Finally, Pay Doctor Directly Is Being Recommended

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#ObamaCare
#Affordable Care Act

Here is a link to a commentary in The Wall Street Journal, September 2, 2015, that clearly and cogently argues for two key elements in reforming ObamaCare: Two Essential Elements of ObamaCare Reform.

The authors, Scott W. Atlas and John F. Cogan, add pre-tax health-savings accounts to high-deductible insurance coverage, the latter of which we have advocated. These changes put health care back into the hands of consumers instead of in the power of government and insurance companies. Both of these changes are eminently practical!

Another crucial reform is to allow consumers to purchase health insurance across state lines. The health insurance companies, which helped write ObamaCare (to speak conservatively), are the elephants in the room that hope they are not noticed. Make them compete! Then costs will come down. We are supposed to be a society of free markets. Too often, we are a society of rigged markets in favor of big business in league with big government. When President Eisenhower was leaving office, he warned about the perils of the military-industrial complex. That is still a peril, but big business-big government (which encompasses the military-industrial complex) is a scourge that can destroy our way of life.

A Simple Solution to ObamaCare

Decide about health insurance now!

#ObamaCare

Doctors, there is a simple solution to ObamaCare in your hands!

This letter to the editor of The Wall Street Journal was published on July 27, 2015, and it was written by Jonathan Sheldon, M.D.

Doctors Serve Patients Without Insurance

In his July 23 letter, Dr. Karl Hafner laments that, “As a physician I would love to provide free service sometimes, but insurance prohibits it.”

There is a simple solution to this problem and it is one available to all physicians: Stop accepting insurance and instead work directly and exclusively for your patients.

My partner and I did this back in 1998 and since then have enjoyed a most wonderful practice. We charge fairly and rationally for our work — our fees don’t have to be artificially inflated to account for the big discount the insurance companies apply — and about 10% of our care is provided gratis to deserving patients.

I am increasingly convinced that the solution to much of what ails our health-care system lies not in commercial or government insurance, but in physicians reclaiming what we lost when we ceded control to insurance companies.

This blog is provided by David Gentry, owner of Sites That Sizzle.

ObamaCare: The Freedom Option

obamacare

President Obama strongly declared: “If you like your doctor, you can keep him,” and “If you like your insurance plan, you can keep it.”

We know how that worked out.

In this session of the Supreme Court, the court will rule on an important provision of ObamaCare involving subsidies. The decision may require major changes to ObamaCare, and the Republicans need to be prepared to offer an alternative. Mr. Phil Gramm, a former Republican senator from Texas, recommends “the freedom option.” If you like ObamaCare, you can keep it; if not, you can choose a health plan you prefer: Freedom Choice.

The Bureaucrat Sitting on Your Doctor’s Shoulder

This is a stunning glimpse into the world of doctors in the U.S. today. It is from The Wall Street Journal of May 22, 2014.
#ObamaCare #Health Care #Government Regulations

Bureaucrat on Shoulder

Zane Pollard Article

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My Own ObamaCare Story

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#ObamaCare #Health Care

I took my sister who has dementia to an optometrist for further tests to determine if my sister has glaucoma. My sister is covered by Medicare Disability.

The visit in the examining room took two hours. For an hour and forty-five minutes of that time, my sister and I were with someone who described himself as “a technician.” The optometrist examined my sister and the results of the tests administered by the technician. Thank goodness the optometrist said my sister’s eyes do not show any sign of glaucoma!

microscope clip art

What struck me about this experience was that during most of the time with the technician he was completing a form on a computer while questioning us. He explained that this was a new form from Medicare, and if even one field was not completed the clinic would not be paid by Medicare. Our next visit would take less time.

I know that doctors are being paid less than they were by Medicare. How can they afford to spend two hours with every new patient? I was left with a fear that this situation can not continue. Many doctors will not accept Medicare today, and the list is growing fast. Will our new optometrist drop Medicare? If so, what will we do?

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A Doctor’s ObamaCare Story

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#ObamaCare

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This is a doctor’s story in his own words with full attribution to The Wall Street Journal of April 29, 2014.

A Doctor's ObamaCare Story

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Unfortunately, It’s True: A Woman’s Cancer Medicine Is Not Approved by ObamaCare

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#ObamaCare

[I am the author of this blog, and I regret that I have not posted anything in the last few weeks. My day job has interfered! I will not be able to post much for the next 2-3 weeks, but I will resume after that.]

Unfortunately, my cartoon prediction that I created in December 2013 has become true in some cases, although I truly hope not exactly as I predicted in the nearby cartoon.

ObamaCare, January 2014

Mr. Stephen Blackwood’s ObamaCare and My Mother’s Cancer Medicine, in today’s The Wall Street Journal, is the horror story of one woman’s valiant fight to get her cancer medicine covered by ObamaCare. Her claim has been rejected and is under appeal. This is one person’s story. How many other people have had their cancer medicine canceled by ObamaCare? It is depressing to even imagine.

Mr. Blackwood’s mother had a Blue Cross/Blue Shield plan that covered her cancer medicine. Then it was declared illegal under ObamaCare, and her coverage was canceled.

What makes this story additionally fearful is that Mr. Blackwood’s mother is a medical office manager with decades of experience! She has had the by now frequent experience of many individuals of spending many, many hours working to get her questions answered by the unbelievably complex ObamaCare bureaucracy. If she cannot easily navigate ObamaCare, who can? How many tens of thousands who do not have her medical experience have just given up? Mr. Blackwood concludes his article, “It [ObamaCare] will cause many individuals to suffer and die. We can do better, and we must.”

