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What Happens When Doctors Only Take Cash (2017)

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Re: What Happens When Doctors Only Take Cash (2017)

#71

I've been wondering for a while now why health insurance companies exist at all. They introduce a massive bureaucracy and massive costs and provide very little value. They evolved from a reasonable idea into a monster that just drains our system and do not provide enough value to justify their existence in my opinion.

Historically health insurance developed around the turn of the century along-side things like fire insurance. This sort of made sense at the time, when our understanding of health and our ability to treat disease was extremely primitive.

Eventually science progressed to the point that medical care was an inevitability in people's lives; which is a surprisingly recent development due to modern medications, lab tests, improved treatments and surgeries, increasing preventive care, etc. Faced with this sea change, developed nations around the world transitioned to some form of universal health coverage.

Only the United States persists in the delusion that an insurance-based system is an efficient way to provide healthcare.

Re: What Happens When Doctors Only Take Cash (2017)

#72

My local mechanic is required by law to tell me how much something is going to cost me before they start work. Why is my doctor not held to the same standard. Ever tried calling a provider to find out how much something is going to cost? Sounds like the medical industry had better lobbyists.

>My local mechanic is required by law to tell me how much something is going to cost me before they start work. Why is my doctor not held to the same standard. Ever tried calling a provider to find out how much something is going to cost? Does that include a situation where say, when emptying out the oil, the nut over the drain breaks off which necessitates changing the oil sump, except they then discover the engine…

I'll let an ex-mechanic answer: me. In that situation the service writer (my go between me and the customer) calls the customer and tells them what is needed. If they don't want to do it, button it up and send them on their way. In your made-up example, there are fixes for a stripped drain plug that don't require dropping the oil pan. If it weren't for Jiffy Lube (who, more than once, stripped it before it got to me), I wouldn't have to know this, but I do. So let's use a real-world example.

Customer comes in for an oil change. Change the oil, go to start the car, it won't start. A bit of diagnosis later, and the ignition control module has coincidentally decided to die. It's an old GM, so thankfully it's only $35, but still: the car was running when the customer dropped it off. I hate those phone calls. Customer said, "okay, do it". Had they not, we probably would have just dropped a module in and eaten the cost. I mean, what are you going to say? "Umm, yeah, it's just coincidence that you need to spend $35 more before you can drive it home"?

I also tell customers ahead of time the possible outcomes of the work. Honda comes in needing a top-end job, but it has over 100K miles on it. I tell the service writer that we can do the job, but it stands a chance of blowing the rings. (New valves with better sealing on the top end, now the piston rings are the weak link.) Customer is informed, I do the job. Two weeks later, the Honda pulls up blowing smoke. Told you so. I forget the outcome, but I don't recall pulling the engine on that one.

But they don't always say, "yes". Customer comes in looking for an estimate on a brake job. You know that grinding you hear when your pads are shot to hell? Imagine what happens when you let that go for, say, a couple of months. Imagine no more, I'll tell you what happens: it'll grind the rotors down to the cooling vents such that what's left of the brake pad backing plate no longer has a solid surface upon which to grind. Of course wheel bearings are shot, calipers need replaced. It was a long time ago, but many hundreds of dollars were estimated. Of course this is on a piece of shit that isn't worth fixing for that much. The vehicle is not safe to drive by any means. Customer doesn't want to do the work (duh). What did I do? Put the wheels back on and let them drive off. We're mechanics, not the state police, but trust that there was discussion of what "the right thing to do" was.

Your surgeon is in the middle of heart surgery. You wanted an estimate on a (cardio) valve job. Surgeon gets in there, your arteries are all clogged up. Wake the patient and ask for approval on the extra expense? Button 'em back up and negotiate the cost later?

So the car analogy doesn't work for all cases, or very well at for human beings.

Re: What Happens When Doctors Only Take Cash (2017)

#73
post #68

I've been wondering for a while now why health insurance companies exist at all. They introduce a massive bureaucracy and massive costs and provide very little value. They evolved from a reasonable idea into a monster that just drains our system and do not provide enough value to justify their existence in my opinion.

I've studied this a little. There are many stories depending on what you choose to believe. I believe the current state of affairs is a consequence of tax policy; health insurance benefits are untaxed income, a tax policy often attributed to powerful labor unions in the early 20th century. ACA attempted to tax "Cadillac" plans but the sunrise on that was kicked years down the road and when it was about to take effect…

> is a consequence of tax policy; health insurance benefits are untaxed income, a tax policy often attributed to powerful unions in the early 20th century.

I can't remember where I heard it, but IIRC employer-sponsored health benefits had to do with a fringe benefit that employers could give to attract employees during a national wage freeze (perhaps WW2).

