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.
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.
Seems like you'd need to have a separate catastrophic plan. Of course Obamacare has made those kinds of plans illegal. It might be time to look for a "religious exemption" and get a plan set up under that.
What about prescription drugs though? I sure haven't been offered any discounts when I have to buy a prescription with cash because my insurance doesn't cover it.
A lot of pharmacies have a list of drugs they sell for cheap to address this issue. Wal-Mart has a pretty long list of ones that are $4/month or $10/quarter, Costco also has a reduced-price list. Also, ALWAYS shop around for prescriptions. I’ve seen variations of as high as 3:1, and it’s not like the pharmacies always place in the same order for cost. One that was the cheapest on one item might be very high on another. It’s very strange, but you save a lot if you do the work every time.
For example, for every prescription, I call Wal-Mart, Costco, a grocery-store pharmacy, and a couple conventional pharmacies (well on a refill or other prescription I’ve had before I might only call the previous winner to verify current pricing). I don’t think I’ve ever had one of the regular pharmacies be lowest on anything, but there’s no telling whether Wal-Mart, Costco, or the grocery store will come out on top in any given case.
Perhaps a voucher system would be better.
There are excellent Dr.s in those countries. Many of them trained here and some practicing at US accredited hospitals . We will not be bringing then here because they are not dumb enough to come. We will be going there.
My surgeon moved back to Spain. I will follow him anywhere and he can now do an operation for 1/10 th of his old rate. But you do give up your ability to sue.
Or we may split up like the old Soviet Union.
I do Primary Care, 50% off for cash!
I posted years ago that when Bozo is done you will be able to get an abortion on Main Street but you will have to buy Lipitor in an alley shoved through the car window.
Hah! The libturds may think Healthcare is a Right but I got some bad news for them. Try getting what I have learned over decades out of my brain against my will. Good luck with that.
My veterinarian says that the lack of widespread pet health insurance is what keeps her prices relatively low in comparison to people docs. She says malpractice insurance drives her prices up but nowhere near what widespread pet insurance would do to prices.