Quote:
Originally posted by Doc T
My 2 cents on your plan:
Economics: Its not a simple fee for service for most things. People are often told what they need to pay...whether it be co=pays or fee for service. If you go to see a surgeon for elective surgery he/she will often have a billing person sit down with you in the office and give you an idea of the cost and refuse to do it if you cannot pay. For emergency stuff that obviously isn't really an option. Physicians can not refuse to treat in an emergency situation unless they can find another accepting MD. Patients are not informed of costs because, for the most part, we have no idea what things will cost. As for deciding for or against treatment, most people assume insurance will pick up the cost and never think twice about it. I cannot tell you the number of patients that ask to stay "just one more day" despite the fact that I tell them insurance WILL NOT pay, that they are fine to go home...but they cannot find a ride or such.... I let them know they will recieve a charge in excess of $400 but they say they don't care.
Tort reform: a necessary thing. I am not certain the increase in sections is because of fear of suit but rather lots of it is public demand...speaking from experience, lol. Patients are more informed of risks and benefits and want an active choice in procedures.
Medical care is a right...at least emergency care...and society has already decided to be charitable on this one and its awfully hard to reverse what is already done. It is as simple as that....and I don't think i'd want it any other way. Most of my patients are indigent... they are appreciative of what I do and show me in ways that they can since they know they cannot pay....with cards, and cookies, and writing letters to the hospital to say how much they love me...lol. And complimenting me by saying I am much too young to run an ICU...lol.... Worth more than money to an aging woman.
doc t.
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OK, I withdraw the claim of victory. For now.
Good points on emergency care, etc. But here is the problem as I see it:
Hospital/provider bills insurance company.
Insurance company ignores bill.
Hospital/provider rebills insurance company.
Insurance company ignores bill.
Hospital/provider rebills insurance company.
Insurance company pays tiny portion of bill, claims that most of services were unnecessary, excessive, overpriced, etc.
Hospital/provider bills patient.
Patient's blood pressure rises dramatically. Patient calls insurance company and screams bloody murder.
Insurance company ignores patient.
Hospital/provider bills patient again, threatening to destroy credit, etc. if bill is not paid.
Patient's blood pressure rises again. Patient calls insurance company again, is assured that this was "just an error," and that problem will be fixed.
Hospital/provider bills patient again, more threats.
Patient gets employer involved. Employer tries to fix problem. Insurance company makes further partial payment.
Hospital/provider bills patient again, more threats.
Etc, etc.
I think you have to break this cycle somehow. You have to make insurance companies lose business when they refuse to pay what they are supposed to pay. I don't think that happens fast enough when you have third-party payors.
Thoughts?