Skip to comments.Obamacare Side Effect – Doctors Abandon the Health Care Insurance System Altogether
Posted on 10/24/2013 1:30:22 PM PDT by RKBA Democrat
Free Market Alert!
Many medical practitioners have apparently simply had enough. Instead of continuing their never-ending struggle with the welfare state's red tape, they have decided to revert to a free market model without insurance. At first glance that seems to represent a barrier to obtaining medical care for poorer strata of the population. However, a second glance reveals that this might actually not be the case. No doubt to the great dismay of the sick-care cartel and the bureaucracy administering it, the refreshing breeze of the free market suddenly intruding upon the system shows what prices actually would be if the State were not involved in health care. According to a recent report on the spreading 'cash only' medical care phenomenon:
Fed up with declining payments and rising red tape, a small but growing number of doctors are opting out of the insurance system completely. Theyre expecting patients to pony up with cash. Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system.
In Wichita, Kansas, 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. (Cash-only is a loose description. Nunamaker accepts payment by debit or credit card too.)
Under the traditional health insurance system, a large staff was required just to navigate all the paperwork, he said. That resulted in high overhead, forcing doctors like Nunamaker to take on more patients to cover costs. Plus, the amount insurance companies were willing to pay for procedures was declining, leading to a vicious cycle. The paperwork, the hassles, it just got to be overwhelming, Nunamaker said. We knew that we had to find a better way to practice.
So Nunamaker and his partner set up a membership-based practice called Atlas M.D. a nod to free-market champion Ayn Rands book Atlas Shrugged. Under the membership plan also known as concierge medicine each patient pays a flat monthly fee to have unlimited access to the doctors and any service they can provide in the office, such as EKGs or stitches.
The fee varies depending on age. For kids, its $10 a month. For adults up to age 44, its $50 a month. Senior citizens pay $100.
The office has negotiated deals for services outside the office. By cutting out the middleman, Nunamaker said he can get a cholesterol test done for $3, versus the $90 the lab company he works with once billed to insurance carriers. An MRI can be had for $400, compared to a typical billed rate of $2,000 or more.
Kevin Petersen, a Las Vegas-based general surgeon, stopped taking insurance in 2005. Petersen named the same reasons as Nunamaker: too much paperwork and overhead, declining payments from insurance companies, and a general loss of control. The insurance industry took over my practice, he said. They were telling me what procedures I could do, who I could treat I basically became their employee.
Now Petersen does hernia operations for $5,000 a pop, which includes anesthesia, operating room time and follow-up visits. He negotiates special rates for the anesthesiologist and the operating room, and is able to provide the service for about a third of what a patient might pay otherwise.
Many of his patients are early retirees who are not yet eligible for Medicare but cant afford a full-fledged health insurance plan, he said, and business is booming. My practice at this point is the best its been in my 26-year career, he said. By far.
While the cash-only model may please doctors, some question whether its good for middle- and low-income people. Kathleen Stoll, director of health policy at the consumer advocacy group Families U.S.A., didnt want to speak directly to either Petersens or Nunamakers practice, as she didnt know the specifics of each.
But in general, she fears that doctors who switch to a cash-only model will drive away the patients who cant afford a monthly membership fee or thousands of dollars for an operation. They cherry-pick among their patient population to serve only the wealthier ones, Stoll said. It certainly creates a barrier to care.
Obviously, both the named and unnamed 'health advocates' and worriers have it completely wrong. People who don't have to pay thousands of dollars for health insurance actually can afford 'thousands of dollars for an operation' that costs only one third of what it would otherwise cost. It is not only the wealthy who can afford this free market care (besides, people who don't want it have the option to continue with the existing system).
Look at those prices! A cholesterol test for $3 instead of $90 that is more than 96% less! An MRI for $400 instead of $2,000 or more (usually will be 'or more')? Not to mention the fact that these doctors now have more time to actually care for their patients properly. What's not to like?
A Win-Win By Mistake?
Imagine for a moment what might happen if the government were to get out of healthcare altogether and there would be free competition between all health care service providers. What would happen to prices in that case? It is probably fair to assume that they would come down precipitously even from the low prices free market doctors are already able to obtain for their patients nowadays.
It is actually a good bet that the onerous red tape and the likely explosion in costs due to Obamacare will accelerate the move toward a free market in health care unless the government explicitly forbids it, that is (unfortunately we cannot rule out completely that such tyrannical steps will eventually be taken the government generally doesn't like it when its 'help' is refused).
If so, the Obamacare Act could turn out to become a win-win by mistake so to speak, as more and more people decide to opt out of the system. It seems clear that the free market solution is preferable to the cartelized health care system imposed by government and the lobbyists that have co-written the laws. The doctors portrayed in the article above are leading by example, and we expect their ranks to swell in coming years.
