Some Physicians Fire Insurance Companies | Arthritis Information
For More Quality Time With Patients, Some Physicians Fire Insurance Companies
A type of old-fashioned medical practice is making a comeback in some corners: While most physicians contract with one or more insurance companies, some are no longer accepting health insurance at all. They want to increase their quality time with each patient, reduce hassles, and return to their passion - healing people.
In medicine's past, the physician - little black bag in hand - had more time with each patient to listen to his or her concerns and develop a treatment plan for care together. With no insurance copays or deductibles, the patient paid for his or her care, sometimes even in chickens or other livestock.
Then came "managed care," HMOs, copays, deductibles, preauthorizations, billing hassles, and more. In the opinion of many physicians and patients, the health insurance model of care greatly interfered with the patient-physician relationship. Doctors and patients no longer had control of the health care decision-making process. Instead, a third party, the insurer, influenced it. "Over the years, the [health insurance companies] have certainly interfered with the patient-physician relationship," says TMA President Josie R. Williams, MD. "They have become the unseen but ever-present censor of what the doctor orders."
http://www.medicalnewstoday.com/articles/119640.phpWow, but wouldn't that mean that only the rich with vast amounts of cash could afford healthcare?In my area, several doctors are starting independent practices where a patient or family pays a few thousand dollars per year for 24 hour medical coverage by this physician. It is an elitist sort of thinking where those with the where-with-all to afford this kind of care triumph over those who have traditional medical/hospital policies
It's just one more indication that health care needs to be revamped to include everyone..
A 2005 U.S. Government Accounting Office study reported a small number of physicians, located primarily on the East and West coasts of the United States, practicing under the annual-fee model. A majority of the 112 survey respondents were primary care physicians. Many physicians believe practicing without enrolling in insurance networks is risky, though they certainly feel the pinch of "managed care." So while not all physicians want to choose this practice model, some find it the best route back to good old-fashioned doctoring.
And for these doctors, it does not matter if the patient is uninsured, as are one-quarter of Texans. Physicians are free to provide charity care or see patients for substantially lower fees as easily as they always have.
"Medicine is supposed to be about love and nurturing, and about having fun with our patients, maybe even a hug once in while," Dr. Jones explains. "It is not supposed to be about how to operate a faster conveyor belt."
This approach, doctors not dealing w/health insurance companies, may simplify the administrative aspects of their practice, but what does it do for the retiree or disabled on Medicare, kids on SCHIPS, military on TRICARE, the poor on Medicaid, the worker with health insurance but no extra income for additional medical expenses. If these doctors truly care about having more time with patients and spending less time with paperwork, then they should support a single payer system.
A medical provider's administrative costs has been estimated to be 20 to 30% of their costs. Wouldn't it be more efficient to do away with all the various private insurance plans and government insurance programs and have one administrator, a single payer? Medical care would still be provided by private physicians and hospitals, patients would still have "choice", but money saved from minimizing paperwork could be redirected to actual medical services.
There is federal (Sen. Conyers) and state legislation (California - SB 840) proposing a single payer system but such a system is seen as not viable since the powerful insurance industry is opposed to it and the public is wary of a system they are unfamiliar with.
For those interested, the link below is an article that discusses many questions about single payer, an excerpt:
"In discussions of health care reform, consensus is rapidly developing around the urgent need for universal health care coverage in the United States. There is also an almost universal understanding that this coverage is not feasible without cost containment. Given the facts that over 47 million people in the
U.S. are uninsured and an even greater number are underinsured and that the percentage of the
U.S. Gross Domestic Product (GDP) going to health care is over 16 percent, it’s not surprising that the issues of access and cost have become priority issues in our country.
An increasing number of health care professionals and policy makers are claiming that a single-payer system is the only rational approach that can actually contain costs, achieve universal coverage, and maintain or improve quality. They argue that only a single-payer approach can address the economic pressure on businesses and the rising costs of health care for individuals and still be able to expand coverage to everyone. However, these statements are guaranteed to bring forth a series of questions about single payer. Here are responses to some of the questions that are frequently raised."
For the rest of the article, and responses to common questions about single payer, see:
and lets not forget that the concierge practices still charge you per visit. This annual fee is for access and paperwork and supposedly smaller practices. Lets see say 500 patients at 00/ year and you've got up front a cool 0,000. They charge you say - per visit and they make far more than they would if they took insurance...but it is all about patient care for these drs.
