Are New Special Doctor's Fees Illegal?

KomoTVNews ^ | August 12, 2003 | Liz Rocca

[microgood]

SEATTLE - All of us want extra attention from our doctors, we want to get in to see them quicker, and we'd love more one-on-one time when we're sick.

Now, you can get that -- if you pay a special fee.

But now, the state is trying to figure out if that fee is legal.

Insurance paid for Meg Clara's major back surgery. But she pays extra to get extra attention from her doctor.

A monthly $25 access fee on top of her insurance premiums buys her extra perks.

"Longer appointments, more timely appointments, providing emergency care on site when needed and in the emergency room," said Dr. Brad Harris.

Dr. Harris says the fee means he can reduce his caseload and spend more time with each remaining patient.

But, when angry patients flooded the insurance commissioner with complaints, the commissioner warned doctors and insurance companies they believe the access fee is illegal.

"In some situations we have heard from patients who say I cannot afford that additional fee," said Deputy Insurance Commissioner Beth Berendt.

For the first time, the Commission met with doctors and insurance providers to encourage them to stop the practice. Insurance broker Sean Corry believes patients are being hurt.

"It creates a double standard and a double payment," he said. "I've talked to people at some of the clinics, for example, who are told they have to leave their long standing relationship with their provider because they won't or can't afford to pay the extra fee."

Doctors don't think the fee is illegal because they insist patients get extra services.

"What I want to have happen is that the system allows for us to have the opportunity to make that choice," Clara said.

Clara says if she's willing to spend the money, the insurance commission should butt out!

But if the insurance commission decides the "new access fee" is illegal, it can sue doctors and insurance companies if they don't stop charging the fee.

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try anything new and the whole world comes down on you? Better service for a higher price, what a concept!

[Kozak]

Yeah. F'ing lawyers charge whatever the hell they want. Didn't realize when I went into medicine I gave up my rights and became a slave.

[EggsAckley]

Hmmmmm......not sure I agree with this. After paying premiums, there really shouldn't be any extra fees tacked on. Asuming, of course, they ARE paying premiums.

[Pearls Before Swine]

Better service for a higher price, what a concept!

If a good is rationed, it isn't considered "fair" to have a black-market which changes the equal portions that are rationed out. Here the assumption is that medical care quality and price are regulated and should be regulated.

There clearly isn't enough quality doctor time (almost anyone who has tried to get non-appointment service will agree--good doctors are VERY busy with paperwork as well as patients). However, its in bad form to say the "R" word and admit that the medical pricing system is so gummed up that it is effectively rationed.

[Steve Eisenberg]

After paying premiums, there really shouldn't be any extra fees tacked on.

The question to be asked is whether the people who aren't paying extra are being hurt.

Here is an example where there may be hurt: There is a family physician near me who charges a set fee of $2,000 per patient per year. These patients are encouraged to see him early in their illnesses, and often. Now, from what I read, he sometimes tries to get insurance compensation on top of this. Obviously, since his patients go to the doctor a lot, they would use their insurance a lot. Result: More money paid out to the insurers, and higher premiums.

But if there is no milking of the insurers, I am all for fee for service.

[honeygrl]

I think that's why our doctor doesn't even do the whole insurance thing. You pay it on your own and you deal with the insurance company yourself if you want to get them to cover it. He's a nice old man that hubby and I both love though so he's worth the money. Of course, if we ever needed something major we would have to find a different doctor for the procedure, but for regular stuff we can afford him. He unfortunately has cancer and is very old.. don't know what we'll do when he passes on. I can't stand most of the other doctors in town. My mom's doc is OK but if you are in a lot of pain, you are out of luck because he won't prescribe any pain med that will help much.

[Hostage]

It's not the whole story.

Many people pay hundreds of dollars each month without knowing through their employer to an insurance company.

What the Docs in Seattle are saying is:

"Pay us $250 a month direct".

That's $3000 a year and they will cover most of your contingencies in a much more responsive way. For special disabilities and developments, supplemental payments can be made.

The overhead in a doc's office in the Puget Sound is 90%, highest in the country. Reimbursements are extremely poor. More than 75% of a clinic's time and efforts are spent trying to get insurance companies to authorize care, Medicare is a Federal Gestapo medical terrorist program, Medicaid is Medicare conducted at the State level for political constituencies.

Doc's are saying they have had enough. Now they want to get some quality back into their care and into their clinics. They want to compete head on.

The State is saying that's illegal.

Look at the source, it is a local TV station. I can tell you from experience these local TV businesses are owned by families that are part of the liberal elite of Seattle and they never never get the facts straight when it comes to exposing liberal hypocrisy. The broadcast is biased to say the least.

[SC DOC]

Perhaps the price of a first class airline ticket should not cost any more than coach.

[steplock]

Premiums go to INSURANCE companies - those fees go to the doctors.

[moneyrunner]

Let's examine your premise: who are you paying your fees to, your doctor or your insurance company. And what are the terms of your contract?

[OpusatFR]

Variation on a two-tier pricing system and illegal.

[Eva]

Speaking of lawyers, I have a suggestion that might help doctors with the cost of malpractice insurance. I think that doctors that participate in a PPO should have that percentage of their malpractice insurance covered by the PPO. The PPO must already have some type of insurance since they have oversight of the treatment, so it is actually double coverage for the doctor to have to cover these patients as well.

What do you think?

[microgood]

If a good is rationed, it isn't considered "fair" to have a black-market which changes the equal portions that are rationed out.

If I was going through a set of medical problems and was constantly seeing the doctor, I would pay it just so I would not have to wait so long, etc. If, on the other hand, I only got a physical and went once in a while, I would not pay it and just wait long in the office.

I guess what the people that are complaining are saying they do not want this person to get quicker and better access because they are willing to pay for it. It seems like a kind of Rationed Mentality coming from those who have complained.

[microgood]

Perhaps the price of a first class airline ticket should not cost any more than coach.

Good analogy.

[microgood]

Didn't realize when I went into medicine I gave up my rights and became a slave.

My brother was a GP and gave it up recently. He is only 50. Spending all day Saturday doing Medicare and other paperwork did him in. And the regulations that go with it.

[Between the Lines]

A monthly $25 access fee on top of her insurance premiums buys her extra perks.

Thats a bargain!! In Charlotte doctors who do this charge upwards of $2000 a year.

[Bob]

What the Docs in Seattle are saying is:

"Pay us $250 a month direct".

From the article:

A monthly $25 access fee on top of her insurance premiums buys her extra perks.

You're off by a factor of 10. I'm not sure which way I'm leaning on this one but at $25 a month, it isn't an outrageous surcharge.

[Libertarianize the GOP]

http://www.freerepublic.com/perl/bump-list

[freedomcrusader]

Factor in also that doctor's cannot bill insurance companies for any time spent on the phone, completing charts, etc. If a lawyer thinks about your case while taking a dump, he bills it.

[Hostage]

The original story came out months ago about the straight fee for service $3000 per year.

The local news station twisted this story into some sort of copay premium or extra fee.

I have seen the local news stations get it wrong so many times. The good news is that most of Seattle knows the local news is nuts when it comes to politics.

The original story came out in the press that a group of doctors was charging differently for patients. One set of fees was for premium care and the other was a copay for insurance. So a patient could elect to pay fee for service or to be reimbursed by their isurance BUT NOT a combination fee for service and insurance reimbursement.

The original complaint was based on the premise that a doctor's practice could not separate operating expenses of one from from the orher.

Now the story has morphed in the broadcast media as an illegal surcharge.

The $25 dollar they throw out is a diversion.