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KarinPeterJohn FembupRickLynn Recent comment authors
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Karin
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Karin

“If there is no hope, we must face the possibility that the demand for – and cost of – health care may be spiralling uncontrollably upward. Clinging to the hope that this is not true, people prefer to believe almost any alternative idea. So . . . what if there is in fact no way to constrain the rising demand for health care services?” The way to constrain the rising demand is in one of two ways- either we as health care consumers need to be demanding of care that actually has value (and stop demanding that which does not),… Read more »

Peter
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Peter

Great John, I think that’s an approach I’m happy to hear about. There is a local doc here doing much the same thing although you seem to have a better handle on helping some not able to pay full cost for care. In his practice he also does a lot of the labs. The problem is he’s not accepting any more patients. From your comments on the AMA and your practice habits I would welcome you to the table of any discussion on trying to halt this Titanic system.

John Fitzgerald
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John Fitzgerald

I charge the same for everyone, except there are some that I charge less to if they cannot afford the usual rates. Payment is expected at the time of service. My charges are close to what I received from insurers, in some cases lower (well child checks), i.e., I pass along the discounted rates to the patients, since my overhead is significantly, significantly lower then when I participated in all of the plans.

Peter
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Peter

John, do you charge more for the uninsured, or are they billed the same? Do your charges reflect what you/other docs would receive from insurers, or are you charging a premium?

John Fitzgerald
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John Fitzgerald

Peter–I am all for price transparency. In my cash-only office, there is a menu of services, all clearly, and fairly priced. When my own family members need a service from the local hospital or lab, I call first and get detailed information about how much it will cost, because I can only afford a high deductible health insurance plan. But, if I go to a lab, or call a plumber, and I am angry that they will not provide the service at a cut-rate that does not even give them any profit, I am not going to stiff them on… Read more »

Peter
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Peter

Posted by: Lynn | Aug 29, 2006 2:01:25 PM “Smart shopping tip #37 for the uninsured.” :>D :>D What a great free market solution that works within the system. I noted it for future use. Posted by: John Fitzgerald | Aug 29, 2006 6:46:02 PM “Lynn, What a wonderful attitude to have. I hope you treat your other service professionals the same way. Do you insist that your plumber give you Home Depot prices or hold your payment until the point of damaging your own credit and cutting the rate they get to the point of paying them below their… Read more »

John Fitzgerald
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John Fitzgerald

Sorry, I got my facts wrong. BCBS of MA EMPLOYS more people to administer its plan to 2.5 million New Englanders then Canada EMPLOYS to administer its single payer system to 27 million Canadians country-wide:
http://www.pnhp.org/facts/why_the_us_needs_a_single_payer_health_system.php
http://www.diemer.ca/Docs/Diemer-TenHealthCareMyths.htm
https://thehealthcareblog.com/the_health_care_blog/2006/03/policyhealth_pl_2.html

John Fembup
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John Fembup

“Why focus on administrative costs? I read it here not long ago. More is spent to administer BCBS-Massachusetts than to administer the entire health plan of Canada. That’s why.” I think that’s highly unlikely, and here’s why. Blue Cross of Massachussetts total administration costs for 2004 were about $480 million. (Blue Cross audited financial reports). Population of Canada in 2004 was approximately 32 million. (Canadian census). If the Canadian health care system operates on less than it costs to run Massachussetts Blue Cross, then it must be operating on less than (USD)$1.30 monthly per Canadian. That’s a bagel with cream… Read more »

John Fitzgerald
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John Fitzgerald

Why focus on administrative costs? I read it here not long ago. More is spent to administer BCBS-Massachusetts than to administer the entire health plan of Canada. That’s why. It’s a downward spiral. Increased utilization and expectations (incl. litigation) is a big part of it too. But it would be easier to find a single payer solution then it would be to tell the Smiths that grandma cannot have her third cardiac cath of the year.

John Fembup
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John Fembup

Matt, I would agree that the infernal paper chase you were caught up in is a significant part of current provider costs and therefore “health care” costs – and, if eliminated, would reduce those costs by – pick a number. But still . . . Adminstrative costs are not the reason that health care costs increase by 10% a year. And they are not the main reason that the cost of health care in the U.S. is so much higher than in every other country on the face of the planet. The main reason for both of these lies in… Read more »

John Fitzgerald
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John Fitzgerald

Looking further, and reading the following two columns, I now realize that Lynn must be being sarcastic. Hard to tell sometimes in the written word. Here are a couple of her recent writings which better speaks her heart:
http://greenvilleonline.com/apps/pbcs.dll/article?AID=/20060415/OPINION/604150304/1016
http://www.thestate.com/mld/state/news/opinion/15356085.htm

John Fitzgerald
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John Fitzgerald

Lynn, What a wonderful attitude to have. I hope you treat your other service professionals the same way. Do you insist that your plumber give you Home Depot prices or hold your payment until the point of damaging your own credit and cutting the rate they get to the point of paying them below their costs? Everyone should know, especially physicians in Columbia, SC, that Lynn Bailey is a Consulting Healthcare Economist, teaches a course at Webster University in “Issues in Business: Entrepreneurship.” If you’re a bill collector, you can search her email address in Google, you’ll find all of… Read more »

Barry Carol
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Barry Carol

Rick, I can well appreciate your comments. I always find it extremely frustrating when companies or individual people overpromise and underdeliver. It is United that I understand plans to introduce this early next year. Along with Wellpoint’s recent announcement of its intention to roll out HSA’s to their entire customer base (including individuals) starting next January, it sounds like the market opportunity is reaching the point where they perceive it is worth their while to try to respond to it in a meaningful and robust way. Hopefully, this will include giving docs and other providers real time information as to… Read more »

Rick
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Rick

Barry, don’t even get me started on medical debit cards. I’ve had one with my FSA for two years, and it has yet to perform as advertised. Imagine a scenario like Matthew has described, with paper flying back and forth, miscommunications, and punitive actions against the healthcare consumer, not just on occasion, but with nearly every healthcare transaction! Our HR director (my company has about 330 employees) says she’s beginning to think they are not worth the trouble since most folks report trouble using them. I can understand not actually being able to use one at certain provider offices, because… Read more »

Lynn
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Lynn

Being uninsured, I always wait for the collection agency to call. I can usually negotiate a 50% discount for immediate payment. The provider gets 20% and the collection agency gets 30%. If the provider had accepted my original offer of Medicare + 25% they’d have been better off but they didn’t so they get 20%. When the ding shows on the credit report. You note it as a medical bill you could get the insurance company to pay so you just gave up and paid the collection agency to end the hassle. Smart shopping tip #37 for the uninsured.