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| Economy |
| A Third Way For Doctors - No Insurance, No Government |
| 2010-04-19 |
| Reads kind of like an infomercial, but he's got a good point. When I was a kid my parents used to take us to our local GP. Mom paid $10 a visit, if I can remember that far back. I think she switched docs when the price went up to $20. When one of my brothers and one of my sisters was born in a hospital -- the rest of us were born at home -- the hospital billed her and she paid it off at so much per month. Dr. Silberman was rumored to make better than $10,000 a year. As evidence there was his black '55 Cadillac that he drove when he made house calls. You could buy Blue Cross and Blue Shield in those days but they weren't cost effective for the lower half of the income curve. HMOs were originally sold as a way to keep health care prices down. Particularly appealing was the emphasis they put on preventive medicine. Go to the doctor for your routine checkups and you'd get sick less often. Prices kept going up and PPOs were supposed to do what HMOs weren't doing. Particularly appealing was the emphasis they put on preventive medicine. Go to the doctor for your routine checkups and you'd get sick less often. The insurance companies, medical billing companies, claims processing companies, utilization managers, and what have you add a layer of costs that wasn't there before. Adding in malpractice insurance costs makes things even more gruesome. I went to routine physical therapy appointments for the past few weeks. I'm fully covered, with Tricare Prime. I had a $20 copay with each visit. The physical therapy office had stacks of "Iron Mountain" records boxes, chock full of documentation. Now we're gifted with B.O.Care. But not to worry. Despite the number of digits in the price tag it's gonna save us money. Particularly appealing is the emphasis they put on preventive medicine. Go to the doctor for your routine checkups and you'll get sick less often. |
| Posted by: Anonymoose |
| #5 most people seem to gloss over the fact that most if not all MD's are way frickin smarter than Joe the Plumber, WAY SMARTER! And so are licensed nurses. Look at the body of medical knowledge that a doc had in 1920 or 1940 and look at the body of medical knowledge a licensed nurse has today. Why is one a doctor and the other a nurse? Why is one only allowed to perform medical protocols within that body of knowledge and another is not? Because the medical community has operated a guild and has through the politicians imposed requirements to maintain their economic position. Back in the late 60s, DoD was establishing a military medical college to produce doctors for the war. The AMA went to Congress and got it killed because they didn't want the system to be flooded with 'competition' and to control the number of doctors turned out into the system. Doctors didn't have those grand salaries in the 30s and 40s. Then the baby boom hit. Demand soared and the law of supply and demand hit. Doctors got 'comfortable' in the 60s and weren't about to allow their economic fortune and position decline. When we talk about tort reform somehow the responsibility of cleaning their own house, which is usually associated with a 'profession', doesn't really get discussed. The guild (ie associations) makes sure it doesn't happen. They're looking after their own interests. We all are. There are no innocent parties in this game. The system isn't broke because it never was whole. There's a difference between broke and sub-optimal. No one wants to trade back to care level and abilities of 1990, 1970, or 1950. However, the expectation that each is entitled to rob their neighbor blind to stay alive just a little longer hoping for immortality is going to destroy what we do have. |
| Posted by: Procopius2k 2010-04-19 17:01 |
| #4 Eliminating the billing office + the insurance vultures' take would eliminate maybe 25% of medical costs. Add in tort reform and you could cut another 8%. Bottom line, this is a viable and attractive model for many docs and their patients. Bring it on. |
| Posted by: lex 2010-04-19 15:43 |
| #3 Great article. That's how it still works in Mexico, and I have found the quality of GP care to be good there, don't know about hospitals, knock on wood. Doctors should also remember that most of those $20 payments are going to be CASH. |
| Posted by: bigjim-CA 2010-04-19 14:44 |
| #2 most people seem to gloss over the fact that most if not all MD's are way frickin smarter than Joe the Plumber, WAY SMARTER! |
| Posted by: 746 2010-04-19 14:32 |
| #1 A trend whose time has come. This will accelerate as more and more docs realize that the intention behind Obamacare is to shift them from private practictioner/LPs into unionized hospital employees a la the SEIU. |
| Posted by: lex 2010-04-19 13:42 |