Out-of-pocket doctors

[anactivegrenade 25]

So with Obamacare being the hot topic of the hour with the gov't shut-down, I've determined that gov't-controlled healthcare is a failure - I'm sure most of you feel this way, too.

 

My ancestors had to endure it in Poland under Nazi-occupation, and then under Soviet-occupation. I, as a first-generation American, have no desire to be part of this system that ignores its own historical failure.

 

Thankfully, I've found that the way out is through out-of-pocket doctors. The lack of an insurance "middleman", whether it be gov't or private, immediately cuts costs, as well as allows the doctors to do what they think is best for the patient.

 

I keep reading about doctors popping up everywhere, dropping all kinds of insurance to work out-of-pocket. It sounds splendid. Do we have any of these docs in NJ who shun Obamacare and insurance companies?

[djg0770 481]

I think you will find that this grey market will make itself known very very quickly.

 

Hey, there's always India where you can get a knee replacement for 80% of what YOU would pay in the US despite insurance.  Hey, it's not like the doc over here isn't already Indian.  Most of the doctors over there are educated here or in the UK.

[mcbethr 42]

Many doctors will work for cash - in fact they prefer it.

[Smoke Eater 0]

Many doctors will work for cash - in fact they prefer it.

Before I had health insurance I used and saw a dr in lakewood that charged you by what was wrong... I was a little off put when I was told this.. but necer paid over 50 buxks for a visit I can ask the wife for the guys name if ur interested. This was 4 years ago mind u

[Respect2A 0]

Many doctors will work for cash - in fact they prefer it.

Most will offer a cash discount. Just inquire.

[JackDaWack 2,895]

Kinda defeats the purpose doesn't it? Anyone can pay for simple doctor visits. However, the second you need a serious procedure, your screwed. The doctors can charge what ever they want. For example. If you get apendicitis, your probably looking at 50k in doctor and hospital fees. With insurance not only do they cover most/some of the costs they also haggle the doctors and hospitals on the cost.

Which again defeats the purpose of pre existing conditions when you can just jump on a plan when u need it, but how quickly can you get covered If u need medical attention ASAP?

 

Talk about a shit show.

[carguy3j 0]

This type of arrangement is probably fine for minor injuries/illness and preventative care, as many "urgent care" places are popping up all over the place. Many of them of have fairly reasonable "cash" prices on a "menu" of common and basic problems. However, they are not a substitute for an ER, in a serious or life threatening emergency. Many of them are also not willing to be your "regular" doctor. They will see you once or twice, and then insist that you follow up with a primary care doctor.

 

The problem IS the "big" medical events and true emergencies, as well as long term complicated illness. Ironically, in the most expensive of circumstances, negotiating isn't really feasible. Of course you can haggle and try to lower the bill after the fact; but the greatest success there comes with the ability to pay a substantial lump sum.

 

As far as ObamaCare goes, yes it is clearly a failure from the start, as it was probably meant to be. There are really only two viable ways of handling healthcare. 1.) Those who can afford it, get it; and those who can't.... Well, that's life, and it ain't always fair (or long, or fun, happy, and pain free) OR 2.) If you are of the mindset that letting anyone "fall through the cracks" is not acceptable, period; well then the only possibly workable solution is a single payer, government provided free healthcare.

 

I say this as someone who is currently making such a small amount of income that I will likely qualify for the Medicaid expansion in NJ, yet I refuse to participate in this unconstitutional joke. I will also refuse/ignore the fine. As yet another example of this law being INTENDED to fail, they put a very easy loophole in it. Sure, if you don't have insurance, the IRS "fines" you. EXCEPT, the law specifically (not an accidental omission) prohibits the IRS from using any of the usual means of forcibly collecting this so-called" tax" (as per the supreme idiots  court). They can NOT garnish wages, seize or place liens on any property or bank accounts, nor do you face any criminal penalties. The ONLY thing the IRS is allowed to do is offset any refund due, by the amount of your "fine". Simple, adjust your withholding so you have no refund due, and instead owe a small amount. As a bonus, you'll avoid giving the government an interest free loan on YOUR money, all year.

 

Further, as someone is almost always against anything having to do with more government, nonetheless,in this case, I see single-payer as the only reasonable solution, assuming that we do in fact intend to provide healthcare for "all". I'm not sure we should do that, but if we are going to, then  keeping insurance companies in the middle of it is just plain stupid. "Insurance" works on the principle that not everyone buying it will need it. That is how the insurance company makes its money. But, there is a value to the consumer, in that the risk of a huge catastrophic expenditure is greater then the fairly small cost of insurance (such as homeowners, car insurance,etc...). However, that business model simply can;t work, in the case of healthcare, absent some amount of fraud or other "funny business" on the part of the insurance company; or prohibitively high premiums, or both. EVERYONE; every single customer, will eventually need to use the insurance. The idea of "health insurance", for routine preventative care, or common illness/injury, is nothing but pure insanity. Yes, I could see the feasibility of "catastrophic only" policy, as that is something that only a relatively small portion of the policy holder pool will ever experience.