You still have to have insurance for hospitals, labs and specialists so your personal medical expenses are likely to increase for most healthy folks
I saw a dr. blog about this recently, and I wish I had time to track it down, but the thing that surprised me: He said he
could not provide charity care or he would have to stop seeing Medicare/Medicade patients; something about the regulations about giving discounts to others that he did not give to Medicare?
It would be interesting to hear from members from Canada or other countries that do not have private insurance.
I think it might not be a very good system for people with rare or difficult to dx diseases, but I'm not sure. In my case, my rx are about ,000/month (just added cellcept at 5) without insurance and monthly labs would be about 0. I have numerous specialists as well, but not a clear dx. But I know many people who are not getting the care and meds they need under our messed up system. I feel terrible when a retired person in the drugstore is paying a couple hundred for an rx and I am paying only a copay. It is a complicated problem.
Another thought - I have occasionally scheduled appts with my primary dr as a consultation to just ask questions or have a face-to-face on what specialists are doing to see if she thinks it makes sense. That helps fill the communication gap created by these 8 minute appointments.Laker - you mentioned two things that hit home. The last time I was at the pharmacy, an elderly man was picking up his rx's. It was 6. I felt so bad for him. He was asking the pharmacist about each med, trying to decide what to do.
The other is the consultation. I've done that with my daughter's ped, too. I'd rather fill him in about stuff when she isn't sick. It's too much to 'catch him up' on everything during a sick appt., when he also has to dx/treat her for whatever is going on. He lets me e-mail him updates, too, but I know he gets paid if we go in!
[QUOTE=Suzanne]I saw a dr. blog about this recently, and I wish I had time to track it down, but the thing that surprised me: He said he
could not provide charity care or he would have to stop seeing Medicare/Medicade patients; something about the regulations about giving discounts to others that he did not give to Medicare?
[/QUOTE]
I know many doctors in my area; most of them take medicare/medicaid patients, and most also provide charity care. Perhaps this is one of those bogus federal regulations that isn't enforced... can you imagine the public outcry if a doctor got busted for providing charity care?
[QUOTE=JasmineRain]
[QUOTE=Suzanne]I saw a dr. blog about this recently, and I wish I had time to track it down, but the thing that surprised me: He said he
could not provide charity care or he would have to stop seeing Medicare/Medicade patients; something about the regulations about giving discounts to others that he did not give to Medicare?
[/QUOTE]
I know many doctors in my area; most of them take medicare/medicaid patients, and most also provide charity care. Perhaps this is one of those bogus federal regulations that isn't enforced... can you imagine the public outcry if a doctor got busted for providing charity care?
[/QUOTE]
Maybe it is a state thing? I want to say this guy was in TX? I can't find the blog yet; I remember the 'title' didn't jibe with the blog, the link didn't look like it would be about insurance, was about patients....
Found it!
http://distractible.org/2008/08/22/my-patients/From the blog:
" The business argument for quitting insurance is solid. I would not
need billing staff, could give upfront fees to patients, and could set
my rates as I saw fit. I would not have to do authorizations for
procedures - passing any hassles off to other physicians. In my
market, I could even charge an annual fee for the many IT services we
offer above and beyond what most practices offer.
Ironically, I could also start not charging patients if I
choose. Since I am a Medicare provider, to no-charge a non-Medicare
patient would be considered fraudulent. Why? Because I am not also
extending that discount to my Medicare patients.
So why don’t I do it? Why do I hang on to the arcane, complicated mess of medical insurance?"
Read his blog to learn why......
Suzanne2008-09-01 08:27:37Doctors around here state in their advertisements that they take medicare and that they also offer discounts to folks without insurance. If there is a regulation against this, perhaps they get around it by billing the patient for the services and never expecting to get paid. I don't know too many docs who would allow the government to tell them that they could not treat someone in need, regardless of the ability to pay.
[QUOTE=JasmineRain]Doctors around here state in their advertisements that they take medicare and that they also offer discounts to folks without insurance.
[/QUOTE]
I'm just throwing things out - 'discount' is different than 'no charge'? And the discount to people w/no insurance is the same as the Medicare rate they charge, so it
is what they offer Medicare patients?
[QUOTE=Suzanne]
[QUOTE=JasmineRain]Doctors around here state in their advertisements that they take medicare and that they also offer discounts to folks without insurance.
[/QUOTE]
I'm just throwing things out - 'discount' is different than 'no charge'? And the discount to people w/no insurance is the same as the Medicare rate they charge, so it
is what they offer Medicare patients?
[/QUOTE]
One that advertises in my church bulletin offers a 50% discount to folks without insurance, and the first visit is free.
Copyright ArthritisInsight.com