Colorado Bills

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  1. Attending Physician
Figure a running thread on Colorado might be worth while.

Last time I read some articles on this, the future of health care in that state doesn't look good and I forecast a physician exodus. Anyone know the current status, has anything been passed? What's happening now?
 
I hate it when people start a thread without any details or links in their OP, such that you have to start googling to figure out what the heck they're talking about.
I've heard that Colorado has a rash of toke-smoking layabouts causing havoc on the healthcare system.

The ambulatory have become so indolent they are demanding medically unnecessary wheelchairs. The previously healthy are munching so much they have become rotund. And addled surgeons are sawing off the wrong leg with greater frequency than usual.

They call it: Reefer slowness.

They barely had enough air up there before all this. And now the precious little atmosphere they had is filled with the miasma of hippies.
 
I hate it when people start a thread without any details or links in their OP, such that you have to start googling to figure out what the heck they're talking about.
Yeah, people post as if there is only one thing going on in the world
I predict a big fat failure akin to Vermont and Washington in Colorado's future. I will never work in a state that forces me to accept insurance, and I'm sure sentiments like mine would lead to major access issues over time if they actually used health commissioner authority to try and force physicians to accept an insurance plan. This is less about the reimbursement and more about autonomy, personally.

A big thing single payer and public option advocates never really talk about is the working conditions in the United States versus countries with more equitable coverage options. They want to have European costs with American level access and services, which creates an untenable work environment for physicians. If you're going to pay me like a Swedish doctor you best work me like one too, with both patient volume and hours. 2/3 of doctors in Sweden work less than 45 hours a week, conditions which are similar in Australia and New Zealand.
 
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At least looking at the linked story, it seems the fine for not accepting the insurance is removed. But the threat of being forced to accept it if not enough options/alternatives are available isn't a good look. I agree there could be a lot of physicians leaving the state, accompanied by a push by the larger hospitals that survive to fill positions with cheaper alternatives.
 
Yeah, people post as if there is only one thing going on in the world

I predict a big fat failure akin to Vermont and Washington in Colorado's future. I will never work in a state that forces me to accept insurance, and I'm sure sentiments like mine would lead to major access issues over time if they actually used health commissioner authority to try and force physicians to accept an insurance plan. This is less about the reimbursement and more about autonomy, personally.

A big thing single payer and public option advocates never really talk about is the working conditions in the United States versus countries with more equitable coverage options. They want to have European costs with American level access and services, which creates an untenable work environment for physicians. If you're going to pay me like a Swedish doctor you best work me like one too, with both patient volume and hours. 2/3 of doctors in Sweden work less than 45 hours a week, conditions which are similar in Australia and New Zealand.
I didn't realize this was already a thing in Washington or Vermont. Are physicians in those states capable of declining patients with those insurances? How does cash-only private practice work? I suddenly have great dread about practicing in my home state after medical school...
 
I didn't realize this was already a thing in Washington or Vermont. Are physicians in those states capable of declining patients with those insurances? How does cash-only private practice work? I suddenly have great dread about practicing in my home state after medical school...
Vermont dropped single payer plans entirely because they were deemed unfeasible. Washington created a public-private option no one has to accept that subsequently ended up costing more than most options on the ACA exchange. Colorado dropped fines for nonparticipation but the ultimate option of health commissioner intervention may still be on the table in areas where no access can be found. I'd wait to see how it pans out, it'll probably end up like VT and WA and be a big fat nothingburger
 
I don't know if VT/WA were able to get the same deal but a major reason MA's single payer is solvent is additional federal assistance.

Re: enforcement--they removed the part where the new insurance commissioner can fine or affect your license. I don't know enough about law to know whether they can just assign the medical board to place sanctions on your license as enforcement as part of the implementation stage of the new law.

It's a stupid law in the first place. Maintain or increase access/coverage while also cutting costs by an arbitrary percentage? But then they gave insurance companies an out by allowing the insurance czar to reduce FFS reimbursement. Margins in both insurance and hospitals are generally low (although potentially obfuscated a bit) such that causing 15% cuts across the board is a BIG ask. There's also the "indexed for medical inflation" weasel that was included but I'm skeptical that will be more than a few percent back on the mandated cuts.
 
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