Skip to comments.As Obamacare Deadline Looms, Doctors are Opting for “Cash Only” Clinics
Posted on 08/23/2013 1:23:49 PM PDT by NCjim
Physicians across the country are attending seminars that teach doctors how to start their own direct primary care practices. Direct primary care practices take no health insurance, only cash. In a recent survey conducted by the DPMA Foundation, 2 out of 3 doctors say they are just squeaking by or in the red, and 83% say they are thinking about quitting the business. With the looming threat of Obamacare, many doctors are planning to ditch the traditional business model for a more simple and straightforward one.
Dr. Jerome Aya-Ay from Palmetto Proactive healthcare in South Carolina uses the Direct primary care, model which is successful because it eliminates the bureaucratic hassle of insurance and lowers prices for the consumer.
Dr. Jerome Aya-Ay charges his patients via a price list similar to a restaurant menu. He also charges a monthly fee of $60 for routine services which most doctors cannot do. Listen to the interview below.
Chiropractors have been using the cash only business model for many years and are experiencing great success. Dr. Scott Baker, owner of Upper Cervical of Spartanburg, S.C. said, We started to go 100% cash in May 2012 and are experiencing great success, now we are moving into a state of the art facility 3 times bigger than our current venue, and we will be hiring a new doctor. Dr. Scott said he is creating a patient-driven practice. His new clinic will have a health-spa feel with digital touch screens for patient check-ins, flat screens TVs, and a paperless office so he can have more time to focus on his patients.
The Heritage Foundations Ed Haislmaier said, I think we are going to see primary care doctors increasingly moving to a cash-only arrangement, where they opt out of insurance rules. The simple truth is that doctors want to get off the insurance grid not only because of the risky regulations and economic factors, but because they want better relationships with their patients.
Dr. Tom Kendall of Greenville, S.C., a practicing physician and the president of the Association of American Surgeons and Physicians said, Obamacare is not about healthcare, its about control. Obamacare puts the relationship of the patient and physician under the jurisdiction of the government. This means more government control and less patient choice. Under Obamacare, healthcare will be rationed, healthcare costs will increase, and bureaucrats will decide medical treatments instead of the physician and patient.
Upstate doctors who are moving to a direct primary care are creating win-win solutions for medical professionals and their patients. It would be a move from a bureaucracy-driven model which is enamored with red tape and creates a wedge between the doctor and patient, to a patient-driven model with no insurance interference, less government intrusions, and no wasted time dealing with paperwork. It is a model that will create lower fees for patients and will allow doctors to foster better relationships with patients. The real solution to healthcare is to give patients more control over their health care dollars, and unchain doctors from the shackles of government control and regulations.
I would assume the government will not tolerate cash for pay medical services and will demand that they serve anyone who walks in and demands it
The problem is that the patient will still have to purchase insurance. So now you have to pay cash for a doctor and also have to have insurance which you can not use.
Next up - Obama making all doctors part of the government and therefor can’t close their business.
and if you pay in cash the price is a lot lower apparently
Is the government going to pay the bills and the rent? If not then the doctors can just make sure to let those lapse.
The building will be owned by the gov’t under OBamacare.
My excellent dermatologist told me they would probably have to close the entire operation come ObamaCare implementation.
He is president of the largest medical provider in the city. Hundreds of docs, hospitals, etc. He would just go into private practice. And probably take cash only.
If I need anything done, I should probably get it done by the end of this year, and you should too. Any possible upcoming surgery for the foreseeable future, any condition that might possibly escalate, any health problem that might come up....take care of it NOW.
My doc just told me he is closing shop. new regulations...
I have been telling my wife, look for cash only clinics just across the border in Mexico in the not too distant future. For those who can afford it, look for cash only clinics in more exotic locations.
It will eventually come to that because everyone has a “right” to health care.
ObaMao's next step will be to make FSAs and HSAs far more restrictive in what you can save in before tax dollars and what you'll be allowed to pay for.
Hospital ships. Turn on the operating room when you’re 3 or 12 miles offshore. It’s got to happen.
They may have to be foreign flagged, but they will be nearby.
There’s a history for tolerating things in boats that aren’t tolerated on land, like gambling barges in states that don’t allow casinos on land. Of course, that’s state run, and the problem here is Federal, but you get the idea.
