Posted on 07/03/2006 8:42:18 PM PDT by neverdem
Minnesota doctors say health plan rules keep them from talking to patients. Others say the moves add to a shortage in care.
Dr. Eric Larson calls himself a "conscientious objector." Six months ago, the Edina psychiatrist announced that he would no longer accept insurance payments. If his patients wanted to keep seeing him, they would have to pay his fee, in full, at the door. Cash and credit cards accepted.
The change meant giving up a steady source of income. But for Larson, 48, it was a gamble worth taking.
He's one of a small cadre of psychiatrists in Minnesota who are bucking the system in an effort to escape the rules and reimbursement rates of HMOs and other health plans.
In part, it's a backlash against the growing pressure on psychiatrists to limit patient visits to 15-minute "medication checks," with no time for anything resembling talk therapy.
"I was trained in an era when we still thought that psychotherapy was integral to being a psychiatrist," said Larson.
"I'm a therapist at heart," said Larson, who has been in practice 19 years. Now, if patients want to talk for an hour, "I'm happy to do that. They're basically renting or buying my time."
So far, only about a dozen or so psychiatrists have started "cash-only" practices in Minnesota; several have led the state psychiatric society. But a recent survey found that 35 percent of psychiatrists nationwide refused to participate in managed-care plans last year. Some refuse Medicare and Medicaid as well.
Critics say the doctors who opt out are, in effect, abandoning the sickest patients for those who can pay upwards of $300 an hour and making a bad situation -- the shortage of psychiatrists -- worse.
But some call the step an act of protest against a dysfunctional system...
(Excerpt) Read more at startribune.com ...
Our country's health care system needs a doctor.
"Our country's health care system needs a doctor."
It needs for government to get its greedy, incompetent hands off.
Practically the only legitimate role I can think of for government in health care is to disbar and jail lawyers for bringing frivolous malpractice suits.
So, I shan't make that observation.
Good. Glad to see some doctors are rebelling against government rules and mandates. There are some doctors that have opened cash-only practices.
Michael Dukakis made this illegal when he was governor of Massachusetts. I guess he thought doctors wouldn't mind a bit of indentured servitude.
If I recall right, the sudden stampede of doctors across the state border made the legislature have to go back and overturn the rule.
insurers are the evil empire. you can blame them and amoral legislators and physicians for the mess.
Lots of medical doctors are already doing this and I don't blame them at all. My family dentist stopped taking insurance years ago.
"Our country's health care system needs a doctor."
Somebody needs to post the pic of Bones saying "He's dead, Jim." What our country's health care system needs is an autopsy.
My Family Doc is one of these. Flat $50.00 for an office visit, and he usually spends from 30 to 45 minutes with me.
He will not process insurance, but my co-pays would be nearly this large and with a 2000.00 deductible per year per person, I just never make it, (knock on wood).
I went to get a flight physical and paid the bill in full on my credit card. That wasn't enough money for the hospital. They wanted my insurance information to see if they could get even more money for the services for which they had already been paid in full. Double dippers...and worse.
"insurers are the evil empire"
Without insurance who could afford a heart lung transplant?
The following all result in higher and higher medical costs paid for by insured persons through premiums:
Aging population demanding state of the art care. Uninsured population using ER as primary care.
Doctors insuring against malpractice.
Overuse of medical care by group coverage.
The medicalization of non-disease.
I'm gonna have to disagree with you on that statement. There are a lot of vets returning home from Iraq and Afghanistan, myself included, who are getting some help readjusting to home life. Are we completely nuts? No. Do we have issues? Yes. I've been home for over a year now, and every night when I go to sleep, I see the faces of all the guys in my unit that I closed up body bags on. I can close my eyes right now and hear the sound of incoming mortar and rocket fire, feel the heat and the jarring impact from a road side bomb detonating near my vehicle.
The VA has some great people who are trained to deal with the kinds of issues that returning vets are facing. I still won't go into a convenience store with a cashier that looks middle eastern, but I'm not shifting lanes on the highway everytime I drive under an overpass anymore.
It's their time. They can allocate it any way they want.
My wife recently had a gastric banding procedure not covered by our insurance. With an up front cash payment the discount was nearly 40% of what they would have charged our insurance company.
I wish patients and doctors could opt out of litigation. Sign off on an agreement that all complaints would go to one single arbitration hearing, loser pays the $500.00 cost. Doctor visits would drop to about $30.00.
Ah, yeah, nameless "critics" used as a fig leaf for the reporter's own unsupported opinion -- in this case, that businessmen and -women ought to give away their product to the "needy". Lord love a duck.
Insurers have long been cracking down on mental health cases, because, like chiropractic, there are extremely high levels of fraud and abuse. (In all mental health practice areas, the worst are in substance abuse treatment). So there have long been all kinds of caps and lifetime limits, etc.
Some doctors (not just brain housing group mechanics) also like to "run the meter" by giving pts a very short-duration script. An example is 30 days for a cholesterol med. Look, if a pt is going to be on lipitor, he's on it for good once the dosage is established. Bringing him in every month or two serves no purpose but runs the doctor's meter.
Doctors, for their part, see this as retaliation against insurers that try to nickel and dime them constantly.
Medicare and Medicaid have two things happening: 1) rampant fraud, mostly in organized rings, and 2) aggressive US Attorneys chasing the fraud, that can wind up ensnaring legit docs when they presto-chango a rule in midstream. Unless you are practicing in the South Bronx or Palm Beach,where your demographics have you screwed, these welfare programs can be more grief than they are worth.
d.o.l.
Criminal Number 18F
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