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.
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bc

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

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

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.

....

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.

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?

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

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.

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.

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.

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.

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
(215)

Or

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

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?

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 ?

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.)

What is the "self insured public service well" ?

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:

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.

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

Ok. Thanks for the explanation.

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...

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.

U.S. medical school applications since 2003 -

https://www.aamc.org/download/321470...actstable7.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.

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.
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bc

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

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.

The Villages Health Care System
 

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

Villages Health
 

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.