But if you purchase insurance to cover a catastrophic surgery or hospital stay only, it will be much cheaper. You pay for doctor visits and medicine out of your own pocket. Just like you used to.
Yep. It’s going to be a mess.
It may drive us toward prevention, however. Watch diets, get exercise, etc, in order to STAY healthy, cuz we’ll be in big trouble if we need a doctor.
My doctor asked me how I felt about ObamaCare the other day.
Told him I didn’t care personally and I’d pay the fine.
However, I pay cash for meds, visits and everything else, hoping to get to the front of the line not just for my greenbacks but, for a patient who is very proactive in his healthcare.
If it comes down to it, I’ll start vacationing at cheaper and better places around the world.
He did ask about hear attack.
I laughed and said “Do we need to discuss the numbers, survival probabilities, possibilities and 7% of people being rescusitated with CPR?....Life is tough Dr. and I will one day no longer exist on this earth but, be with my fellow Christians and family in heaven...maybe...”
He laughed and said “Good outlook”.
The doctor doesn’t need to hire two or three people to handle insurance claims.
And once that happens, just imagine what their union dues will be.
Indian reservations, too, perhaps, for major procedures.
I should add that I am concerend for a good number of my friends and Americans in general who cannot now afford that decision but am greatly distressed over the lack of choices they will have once ObamaCare is implemented.
Good observation. I can hear it now: "Mohegan Sun... opulent food, exciting gambling, top-rated hip-replacement clinic."
I read a proposal on Slate to set up low cost health clinics on reservations, though they suggested employing foreign born Indians as doctors.
But doctors setting up clinics on reservations would provide local jobs, care and legal protection from Obamacare.
Actually, it has some potential as a gap-filler. You pay the fine and the cash primary care payment and they still add up to less than the “comprehensive” insurance would cost you. Then if you get really sick, you take advantage of the “shall issue” provision in Obamacare and get insurance for the period of your illness. Looks like there’ll be a new job market for people to go to the hospital and do “on the spot” insurance sign-ups.
Obama is really sticking it to us.
Hillary’s attempt at healthcare made fee for service illegal. I expect Obama’s HHS Emporer would deem it the same.
I suspect they will make accepting Obamacare a condition of retaining a medical license. That won't be as obvious as a flat edict and will be handled by the medical boards state by state.
The classic respone I’ve seen is that doctors who do this and are not affiliated with an insurance practice lose their admitting priveledges at the hospital/s in the area. The hospital boards either buy out the clinic to close it or the doctor goes back to taking insurance in order to retain admitting priveledges.
Next up - Obama making all doctors part of the government and therefor cant close their business.
Yup, Government is like an elephant on a water bed trying to smooth all the bumps out, they keep pressing down on another bubble in the bed only to cause three of four more to pop up, and the damn morons don’t realize that if they got OFF the damn bed the bed would itself smooth out....
This idea was first seriously proposed during the New Deal—make all medicine part of a National Health Service. Since Obama has been recapitulating New Deal excesses in most of his initiatives, we can assume that this is his ultimate goal for medical care.
Those who don't want the feds controlling their bodies can pay the "tax" to opt out.
I've said all along that Obamacare is going to create a two-tiered system. One tier will pay to opt out, have doctors who refuse Obamacare patients and will pay their own bills. The other tier will be stuck with whatever health care the feds decide to give them.
My question is if those who opt out can still get a catastrophic-only insurance policy with a high deductible that does not cover all of the stuff in Obamacare.
A REAL reform would:
1) Eliminate ANY rôle for the federal government—because the Constitution gives the federal government no rôle.
1b) Repeal the 16th Amendment. That would eliminate non-taxable “benefits” as opposed to salary.
2) Allow the free market to operate—in which most people would, freely, choose catastrophic health insurance, and pay cash for routine medical care.
3) Any STATE that chooses, can constitutionally assist the poor with their health care or health insurance.
Soetoro has already done that. Parents of disabled children are already being punished, financially, for failing to do the right thing—abort their disabled babies.
No. Catastrophic policies are illegal under BonerCare.
Well the tax penalty in the first couple of years is cheap or cheaper than the insurance but as the years go by the tax is hefty and I believe if I read it right was 2.3% of your income times your family members so that could be hefty in the thousands so any disposable income you might have will be taken away to pay for something you don’t even have.