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Republican Health Care Proposal

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#ObamaCare, #Reason.com

As an alternative to ObamaCare, three Republican senators are offering a proposal for discussion: Sens. Coburn (Okla.), Burr (N.C.), and Hatch (Utah).

Peter Suderman says, “The goal isn’t to rethink the health care system. It’s to make it better, cheaper, and more accessible for the majority of people”: How Republicans Could Replace Obamacare.

The proposal retains popular components of ObamaCare. Mr. Suderman explains:

Most forms of rescission, in which insurers unilaterally terminate coverage, often when expensive treatments begin, would be prohibited. (Insurers could still cancel plans in instances of clear-cut fraud.) The proposal would continue to allow dependents up to the age of 26 to stay on their parents’ health plans. And it would eliminate medical underwriting for the continuously insured; those switching plans, even from employer coverage into the individual market, would not have to worry about being denied coverage due to preexisting conditions. If you have a plan, you can keep your plan—or get another one.

Republican Health Care Proposal

The uninsured would have an opportunity to purchase health insurance, but would not be forced to do so. Tax credits would be available to help people who otherwise would not be able to afford insurance.

The bill is called, “The Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act.” It will be most interesting to follow the bill.

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ObamaCare Forces Middle Class Onto Government Assistance

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#ObamaCare

Ben Winslett, a fellow Alabamian, writes a powerful blog on how ObamaCare has negatively affected his life: My Obamacare Tale.

Ben’s amazing and frightening recent post tells how ObamaCare makes many of us government dependents whether we like it or not!

But here’s where you should be outraged. If you are in the middle class – YOU TOO have been forced onto a subsidy. You just don’t realize it yet. Let me explain:

I could make as much as 100k a year and still qualify for two of the three forms of assistance aforementioned [a health insurance subsidy, Medicaid, and All Kids]. This isn’t about me making low income. Get this – EVEN IF I did not claim the subsidy for my monthly premiums the Feds would grant it to me when I file my taxes. I, along with the rest of the middle class, apparently have no choice! They’ll give it to us anyway, in one form or another.

ObamaCare Forces Middle Class Into Government Dependency

When you sign up through healthcare.gov, you have three options. 1) Receive no subsidy on your premium and get a big “refund” check at tax time, 2) Receive some subsidy on your premium and receive less of a “refund” at tax time, 3) Receive a full subsidy and get no extra “refund” at tax time.

You have no choice. Understand, I am not living in poverty! I am securely in the middle class earning nearly the exact average US income each year. I am Mr. America, your average Joe.

The arrogance, cynicism, and oppression of the Democrats who voted for ObamaCare are beyond the pale. No Republican voted for it.

Some may react: “Why complain? You’re being given money!” This attitude reminds me of attitudes during the age of the Roman Empire. The emperors said, “Give them bread and circuses! That’s all they care about!” Government cannot give us money they have not first taken from us! Meanwhile our federal budget deficit grows and grows and grows.

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Two Real-Life Stories: One Using Health Insurance, the Other Paying Directly

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Paying Through Health Insurance

Let’s call him Person A. His son was having recurrent headaches. An MRI was called for.

Person A has health insurance through his employer. The employer pays 80% of the monthly premiums for the employee and 20% of the additional premiums for the family. Person A pays sizable out-of-pocket costs every month. He has a wife and three children.

The MRI cost $14,000! Person A’s out-of-pocket cost was $1,500, so insurance did its job. Person A adds, “But for a test like an MRI to cost that much is absolutely insane!”

Paying Directly

Person B had a painful lower back and hip. MRI’s were called for, one for the lower back and one for the hip.

Person B also has employer health insurance. He has a wife and two children. He has to meet a deductible and then pay 20% of health care expense up to a certain amount.

Paying Health Care Providers Directly

If Person B had used his insurance, the out-of-pocket charges would have been a total of $2,040.

Person B decided to shop around. He looked online. He looked for MRI providers in out of-the-way places, and due to the large population of older people he looked in Florida. He lives in North Carolina. He looked for ACR accreditation. He read provider websites, reviewed their MRI images, the number of doctors they had, and the age of the MRI machine.

Person B flies to Ft. Myers, FL, on business, and he talked to an MRI provider there. He was quoted $500 for both MRI’s to be paid for by credit card, that is a total charge of $500. Then he spoke to his doctor in North Carolina. His doctor tried to dissuade him, saying that the images would probably be of low quality, but his doctor did provide the required prescription for the MRI’s.

When Person B’s doctor received the MRI images, he said they were clear. The damage was quite evident. Person B was very pleased with the facility and staff. The staff told him he did not even need an appointment! Person B says, “I then realized how idle the machine was. Perhaps, I should have negotiated for an even better price!” He saved $2,040 – $500 = $1,540.

Conclusions

By paying directly, Person B did not reduce his insurance deductible, and by paying through his insurance company Person A did. Everyone’s health care situation is different, many health care challenges are unique, and judgments must be made.

Not everyone has the tenacity, skill, and time of Person B to find low prices. (Person A has tenacity, skill, and maybe time, but he chose to go the insurance route in this case which may have been better for him and his family.) Also, one might say, “I don’t fly on business so I would not have been able to go to Florida.” Person B says that Lawrenceville, GA, near Atlanta, was another good possibility. Driving from eastern North Carolina to Lawrenceville would have been feasible for Person B.

This experience of Person A is a perfect example of a truism that when a third party, such as a health insurance company, is part of a transaction the cost of the transaction will rise. Add to that truism the fact that our health care system is anything but a free market system and one can realize why our health care costs are through the roof and irrational.

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