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Cheat Sheet Q & A:
Today’s Topic: ACA from a Doctor’s perspective
The topic and questions:
Just heard you quote estimates for insurance premiums, which are obviously hard to compare due to the difference in deductibles, maximum out of pocket expenses etc. One thing you fail to take into consideration is ... in any
given geographic area:
1) Will my hospital accept this insurance?
2) Will my walk-in clinic accept this insurance?
3) Will my physician accept this insurance?
We accept most insurance; however we are contracted with
several companies such as Blue Cross / Blue Shield, etc. I have my hands tied, as I am required to accept reduced fees that may be only 65-75% of what Medicare pays for the same service.
I have no clue of what will happen if I get a dozen new patients next week, with a dozen different insurances, fresh off the exchanges. Am I on this panel? Do I have to apply to provide services to this patient? Am I charging their fee schedule or mine? Am I being paid 125% of Medicare rates, or 65% of Medicare rates? Do
they allow surgery, need pre-clearance, authorization? Believe me; I have been paid nothing many times in the past because a plan was very restrictive, out-of-state.
I am tired of people who say we "pad the bill" to make up the difference.
Bottom Line: I have nothing to add. This gentleman’s perspective demonstrates the myriad of questions, issues potential pitfalls that we’re on the precipice of with the ACA.
If you have a topic or question you’d like me to address email me: firstname.lastname@example.org
What a Government "shutdown" would actually look like:
Bottom Line: To be clear there is no such thing as a Government shutdown as long as Federal tax revenue is being collected. So as long as the country continues to operate so will the Federal Government. From a macro perspective under a “shutdown” scenario, the Federal Government would be forced to work with existing revenue coming into the Treasury. This forces Federal Agencies to prioritize what to keep operating (and at what capacity) and what to furlough. In essence it’s a forced balanced budget, though not the ideal way to obtain one. So it’s not all bad news. Let’s get to a few key notes if a deal isn’t agreed upon today.
That gives you a bit of an overview. What’s important to note is that we take on an additional 1.92 billion of new debt to operate our Federal Government per day. That would mean that across all Federal Agencies we’d have to account for that difference. That could lead to varied outcomes depending upon how long they’d have to account for no debt spending.
3. Cash is dominating local real-estate markets in
Bottom Line: Nationwide cash has been pouring into the residential real-estate and that’s been true for the duration of the recovery. At first it was largely investor based case but more recently investors have accounted for less than 20% of buying as prices have risen. The cash pouring in now is being used by people looking for a home. What’s interesting is that as interest rates have risen so has the percentage of all cash buyers. According to Realty Trac 45% of all properties purchased in August were all cash deals! That was up from 39% in July. In
All of those cities are at 59% or higher cash being used for residential property purchases. Again it’s worth noting that investor buying is less than 20% of these markets indicating that many Floridians are debt averse and wanting to own their home outright. That’s good news from a sustainability standpoint as these homes won’t end up in foreclosure.
4. The life decisions that will forever determine our financial outcomes:
Bottom Line: Forbes put together several life choices that will forever impact your financial future. It’s a great article and we’ve talked about the items on their own but never the way Forbes put information together. I want to highlight a few that are the most impactful.
Forbes makes a great point about checking retirement benefit offerings. So often we over look a company match on a 401k plan for example, but as they point out it can be the difference in $600k over 25 years! They also accurately pointed out something we know to be true. Marriage can be the biggest financial boon to your financial future if you share financial goals and work together to achieve them. It can also be the biggest financial malady if you divorce.
5. Verizon demonstrates that it gets it & introduces us to the ugly end of the future of TV and technology:
Bottom Line: I’ve discussed the future of the home entertainment center requiring only a simple internet connection. Verizon is now ready to bring the future to
6. Nearly 6 in 10 eligible devices are now on IOS 7:
Bottom Line: The record adaptation by Apple owners to the new iOS 7 continues to set records. By the end of day one a record 18% of all eligible devices had converted despite wait times of two hours throughout the day. The adaptation by the end of last week also set a record. By the end of the week 60% of all Apple devices that could convert to iOS 7 had. It’s the fastest conversion to a new OS of any device or computer ever. It also demonstrates that the brand power of Apple is as strong as ever. It’s also an indication that software developers have to been on their toes. Back in the 90’s OS cycles were about three years apart and adaptation above 50% took more than 5 years. These days it’s near constant. You’ve likely noticed all of the app updates if you’re on iOS 7.
7. Bailing out reverse mortgages:
Bottom Line: If you’ve heard me discuss reverse mortgages you know I’m no fan (despite what the Fonz or Fred say – if it’s so good as them why they don’t have them). I have shared the information with you that over the past few years the highest default rate of any loan product has been reverse mortgages with nearly 10% in default! The result… The FHA asked for and received a bailout of $1.7 billion on Friday to shore up the unsustainable rate of reverse mortgages. That alone should speak volumes.
8. It really is true that almost no is from around here:
Bottom Line: While we may not always like them, stereo-types tend to exist for a reason. As for the saying that no one is from