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tod evans
06-11-2013, 06:39 AM
Front page of the Communist Newz Netwerk


Cash-only doctors abandon the insurance system


http://money.cnn.com/2013/06/11/news/economy/cash-only-doctors/index.html?iid=HP_LN&hpt=hp_c3


Fed up with declining payments and rising red tape, a small but growing number of doctors are opting out of the insurance system completely. They're expecting patients to pony up with cash.
Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system.
In Wichita, Kan., 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. ("Cash-only" is a loose description. Nunamaker accepts payment by debit or credit card too.)
Under the traditional health insurance system, a large staff was required just to navigate all the paperwork, he said. That resulted in high overhead, forcing doctors like Nunamaker to take on more patients to cover costs. Plus, the amount insurance companies were willing to pay for procedures was declining, leading to a vicious cycle.
"The paperwork, the hassles, it just got to be overwhelming," Nunamaker said. "We knew that we had to find a better way to practice."
So Nunamaker and his partner set up a membership-based practice called Atlas M.D. -- a nod to free-market champion Ayn Rand's book Atlas Shrugged. Under the membership plan -- also known as "concierge" medicine -- each patient pays a flat monthly fee to have unlimited access to the doctors and any service they can provide in the office, such as EKGs or stitches.
The fee varies depending on age. For kids, it's $10 a month. For adults up to age 44, it's $50 a month. Senior citizens pay $100.
The office has negotiated deals for services outside the office. By cutting out the middleman, Nunamaker said he can get a cholesterol test done for $3, versus the $90 the lab company he works with once billed to insurance carriers. An MRI can be had for $400, compared to a typical billed rate of $2,000 or more.
Nunamaker encourages his patients to carry some type of high-deductible health insurance plan in case of an emergency or serious illness. But for the everyday stuff, he said his plan works better for both doctor and patient.
"It would be like if car insurance paid for gas, oil and tires," he said. "It would be very expensive, and you'd have to get pre-approval for a trip out of town."
Most of his clients are self-employed, small business owners, or employed at small firms that have found the monthly fee, combined with a high-deductible plan, a cheaper option than traditional insurance.
Nunamaker now has a patient list totaling 400 to 600, compared to the 2,500 to 4,000 he said a typical family physician usually maintains. He's quite happy with his annual salary of around $200,000.
"My professional life is better than expected, my family life and personal time is better than expected," he said. "This is everything I wanted out of family medicine."
It's believed that only a small number of doctors have switched to a cash-only model. The American Academy of Family Physicians said about 4% of respondents to a 2012 survey reported taking only cash, up from 3% in 2010. A Medscape survey found 6% of physicians in the cash-only business in 2013, up from 4% in 2012.
Most are primary care doctors, though not all.
Kevin Petersen, a Las Vegas-based general surgeon, stopped taking insurance in 2005. Petersen named the same reasons as Nunamaker: too much paperwork and overhead, declining payments from insurance companies, and a general loss of control.
"The insurance industry took over my practice," he said. "They were telling me what procedures I could do, who I could treat -- I basically became their employee."
Now Petersen does hernia operations for $5,000 a pop, which includes anesthesia, operating room time and follow-up visits. He negotiates special rates for the anesthesiologist and the operating room, and is able to provide the service for about a third of what a patient might pay otherwise.
Many of his patients are early retirees who are not yet eligible for Medicare but can't afford a full-fledged health insurance plan, he said, and business is booming.
"My practice at this point is the best it's been in my 26-year career," he said. "By far."

How much has health reform helped Medicare?
While the cash-only model may please doctors, some question whether it's good for middle- and low-income people.
Kathleen Stoll, director of health policy at the consumer advocacy group Families U.S.A., didn't want to speak directly to either Petersen's or Nunamaker's practice, as she didn't know the specifics of each.
But in general, she fears that doctors who switch to a cash-only model will drive away the patients who can't afford a monthly membership fee or thousands of dollars for an operation.
"They cherry-pick among their patient population to serve only the wealthier ones," Stoll said. "It certainly creates a barrier to care."
She's also concerned that the limited scope of the discounts these doctors negotiate for services outside their purview may not cut it if a patient comes down with a really serious illness.
"I'm always cautious when it's a cash basis," she said. "Are you somehow being put at risk? I'd have a list of questions."

Anti Federalist
06-11-2013, 06:45 AM
While the cash-only model may please doctors, some question whether it's good for middle- and low-income people

Of course, always...

The doctor mentioned in this article has a "retainer" fee for kids that costs $10 a month.

Less than two packs of smokes.

But the poor can't afford it...

Jesus weeping Christ.

tod evans
06-11-2013, 06:50 AM
Yup they're trying to paint him as a money grubber for opting out of socialized medicine..

