Flat rate to see a doctor?

[question everything]

bypassing insurance Video

http://www.msnbc.msn.com/id/3032619#32716070

[eleny]

1. Paraphrase of the final comment: Focus on health care not health insurance

I hope that point gets traction. It's the reform that so many of us want.

[CocoaBeachCoco]

5. yes

[murray hill farm]

2. But....

what happens when a person needs a hospital...or chemo...or dialasis....and more? It is the hospital costs that are the most horrendous.

[question everything]

3. You clearly need a "major medical" insurance

which is how it used to be.

But today we expect insurance to cover every office visit and every lab test and vaccination and allergy shots.

And we never look at the bill since "the insurance pays." At least, once we went through our deductible and co-pay.

And I think that this is a reason why health care costs have soared so much. Most of us don't look at the bills. And one reason why doctors charge so much is because they have high over head, a whole group dedicated to process insurance forms.

[FLDCVADem]

4. All excellent points

I can remember when I was child (born in 1961), doctor visits were paid out of pocket, and we had hospitalization insurance, should we need it.

I was listening to CSpan yesterday - LBJ getting the details on the Medicare bill that was passed in committee. When told of the 20% co-pay he said "Good - that'll keep the hypochondriacs out".

A present day example is a co-worker - two kids, ages 3 & 1, and she takes them to the doc for every little sniffle & sneeze. She said that for the two kids, (neither with any chronic illness), she made over 100 office visits last year. But with a low co-pay ($15), she doesn't even notice.

[eleny]

7. I was born in 1946 and remember house calls

The last house call I clearly recall, I was in college - mid 1960s. I had a bronchial infection and doc came over to keep me from spreading it. His office was in the neighborhood.

Our other local doc had his office in his home which he kept until he retired not long ago.

This was in Queens, NYC. :hi:

[question everything]

9. Some 15 years ago I coordinated the health insurance

registration and payments for my employer.

One manager, who then was making 80K and, of course, her husband was working too, was complaining about a $10 co-pay for each visit. Her husband was taking allergy shots that cost... $8.00, so he had to pay for each one of them..

[RB TexLa]

6. You ought to see the look on the doctor's and office manager's faces when you tell them that

you will file your insurance claim yourself. The first time I did it and the office manager was telling me how he didn't want me doing this anymore, I just said "don't worry there are more people in the waiting room, you can upcode and steal from their insurance."

[question everything]

8. Some years back I was scheduled for an endoscopy

I had insurance but still asked how much it would cost. The answer: "the insurance will pay for it." This was in the early 90s when I started paying attention to this topic. And angrily I replied: this was not my question.

[exboyfil]

10. Three years ago my employer sold its captive health insurance

arm, and we got a high deductible plan. They kept beating us in the head about taking ownership for our own health care. I requested at the time that they publish all the negotiated rates with the local doctors so we can use these rates as part of our selection decision for treatment. They said they would, and they have not to this point.

$90/visit is a steep price to pay to see the doctor when you know exactly what the prescription is going to be. I know that I have avoided going to the doctor several times to not be hit by this charge (times which I really should have gone in like hoping that a sore throat or ear infection would clear up).

I liked the idea of cash only clinics at $40/visit. I tried to find one down in Florida when I was visiting my mom, but I was unable to.

Providers are never willing to give the charges upfront. They may tell you the non-negotiated price. If nothing more they should give you the codes and let you call the insurance company for what the negotiated rate is going to be.

Of course something seems wrong about negotiating for health care like it is car maintenance. At the same time if it is free then it gets consumed at ridiculous rates (trust me I know from personal experience on this one). A relative of mine on Medicaid always wants to see a doctor. I know several of the European countries have put in copays to reduce this level of consumption.

I really don't understand why a German style system has not been proposed. It has been tried and works in Germany. 16% of your income (employer and employee paid) seems like a reasonable price for a lifetime of protection and portability (even for working professionals). I regularly talk to engineers from Germany, and they like their system. I can't say the same for our system. Except for annual check ups, my insurance company does not pay a single dollar until $16,300 is spend ($12,000 in premiums for a family of four and $4,300 for the deductible).

[question everything]

11. With such numbers you have to wonder whether you'd be better off

purchasing your own individual insurance - and do it before anyone develops "pre-existing" conditions - even though it appears that this is one point that even the Republicans are willing to sign on.

[exboyfil]

12. Since I pay only about 20% it is still better to

take the employer subsidized plan, but the insurance company loses all credibility with me with these insurance rates. I really don't think the insurance companies like these numbers being out there, but my employer includes everything in our statements (including those taxes and payments that are made on our behalf). I like to openness of this approach.

We you figure the 3% for Medicare, the $12K I and my employer is paying, the chunk of change coming from my taxes for the other public health care costs, and the inflated costs charged by providers to cover un/underinsured the 16% for the German style system does not seem unreasonable even for a highly compensated individual (up to $100,000 for example would be $16K). Assuming that my employer continues to fund 80% (or even 50% like the German style plan) I really don't think that even someone making $100K would be much worse off than before (assuming we can hit the 16% of salary mark).

Can't understand why the administation does not sell it in this way. Portability has a big value that is not being recognized.