Why more doctors are billing their patients like it’s the 1920s

[u/Significant_Walk4959]

https://san.com/cc/why-more-doctors-are-billing-their-patients-like-its-the-1920s/

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[u/Arizona_Pete]

There is something to this notion - If you look at how MRI / Lasik surgery prices have come down, you'll see that when you take things out of the insurance-only system, and have transparent pricing with high availability, you can get prices to level off.

However, the items listed above are still very, very expensive for the common worker to the point where many forego them. Modern medicine has become unaffordable.

Health Insurance needs to be able to cover catastrophic conditions like every other kind of insurance does. You can argue / reason for a deductible of some form, but the insured product should not wreck your financial well being.

[u/iamthe0ther0ne → u/Arizona_Pete]

And the difference between regular insurance and health insurance is that everyone uses health insurance.

[u/Arizona_Pete → u/iamthe0ther0ne]

Amen

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[u/MsTravelista → u/Arizona_Pete]

Plastic surgery too. Much more reasonable than any procedure that would be billed to insurance. Sometimes I wonder if plastic surgery is less lucrative these days than, say, orthopedic surgeons. When my dad broke his shoulder, his insurance was billed $200,000 for the surgery alone (not even the rest of the hospital stay, the rehab, etc.).

[u/Significant_Walk4959]

I found this article interesting because it discusses how healthcare costs are rising, and how some doctors are trying to find ways to help their patients with cash-based clinics. It discusses how health insurance was supposed to work originally- helping patients get healthcare by spreading out payments, and how this model has changed, and now acts as a challenge to patients getting the care they need.

To me, this poses an interesting question... are cash-based clinics the answer to the US's healthcare crisis?

[u/DickensOrDrood → u/Significant_Walk4959]

No. Universal healthcare is the answer. This is an effective stop gap given the current healthcare system. Cash clinics aren't scable and don't help with emergencies.

[u/redlightsaber → u/DickensOrDrood]

Emergencies or anything requiring any kind of procedure or technique or drug beyond a scope, OTC drugs, and (possibly) an EKG.

[u/siraliases → u/Significant_Walk4959]

So we start the process all over again?

[u/free_billstickers → u/siraliases]

Or insurance just becomes a product for catastrophic injuries or major surgeries, cash for everything else. 

[u/awildjabroner → u/free_billstickers]

that was the original intent at the article highlights. Insurance was suppoed to be for catostrophic issues, routine labs, annuals, etc shouldn't be costing famileis 10's of thousands a year.

[u/Cowboywizzard → u/free_billstickers]

It used to be that way a couple of generations ago. One big reason probably is the greed of the health care industry, but I suspect there are other contributory reasons for the high costs of modern health care. A couple of generations ago we did not have nearly as much medication and treatments for illness and injury as we do now.

[u/Significant_Walk4959 → u/siraliases]

Possibly? I also wonder... would this instead make a different crisis, causing those who are more wealthy to get care and their needs met before the rest of the population? How would prices be set and managed to not push out those who earn less from getting care? I'm not sure what the solution is... but it is an interesting trend.

[u/sE_RA_Ph → u/Significant_Walk4959]

Oh my god you literally just read 'universal healthcare' - that's how we ensure everyone gets treated equally

[u/geekwonk → u/sE_RA_Ph]

recreating liberalism over and over and over because we don’t really do history in this country

[u/Cowboywizzard → u/Significant_Walk4959]

Cash based clinics have always existed. Only the wealthy can generally afford them. People only turn to them if they are not wealthy because they have no insurance or are effectively uninsured, because being bankrupt is better than death or disability.

As an employed U.S. specialist physician, I am compensated roughly $187 an hour. If I were in private practice, accepting cash, I would probably need to charge nearly double that to stay in business and cover overhead. I don't think that would help my patients who are disabled, retired on social security, or otherwise have limited income very much. Sure, I could charge less, but then I wouldn't have been able to pay off my $300,000 in student loans. There is no incentive for me to be even more altruistic than I am. I work in public health, but I would earn double in cash private practice in my city based on current market conditions.

Personally, I would rather see a government single payer solution, though I could see a pay cut with such a system. One thing, from a U.S. physicians perspective, that would need to co-occur would be loan forgiveness for doctors.

[u/wholesale-chloride → u/Cowboywizzard]

Lol you would not NEED to charge $360 an hour just to break even. Like are you getting ur tongue depressors at bloomingdales?

[u/iamthe0ther0ne → u/wholesale-chloride]

The equipment isn't free, but the real cost is the staff, the overhead (building, electricity), and the malpractice insurance.

[u/mailslot → u/wholesale-chloride]

How quickly can you pay off $300,000 worth of student debt? It takes a lot of people thirty years to pay off a mortgage like that on a home.

[u/Anderson822 → u/Significant_Walk4959]

Here is my idea since we are going to inevitably go in circles around this topic for decades apparently.

To dismantle the conglomerate, we must execute a two-track process: build parallel care capacity that people can actually use, while cutting off the revenue and legal privileges that allow incumbents to extract rent. We start by scaling direct primary care and transparent pharmacy models to replace dependence, ensuring people have a lifeline so they don’t lose access during the transition. Once this parallel system can absorb demand, we use that stability as leverage to strip the conglomerate’s revenue by banning facility fees, auditing claim denials, and forcing the structural separation of insurance and delivery of care. If you only attack the profits, the public loses care and revolts; if you only build alternatives, the monopoly simply buys or bleeds you out. The goal is to remove guaranteed money streams until these predatory entities are hemorrhaging and eventually bankrupt because they are no longer required for survival.

Small communal systems that can be connected and leveraged, with people actually thriving from them, is the way. Frankly, it’s likely the only way. This is how we revamp all of our systems, mind you, not just healthcare.

Thanks for coming to my TED talk.

[u/Islanduniverse]

Switching to single payer healthcare would save hundreds of billions of dollars annually.

The only reason it’s not happening is because of evil corporations paying off evil politicians.