by BoiseBYU · 1/21/2010
BYULV wrote:
How about getting doctors out of the insurance business. Do not allow doctors to bill insurance plans directly, rather require each individual to bill their own claims. This accomplishes a number of positive things:
1) the potential for fraud/abuse is nearly eliminated (I have heard estimates of $billions yearly due to false claims);
2) patients will know what their costs are upfront, before they see the doctor (medical services will start to become commodities sensitive to supply and demand which they currently are not)
3) medical office operating expenses will be cut by $50K - $100K yearly per physcian by eliminating interactions with insurance companies (multiplied by # physicians in America = $$$$$$).
4) patients become more active participants in their healthcare by being sensitive to the insurance coverage they have, by knowing what things cost and by being the true consumer of healthcare from the physician rather than through the 3rd party insurance companies.
5) other benefits I'm sure, but these are just off the top of my head.
ABYUFAN wrote:How about getting doctors out of the insurance business. Do not allow doctors to bill insurance plans directly, rather require each individual to bill their own claims. This accomplishes a number of positive things:
1) the potential for fraud/abuse is nearly eliminated (I have heard estimates of $billions yearly due to false claims);
2) patients will know what their costs are upfront, before they see the doctor (medical services will start to become commodities sensitive to supply and demand which they currently are not)
3) medical office operating expenses will be cut by $50K - $100K yearly per physcian by eliminating interactions with insurance companies (multiplied by # physicians in America = $$$$$$).
4) patients become more active participants in their healthcare by being sensitive to the insurance coverage they have, by knowing what things cost and by being the true consumer of healthcare from the physician rather than through the 3rd party insurance companies.
5) other benefits I'm sure, but these are just off the top of my head.
We had a family vacation in Yellowstone and there my son's finger was shut in the van door. Fearing a possible broken finger we took him to the local medical clinic for an x-ray (not broken, we just put a splint on it.) I paid for that out of my own pocket and sought reimbursement from the insurance company directly. Over the course of more than a year, I literally heard five (FIVE!) different reasons why they wouldn't pay for that claim - one person indicated that I should have driven the 15 hours back to my region to see his primary health care provider who would then have referred us back to the local guy in Yellowstone, so we could then drive the 15 hours back there to have to possible broken finger looked at.
Ultimately I had to initiate the mandatory arbitration provision of the policy for me to get my $100.00 that I was owed.
I can see why a Doctor would want out of that crap, but I cannot see how by giving an insurance company more latitude to screw over the average American, we would end up with a better system.
If they fought me that hard over $100.00 imagine how hard it would be to collect on a $50,000.00 surgery.
BYULV wrote:
If you had to fight for even the most basic reimbursements all the time like you did in this case, you would be looking for a new insurance plan. Insurance plans would have to start catering to their subscribers and be more honest to keep their clients. It's a self-correcting problem. Your experience is what a doctor's billing office goes through every day with a huge portion of claims. Currently doctor's offices are paying this cost and the insurance companies are getting away with this type of abuse. Doctors can do very little about correcting this problem because they are not the subscriber of the insurance plan - and as patients we don't do anything about it because we don't usually realized there is any kind of problem because the doctor's office is dealing with the insurance company's denials. Think about an auto insurance plan giving you that much trouble, it wouldn't happen becuase they know you would find another company.
Additional evidence to support this theory is the advertising of auto insurance companies. How often do you hear ads for auto insurance based on customer service related issues (quick claims approvals, immediate call response, roadside assistance, etc)? The auto insurance industry is driven by providing good coverage at comptetitive rates with good customer service. Making health insurance more direct to consumers in a similar fashion will naturally bring health care insurance more along these lines as well.
CougarClaw wrote:
are any of you running for office? I'll vote for you.
I really like the transparency idea. have the doctor's give me a "menu" of things I want done INCLUDING PRICES and let me make my own decisions. I would hate dealing with insurance companies, but if it meant service improved and prices came down, I'd live with it.
Limiting medical malpractice has to come in here somewhere since doctor's two largest expenses are 1) customer who don't/can't pay and 2) malpractice insurance. I'm all for having recourse against truly negligent and poor care, but the proliferation of trial lawyers and predatory medical cases only clogs up the judicial system and prevents people from forgiving each other.
And here's something that will take a real political hero to attempt: Get rid of Medicare/ Medicaid and Chip (frees up about 40% of the federal budget instantly) and replace the institutional elderly supportive care (no more free electric wheelchairs!) with infant through teenager preventative medicine. Sorry Grandma, I love ya, but babies are more important than you.
As long as AARP is the most powerful lobby group in america, it'll never happen, but we can't keep supporting this level of care. The money simply is not there. It's going to break the system.
CougarPeasant wrote:
Get rid of Pelosi and Reid.
nuk13 wrote:
There are many problems with health care. From what I can see (no I haven't read the 2500 pages) they aren't fixing the problems, just paying for them.
I agree. Fixing healthcare would be much easier if we addressed one problem at a time, actually attacking the problem and not complicating the issues with unrelated. Make 10 small bills, each adressing a separate problem. Let the debates roll and see what we can come up with to actually solve each problem. (side note: I hate it when I hear people defending this healthcare bill by saying, "well at least they are doing something. Something is better than nothing." The next person that says that to me is going to get a prescription for their cold . . . "Here's your cyanide tablet Mr. Jones. Doing something, anything is definitely better than just leaving it the way it is." ;)
I haven't heard anything about the hyper cost of med school. When someone goes to school 9 to 11 years and pays $300,000 and more we ain't gonna have reasonnable health care costs.
I kind of agree with you here as well, however, healthcare costs are not on the rise because doctors are making more and more money every year. I started practicing medicine nearly 8 years ago and every expense I pay has gone up nearly every year. On the other hand, every reimbursement I receive from insurance companies has either stayed the same or gone up during that same 8 years. I'm probably a little sensitive on this point, because there seems to be a growing sentiment out there that doctors are getting rich on this system. I also see a trend toward devaluing the services physicians provide, especially in primary care... anyway, this cost of med school problem is now solved since Pres. Obama declared last night that we won't have to pay back our school loans if we work for the government for 10 years or if we pay back 10% a year they'll take care of whatever else is leftover... I love all this free money :whistle:
I also think lawyers and law suits needs to be addressed. That will be hard if there's as many lawyers in Washington as I've heard there are.
Way important. You hit right on the problem here. With all the lawyers in Washington and in the States lobbying it is an uphill battle. There is an ever increasing attack by lawyers on doctors, hospitals, pharmaceutical and medical device companies, and any other provider or supplier of healthcare services and supplies. All I see on daytime TV are ads for Plaintiffs attorneys and companies trying to sell gold.
How much do medical people pay for government paperwork? Has that been addressed?
It's a lot of work and expense to keep up with the government's demands and it keeps getting more onorous. OSHA, HIPPA, ADA, FMLA and other legislation aimed at protecting Americans in one way or another are becoming beuracratic nightmares for doctors and employers. We need an overhaul big time.
declocoug wrote:http://bigjournalism.com/kashiver/2010/02/10/willful-blindness-msm-ignores-republican-half-of-the-story-on-healthcare-reform-efforts/
Not a huge fan of republicans, just a fan of stopping the federal govt from stepping on our toes at the moment. But I did find this article interesting. Repubs have had some good ideas on the table for a while now. And amazingly their bills are less than 200 pages long. Too bad non of them have been taken seriously by this so called "bipartisan" effort.
