I’ve been thinking about starting this one for a while. Hope to see people from both sides joining in. Since it’s 2:41am, I’ll just start with a few thoughts:
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We can’t afford to see doctors because they are too expensive. It used to be you could go see a doctor for a cold and pay $20. Now you can see a doctor for a cold and get charged $100. Why? Insurance may only pay 80%, and the doctors have huge overheads. A nurse may come in to take your temperature and ask questions, things that the doctor can do, but they’re too high and mighty to do that anymore, so they pay $30K a year for someone to do that and they end up pocketing the same $20. They charge more because a lot of the fee is eaten up.
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Getting money from insurance company sucks. Insurance tries to control what the doctors do now and pay as little as they can get away with. I’ve heard from one insurance adjuster that they went to a seminar which taught them to underpay doctors and only 50% would write back to dispute the bill. Sometimes they refuse to pay for something that is legitimate and it’s in your contract with them that their determination is final and you cannot collect from the patient.
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Insurance should be run by a non-profit organization, like hospitals were run by the religious orders in the old days. Making money is actually a conflict of interest for insurance companies. They collect money from the insureds and pay it out to the providers. To them, maximizing profits means covering as little as they can get away with and paying as little as they can to the providers. For the greatest benefit to all, all monies should be spent in covering their insureds and paying the providers, not making more money for themselves.
Insurance companies can legitimately deny payment by saying that the patient didn’t need the treatment (that’s like the adjusters actually diagnosing the patient and being the doctor), the doctor didn’t get authorization first (that’s getting off on a technicality), not billing in time etc.
4) Part of the increased cost is the fault of lawyers and patients being sue happy. Doctors are not gods. If someone comes in with a problem, doctors generally look for the most common problems first and then proceed on. Everything that someone comes in with can be cancer. It seems that doctors are fair game if the patient thinks he was misdiagnosed, but the fact is diagnosing a problem is complex task. It’s like a mechanical replacing different things on a car before he fixes the problem.
5) Having said that, there are bad docs around. There are still a lot of people who go into medicine thinking it’s a gold mine. Unfortunately, it’s not true anymore. And anyway that’s the wrong reason to go into medicine. The worst part about it is that if a doctor is inept and they can keep practicing for a long time. There should be no malpractice insurance. This would cut overhead. If a doctor screwed up royally, their license should be taken away from them, instead their malpractice pays and they keep on practicing.
Thoughts?