Obama's healthcare plan and optometry...what's the future hold?

[Grover3060]

Now that Barack Obama has successfully defeated John McCain steps will be taken to provide all people in the United States with health care. Does anyone know how universal health care will effect the dynamics of the optometry profession? Will it help us or hurt us? Will our incomes increase or decrease? If anyone has any solid insight into this issue I would appreciate it.

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[KHE]

Now that Barack Obama has successfully defeated John McCain steps will be taken to provide all people in the United States with health care. Does anyone know how universal health care will effect the dynamics of the optometry profession? Will it help us or hurt us? Will our incomes increase or decrease? If anyone has any solid insight into this issue I would appreciate it.

Obama has never advocated socialized medicine or universal health care. Also, with the economy being the way it is, the government is simply not going to be able to afford it for years to come so I wouldn't bet on it happening any time.

But in a theoretical discussion, universal healthcare would be good for optometry to extent that optometry can participate in it. To the extent that we are excluded is a disaster.

 

[SarahNC]

Anything that provides more services for more people and brings patients in your door is a good thing.

 

[KHE]

Anything that provides more services for more people and brings patients in your door is a good thing.

Really?? What if the reimbursement from this universal health plan is $18 per exam? Is that a good thing?

 

[Oogilily]

Really?? What if the reimbursement from this universal health plan is $18 per exam? Is that a good thing?

Haha, only KHE can say it that way.....

 

[SarahNC]

Then it would probably be time to find a new career.... But seriously why would it be? In the office I worked at, Medicaid provided the highest reimbursement for eye exams, so why wouldn't a universal health care system pay reasonably well too.

 

[KHE]

Then it would probably be time to find a new career.... But seriously why would it be? In the office I worked at, Medicaid provided the highest reimbursement for eye exams, so why wouldn't a universal health care system pay reasonably well too.

Because utilization would likely skyrocket under a universal health plan and you can't keep reimbursements the same if usage skyrockets.

Also, in many states medicaid pays so dreadfully low that only a microscopic number of providers actually participate in it. In my state, there are a number of medicaid programs and my office participates in only one because the reimbursement is so feeble. Sadly, medicaid patients are also notorious for showing up late or not at all to their appointments.

If it were to pay what it does in your state, maybe it would work. If it paid what it pays in mine, we would all be looking for new careers.

 

[Dena1342]

I'm not sure that anyone in the Obama camp, or anyone else's for that matter, would be blind enough to overlook what would happen to this economy if our doctors weren't being reimbursed fairly for the work they do.

Medicaid patients are often the ones that no show, and when they do they come late...but they are also often the most appreciative of patients, who are in desperate need for help from our optometrists.

I don't claim to know what its like out in the real world, I have only been recently accepted into optometry school, but I wish that the people of our world, and specially the well educated, affluent, and capable individuals of our society would step it up every once in a while, and help out their fellow men and women in need.

If you are Jill the Optometrist and are making over $250,000 a year, how badly are you hurting for that couple of thousand you may be paying in extra taxes to help out someone?

 

[KHE]

I'm not sure that anyone in the Obama camp, or anyone else's for that matter, would be blind enough to overlook what would happen to this economy if our doctors weren't being reimbursed fairly for the work they do.

Medicaid patients are often the ones that no show, and when they do they come late...but they are also often the most appreciative of patients, who are in desperate need for help from our optometrists.

I don't claim to know what its like out in the real world, I have only been recently accepted into optometry school, but I wish that the people of our world, and specially the well educated, affluent, and capable individuals of our society would step it up every once in a while, and help out their fellow men and women in need.

If you are Jill the Optometrist and are making over $250,000 a year, how badly are you hurting for that couple of thousand you may be paying in extra taxes to help out someone?

Dena,

When you have a $150000 in student loans, $350000 in mortgage, and $500000 in practice acquisition debt, then yea....that extra couple of thousand makes a difference, even for those making high salaries.

When you get out in the "real world" and you have a business, and you have lab bills, and rent, and staff that keeps wanting raises and insurance companies who keep wanting to lower your reimbursements and fuel costs that keep escalating, then you will find that you get tired of seeing people who are "grateful" when they finally show up after their 3rd no show. The fact that they frequently no-show and come in late shows that they are in fact NOT grateful or mindful of your time, office, or schedule. You also get tired of having to submit and resubmit these medicaid claims multiple times to finally collect your $32.43 in reimbursement because the bureaucracy is so thick that you finally end up just saying "you know what....I'm not going to participate in medicaid"

Our practice does participate but only because we service about 10 area convalescent homes. In our office, we do our best to NOT advertise that we accept medicaid because we actually end up losing money seeing these patients in the office.

Can't be losing money on each patient and make it up in volume. So to that extent, universal health care would be BAD for optometry if we turn into a medicaid situation.

 

[SarahNC]

Wow, I am shocked it is only $32 in your state. Last I checked in NC, it's around $80. Why the discrepancy? Do you know what it is in other states?

 

[KHE]

Wow, I am shocked it is only $32 in your state. Last I checked in NC, it's around $80. Why the discrepancy? Do you know what it is in other states?

In my area there is a whole host of different medicaid plans. The medicaid that is straight from the state pays around $65 but pays virtually nothing for materials of any kind.

Most medicaid patients however have their medicaid through one of a host of various managed care medicaid with whom the state has contracted with to administer the program. These programs pay in the area of $40. Usually the patient has a $10 copayment (which they bitch about furiously) and then we battle the managed care company for the remaining $30. This is precisely why we don't take any medicaid other than the one directly from the state and even then, we really only try to take it for nursing home patients.

If I was getting $80 per exam, and then something for materials, perhaps I would consider it but even then probably not.

If I were to book 1 medicaid patient per day, I would expect to earn $400 per week.) ($80 X 5) However, since the show rate for medicaid patients hovers around 50%, I can really only expect $200 for my five appointment slots which averages out to $40 per appointment slot booked. This arrangement would actually lose me money.

However, if I don't take medicaid I can book those 5 slots with patients that average around $120 in reimbursement and have a show rate of around 80-90%%. That means I can expect $400 on the low end for those 5 booked slots or, $100 average per booked slot.

If you're running a business, which scenario would you go for?

 

[eyestrain]

I get some where around $125 for 92005/92015 in SD, which is great if, like discussed earlier, they show up. SV lenses and frames we get like $110-120.. I can live with it.