We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
I have had a few interesting experiences with my patients and bill paying over the past few weeks.The business aspect of my practice is usually routine and unremarkable, but these stood out:
1. Phone message from a wealthy law firm partner one hour before his initial consultation: "Dr. Bliss, I just found out that you are not on my insurance so I decided not to come in."
(I threw a fit.)
2. An email from a college student patient with no money who I have seen on a charity basis "Dr. Bliss, my Dad" (who is unemployed) "and I were talking, and decided that we need to pay you something for the phone time and emails to adjust my medicine while I'm away at school. Please calculate something and put it on my account."
(I explained that I do not charge for brief phone calls or emails.)
3. Patient in the office "Dr. Bliss, you made a mistake on last month's bill." "Oh I did. I'm sorry." "Yes, it's the second time in two years when you undercharged me. Please correct it."
(I was naturally pleased by her honesty.)
4. Patient in the office: "My husband nickels and dimes me about every expense for the kids, and last week he went out and paid cash for a new Escalade for himself." "Did he?" I replied, "That's funny, because he told me on the phone that you all had no cash and asked that I give you a discount for a while." "Oh yes," she said. "I'm not surprised. His rule is 'Only suckers pay retail.'"
(I told her that as of today, it will be the full original fee because I was not pleased being one of his suckers.)
5. Business guy: "Doctor, will you take a discount for cash?"
("No. I happen to be one of those people who reports all of my income.")
Maybe I have a jaundiced view of people and maybe this was not representative, but having half of them positive experiences sounds really good... Sorry for the "frogs", but maybe that makes the "princes" that much more valuable.
I was going to make the same point. I ask for a discount when paying cash to my dentist and receive it. Oh, and I don't actually pay cash I use a card. He gets the benefit of immediate payment and no insurance hassles.
I have asked my doc when he is going to start charging for email services - he will do RX refills via email without making me come in for an office visit. I would pay just not to have to waste the time going to the doctor. But he doesn't charge. I think he should. I am using his knowledge and time and that's what he has to sell.
The insurance trap is the worst. My Daughter takes anti-migrane drugs only on onset and since she goes to school in the high mountains, her allergies (and migranes) have gone way down. My wife was going to renew her prescription and send it to her to cover the remainder of the school year when she found insurance wouldn't cover it. (they would if the lower cost alternative didn't work). We didn't want to change drugs during classes, so my wife was ready to go on the warpath. I just reminded her that we could just pay for the current prescription and deal with changes later.
It is so easy to conflate health care with insurance payment that even die hard conservatives (like us) lose track.
The patients, the individual citizens of this country are not at fault for this. Let me give you an example of where the problem is. If I go to the doctor the charge for an office visit is about $100. My insurance (medicare) adjusts this to what they consider to be an acceptable charge to $30 and they pay 80% and I pay 20%. Because Medicare and other large insurance companies can get away with this the doctors and clinics are forced to keep raising the charges. Who pays the higher charges??? Not Medicare, not the private insurance companies, the individuals without insurance or who file their own insurance claims pay for it. If I didn't have insurance I would have to pay the full $100 which was inflated to compensate for the insurance companies ability to set the fees they will pay. You need to set your sights on the cause of the problem and not the symptoms. The patient is not at fault and they are getting screwed if they don't have insurance.
Once I tell my doctor its a cash payment he adjusts downward the amount needed. Actually he picks the middle of 3 types of office visits and answers all my questions.
By the way did anyone see where Wal-mart wants to start putting bigger clinics in their stores. May change the way health care is delivered.
The insurance argument by GoneWithTheWind is valid BUT
I deal with the same bad arguments as an Engineer and my services are not doled out with insurance.
My comment remains with the modification that some instances of bad behavior may be influenced by the evils of inappropriate insurance.
FWIW Last year I switched to a health savings account where I pay the first $4000 of medical costs before the insurer kicks in. Recently I decided to cut short some physical therapy. The therapy was useful at the beginning but far too redundant after five or so weeks. I saved several hundred dollars. I also found a way to cut the cost of a prescription by two thirds and glasses by 80 percent.