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New York, NY - State Bureaucrats Fight Doctor's $79 Flat Fee for Uninsured
http://www.vosizneias.com/28392/2009/03/04/new-york-ny-doctor-trying-to-help-uninsured-patients-with ^ | 3/22/09 | anon

Posted on 03/21/2009 11:43:25 PM PDT by genghis

New York, NY - The state is trying to shut down a New York City doctor's ambitious plan to treat uninsured patients for around $1,000 a year.

Dr. John Muney offers his patients everything from mammograms to mole removal at his AMG Medical Group clinics, which operate in all five boroughs.

"I'm trying to help uninsured people here," he said.

His patients agree to pay $79 a month for a year in return for unlimited office visits with a $10 co-pay.

But his plan landed him in the crosshairs of the state Insurance Department, which ordered him to drop his fixed-rate plan - which it claims is equivalent to an insurance policy.

Muney insists it is not insurance because it doesn't cover anything that he can't do in his offices, like complicated surgery. He points out his offices do not operate 24/7 so they can't function like emergency rooms.

"I'm not doing an insurance business," he said. "I'm just providing my services at my place during certain hours."

He says he can afford to charge such a small amount because he doesn't have to process mountains of paperwork and spend hours on billing.

"If they leave me alone, I can serve thousands of patients," he said.

The state believes his plan runs afoul of the law because it promises to cover unplanned procedures - like treating a sudden ear infection - under a fixed rate. That's something only a licensed insurance company can do.

"The law is strict on how insurance is defined," said an Insurance Department spokesman.

A possible solution that Muney's lawyer crafted would force patients to pay more than $10 for unplanned procedures.

They are waiting to see if the state will accept the compromise. Still, Muney is unhappy because, he said, "I really don't want to charge more. They're forcing me."

One of his patients, Matthew Robinson, 52, was furious to learn the state was interfering with the plan.

"The whole point is, he [Muney] found a way of paying his rent, paying his workers, and getting to see patients for the price," said Robinson.

"How can the state dictate you've got to charge more?"


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events; US: New York
KEYWORDS: flatfeedoctor; regulation
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To: genghis

This sounds exactly like a retainer.

Does that mean that lawyers are charging for legal insurance?


41 posted on 03/22/2009 5:53:27 AM PDT by chrisser (The Two Americas: Those that want to be coddled, Those that want to be left the hell alone.)
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To: genghis

Somebody needs to get this Doc an award for free market capitalism..and common sense. His critics need an enema.


42 posted on 03/22/2009 5:56:28 AM PDT by mo
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To: chrisser
The difference: when billings exceed the retainer, you get charged the difference. This is exactly the issue raised by the doctor's service. If he gets more than the expected number of accidents or illnesses, he will go broke. And his patients will be left high and dry.
43 posted on 03/22/2009 6:00:10 AM PDT by FlameThrower
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To: kcvl
The doctor is not being an insurance agency, he's being a one-man, limited-coverage HMO.

The insurance companies and bureaucrats can't afford to have this catch on. Otherwise the next step would be comprehensive group practices doing the same thing. The step after that would be for people to only have catastrophic hospitalization insurance, plus a yearly plan with their local doctor/group.

44 posted on 03/22/2009 6:01:05 AM PDT by PapaBear3625 (The problem with socialism is that you eventually run out of other people's money -- Thatcher)
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To: PapaBear3625

which will do away with any need for a national health care system


45 posted on 03/22/2009 6:02:57 AM PDT by Gone_Postal ("Men who say it cannot be done, should not interupt those doing it.")
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To: jeffc
Why is there a law that prevents this doctor from doing this?

Who is John Galt?
46 posted on 03/22/2009 6:06:40 AM PDT by tanknetter
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To: FlameThrower
If he gets more than the expected number of accidents or illnesses, he will go broke. And his patients will be left high and dry.

Or he will have to change his rates, or not retain patients with chronic conditions (For this to work, the doc has to have the option of not renewing a patient who has a chronic condition at the end of the year).

For other patients, it is reasonable to assume that illnesses and accidents will be fairly evenly distributed over the year, and that this month's payments can be used to cover this month's expenses.

47 posted on 03/22/2009 6:19:45 AM PDT by PapaBear3625 (The problem with socialism is that you eventually run out of other people's money -- Thatcher)
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To: Wiseghy
Government officials are becoming more unhinged by the tminute.

Key observation.

It is because There's few limits to their authority. The presumption of enumerated powers of government is pretty much gone. Many officials, from the local queen bee at the town hall to the State and Federal bureacracies, feel that if they say it, its the law unless some other more influential politician or agency says otherwise. If you don't like it, tough... go to court and fight government paid drone lawyers... with the high costs and lengthy delays. Good luck in anything but the clearest cases, because of the politicization of the courts, too. And, for the official... the consequences of a reversed decision are minimal.

48 posted on 03/22/2009 6:23:39 AM PDT by Pearls Before Swine (Is /sarc really necessary?)
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To: PapaBear3625

You have described an actuarial (insurance math) solution. I think NY State is being foolish. But it is an insurance-type product.


49 posted on 03/22/2009 6:28:19 AM PDT by FlameThrower
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To: genghis
"How can the state dictate you've got to charge more?"

Easy, the state is a dictatorship and can do whatever it wants. We gave them that power one slice at a time over the last 200 years. Maybe it's time to take it back.....

50 posted on 03/22/2009 8:29:09 AM PDT by Cacique (quos Deus vult perdere, prius dementat ( Islamia Delenda Est ))
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To: goldstategop

But it’s not single payer and according to DU the ONLY way to fix all our health problems is single payer.

So obviously this guy has to be stopped...


51 posted on 03/22/2009 9:58:11 AM PDT by GreenLanternCorps ("Barack Obama" is Swahili for "Jimmy Carter".)
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