affects folks signing up for insurance there has been little attention to how doctors and other health care provide remembers affected, especially those who might operate outside of any insurance network. for that perspective i m joined by karina wu, a physical therapist who always has been an out of network practitioner. help our viewers understand what that means. you set your prices and insurance companies tell you how much they re going to reimburse, right? out of network provider is a health care practitioner that does not contract with an insurance company. so we are not capped by a reimbursement rate, like an in-network provider is. jon: if you were to do that, if you were an in-network provider for lots of insurance companies how does that affect your business? means we rely more on volume. because your name is listed in, say the cigna website. so the people who have cigna as their insurance are going to find you. but the problem is, the reimbursement level is so low, that
approval numbers for the president in the month of october, and, of course, republicans are also watching with great anticipation. we ve been down this road before said house energy and commerce chairman fred upton today as officials looked us in the eye for months pledging that everything was on track and we now know with the chaos bekind the scenes that it was on track for disaster. what reason do we have to believe things will be different now? heather: health james rosen live at the capitol where the christmas tree aears to have arrived. thank you very much. gregg: well, it is a good question. why would we expect anything different now? and there s also another crisis that is looming under obamacare as millions of newly-insured patients enter the system, states are seeing a major expansion of medicaid. but if low reimbursement rate means a serious shortage of
it shows that obamacare is already being implemented on the ground in some of these provisions. there are other things happening now, too, for nursing mothers. there are. you can also have access to a lactation consultant. that benefit is also covered. these are professionals who offer breast-feeding assistance and education. but once again, what sounds good on paper, it also has some hiccups in practice because we talked with some lactation consultants who said the reimbursement rate from these insurance companies is so low that they re not so gung ho to get in on being an in-network provider. so in sum, what tough to have more choices or define that lactation consultant under this benefit, so, yes, all of these great benefits are in practice, they sound great but they re having a few hiccups along the way. so do your home work. thanks, alison. president obama still can t shake the perception that he wasn t prepared for the presidency. i ll ask a man who was there
the health of a population is primary care doctors. we need primary care doctors. thyroid is a little bit big. what s happened today is we ve found ourselves in a position where we don t have enough primary care clinicians to provide that important fundamental level of care. when was your last mammogram and pap smear? 2008. why? we have underpaid on a chronic basis. under rewarded primary care. some would say over rewarded specialty and subspecialties. okay, so first topic, medicaid reimbursement. about three weeks ago, because of the state budget crisis, we got told with very little notice that medicaid and medicare reimbursement was going to be cut by about 25%. so, to make up that difference in the reimbursement
reimbursement was going to be cut by about 25%. so, to make up that difference in the reimbursement rate, next week we re on track for that on tuesday. right now, the only way we have to make up the difference is to see more people. right. that s a little might be a little bit of a culture shift, too, for the patients. and if they have a relationship with you, feeling truncated. that s going to be a little bit of a change and a little unfortunate. it s a financial necessity. that s the only reason we re making the change. but you have to have the time to educate your patients. and they don t reimburse for nutritional counseling or anything like that. we re going to talk to them about it still, you know? we all know there s things we can do and they make us feel good and we like to do them, but we re going to feel really bad if our doors close. then we re not going to help anybody. conventional wisdom is, over the next two years, we will likely go out of business.