It seems that when doctors themselves stop accepting insurance, their patients get better care at a more resonable cost.
More and more doctors are fed up with private insurers. It’s not just a question of how stingy they are, but how difficult it is to get reimbursed. Paperwork, phone calls, insurers who play games by deliberately making reimbursement forms difficult to interpret …
Some physicians have just said “no” to insurers.
Now, the cost differences that these doctors are charging is astounding.
A story in a New Jersey newspaper describes how physicians in Northern Jersey have begun following in the footsteps of “elite Manhattan doctors and are withdrawing from all insurance plans.” The article compares fees with and without insurance. On the right, the fees that insurers typically pay for these services; on the left, the fees that Jersey doctors who don’t take insurance charge:
- Mastectomy: $5,000 / $900
- Ruptured abdominal aneurysm: $8,000 / $1,800
- Initial neurological consultation: $400 / $100
- Routine screening mammogram: $350 / $100
Many folks that do not have insurance, find themselves being charged double to quadruple the amount insurance would pay by doctors and hospitals that accept insurance. The difference is that these doctors in NJ do not accept ANY insurance, and can cut their costs across the board, while still making a decent income for themselves, and most importantly, spend more time with each patient.
Maggie Mahar also highlights a particular doctor and his business model, that I really wish would catch on. Let’s take a look at what she highlights:
Over at Revolution Health, “Dr. Val and the Voice of Reason” tells how Dr. Alan Dappen has set up his practice:
“He is available to his patients 24 hours a day, 7 days a week, by phone, e-mail and in person. Visits may be scheduled on the same day if needed, prescriptions may be refilled any time without an office visit, he makes house calls, and all records are kept private and digital on a hard drive in his office.
“How much do you think this costs? Would you believe only about $300/year?”
Dappen has streamlined his practice. It’s not just that he doesn’t need an assistant to keep up with stacks of insurance paperwork. In general, he keeps his overhead low, offers full price transparency, has “physician extenders” who work with him, and “charges people for his time, not for a complex menu of tests and procedures.”
This sounds great, and his patients have his full attention and care. What could be better???
Perhaps it will be the doctors, fed up with the hoops set up by insurers to get a simple payment, will start the health care revolution.
Let’s hope this spreads.
This is fascinating. I’d heard about the no-insurance physicians, but hadn’t really looked into it.
What Dr. Dappen is doing reminds me of my eye doctor’s practice when I lived in Manhattan. I paid about $300 up front every year for unlimited visits and a deep discount on purchasing my contact lenses.
Every two years, I paid a couple of hundred dollars extra for extensive preventive eye exams. It was a bargain to know that my eyes were carefully monitored all those years – about 37 that I lived in New York. And when I had a major accident – a piece of metal flew into my eye – I had no worries about the cost of the extra visits required until all was well again.
Contrast that with what I’ve been able to find since I moved to Maine: every visit, depending on which tests I want, costs about $350, no discount for lenses. I was accustomed, in New York, to four regularly-scheduled visits a year. Now, my budget allows only one visit a year.
I no longer have the peace of mind about my eye health I had for so many years.
I wonder if we started calling doctors offices to see if they DO NOT accept insurance, and had business models like the above, if doctors would sit up, take notice and start streamlining their practices to the concierge business model?
My Primary Care Physician retired a few years ago rather than put up with another minute of insurance falderol. He then opened a free clinic in the Morristown projects and takes care of the indigent. He gets free prescription samples from drug co’s and occasional grants. He’s happy and providing a much needed service. Because I have a job and insurance, he won’t see me. But I do make occasional donations.
Capitalism is not perfect. It needs to be regulated by the government. Health care should not be subjected to a profit system.
We have gone to a neoliberal economic system so that things are just going to get worse unless the American people do something.
We have nothing vested in supporting either political party since they are not the parties of our parents or grandparents.
