A different approach to the health care insurance problem
This doctor has what seems to be an awfully good idea for a way to reduce health care costs for the patient.
Is insurance really responsible for that much of the cost of everyday medical care? Shocking.
Insurance is responsible twice. The doctor must keep a staff to process paperwork and the insurance company has to keep staff to process paperwork and write checks.
To expand a bit on Mr. Frank’s comment, the communication between the doctor’s office and the insurnace company usually involve several phone calls and faxes (still a primary means of communication) to argue over reimbursemdnt.
The healthcare financing system is converting to a new system of coding diseases (ICD 10) that is intended to increase the specificity of claims submission. In reality it will increase the complexity of claims submission. Thus, lots of training, which is expensive.
The federal government is the biggest payer in the country, therefore they make the rules, including the ICD 10 and other innovations.
Secondly, in some states physicians who charge a monthly fee in advance are regarded in the same way as insurance plans because they collect money in exchange for a promise to render care in the future. Regulators are contemplating a requirement that the doctor post a bond (or provide some form of guarantee) to ensure that the services will be available when the patient needs them.
Patients who choose these doctors usually have good incomes, along with the sense to prioritize healthcare ahead of more discretionary expenses. These are not the people who are the beneficiaries of Healthcare Policy Advocates. They are usually the people from whom Healthcare Policy Advocates can expect money to pay for progressive healthcare policies.
There is no free lunch, health insurance included.
Just think what it would do to any line of work if the customer paid only a 3% co pay and a massive beauracracy took over pricing, collections and payouts from there.
So the doctor takes 18% of the cost of medical care, and the bureaucracy takes 82%.
That makes a lot of sense.
I always thought a simple monthly premium to your preferred doctor was the better alternative to expensive, multi-tiered insurance. I always deal in cash myself. It’s remarkable what a response you can get by calling a doctor’s office and tell them that in lieu of insurance, you have $100 in cash. I think most reasonable MDs will work with you if you can pay at least half their going rate in greenbacks because it’ll usually be more than what they’ll receive from government insurance (Medicaid, Obamacare, Medicare) in less time.
This is a breath of fresh air–people thinking about solving problems instead of getting votes.
The insurance model began to go wrong when this happened:
From wiki:
“The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals and ambulance services to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. As a result of the act, patients needing emergency treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment.”
The hospitals had to get the revenue from somewhere, so they just raised the prices on their insured patients. The insurance companies didn’t like it, but they were under pressure from the government to play ball. As a result they just raised their premiums. In effect the insured became the payers of last resort for all those with no insurance. A form of forced charity.
In 1985 I got four small skin cancers removed by freezing with liquid nitrogen. Cost – $37 In 1987 I had some more removed. Cost – $55 per lesion, plus a charge for the “surgical kit.” (The bottle with liquid nitrogen in it.) Total bill – $275. That is when hospitals and medical practices began charging $5 for an alcohol wipe and $5 for an aspirin and other such padding of the bills. It was necessary to pay for all the pro bono work they were doing. The merry-go-round has continued to spin with prices going ever higher and no end in sight.
Going back to cash only type practices may help at the local physician level, and i certainly think this is a good idea. However, we need to get to a place where we no longer pretend that charitable medicine is an entitlement. If we acknowledge it and try to use actual charity instead of the largess of insurance companies and their policyholders, it might bring more reality and conservative pricing into the system. Of course it means both medical providers and patients would have to accept that we can only get the level of care that we can pay for. That seems to be a difficult concept for many, especially our progressive friends, to grasp.
This is nothing more than conceirge care except these doctors do not appear to be helping you with insurance forms. Most of us have some type of insurance that is supplied with our employment or by the government. We are planning to add a lot more people with insurance under obamacare. Right now, we are short 40,000 primary care doctors in the USA. This type of program means that some of the best primary care doctors will now limit the number of patients to about 30% of their current number leaving a lot of patients out searching for a doctor. In addition, many more doctors are not taking some types of insurance and if mediare and medicaid are cut by the fed and states, most primary care doctors will not be able to accept either without losing money on every patient. Bottom line is that fixes in healthcare can never be in one area only as it is like a baloon and when you squeeze one side, the other expands. This will mean a lot more patients dependent on ER and the end result will be higher care overall.
Greta and JJ formerly Jimmy make excellent points, but the biggest problem of all is people thinking they have a right to medical care. No one ever ever ever has a right to the labor of another person yet that is exactly what is contemplated by those who claim a right to medical care: they make a claim on the life of a doctor and nurse and others. You cannot claim to be entitled to the labor of another person without turning that person into your slave.
I would dearly love to ditch the entire Medicare/Medicaid system and simply spend half the money spent on those wastes of time, people, and paper building and staffing charity hospitals and clinics. Anyone who can afford private care can go to their chosen doctor; anyone who can’t can go through the charity system. Seems like if people weren’t processing payments as is done now, this would be much cheaper.