Posted on 11/12/2013 5:01:50 PM PST by grundle
Eliminating insurance billing cuts 40% of the practices’ overhead expenses, enabling them to keep fees low, doctors say.
(Excerpt) Read more at finance.yahoo.com ...
I’ve heard it suggested that for advanced medical procedures you could pay into a regional Hospital/clinic system where they would charge a monthly or annual fee, insurance companies would be eliminated so the fees would be much cheaper. This would cover you for catastrophic illnesses or serious injuries. You could choose the best system in your area for competition. Basic visits to your family doctor would be paid in cash, or you could pay your doctor a similar monthly fee to cover minor illnesses. All much cheaper than insurance. Your thoughts?
Before the war, it was “even more so the case.” My family doctor was himself a “farm boy,” and when after the war his practice made him more than comfortable he bought a nice place outside town where he could enjoy the weekends doing chores he hated as a boy. ;).
The best thing would any system that would re-establish the personal link between doctor and patient.
I would be fine with something like that. Certainly: Routine doctors’ office visit should be paid in cash. I mean, that much is inarguable. At some level, I don’t care how damn good your insurance is, I believe you should have to pay ten bucks to go see the doctor. You don’t get out of a freaking oil change joint for less than $30, do you? What about your food market? 3-5 items, nothing, and you’re up to $20. What is it about medical care that makes people think they should be getting it for free? Are you/I/they not consuming it? Is not the education of a doctor the single most expensive “trade” a person normally, if not in their lifetime, a consumer of same comes into contact with?
There are many, many ways in which the capital cost of an expensive whizbang machine might be amortized. I could even see (and this is in some ways absurd so brace yourself) a doctor’s office or hospital offering revenue shares in such a machine....to patients.
I think catastrophic insurance should be by far, by MASSIVE far, the normal mode of insurance.
People always talk about the military industrial complex. The medical industrial complex is quite possibly 3x as large. We have been brainwashed into thinking med care is a right and somehow we should not have to pay for it. The fact is that the healthcare industry has ensconced itself into our economy in jaw-dropping ways. Another fact is, that when people do not see money being extracted from them, they think stuff is free. Withholding taxes, anyone?
Do you know that the state of Maine is being sued for importation of prescription drugs? The costs of those drugs sourced domestically is in many cases 20 times and in some cases ONE HUNDRED TIMES the generic substitute cost. (You will see dozens of examples if you watch that vid I linked in my prior post) Why are there laws prohibiting importation of Rx drugs? And perhaps more alarmingly, do you know what the penalties are?
Talking $100 million and 10 years. I kid you not. Why would there be such insane penalties if the protective measures were not being instituted by the drug companies themselves?
Did you know that in most counties, doctors or hospital administrators sit on boards that govern the permits for say, MRI machines. This is a topic known as CON (certificate of need) law (and there could be no better name) Many times, these docs sit on hospital boards and thus have an interest in the scarcity of medical care within their jurisdictions. So, if you want to come into an area and set an MRI lab where, judged on volume, you could provide the service for say $350 when the going rate is $2500, you’re likely to be denied permission to do so. Another example of the ensconced nature of the officially sanctioned monopoly power given the healthcare. It’s unconscionable and in any other business would be a black-letter violation of all the anti-trust and anti-competition laws written in the 20’s.
But like most other aspects of our economy, it’s scam-based.
Concierge Medical Care. On the horizon (and those who can afford it, welcome it).
State medical boards have docs by the ba**s. Eventually, in order to get a license to practice, docs will be required to see medicaid and medicare patients. Checkmate on the “concierge” crowd.
If you're having a major surgery--a transplant, a THA, something big and costly--gettng on a plane and spending a fortune to go to another country might be an economically viable option. But if you need a cardiac cath right now, you don't have time to get on a plane to have it done. If you need a Mohs reconstruction for skin cancer on your nose, it's not worth going abroad; it's not typically going to be done in a hospital anyway. But it is too expensive for the average person to pay for himself even if the physician reduces his prices dramatically.
I'm unenthusiastic about medical tourism. For most major procedures, I want my surgeon and team a short drive away so I can be followed easily. Go to India to have a mastectomy and you're 12000 miles and a lot of hard traveling away from the guy who would need to follow your cancer case. Not practical.
Elective surgeries, like plastic surgery and lasik for eyes, are affordable for many people, because they don't take insurance. Those docs make a good living. There are enough routine procedures that I can see where cash only practices will become more common, especially with Obamacare and the high deductibles.
bookmark
The government will crack down on this.
My wife just turned 64 three weeks ago and had her medical insurance policy cancelled about two weeks ago. Happy Birthday from ObamaCare. When she checked on getting replacement insurance, it would have cost her a whopping $856 a month with a $6000 deductible and 20% co-pays after that. She is retired and on Social Security. The medical premium would have taken 2/3 of her monthly income. She is healthy and will be eligible for Medicare in a year, so she decided to ride out this next year as uninsured.