I just found this timeline[1] that confirms my broken memory (@see 1943).

[1] https://www.ebri.org/publications/facts/index.cfm?fa=0302fac...

Re: What Happens When Doctors Only Take Cash (2017)

#74

What about making a website people can enter the price of past procedures, their insurance plan and note where it was done. Then you could help people comparison shop before hand by showing typical prices.

That seems interesting. Such a site would be prone to fake entries/astroturfing though. I wonder how that could be avoided?

Re: What Happens When Doctors Only Take Cash (2017)

#75

Earlier quoted context omitted.

Because the cost is unknown until treatment is over. Also, funny comparison, try to make it with software engineering.

> Because the cost is unknown until treatment is over. If you held a mechanic to the same standard, they "wouldn't know the cost" either. Maybe the doctor's office doesn't know your out-of-pocket cost, but they generally know (within a reasonable rage) how much they will bill the insurance company for. Perhaps an underlying problem is that a health insurance-medical pratcice contract prevents the medical practice fro…

Medical insurance reimbursement is based on correctly filling out a coded form (there are like 10,000 or more codes covering every type of service), waiting for some human at the insurance company to agree and provide payment, or often a protected argument about coding and necessity. Until a month or more later the doctor has no idea what the insurance will actually provide. The final cost will be determined by how many services are performed, how many interactions with various people occurred, how many supplies or drugs were used, tests run or ordered, etc. When you walk in and say I feel bad, it could be nothing or you are dying. Guessing what is wrong before they even see you is impossible.

Try estimating software development costs with no idea what is to be written. With software at least no one will die, and probably no one will sue if you are wrong.

Re: What Happens When Doctors Only Take Cash (2017)

#76

My local mechanic is required by law to tell me how much something is going to cost me before they start work. Why is my doctor not held to the same standard. Ever tried calling a provider to find out how much something is going to cost? Sounds like the medical industry had better lobbyists.

Heh. I have tried to call to see the cost. I see a retina specialist twice a year. I recently changed to a high deductible plan with an HSA. I called to see what the cost of my appointment would be. They could not or would not tell me. Incall three separate times, talking to different people and different departments. I went in and continued asking the front desk. "It depends on the services you end up getting." Ok,…

The same happened to me when I had an HSA. Estimated price for a procedure was first $4000, then $2000, then $100. Eventually paid $500. they just seem to make up prices.

Re: What Happens When Doctors Only Take Cash (2017)

#77

What about making a website people can enter the price of past procedures, their insurance plan and note where it was done. Then you could help people comparison shop before hand by showing typical prices.

That seems interesting. Such a site would be prone to fake entries/astroturfing though. I wonder how that could be avoided?

Just ask for a receipt to be scanned in.

Re: What Happens When Doctors Only Take Cash (2017)

#78

My local mechanic is required by law to tell me how much something is going to cost me before they start work. Why is my doctor not held to the same standard. Ever tried calling a provider to find out how much something is going to cost? Sounds like the medical industry had better lobbyists.

Part of the problem is that no one negotiates the price with the hospital. "Oh, I'm insured. All I have to pay is the deductible"

What you want is a buddy like Ed who can get the cost knocked down by 90% https://youtu.be/pY-BGNjI2Rg?t=6m18s

Re: What Happens When Doctors Only Take Cash (2017)

#79

I've been wondering for a while now why health insurance companies exist at all. They introduce a massive bureaucracy and massive costs and provide very little value. They evolved from a reasonable idea into a monster that just drains our system and do not provide enough value to justify their existence in my opinion.

And yet, health insurance companies have very low profit margins, the lowest amongst the insurance companies. So who is getting all the money?

It's a gigantic market though. (Revenue of $850 billion in 2016 according to https://www.statista.com/statistics/214544/total-revenue-of-... )

I'm not an economist, but it seems like a 5% margin on a $850 billion market is worth a 10% margin on a $425 billion market.

Re: What Happens When Doctors Only Take Cash (2017)

#80

You son has broken his arm. The doctors in your town will only take cash. One of the doctors charges $50 to set the broken arm. The other doctor charges $500. Which one are you going to take your child to? Most likely, the $500 one. Because going to the bargain basement doctor is not something you do when dealing with medical issues if there is absolutely any way to afford it. It creates what I call 'reverse capitali…

I don't think thats true. There is a price bias, but thats not the only quality signal for medical care. There's reviews, facility and installations, reputation, etc. People are price sensitive regarding their own life and their children's. You can find how much they value things with "revealed preferences", an economists principle. Its a bigger problem that as a consumer you don't have to or face the decision of cho…

"Little Billy - would you mind biting on a bullet for an hour while I check Yelp and online reviews to find the cheapest doctor to set your broken arm."

...said no one ever.

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