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I got this idea from the linked idea about charging doctors, but was seriously wondering if this would work. Based on my knowledge from friends and family that work in the medical and insurance profession, I believe that some of the problem of skyrocketing costs in medical care have to do with a lot
of billing nonsense and ineffeciency. For example - my daughter recently had a in-hospital procedure. The bills before insurance came to $15,000 for the room and materials and anesthesiologist. This was a 1 hour procedure. The bill after insurance discount was $3,500 - and then I had a copay. These sorts of discounts seem to me to be keeping the HMOs in power and promote inefficiency. I would like to know what would happen if every medical organization was REQUIRED by state law to publish their medical fees, AND could not discount them for anyone - they would have to charge everyone the same thing (but could price things however they chose). Would it force insurers to really shop for fair-priced medical providers? Would things just be worse? Would the individual doctor be able to flourish again? I don't know, but I would like the help of the HalfBakery members to think it through.
Pay Doctor's Based on Patient Health
Pay_20doctors_20acc...ir_20patients_20are
A HalfBakery idea not doing too well. [trekbody, Mar 08 2005]
(?) Hi Everybody !
http://home.t-onlin...r/images/drnick.gif
[Jinbish, Mar 08 2005]
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Thanks for the info Unabubba, but this system would REQUIRE the doctor to charge everyone the same rate that THEY decide. Individual doctors can price differently. This is different from following a fee schedule and none could jump the line, they could go to a more costly doctor though. I think it would have the benefits of retaining free-market pricing, but removing hidden "conspiratorial" practices. |
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Doesn't the esteemed Dr. Nick Riviera perform 'procedures' with this payment scheme? |
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// this system would REQUIRE the doctor to charge everyone the same rate that THEY decide. // |
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Right, so they would just say 'fuck the HMOs' and charge $15,000. (And many American doctors do exactly that.) There's no conspiratorial practice. Doctors choose to become part of HMOs all on their own. |
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The hospital, in this case, bills out the 15 grand expecting that if you have insurance (in which they participate), they know they'll get less, and that's okay - they knew that when they signed up. But if you don't have insurance, they want the whole amount, within 60 days or your ass is in collections. |
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So I don't get your complaint. Would you have rather paid $15,000 than your copay? Don't you think that HMOs are doing a service by negotiating reduced rates? Would you preferred your doctor charged $100,000 just so it makes it look like the HMOs are really ripping him off? |
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'Hi everybody!' 'Hi Dr. Nick!' '...So the red things connected to the red thing, the red things connected to my wrist watch... Oh no!' |
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Imagine having a doctor like that! |
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I like the suggestion about jailing them for accepting perks from the pharm. companies, - El Dorado you are right on - that is a conflict of interest if ever I heard it. Not sure I agree on the salary part though. |
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The reason they could not get away with charging $15,000 is because of supply and demand. You would then choose to go to the $10,000 doctor, so the overpriced doctor has to lower his rates to attract clients, and eventually a happy medium is found. Competition kicks in (at least I imagine it would) when you do not have the tricks and games going on. Maybe the doctors could only change the prices once per year, so that they are not like gas stations, with speculative pricing. And I understand that because of the cost of malpractice insurance, a lone doctor cannot make it any more. So they are forced to work under the "protection" of HMOs, a lot of them do not choose to. |
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I am blessed to work for a big employer who pays for good health care, but the best plan we have recently went up $4,000 per year (for a family). That's just nuts - especially since my company PAYS ALL THE MEDICAL BILLS - they are only using the insurance company to manage the plan and provide discounts. I'm not saying I have the answers or even understand the entire problem - but it seems to me it can't help to have all this back-room nonsense going on. We need to get to a point where somehow we eliminate the middle-man (medical insurance companies) - I'm a capitalist, but I would prefer they go away rather than have socialized medicine. |
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Agreed. Insurance is largely a scam. There must be a better model out there somewhere. |
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- for the idea. There would be too many doctors who just suck yet get paid exactly the same. |
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When sentenced in court, doctors must receive jail terms of a minimum two weeks in a medium security prison, no protective custody. |
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[RayfordSteel], I don't know if I agree that it is a scam, it is just another cog in the machine, one that requires turning a profit. That's not bad by itself, but I would rather 1 less middle-man when it comes to my health. If we can elimate some of the middle profit-takers and inefficiencies, we might have a medical system we all would be more happy with. Someone once told me - Socialists don't just take over, they get you to vote for socialism. It's so easy to keep saying we want more and more, and it should be accessable to everyone. I don't agree with that. I also don't believe medical costs should be inverse to how the economy grows - isn't it true that if interest rates are low, and the economy is not vibrant, that insurance companies make little on their investments, so they must charge more for premiums to make their profit? I wan't to pay for decent medical, I just don't want the structure of it to work against me. |
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To relate another story. My mother was in a near-vegetative state for some years, and we care for her at home. One of the items she required was a bag to deliver liquid nutrition to her stomach via a feeding tube (the bag held an Ensure-like liquid). These bags were available on the Internet for a couple-hundred dollars for a case of 30, or about $8/bag. My medical supplier charged my mother's insurance company $40/bag. When I called the insurance company to tell them they were being overcharged, they told me they weren't - that $40 was the agreed-upon price since the retail was $80. $80 each for basically a zip-lock bag with some aquarium tubes hanging off it and a little plastic plunger. With that in mind - extend my idea to the price of medical equipment as well - a flat rate from each supplier for every customer - no $80 from you, but $40 from you, but $10 from you. Medical supplies are needed by individuals, I don't care how many people are in each HMO or "Policy group" - those things don't really matter price the things so you can make a profit, but so everyone can pay a fair price. |
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I think my idea, "pay doctors by health of their patents" was what promted your idea. I agree with your idea. We think we have a capatilist maket, just because we live in America. But do you shop for health care? Do you even know the real price before going? Doctors should have to publish the price of different procedures, just like everyone else! |
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[trakbody] gives me an idea: Maybe you could buy your own supplies and bring them to the doctor and say "here, use this", if you're afraid the doctor will overcharge you for the equipment. |
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Insurance companies would save money too if patients did this. After all, insurance companies suffer when doctors overcharge for supplies. |
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