Luxembourg. What "works" there might not work here for a whole array of reasons, more on that later. As far as the Canadian system being "excellent", for some things it is. They are very good at preventative care, prenatal care, immunizations and simple problems. I assume your nurse friends never had a serious problem. They might think differently if they needed an MRI or open heart surgery, as they got sicker and sicker on a long waiting list. Seattle, Detroit, Buffalo, Albany, and to a certain extent Boston has a thriving business providing advanced care to Canadians who cross the border to utilize these services

While traveling in Australia, the people we met were all very happy with their universal health care.

Again, they tend to be happy as long as they don't get seriously ill.

No "death committees" in either country. Health care is considered a right in those countries as well as in the many other developed countries who rank above us in quality and outcomes.

I think "death committees" was a fear tactic of Sarah Palin and the far right. But you can only pay for universal health care either by higher taxes or rationing. European socialist republics do it with a little of both, something that Americans probably would not stand for.

I don't understand how that works. If universal health care is such a bad idea, why has it been so successful and well received in so many other nations? And why have we consistently ranked so low in outcomes?

Now here is the real fallacy with the arguments we hear all the time in the media. How successful is it, really. In Scandinavia, their 80% income tax is "well received"? And just ask the Greeks how it is working out for them. Italy, Spain, Portugal and Ireland are right on the same precipice. But more importantly, let's take a close look at the "low rank" of the US in health care
These so called rankings are generally based on life expectancy---the CIA World Fact Book ranks the US 43rd in this category. However, life expectancy to a large degree is a function of infant mortality, which the CIA ranks the US 57th in. But why? Almost every other country reporting infant mortality only counts live births after 34 weeks, some 36 weeks. We count every live birth---25 weeks, botched abortions, miscarriages--as long as the baby took 1 breath, we count it, therefore skewing the statistics.
There is also probably a genetic component to life expectancy as well. Japan is #1 or 2 on all the lists. The following is not racist, repeat that to all liberals, NOT RACIST, but fact--40 of the 42 lowest life expectancy countries are in Africa (the other 2 are Haiti and Afghanistan). Yes--- war, poverty, HIV and other disease and starvation are huge factors, but I wonder if some genetics is at play as well, as noted below
Even within the US, there is a large variation from state to state---from 81.3 years down to 75.0. Guess which state is #1----Hawaii, coincidentally a state with a high percentage of Japanese DNA. Which state is #50?---Mississippi, which in addition to some poverty and lack of access to care has a high percentage of African DNA (again, to liberals, fact, NOT RACIST)
Now let's look at the criteria by which the WHO rank the US system 37th in the world:
The rankings are based on an index of five factors:[2]
Health (50%) : disability-adjusted life expectancy
Overall or average : 25%
Distribution or equality : 25%

Responsiveness (25%) : speed of service, protection of privacy, and quality of amenities
Overall or average : 12.5%

Distribution or equality : 12.5%

Fair financial contribution : 25%


So, you can see how ridiculous this ranking is---every statistical factor works against the US and works in favor of small, genetically demographically homogenous populations that all pay high taxes.

I prefer the following test of the quality of the US health system:
When world leaders, royalty and billionaires get really sick, do they flock to NY City and Boston, or do they flock to "Luxembourg"?

Costs have increased dramatically during my years working as a RN, the
pay....not so much. The Hospital corporations are flush with cash, HCA for example, (Governor Rick Scott's former "ATM card") where I worked for the last 10 years has made record profits year after year. Their hospitals are 12 of the top 25 in profits year after year.

Some one is making a lot of $$ on the back of the health care industry, it's healthcare providers, and patients alike.


Well, it certainly wasn't me! But the last figures I saw 4 years ago showed 78% of all US hospitals were in the red. And doctors only account for 9% of every health care dollar. And if it's the "mega insurance companies", let's all go out and buy Humana stock. Remember, it's possible to take in tremendous amounts of money and still lose--just look at the federal budget!!

Well, "that's all folks":024: My arm is tired:1rotfl:

Be sure to read the article in todays Daily Sun on page C1 title Villages Health Takes An Important Step . It states "Effective immediately the grassroots health care organization (Villages Health) will accept only United Healthcare Medicare Advantage plans for new patients."

So yes, there is room for new patients as long as you belong to the only Medicare Advantage plan that pays commissions to Morse. Nobody else can get in.

So don't believe the BS about Villages Health having to many patients. There's plenty of room if Morse gets a cut.

You didn't need a program to see this coming. In fact I will predict that the developer's exit strategy for the so called health system ultimately involves a sale to UHC.

You are so right! It is all about the money. The villages health is a great concept that is sucking a lot of red. The developer has been subsidizing the operation into the millions each month. I believe they thought Unitedhealthcare's MA program would grow substantially with the association with the villages. That did not happen so the anticipated payer mix did not generate the projected capitated payment revenues. This move positions the system for a stock buyout. Stock is held by management and physicians. The most likely buyer is United Health Care. Meanwhile, where will the original Medicare patients go? A smart move for a quality primary care group would to set up shop adjacent to the villages.

That is a reasonable prediction!!

Not disputing this post, but what is the source of this info?

Thank you!

Whatever happens, I'm sure it will be in our best interest.

