Tuesday, May 18, 2010

Jiffy Lube Health care

There is an interesting article in the Weekly Standard entitled, "Cash for Doctors" with the subtitle "And other ways to escape the diktats of Obamacare:"
On a wall inside Dr. Brian Forrest’s medical office in a suburb of Raleigh, North Carolina, is something you won’t find in most doctors’ offices, a price list:

Office visit $49

Wrist splint $41

Pap-smear $51.

Those are the prices patients pay for the services, and they pay on the spot. Forrest doesn’t take insurance. If he did, the prices would be far higher and not nearly as transparent. He says listing prices up front is about trying to do business in a straightforward way, “like a Jiffy Lube.”

Straight forward can be good. It often gets tiring to get bills from the doctor or hospital that are confusing, not transparent at all, and often, wrong.



Anonymous Anonymous said...

A single payer system would make things a lot less confusing. It would also avoid equating human life with a dollar value, something street criminals and insurance executives have little trouble doing.

10:29 AM, May 18, 2010  
Blogger TMink said...

Real insurance reform would include out of pocket expenses for EVERYTHING with insurance sending the check to the insured. If you don't see or understand the bill, the market will not work.

That is why the costs for elective surgeries are so much less than those covered (covered up as far as price goes) by insurance.


10:29 AM, May 18, 2010  
Blogger TMink said...

Bacon, a single payor system would murder competition, leaving your health care as effecient and competitive as the US Mail.

No thanks.


10:30 AM, May 18, 2010  
Blogger Cham said...

If you work exclusively with doctors that know you and don't operate out of large medical clinics, before you make an appointment you might say, "How much for these services? I'll be bringing cash and won't require a receipt", the price can quickly become negotiable. Allegedly, of course. Not that I would ever do that.

10:48 AM, May 18, 2010  
Blogger HMT said...

TMink said...
If you don't see or understand the bill, the market will not work.

While I think there are many properties of health care that make it impossible for it to work as a free market; I think cost visibility to the consumer as suggested by Trey would go a LONG WAY it helping keep it sane.

This year I changed to an insurance has a very large deductible ($1000s) so I feel every visit right in the wallet. I went to the dermatologist to have some questionable spots looked at and he removed them, just like has happened before for around $50 copay for the visit.

THIS time it cost me $50/removal from him PLUS $200/spot from the lab for the biopsy. No more dermatology visits for me this year...

12:01 PM, May 18, 2010  
Blogger Dr.D said...

This MD is doing the only thing that will enable any of them to remain in practice in the future, namely refuse to be caught up in the insurance mess. Cash on the barrel head is the only way to make medicine operate without driving administrative costs through the roof. I look for a lot more of them to do this, at least I hope they do this rather than simply leave medicine altogether.

If you want the service, you should be willing to pay for it. If you are not willing to pay for it, there is no reason on earth that you should have it. I can't afford it is entirely bogus. Do without your wide screen TV or a few less beers if you really think you need medical attention, but be prepared to pay your own way. The idea that "they" should pay for your care is baloney!

12:18 PM, May 18, 2010  
Blogger dweeb said...

One question - if you go to this doctor and pay the cash price up front, are all records, lab results, etc. between you and the doctor? No "permanent record," so to speak?

If so, that would make it even more attractive.

12:48 PM, May 18, 2010  
Blogger Cham said...

If you pay cash you are still a patient of the doctor and records are kept. Many solo-practice doctors only use computers to generate bills and keep financial records.

12:53 PM, May 18, 2010  
Blogger Larry J said...

A single payer system would make things a lot less confusing. It would also avoid equating human life with a dollar value, something street criminals and insurance executives have little trouble doing.

If you think single payer systems don't put a price tag on human life, you're sadly mistaken. Every form of insurance, be it a government single payer system or a commerical insurance company, has a maximum amount they're willing to pay. They have to otherwise they'd go broke.

How much would you be willing to pay to save someone's life? A million dollars? Perhaps, most likely yes. How about a billion dollars? How about the entire US budget? Sooner or later, you'll reach a number that you're not willing to pay. At that moment, you just put a price tag on that person's life.

1:09 PM, May 18, 2010  
Blogger orthodoc said...

"A single payer system would make things a lot less confusing. It would also avoid equating human life with a dollar value, something street criminals and insurance executives have little trouble doing."

Right. It would never put a dollar value on life. It would use pounds, and QALYs (Quality-Adjusted Life Years). Just like the NHS, which is held out as the model of efficiency by the new director of CMS.

Young, and an intervention that costs less than 20,000 pounds? NHS pays for it.

Older, and the intervention costs more than 30,000 pounds? Go home and die. Oh, and no, you can't pay for it yourself.

1:58 PM, May 18, 2010  
Blogger TMink said...

dweeb, I know psychologists who work for cash only and they use the greater security they can afford confidential records as a selling point. I have NO idea about or control of what happens when an insurance company requests my records on a patient. Part of the contract of my providing services to those with insurance is that I will provide copies of the records at the request of the insurer.

Cash patients do not face that potential risk.


2:47 PM, May 18, 2010  
Blogger Bob Sorensen said...

My cash payment for my chiropractor is $35. For some reason, my insurance denies every visit. And that's fine, because my co-pay is $40.

6:19 PM, May 18, 2010  
Blogger Carteach said...

I once made a $5000 hospital bill disappear simply by demanding a detailed accounting of the bill. I told them I was there with my son every moment, and knew exactly what was done and used, and had notes. The hospital folded and canceled the bill.... they had simply guessed at how much they wanted.

5:52 AM, May 19, 2010  
Blogger jimbino said...

I had a Carteach0-similar experience with an emergency room billing for two friends (gallstone, kidneystone), each with a bill of about $1800.

Acting on their behalf, I researched Medicare allowances by CPT code for the treatments given. For this, I had to file a Freedom of Information Act request to the Texas agency dealing with Medicare.

Then I told the hospital that I would make payment contingent on their provision of the CPT codes for the procedures, same as insurance payers and Medicare/Medicaid require.

They ended up writing both charges off, since they wouldn't provide the codes, maybe for fear of revelation of their illegal discriminatory practices in a lawsuit.

Here in Brazil I went to the local clinic to get treatment for an infection I picked up in Texas. For no charge to me, I saw a doctor who prescribed cephalexin for me. I've been back 3 times, each time seeing the doctor and each time getting, right there at their pharmacy, 28 tabs of cephalexin. So far I have had four 2-minute consultations with the doc and about 120 tabs, which, Obama knows, would cost me a fortune in the USSA. (120 tabs of 500mg go for about $150 online).

I am a non-believer in insurance, including Medicare Part B for which I qualify, and will be a "medical tourist" in the future to the extent that I can, enjoying dental care, clinical care and, who knows, more serious, care in places like Mexico, Brazil, Argentina, Hungary, India, Czech Republic and Thailand.

12:44 PM, May 19, 2010  
Blogger Jeff Y said...

I love this idea.

10:32 AM, May 21, 2010  
Blogger dweeb said...

The reason I asked about the records is that my father in law owns a clinical laboratory, and if someone wants to come in and pay cash for a test to be performed, they can say their name is Donald Duck, and no one will ask them to verify it. I would expect a cash doctor's (or psychologist's) practice would be similar.

2:40 PM, May 21, 2010  
Blogger ErikZ said...

I was just looking for a cash only General Practitioner in Denver, but I couldn't find one.

7:55 PM, May 21, 2010  

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