She needed her prescriptions refilled so her doctor agreed to keep her on as a cash patient until she went on Medicare. Today she went in for her first appointment to get her prescriptions refilled. She paid cash for the visit and saved 20% and got her medicines at Walmart. Her total cost was just under $200. Her refills every 3 months will be about $60 each time.
So with the insurance, it would have cost her just over $16000 with premiums and the deductible. By paying cash to her doctor and buying her prescriptions at the lowest prices available, she will spend about $380 for the year, unless she has to go in for more visits. We’re not math majors or financial wizards, but the option she chose was a no-brainer. $380 versus $16000. There is some risk involved obviously, if she were to get injured or real sick but we will take that risk rather that fork over a big hunk of money to the insurance company that we can’t afford. Even if she pays the tax penalty for not being insured, she is still way ahead of the game money-wise.
A lot of elective surgery like cosmetic procedures and LASIK are paid for with credit. There’s a company that offers credit for these non-necessary surgeries (can’t recall the name of this but I’ve seen their brochures).
We could reduce the cost of doctors’ office visits if doctors didn’t have to pay so much for malpractice insurance, but there are other operating expenses of a practice: rent, equipment, staff salaries, waste disposal charges, utilities, taxes, workers’ comp/unemployment, TAXES, supplies, CME, etc. I try all day to find ways to minimize the ceaseless expenses. A doctor who spends twenty minutes with a patient can’t keep his practice going if he accepts ten dollars for that service, or thirty dollars an hour. He is paying his staff (together) more than that thirty bucks an hour.
The hard truth is that many patients, especially the elderly and those of humble means, won’t come at all if they have to pay out of pocket, because there is nothing in their pockets now. Many Freepers who talk about paying out of pocket must be fairly prosperous and have a lot in savings, but these days most of us don’t.
When my son had a serious blow to the head four years ago, his symptoms mandated first a CT scan, then an MRI later. The charges were below the level of the deductible typical for catastrophic care coverage, but were orders of magnitude more than I had in the checking account. I could not have paid for these procedures and subsequent care and subsequent necessary care without the excellent insurance he had.
The clinic would either need to have a pre-existing condition exclusion, or a “life time maximum” that starts at a very low amount and increases every year. Otherwise they’d get the guy who gets diagnosed with AIDS and signs up the next day. You’d also need some kind of coverage for major expenses in areas that the hospital/clinic can’t handle. Reinsurance companies specialize in that kind of coverage. Given those elements, it’d work just fine.
Since, as you indicated, medical care is provided by people, a “right” to free medical care is a right to enslave the physician.
” a “right” to free medical care is a right to enslave the physician.”
Well...it is. This is the critical line between worldviews of the utopian and the individual. The utopian believes that the government is this massive blob of money and power protoplasm that can afford anything, and certainly, there is ample evidence that the government can spend astronomical amounts of money on the most absurd things imaginable.
Individualists, OTOH, are just that. Not permitted in utopia, no thought is given to the amount of time and effort it takes to become an MD. The individualist thanks his lucky stars that his doc was somehow motivated to go to school for 11 years and learn his craft and do it....even if it’s expensive. (And the doc thanks his lucky stars that his plumber can fix the doc’s toilet)
But what the utopians leave out of their calculus, if you can call it that, is that getting the govt to spend money on YOU (and your healthcare) and/or what YOU think is important is strictly a matter of some spending arm of the govt perceiving you as a thing of value.
Once your anticipated medical contribution to the economy is placed into the hands of the government, a simple piece of math emerges.
Is your vote/my vote worth (let’s say) $1 million? An individual with a serious chronic illness or a multiple-episode heart condition (think Dick Cheney) could very conceivably consume $1 MM of medical care.
I would posit that for $1 million, the Democrats could import between 100 and 500 illegals, virtually ALL of whom would vote for Democrats if it were legal for them to vote, but the effort to ALLOW them to be able to vote will in and of itself gather perhaps 1000 more illegals to the Dem cause. And that holds true even if 30% of them die from...wait for it....crappy medical care!
When it’s all said and done FRiend, your vote and my vote, with these pigs, ain’t worth spit.
Well said.
As long as they can manipulate the system to keep them in the position to make the decisions. Their vulnerability is having to give at least lip service to democracy.
The utopian gene and the competence gene are rarely found in the same individual, so even though they achieve the 50% +1 vote, they usually screw things up in a way that ticks off the majority. These days, I live for opportunities like that.
Sponsoring FReepers are contributing
$10 Each time a New Monthly Donor signs up!
Get more bang for your FR buck!
Click Here To Sign Up Now!
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.