Concierge or Cash or Insurance

[talon]

http://www.msnbc.msn.com/id/34019606/ns/health-health_care/

I don't at mind the idea of doctors taking cash only for medical care. In fact, I kind of prefer it because it gives the doctor and the patient the freedom to focus on real health care without having to jump through hoops, or go through tedious and useless processes before finally being allowed to do what needed to be done a long time ago. The insurance industry has long been a leech on medical care.

I do, however, mind the concierge practice, where doctors take both a patient's insurance and charges an additional fee for "expedited" care, double dipping for the same procedures just providing it faster and more personably.

Doctors have to decide. Either they accept insurance and all the miseries and extra work associated with it or they opt out of insurance altogether and go cash only. The patient can choose to visit a doctor approved by their insurance company and pay the co-pays or go to an out-of-network doctor and pay cash up front and get re-imbursed for their out-of-network care (the patient does all the insurance paperwork, not the doctor's office), or they can just pay for their own health care without insurance butting in.

There has always been a chasm netween the haves and have-nots, and insurance has not narrowed that chasm at all. I think, on some days and after hearing and witnessing some incidents, that insurance has actually widened and deepened that chasm. Wealthier people have always had better everything - better homes, better jobs, better health care, better food, better clothes, better vacation and sick leave, better vacations, and so on. The poorer people have gotten what they could when they can, depending on their priorities and finances. There have always been doctors (and others, it's not limited to doctors to be altruistic) who've donated time to free clinics and who've offered sliding scale pay for health care, and I doubt that will change. There have always been doctors who cater exclusively to the wealthy, and I doubt that will change, either.

I don't think universal government sponsored tax-supported health care will change that. It may do what insurance is already doing - make it even worse.

Under health insurance, doctors receive poor compensation - often half or less of what the procedyre actually costs - and hthe only way they can get adequate re-imbursement is through volume and ordering unnecessary tests and dragging through the diagnostic procedure in order to extract as much money from insurance as possible. They aren't doing this for fraudulent reasons (OK, maybe some are), they're doing it just to cover the expenses of the procedure. When insurance companies are paying doctors $30 for a procedure that costs the doctor $100 to do, patients and doctors suffer. Doctors pack in the patients and do as many as they can as fast as they can so they can earn the money to pay their expenses - and it costs to practice medicine - offices, nurses, receptionists, the waiting room and furnishings, the exam rooms, the cleaning and sterilization equipment, utilities, office supplies, computers, internet service, telephones, and we haven't even gotten to basic medical equipment yet! We haven't even helped the doctors and nurses pay off their educational expenses! And here insurance companies are - ripping doctors off by seriously, seriously undercompensating them.

But the way to go isn't to double dip - charge the insurance company and then charge the patient, too. Concierge medical care is an abomination born of insurance company greed and control coupled with doctor desperation and greed. Doctors want to help their patients, they genuinely do or they'd pick an easier field. But squeezed between the high cost of being a doctor and the crappy compensation of the insurance companies they feel forced to accept, they chose what I feel is an unethical path.

I support the cash only doctor movement and applaud what they are doing.

I despise the insurance companies and the concierge doctors. I am not comfortable with government universal health care, which I see a different type of insurance company which will still screw both doctors and patients.

I have no answer to the health care issue.