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Cash-only doctors abandon the insurance system

Rocketman

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Fed up with declining payments and rising red tape, a small but growing number of doctors is opting out of the insurance system completely. They're expecting patients to pony up with cash.

Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system.

In Wichita, Kan., 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. ("Cash-only" is a loose description. Nunamaker accepts payment by debit or credit card too.)

http://money.cnn.com/2013/06/11/news...-only-doctors/

WOW! a $90 cholesterol test for $3!
 

notquiteright

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Fed up with declining payments and rising red tape, a small but growing number of doctors is opting out of the insurance system completely. They're expecting patients to pony up with cash. Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system. In Wichita, Kan., 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. ("Cash-only" is a loose description. Nunamaker accepts payment by debit or credit card too.)

http://money.cnn.com/2013/06/11/news...-only-doctors/

WOW! a $90 cholesterol test for $3!
The link is a '404' for me. Can say while under an old insurance plan we always paid cash for minor procedures and dental. I'd say if that doctor is doing 3 dollar cholesterol tests he must be scamming the system somehow. I could routinely get 25% off most 'in house' work but if a lab was needed there was no discount on that part.

I don't see how any major injury or illness doctor can forgo insurance patients, and I'd bet mostly older, ready to retire doctors are contemplating cash-only.
 

Rocketman

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The link is a '404' for me. Can say while under an old insurance plan we always paid cash for minor procedures and dental. I'd say if that doctor is doing 3 dollar cholesterol tests he must be scamming the system somehow. I could routinely get 25% off most 'in house' work but if a lab was needed there was no discount on that part.

I don't see how any major injury or illness doctor can forgo insurance patients, and I'd bet mostly older, ready to retire doctors are contemplating cash-only.
Because he decreased 40% of his employees that were nothing but insurance. He also charges people $50/month up to 44 years of age for a membership to his office, $100/month over 44. If I had a doctor doing that here, I could save $6k to $8k per year in premiums.

Any time you reduce overhead less revenue is required to make the same gross.
 

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This may be a surprising trend there. But here all doctors are and have always been cash only.

It does gets a bit frustrating later though. You start seeing doctors who would put a price and try to capitalize on people who must be treated or be left to death. Basically as doctors who exploit and capitalize upon people while at their most weakest states!
 

66gardeners

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A little late to shut the barn door on this one. Insurance makes it cost more. They are a middle man who supplies nothing to the equation.
 

Fisher

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I am not sure that would work in a lot of places.
 

lizzie

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I don't blame them at all. Cash-only is much more efficient, and less costly to the consumer in the long run. When I have a minor medical issue (simple urinary tract infection, flu, etc), there's a local doc-in-the-box that I go to. He doesn't take insurance, and the office fee is only 60 dollars. Quick in and out of the office, and no bull****.
 

Rocketman

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I am not sure that would work in a lot of places.
Why not? We are looking at reducing our premiums taking a higher deductable plan and going to this type of doctor. Obama took something that might of been bad for some people (15%) and made it worse for more people (85%).
 

Boo Radley

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Why not? We are looking at reducing our premiums taking a higher deductable plan and going to this type of doctor. Obama took something that might of been bad for some people (15%) and made it worse for more people (85%).
As a former chief medical officer for Dell and Northrop Grumman, Dr. Greenspun said he had had several “executive physicals,” the long and intense exams many of these concierge practices promote. “As a physician, I know the quality of care is not better,” he said. “It’s the bathrobe and slippers. I know I’ve received a whole lot of unnecessary tests.”


(Snip)



Other health care experts suggested that the benefits of concierge medicine had been romanticized. “It may not be the panacea a physician is looking for,” said Steven M. Harris, a partner at the law firm McDonald Hopkins. “Certain physicians are attracted to the retainer payments and perhaps lose sight of the responsibilities that go hand and hand with a concierge practice. There are significant demands on the physicians’ time.”

http://www.nytimes.com/2012/11/24/y...tors-who-accept-only-cash.html?pagewanted=all
 

Fisher

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Why not? We are looking at reducing our premiums taking a higher deductable plan and going to this type of doctor. Obama took something that might of been bad for some people (15%) and made it worse for more people (85%).
Because if you have a chronic condition like cancer or diabetes or kidney impairment, you are not going to get all your care for $1200 a year. In addition, doctors who are affiliated with hospitals/health systems are not going to be able to opt out of the insurance.
 

notquiteright

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That was as interesting for what it didn't say as what it did say.

One big knock on 'socialized' medicine is if the cost is very low folks will abuse the system by demanding a lot of medical attention because it costs them so little. the doctor would have to have a system to triage out hypochondriacs and the chronically ill like childhood asthma. So his patient list will be folks who are basically healthy but don't want to use a 'wellness' urgent care or 'well-fast' clinic. I would imagine for these folks the even cheaper route is a clinic where you pay 50 to 90 bucks per visit.