If enough Americans abandon the major parties in favor of independent candidates then we can force change but if not then America will be destroyed by Globalization.
We need to focus on taking back the country rather than worrying about individual issues such as health care which candidates always make promises about but do nothing.
The issue is getting rid of neoliberalism and globalization. Then the health care problem will take care of itself.
That sounds great. But what if the doctor does not accept insurance and charges high fees per visit, like hundreds of dollars per visit? I know insurance companies are far from perfect, but I need to keep the fees down per visit. I am sorry, but I would opt to pay a copay ($35-$45) vs. full cost, sorry.
Now, if I could find a nice Dr. that does not accept insurance but their rates are about what a copay would be, I would have no problem with that.
What is neoliberalism?
Now, if I could find a nice plumber whose rates are about what a copay would be, I would have no problem with that.
Oh, what? A union plumber is allowed to make a “living wage” but a doctor is not?
BTW: Your co-pay is not all you are paying. There is several hundred dollars per month deducted from your paycheck – even if you never see it because the employer pays it.
First step in fixing healthcare: Transparency. The employer tax deduction should be removed and given to the employee where it shows up on your pay-stubs like all the other deductions. You will be shocked how much you are paying (unless you’ve tried to buy insurance yourself – the prices are about the same).
I just changed insurance co with my employer and had to go to the er in my local town. come to find out that the doctors at TMC HOSITPAL IN DENISON, TEXAS DONT ACCEPT ATENA INSURANCE NOW I HAVE A BILL OF 567.20.
It astonishes me how patients can go out of their way to find money for their cigarettes, beer and what have you, but doesn’t want to pay their doctor to take care of them. What kind of selfish egomaniacal attitude is this??
“Now, if I could find a nice Dr. that does not accept insurance but their rates are about what a copay would be, I would have no problem with that”..
So you would pay your doctor $10 for his time? Why stop there? Why not lock up any doctor and execute those that doesn’t work for free?!
I am a primary Care doctor that am in the process of transitioning out of insurance. Last time, I got a phoencall from an insuarance comapny asking me why I stopped taking their insurance, so I flatly told them my days of being a hooker for them are over. He didn’t have anything to say and simply came up with the phony “I’m sorry you feel that way”.
Check out: http://www.simpd.org
It is happening, doctors all-over the US are ditching these thugs and pimps that keep spitting them in the face. Physicians, rediscover your spine and let the bullies bother someone else.
Ariel
pimps and thugs? this must make the patient the sex fein trying to bust a load–but only when they can scrounge up enough money after purchasing beer and cigarettes.
are you really an MD? is it possible to be so out of touch with the population?
costs are beyond the means of your patients. when you neglect the insured, who pays? the patents. always the patients. i think you are going about it the wrong way, a selfish way. you have to demand improvement not walk away from the problem.
do you make exceptions for the unemployed and disadvantaged or do you spit in their face too?
[...] It’s bad enough that bankruptcies have risen due to medical costs — including for those with health insurance. It’s not just patients that are sinking under the massive costs of health insurance and health care. Doctors spend much of their time and money trying to collect from insurance companies. [...]
I worked in the health insurance industry for a number of years and have a degree in Economics. It is amazing to me that our current systems still functions. It is a testament to the effectiveness of advertising and lobbying. The truth be tolled it is not functioning very well at all. One out of six people in this country do not participate – they are designed out of it. Many of the people insured are not actually insured to any real extent – they find this out after the fact. The average Joe is just glad to carry on a turn a blind eye to these problems. The phenomenon being discussed here is a tolling bell for the current structures of health care sector of our economy. When doctors can’t put up with it – it is over. The whole thing was designed for their benefit in the first place. When the doctors have had enough only the Neanderthal Right Wing knee jerk reactor types are left to believe in the American System. The United States is the exceptional experiment in “private insurance”. Every other developed national has a nationalized system. Their doctors do pretty well by the way. I want my doctor to be paid well for the wonderful work they do!