Tuesday, March 23, 2010
Yesterday while I was out and about I ran into a doctor that I know casually. He is a general practitioner who is in favor of the law that was signed today. His list of reasons included:
Medicare is losing money by not paying for wellness exams. By paying for these exams they can find things at an earlier stage when it is both easier to treat and less expensive. Ok, I think we can all agree this is a good thing. But, it didn’t take almost 3,000 pages to accomplish this.
His bottom line will increase. As a person in favor of capitalism I am ok with that. He writes off tens of thousands of dollars that he is never paid for. Here we have a bit of a disagreement. When I was sick my issues were not really my treatments, but my prescription costs. I didn’t understand that had I called the pharmaceutical company they could have helped me work out a more reasonable rate. I also must be a complete idiot, as I paid back every dime of debt. Apparently most people can’t be bothered. I made arrangements to pay an affordable amount every month. It took me years, but it was paid. I don’t understand why people don’t pay their debts. I know firsthand that if you work with the doctors, they will work with you. Now, I am not saying there are times that people just can't do it. That absolutely happens. Again, we can put in safety nets for this.
He told me that he is forced to increase the costs of the insured to cover the under-payments for services from Medicare. Medicare is scheduled to be decreased, not increased. This problem will still exist and may actually get worse as the baby boomers hit retirement age.
I asked him if I came into his office and paid cash in full at the time of visit would this decrease his costs. He said that it would require less administrative time which would lower his overhead costs. So I asked doesn’t it stand to reason that if we move away from insurance dependence instead of increasing it costs would be lowered? He said that would lower staff costs. He currently has five people who do nothing but fill out paperwork for insurance companies. This has been proven to lower costs at Safeway, Whole Foods, and the state employees of Indiana. I have a similar plan. I have a high deductible that is supplemented by a HSA. Once my HSA runs out I then use my insurance. This has been very cost effective for me. Almost all HSA’s will now pay doctors directly, so they will be paid the same way that they are right now by conventional insurance.
My final questions were to ask him if he accepted Medicaid. He does not. So we are increasing the role of Medicaid into the healthcare system, who is going to treat them? What we have done is given people access to insurance. This will not translate to improved health. For improved health wouldn’t they actually have to have access to a doctor? His response was that it is not perfect. Really?
Lastly, and there is no way around this, if I am wrong, so what? My bad, I’ll take responsibility for it, and the country will be better off. If he is wrong, what then? The most innovative medical care in the world could be destroyed. Who is going to be responsible for that?