Addendum: Somewhat Staged Looking Fainting Spell During Obamacare Speech
During a speech promising that the totally botched web implementation of the Unaffordable Care Act will one day actually be fixed, a pregnant (and diabetic as it later turned out) woman standing behind the president faints and is caught by him 'just in time'. Apparently, the president has eyes at the back of his head too.
If the libs remain in power and ObamaCare continues, I would fully expect follow-on legislation to make it illegal for a doctor or hospital to refuse ObamaCare-covered patients, or make it illegal to operate out of the ObamaCare envelope.
So - ironies of ironies - could Obamacare actually result in the greatest healthcare system ever by forcing a free-market medical system?
I guarantee you that medical treatment outside of Big Gov’s purview will be illegal inside of 10 years. And that may be an optimistic estimate.
Go somewhere, get a service, pay for it, leave...what a concept!
No problem - just hire them from India, Africa and the Caribbean. There are lots of them here now, all grads of medical schools in those places. This going to be great!! (sarc)
I agree, if we don’t stamp out ObozoCare this year it’s only a matter of time before accepting Affordable Healthcare and Medicare/Medicaid patients becomes a requirement for medical professionals to remain licensed.
With Hillarycare, it already was in the law that it was illegal to get or provide care outside the system.
This one has enough loopholes to get around it for a while.
Direct pay and signing up with Christian healthsharing looks like the best route for now. Basically, you’re at <$400 per month “share” with a $300 per incident deductible.
And, I know my doctors are giving a big discount for those paying without having to fill out insurance forms. Just ask your doctor, most do it now.
My GP (and his wife who is a PA) retired early a couple of years ago and sold his practice. He didn’t want to deal with Obamacare. It was a hassel for me, but I understood and agreed with his decision.
I can imagine that operating on a cash only basis would appeal to him since he was fed up with paperwork.
Bank on it. They will have to pass such a law. Constitution? We don’t need no steenkin’ Constitution!
Thanks for the tip. My doc might just agree to something like this.
YOU created the system that incentivizes these guys to deal rationally with their customers. So if this trend hurts the poor, it can only be because YOU hate them!! Why do you hate poor people?
No doubt the regime will try to stop this. My husband’s specialist contacted him a few months ago because he did just that. He offered it to select patients and their spouses. My husband signed up with him and now has concierge medicine. It costs more per year than he was paying for office visits, but he didn’t want to lose his specialist who is a leader in his field. I’m staying with my current doctors for now because I don’t require the specialty of my husbands Dr. and use Medical Dr’s who cross with holistic and oriental medicine.
While this system will actually be BETTER for them (since they're humans), if it did hurt them, so what?? Many of them voted for evil fascists like Osama and cheered when he stole freedom and money from the rest of us with OsamaScare, so how do they not DESERVE to suffer?
In Canada it’s called The Canada Health Care act. It was passed after medicare had been in place for a few years. It made it illegal for doctors to bill directly if they saw even one medicare patient. It was passed because all the doctors were setting up side practices,
They will be squashed. They did not build their practices.
“I would fully expect follow-on legislation to make it illegal for a doctor or hospital to refuse ObamaCare-covered patients, or make it illegal to operate out of the ObamaCare envelope.”
It’ll be worse than that. In high school, students will be tested and their careers will be dictated. Some WILL be State-”owned” doctors and they’ll practice medicine or be deal with harshly. It’s what (other) commie countries do, whether to choose Olympians, or other careers, in order to make the State operate.
My son and daughter in law have enrolled in one of these plans with a pediatrician for their daughters care. Very pleased, they are. Some day, the HHS swat team will appear and cart her away.
Following the Oklahoma Surgical Center model.
You go there, you get surgical procedures for roughly 1/5th of the cost of a stay in a hospital. Cash only. They do not take insurance.
1/5th the cost. Now think...what’s medicare’s co-pay for surgery? It’s 20%. Or 1/5th. So the question is, what do you get for Medicare?
And the answer is: Nothing.
It’s nothing but an enormous scam designed to enrich insurance companies. And I am not down on insurance companies: There is absolutely a need for people to buy insurance of some sort to cover catastrophic occurrences. That’s what insurance should be. People rail about the “military industrial complex”. The medical-industrial complex is vastly larger.
Doing genealogy I encountered Doc Bassinger of Brown County Ohio in record after record, and in story after story from my Dad. He came to the house. During the Depression I do not think they had Obanmacare. Kids were birthed, death certificates were signed, and by my evidence many many of them lived a long life, into the 90s, without modern medicine, without Obamascare. Just with cash payment or a chicken for the doc’s pot, good genetics and hard work for healthy living.