I don't see how dropping one employee, that's what 40% means in most doctor offices, saves huge amounts of money 20-30K most likely. What he didn't go into any detail is just what kind of test a 3 dollar test is compared to a 90 dollar one. I get free cholesterol tests every time i give blood, dunno if they are the same quality as the lab one. Would be interesting to know.

it appears these doctors feed in a very narrow niche, even the surgeon, so their patients will still have to carry insurance. Dunno about others but the wife and i are self employed. We have been plan shopping as our plan is up for renewal. The high deductible plans with no pre-existing run 300 to 400 a month. So if you want to have some form of protection if you get cancer, major illness or accident then it would be 100 a month for the cash only doctor plus 329 a month major medical, the complete coverage plan is 336 a month with 50 dollar co-pays per visit. I don't see the savings.

The article says 4% of the doctors are cash only- financing your healthcare on a credit card seems the worst kind of financial planning but hey to each their own.

The drawbacks for the doctor seem to be on constant guard for 'problem' patients, still need medical insurance and the care and feeding of the services outside his office may become problematic- just how does a doctor get 3 dollar tests? Does the imaging clinic remain content with 400 fees for MRI's? Is that price based like the airlines do airline miles tickets- dates and times blacked out?

Still the idea of doctors FINALLY getting on board with cost management is critical to EVERYONE in the system is encouraging... :peace
 

year2late

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Fed up with declining payments and rising red tape, a small but growing number of doctors is opting out of the insurance system completely. They're expecting patients to pony up with cash.

Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system.

In Wichita, Kan., 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. ("Cash-only" is a loose description. Nunamaker accepts payment by debit or credit card too.)

http://money.cnn.com/2013/06/11/news...-only-doctors/

WOW! a $90 cholesterol test for $3!
That is helpful for the wealthy and very healthy.

But for those of us in the real world, we cannot afford to be on the street if we end up with a complex leg fracture or cancer or fill in the blank.
 

Neomalthusian

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Fed up with declining payments and rising red tape, a small but growing number of doctors is opting out of the insurance system completely. They're expecting patients to pony up with cash.

Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system.
And those people are idiots.

One of the most fundamental problems in our health care system is our radical departure from cash-only forms of health care. The very fact that both providers and patients don't have any idea what the price is of the thing they're transacting until after the fact is what has squashed any semblance of price discipline and created such a ridiculous bubble in health care prices.

What I imagine will happen if cash-only health care re-emerges (and I hope to God it does), everyone who doesn't qualify for the Free Government Insurance schemes will benefit. What a slap in the face to our dysfunctional health care system to have an option to see a doctor and pay cash and still spend less than a 20% co-pay would have cost you.
 

Rocketman

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Because if you have a chronic condition like cancer or diabetes or kidney impairment, you are not going to get all your care for $1200 a year. In addition, doctors who are affiliated with hospitals/health systems are not going to be able to opt out of the insurance.
You don't go to an MD for cancer.......DUH
 

Rocketman

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That was as interesting for what it didn't say as what it did say.

One big knock on 'socialized' medicine is if the cost is very low folks will abuse the system by demanding a lot of medical attention because it costs them so little. the doctor would have to have a system to triage out hypochondriacs and the chronically ill like childhood asthma. So his patient list will be folks who are basically healthy but don't want to use a 'wellness' urgent care or 'well-fast' clinic. I would imagine for these folks the even cheaper route is a clinic where you pay 50 to 90 bucks per visit.

I don't see how dropping one employee, that's what 40% means in most doctor offices, saves huge amounts of money 20-30K most likely. What he didn't go into any detail is just what kind of test a 3 dollar test is compared to a 90 dollar one. I get free cholesterol tests every time i give blood, dunno if they are the same quality as the lab one. Would be interesting to know.

it appears these doctors feed in a very narrow niche, even the surgeon, so their patients will still have to carry insurance. Dunno about others but the wife and i are self employed. We have been plan shopping as our plan is up for renewal. The high deductible plans with no pre-existing run 300 to 400 a month. So if you want to have some form of protection if you get cancer, major illness or accident then it would be 100 a month for the cash only doctor plus 329 a month major medical, the complete coverage plan is 336 a month with 50 dollar co-pays per visit. I don't see the savings.

The article says 4% of the doctors are cash only- financing your healthcare on a credit card seems the worst kind of financial planning but hey to each their own.

The drawbacks for the doctor seem to be on constant guard for 'problem' patients, still need medical insurance and the care and feeding of the services outside his office may become problematic- just how does a doctor get 3 dollar tests? Does the imaging clinic remain content with 400 fees for MRI's? Is that price based like the airlines do airline miles tickets- dates and times blacked out?