Just wait one of the smaller insurance companies will offer a plan that'll reimburse the patient for using cash only/ low cost services like this...

When they do smart investors will jump on..

fisharmor
06-11-2013, 06:53 AM
My Chiropractor has, to my knowledge, never dealt with insurance.
We just started a relationship with a neurofeedback practitioner who also doesn't take insurance.
There are plenty of people who aren't on insurance networks because they practice medicine which isn't blessed by the cartel. And I absolutely adore dealing with them.

Of course, having an HSA helps with that, a lot. If you can pay these cash-only doctors with tax-free money, then everyone wins.

Also, I seriously doubt that poor families can't afford the rates mentioned above. If you're in a nuclear family with five kids then it's $150 a month.
Get freaking real, poor people... between what my employer pays and what I pay, we're sinking the better part of a grand into health care costs - for two adults and TWO children.

Hell, if they offered plans like that in my area, I'd get on it, sponsor two other families, and STILL be paying less.

fisharmor
06-11-2013, 06:57 AM
Forgot to mention two other gigantic points....

When I deal with cash-only places, there's a very good chance that when I phone the practice I'll actually talk to the doctor.
They don't need staff to file paperwork, so they don't have anyone else to answer phones. That means I can describe what's going on to the person who will see the patient.

Also, every place that takes insurance has a mile-long waiting list. Today 6/11, and if I tried to get an appointment at a cartel-blessed place, I'd not expect anything before August to be open.
With the cash-only places, I'm usually the one who needs the appointment kicked out further because something is going on tomorrow afternoon.....

IDefendThePlatform
06-11-2013, 07:01 AM
Stuff like this is a big part of how we'll eventually work our way out of socialized bs like Obamacare. Red tape grows, healthcare gets more expensive and time consuming, more people opt for fee-for-service and eventually realize they don't need to be paying taxes to the government just to waste it on a system they aren't even participating in.

tod evans
06-11-2013, 07:04 AM
Also, I seriously doubt that poor families can't afford the rates mentioned above. If you're in a nuclear family with five kids then it's $150 a month.
Get freaking real, poor people... between what my employer pays and what I pay, we're sinking the better part of a grand into health care costs - for two adults and TWO children.

Hell, if they offered plans like that in my area, I'd get on it, sponsor two other families, and STILL be paying less.

"Poor people" is code speak for government leach...

Not those who work and try to make end meet..

wgadget
06-11-2013, 07:06 AM
But will Obamacare shut these guys down?

I hope not!

fisharmor
06-11-2013, 07:09 AM
"Poor people" is code speak for government leach...

Not those who work and try to make end meet..

I know, right? I was doing more math and figured out that I'm spending almost 10% of my salary on HC.
Assuming the same family of seven paying $150 a month, they'd have to be making under $20,000 a year for that to be 10%.
I really doubt that you can feed and house 7 people for under $20,000 a year anymore. I also really doubt that a man and a woman both working - even only part time - can't manage to make less than $20,000 a year.

Lucille
06-11-2013, 08:44 AM
But will Obamacare shut these guys down?

I hope not!

Count on it. Unless we can convince the pols to protect it by law.


To see just how important it is to destroy the doctor-patient relationship, one merely has to observe what is happening to primary care doctors who have the audacity to leave the system, and set up a direct-pay medical practice.
[...]
The attacks on direct-pay practitioners have followed the usual scheme Progressives follow when they discover a faction they need to suppress (http://covertrationingblog.com/medical-ethics/breaking-the-doctor-patient-relationship-limiting-individual-prerogatives-part-3). First, they were ridiculed. “For a Retainer, Lavish Care by ‘Boutique Doctors,’” said a headline in the New York Times in 2005. Then, they were demonized, widely attacked for their elitism, laziness, greed, and lack of fundamental medical ethics. In this latter effort, it was not difficult to find fellow physicians – generally, from the medical organizations which promulgated the New Ethics – to lead the attacks. There are countless examples. DrRich will give just two.
[...]
When ridicule and demonization fail to suppress their opposition, Progressive dogma indicates it’s time to resort to force. The first pass in this regard, of course, is always to render the opposition illegal. (Actual violence is reserved for criminals who persist in their misbehavior, despite more polite efforts to get them to behave lawfully.)

Making direct-pay medical practice illegal has not been accomplished yet, but clear efforts have been made in this regard. Noting with alarm the rise of direct-pay primary care, numerous Congresspersons have issued statements of concern, suggesting that perhaps Congress should look into the propriety of such activities.
[...]
DrRich does not really know how the Progressives will actually place the final nail in the coffin of the doctor-patient relationship. All he knows is that they have – well, more than the desire – the deep and abiding need to kill that relationship, once and for all. Unless we the people decide we ought to stop them, this is going to happen.