:1rotfl::1rotfl:

I'm interested to know how our veterans feel about the article in the paper today announcing changes to The Villages Health. This includes that they will will no longer be accepting new patients covered by military healthcare (Tricare to include Tricare for Life/Medicare). I called to verify this was correct and was told it is. I personally feel this is just another example of groups paying lip service to supporting our troops when, in fact, they do not.

One of the docs.

Villages Health is not only ones doing this walgreens is a prime example, they will not fill a prescription if you are using Tricare. Villages Health cut off others also. What about them? They made a business decision.. II don't feel that they are paying lip service. I have run into same situation when company I worked for switched plans and my DR did not accept new plan. The Village Health did keep those already enrolled. A point to consider.

I am retired Navy and granfathered in "for now"..but feel certainly feel the change is kind of a slap in the face to our VETS!!!

Curious about the hospital in TV
 

Does the hospital accept Medicare & Tricare for Life? Also, my Medicare advantage plan is through Humana. Does the hospital accept Humana?
:shrug:

I would recommend you call their business office. Most likely they do. However, the $ you pay out of pocket may not be what you expect. That depends on the specific contract the hospital has with each provider.

Medicare tells the hospital what it will pay. Humana is a different story though.

If you have Medicare and Tricare for Life, why are you paying Humana premiums? Just wondering!!!

As of today, The Villages Health is no longer accepting new regular medicare patients--only UHC medicare advantage ones. And I was told by the billing department that even though this applies to new patients only, they are sending letters to let current patients know that this will be applying to them as well (though I don't know when the cutoff date is).

Ft

So very and sadly true!

I got into the program about two weeks ago. My wife had to wait until she was Medicare eligible and they called her to tell her she couldn't participate now. It is a definite change in the program as outlined in The Daily Sun today. Of course, they left out the part of excluding Medicare and Tricare For Life as primary and secondary payers. Another knife in the back of Veterans and their families.

Believe me, try to do it now. Their web site is probably changed by now.

You got it!

That's pretty much it in a nutshell!

That's the way this Air Force retiree sees it as well.

I'm happy with UHC.

This is what is referred to as "turning the screws".

Perhaps. Or perhaps it has to with federal regulation pertaining to ACOs. Just as the federal regulators have decided that 80% of homeowners have to be over 55 to qualify as an adult community, there MAY be a regulation requiring a certain percentage of enrollees in an ACO have a medicare advantage plan. As TV Health aims to be an ACO, they may need to meet a requirement. I don't know if it is true, but certainly possible.

GE - I'm not certain about that either. The Feds announced their plan to eliminate Advantage plans over the next several years.

you are correct..web site changed....Retired Military booted...ugh

Not for Me
 

I prefer to choose my own doctors.....not have them chosen for me. No, thank you.

As for not taking military insurance, not good at all. These people devoted themselves to taking care of us, protecting our freedoms, etc. and this is how they are repaid? Yes, they were protecting the very freedom that VHC is exercising, but that doesn't make it right.

...

Do you know if they are just no longer taking NEW patients with Tricare or also ditching existing patients. It looks as though they are not taking ANY new patients other than UHC Villages Medicare Advantage, but they sent us a letter stating not to worry, they are keeping us with our existing insurance (not Tricare)

I don't see this as Vets being booted, rather than the plans being booted. I know many retired vets that are in the health system but they have acceptable plans. Some posts seem to suggest that the Villages Health Care is the only provider that does not accept Tricare and that is false, there are many providers that do not accept Tricare. Why? Seems the "negotiated rate" that Tricare is looking for is below the minimums the provider can accept. I suspect that VHC has made a business decision with UHC that is in it's best interests while Tricare and other health care plan providers try to do the same thing in negotiating rates. As a vet, I understand that I am not entitled to stuff but that if the government or other businesses provides opportunities I have a choice to take advantage of it or not. Health care providers run a business and they have every right and an obligation to run their business's in a profitable profile. VHC made a decision on what works in their interests and decided to get in bed with UHC. You as an individual made a decision on what works in your interest and decided to get in bed with Tricare. Since there are other doctors and providers in the area that do accept medicare and tricare you can still receive services.

makes sense to me!!!

TV Health
 

We have only lived in The Villages 2 years but have already had 3 PCPs leave. I qualify for TV Health based on my insurance coverage, but my husband doesn't. We have not had good experiences with specialists. The hospital doesn't have a good patient experience score from Medicare.

https://www.medicare.gov/hospitalcom...ng=-81.8879884

We are seriously considering leaving TV because we can't rely on getting good health care here.

My fiancé has Tricare for Life
 

My fiancé's ex was a Navy captain and she qualified for Tricare under their 20/20 program (20 years in service and 20 years married). I personally have Humana Advantage under Medicare as I am not military and not eligible for Tricare.

I'm not sure what Villages Health was thinking when establishing this new policy. There are many retired federal employees moving to The Villages. I doubt if they will give up, or suspend their federal health plan (fep ~ very often Blue Cross) for Medicare Advantage in order to join Villages Health. With Medicare A & B along with fep insurance, a retired federal employee can get medical care almost anywhere if necessary.

This policy means the Villages Health is not available to anyone under age 65.

Doesn't seem to fit the needs of a 55 and over community.

No, it just means medicare eligible members are restricted to one advantage plan. If you don't want or aren't eligible for that plan, you must look elsewhere for service.