Still the idea of doctors FINALLY getting on board with cost management is critical to EVERYONE in the system is encouraging... :peace
40% is a hell of lot more than one employee! The doctor I go to that would be 5 out of 10 employees in his office. WOW just wow!
 

Rocketman

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You don't go to an MD for cancer.......DUH[/QUOTE

Oncologists aren't MD's? :roll:
I sure as hell don't go to my family doctor for cancer, damn, that is a specialist which is why you keep high deductable, please don't make me pull out a chalk board to explain the obvious.
 

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Fed up with declining payments and rising red tape, a small but growing number of doctors is opting out of the insurance system completely. They're expecting patients to pony up with cash.

Some doctors who have gone that route love it, saying they can spend more time with and provide higher-quality care to their patients. Health advocates are skeptical, worrying that only the wealthy will benefit from this system.

In Wichita, Kan., 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. ("Cash-only" is a loose description. Nunamaker accepts payment by debit or credit card too.)

http://money.cnn.com/2013/06/11/news...-only-doctors/

WOW! a $90 cholesterol test for $3!
Weird, that page is gone now. Hmmm.....

At any rate, it makes sense to me. A primary physician isn't doing surgery, performing extremely expensive tests, etc. Doctors don't have to. I suppose it depends on an area's demographics, but it could certainly work. After all, people can still get reimbursed through their insurance companies and have the check (which I assume wouldn't cover the total cost of the service...or maybe it would...?) mailed to them directly. They're entitled to do that if they wish.
 

Lord of Planar

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A few years ago, when I was laid off and had no insurance, the in between jobs paid OK, but I had no insurance. I have a daughter with hypothyroidism, so she needs to bee seen regularly. I went "doctor shopping." I just called various places and told them what I needed, that I would pay cash when I walked in the door, and they wouldn't have to deal with insurance. I found a doctor glad to do just that. For the first visit and blood testing, I paid about $120. I have my most recent Benefits Statement for the same work from the insurance company I now have. $335 in submitted charges.
 

notquiteright

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40% is a hell of lot more than one employee! The doctor I go to that would be 5 out of 10 employees in his office. WOW just wow!
My turn to go wow just wow. 10 employees per doctor... now THAT'S overhead. I don't go to a lot of doctors but the ones I do have one person handling insurance paperwork, the rest working with patients. The doctor I see once a year has two employees, the dentist 4. My wife's special doctor has 4. most practice doctors combine into one suite and run a fleet of assistants shuffling patients in and out, but I don't think Dr. Cotton's group had 30 employees.

But for many years we only carried major illness and used fast care clinics for minor problems like cuts and coughs. I think that would be the cheapest way to go.

Will be interesting to see how this all shakes out, still confused on how a test costing 90 bucks can be had for 3...
 

Fisher

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I sure as hell don't go to my family doctor for cancer, damn, that is a specialist which is why you keep high deductable, please don't make me pull out a chalk board to explain the obvious.
I think you are confusing GP's and MD's. Doctors are MD's regardless of what they specialize in and regardless of how many other letters follow the MD. I sure as hell hope you don't go to one of those Phd doctors if and when you get cancer.
 

Lord of Planar

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Because if you have a chronic condition like cancer or diabetes or kidney impairment, you are not going to get all your care for $1200 a year. In addition, doctors who are affiliated with hospitals/health systems are not going to be able to opt out of the insurance.
That's why the best way to go is pay out of pocket for the normal stuff, and pay for a catastrophic care package.
 

Rocketman

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Weird, that page is gone now. Hmmm.....

At any rate, it makes sense to me. A primary physician isn't doing surgery, performing extremely expensive tests, etc. Doctors don't have to. I suppose it depends on an area's demographics, but it could certainly work. After all, people can still get reimbursed through their insurance companies and have the check (which I assume wouldn't cover the total cost of the service...or maybe it would...?) mailed to them directly. They're entitled to do that if they wish.
I reposted the link about 3 or 4 post after the original
 

Rocketman

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I think you are confusing GP's and MD's. Doctors are MD's regardless of what they specialize in and regardless of how many other letters follow the MD. I sure as hell hope you don't go to one of those Phd doctors if and when you get cancer.
I knew it-FIsher meet chalkboard. I go to my family physician whcih in this case would be the subject of the thread. Should he determine I might have cancer after ths standard test with indicators he would REFER me to an oncologist probably at MAYO which my higher DEDUCTABLE insurance would cover that I am paying much less for because I have a low cost physician for physicals and routine blood work.

Damn, please refrain for posting to me if you require this chalkboard crap!
 
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