IT IS NOT ROCKET SCIENCE. It does not need massive government intervention. It needs a good doctor, and a patient who pays without third or fourth party interventionism. In other words, the doctor - patient relationship that modern medicine has mightily destroyed. As this post suggests it is really not too late to go back to that . . . said with hope and prayer.
Oh yes modern life saving protocols cost thousands (OK then let us all get a policy for catastrophic costs, which is the intent of insurance after all — to share large / catastrophic costs from not probable events amongst a large pool). But between the AMA and the DEA and mandated insurance provisions that are not permitted to cover what the alphabet agencies decide is not appropriate, we have to pay from our own pocket for certain treatments that no Obamacare coverage will ever consider, and which are less costly and more effective than the official protocols in many cases.
Let’s Roll! it back to real medicine, between Doctor and patient.
And the more people who got on catastrophic-only plans, the cheaper they would be.
Pay your doc 50 bucks cash for an office visit and keep your records with you.
Funny how the gubmint thinks it is so smart. Alway under estimating the resourcefulness of the people. If you want something there is always a way to get it. Prohibition worked real well for example.
add me please - thx
I didn’t see any mention of the Obamacare deductibles.
If you’re generally healthy, and have a plan with a high deductible; you still might find it cheaper to use a cash-only Doctor, because of the lower costs per visit.
And any such law will be disobeyed, because you can’t stop the signal. People who need help will end up going to unlicensed, internet trained locals. There will be bribery, black markets, and botched treatments, and yet it will be an unquenchable flicker of freedom that will prevent the collectivists from ever gaining total control. Alignment between resources and needs will always eventually self-correct. No matter how hard they try, it just can’t be stopped. This is why the American left is so behind the curve compared to the nascent movement to the right in Europe. The Europeans, some at least, have started to finally figure it out. Socialism, as a rigid ideology, is not ever going to work.
——They cherry-pick among their patient population ———
They discriminate. Those who pay get service. Those who don’t don’t.
Those who can’t pay can go elsewhere
It’s just business
I may be being Pollyanna here, but I’m thinking Obama has cashed his check with the Congress. Those up for re-election in ‘14 don’t want to be associated with this debacle, and they’re sure as hell not going to add any controversial follow-on legislation while they already face a ticked-off electorate.
So the government makes you cough up to pay into the government rat hole and then pay the doctor for medical care. Great!
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Do you seriously think we're going to let this continue?
"I quit when medicine was placed under State control, some years ago," said Dr. Hendricks. "Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everythingexcept the desires of the doctors. Men considered only the 'welfare' of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only 'to serve.' That a man who's willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyardsnever occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mindyet what is it that they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents itand still less safe, if he is the sort who doesn't."Atlas Shrugged, Part III, Chapter 1
I shudder at how prescient that book was.
I find the “concierge” approach interesting, but what does one do for catastrophic insurance in these days of Obamacare ?
When I was born in 1964, few Americans even had health insurance. The cost of my hospital birth and 2 or 3 day stay was about $85. That was a bit short of 2 weeks pay for my dad.
Collectivism is always a great stimulant to alternative(black) markets. How else do you think Venezuelans are getting their TP?
Not a bad idea for a relatively healthy individual.
THe only problem is that you get screwed if an emergency happens and have to revert to the state-run system.
Maybe, but can you force doctors to stay in the medical profession and practice against their will?
Another little flaw in their Frankenstein bill. They did not remember to ban cash-for-service as they did in Canada.
Very quickly an excellent cash-based healthcare system will spring up. And the prices will be much lower, as doctors now won’t have to hire big staffs to shuffle reimbursement paperwork to try and collect fees that have been aging for 200 days. They’ll pass the savings on to you, and the quality will be miles above that in the insurance-based system.
Will drive Obamacare straight out of business.
But the fines for not having Obamacare levels of coverage are going to become quite large in future years.......
Sounds reasonable, although UK never went that far (but Canada did).
I predict 2 things:
1. Legitimate state of the art Medical Tourism facilities will start to develop on the other side of the south border. Such as those that currently exist in Panama.
2. A return to small business-based insurance purchasing co-ops will re-appear after existing up in to the 80’s or so, when they disappeared under regulatory pressures....someone with some insurance company that sees an opportunity will figure the way to do this
Yep. CommieCare will control the doctors IF they want to remain doctors.
The Medicare website lists exactly 1 doctor in my county accepting Medicare but turns out he is an ER doctor.
Would you put anything past tyrants? Doctors may be forced to work at gunpoint.