The whole thing is just sad.
Obama even said that when he was debating Hillary in 2008
about the health insurance she wanted. He is such a liar.
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ANY politician that says, "Well, all you have to do is ... " or, "I propose that we should ... " or any of a number of other woos answers is an enemy.
The plan has been read ... it is understood ... thinking men see it cannot work ... so whomever does nothing to actually eliminate ... erase .. obamacare ... WANTS us enslaved and THEY want to be our masters.
Kind of like paying mello roos taxes and sending your kids to private school.
EWWWW that is an image we don’t need LOL He better just stick to Reggie instead of us.
Obama will declare a national emergency, reinstate the draft, since no one will stop him. Then he will draft all of the doctors into the military and assign them to whatever hospital he chooses. Refusal to serve will put them in military prisons. Or maybe the camps he’s supposedly setting up.
Then, if there is a shortage of doctors, he will draft the nurses and give them authority to perform as doctors.
The rabble will cheer him on, the politicians will be scared to stop him and run for the hills.
Then he will open up government medical schools and bring in the unemployed, give them a bit of training, and then say they are doctors.
He will build new hospitals on the Cuban model (rusty equipment, crap on the floor, toilets that don’t flush).
Then the media, who get free passes to the government elite hospitals, will tell us this is a much greater medical system than we ever had, and probably the best in the world.
Don’t laugh. He has got away with SO much crap that most people have given up and will just take it.
Awesome. This is what healthcare should be in the first place. It is INSURANCE ITSELF that causes costs to spiral out of control as the burden of care is spread across the whole population.
Let the free market dictate costs and get rid of insurance all together.
If physicians are *allowed* to provide private health care without insurance, Medicare or Medicaid, one more thing is essential to their well being: exemption from Title II of HIPAA.
The Health Insurance Portability and Accountability Act of 1996.
Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. And *mandatory* compliance with these standards by everyone practicing medicine.
Despite what this says, in practice it means that all doctors must keep patient records in a standardized electronic format that can be accessed at will by numerous government agencies and others.
It totally eliminates the “doctor-patient privilege”, and cleared the path for single payer national health care.
N.B.: Many Republicans supported this law, so have to be considered as untrustworthy to oppose Obamacare. They *want* socialized medicine.
In any event, if private physicians, who take neither insurance, Medicare or Medicaid patients, want to continue to be free, they must someone get exemption from Title II of HIPAA.
Great thought—better than casinos!
In my state -- not sure about other states -- insurance will take effect on the first of the next month or, if you apply after the 23rd of the month, coverage will commence on the 1st of the second month following. Much the same as commercial policies currently.
Yes it did, that was on about page 840 of her plan.
I was in the midst of a major problem back then and went to a second doctor for his opinion. I paid out of pocket, and as I did so I told the receptionist that if HillaryCare was in effect (It was still all up in the air) I would be faced with a$10,000 fine for that cash payment I was making and her doctor would be facing 5 years in prison.
She gave me a look of shock, but kept her mouth shut. I don't know if she believed me or not.
Here's how the plan will work - each doctor will charge $1,500 per year per family member ( think 'club membership) - after the annual entry fee's paid, each visit's a flat hundred bucks.
In short, if you're NOT a member of your local exclusive golf club or Yacht Club you won't have access to the best doctors...ever again. And your kids won't either. But the BIGS at the IRS will work out a deal - as will all the other liberal elites... their kids will be protected too... yours - not so much.
“I would assume the government will not tolerate cash for pay medical services and will demand that they serve anyone who walks in and demands it”
That is certainly what happened in several European countries, at least for a while -— although most are now permitting free enterprise.
My docotor is pretty much like that already. Makes house calls, too.
Just kidding... Sorta.
My (once probably what they considered a "cadillac plan" is now useless. I now pay outta pocket for everything up to 6k. My husband just has gall bladder surgery and I joked that it probably will come in at 5999.99.
But for a mello roos don’t they have the residents of the neighborhood vote for it before it is initiated since it is specific to a neighborhood?
I was once told that one of my wife’s meds was $500 w/o insurance, but only $9 with it. That’s insane, but illustrates the problem of being without health insurance.