 

Normally, I'm all for capitalism and the free market. But in this case, health insurance adds little or nothing of value, and merely adds another layer of profit onto the costs to the end user and society. This is without the ObamaFailCare. Now, with these "exchanges" and "credits",etc..., all it is is a gigantic give-away of tax dollars to the insurance companies. They provide very little value, for a disproportionately huge payday. Sure, they may have some "administrative" competencies. Ok, so we can hire/contract them, at commercially reasonable rates, to provide administrative services ONLY. There is no reason they should have any "profits" based on how much/how little of the premiums they do or do not spend on care. 

[Krdshrk 3,878]

HI EVERYBODY!

[carguy3j 0]

HI EVERYBODY!

LOL!!!

 

Did you see the new episode last night? Dr. Nick's head was sewn to Dr. HIbbard's shoulder. Does that mean the pt's get double billed, or will they get a 2 docs-for-the price of-1 discount?

[Vini 0]

Health insurance is VERY overrated. I don't know if it exists anywhere in the world, but there is no health insurance in countries I've been to or know people. 

IMO, local population has been brainwashed into believing that's the way it should be and it's OK for monthly health insurance premium to be priced about same as monthly rent. 

 

Take a look at Canada. It's free there. No, they don't pay sooo crazy taxes. Yes, they happen to come for some medical procedures to US, but not nearly as often as Americans are flying for same to Europe. Yes, your taxes go towards healthcare. In fact per capita average US taxpayer pays more for healthcare than average Canadian. The difference - they have free healthcare while you have mandate to buy insurance.

 

There is no good reason to have h.insur. if you are relatively young and healthy, IMO. If you are not relatively young and healthy, most likely you are qualifying for Medicare. 

Very few people have constant need for healthcare. 

What if something happens? Most of the time you are covered by auto and workman's comps insurance. Add 100K accident insurance for $10/month in case you are shooting/skiing etc.

 

In 11 years without health insurance I've spend less than 1K for doctor's visits and medications combined. Average doc visit is about $60 cash. 

[anactivegrenade 25]

This type of arrangement is probably fine for minor injuries/illness and preventative care, as many "urgent care" places are popping up all over the place. Many of them of have fairly reasonable "cash" prices on a "menu" of common and basic problems. However, they are not a substitute for an ER, in a serious or life threatening emergency. Many of them are also not willing to be your "regular" doctor. They will see you once or twice, and then insist that you follow up with a primary care doctor.

 

The problem IS the "big" medical events and true emergencies, as well as long term complicated illness. Ironically, in the most expensive of circumstances, negotiating isn't really feasible. Of course you can haggle and try to lower the bill after the fact; but the greatest success there comes with the ability to pay a substantial lump sum.

 

As far as ObamaCare goes, yes it is clearly a failure from the start, as it was probably meant to be. There are really only two viable ways of handling healthcare. 1.) Those who can afford it, get it; and those who can't.... Well, that's life, and it ain't always fair (or long, or fun, happy, and pain free) OR 2.) If you are of the mindset that letting anyone "fall through the cracks" is not acceptable, period; well then the only possibly workable solution is a single payer, government provided free healthcare.

 

I say this as someone who is currently making such a small amount of income that I will likely qualify for the Medicaid expansion in NJ, yet I refuse to participate in this unconstitutional joke. I will also refuse/ignore the fine. As yet another example of this law being INTENDED to fail, they put a very easy loophole in it. Sure, if you don't have insurance, the IRS "fines" you. EXCEPT, the law specifically (not an accidental omission) prohibits the IRS from using any of the usual means of forcibly collecting this so-called" tax" (as per the supreme idiots  court). They can NOT garnish wages, seize or place liens on any property or bank accounts, nor do you face any criminal penalties. The ONLY thing the IRS is allowed to do is offset any refund due, by the amount of your "fine". Simple, adjust your withholding so you have no refund due, and instead owe a small amount. As a bonus, you'll avoid giving the government an interest free loan on YOUR money, all year.

 

Further, as someone is almost always against anything having to do with more government, nonetheless,in this case, I see single-payer as the only reasonable solution, assuming that we do in fact intend to provide healthcare for "all". I'm not sure we should do that, but if we are going to, then  keeping insurance companies in the middle of it is just plain stupid. "Insurance" works on the principle that not everyone buying it will need it. That is how the insurance company makes its money. But, there is a value to the consumer, in that the risk of a huge catastrophic expenditure is greater then the fairly small cost of insurance (such as homeowners, car insurance,etc...). However, that business model simply can;t work, in the case of healthcare, absent some amount of fraud or other "funny business" on the part of the insurance company; or prohibitively high premiums, or both. EVERYONE; every single customer, will eventually need to use the insurance. The idea of "health insurance", for routine preventative care, or common illness/injury, is nothing but pure insanity. Yes, I could see the feasibility of "catastrophic only" policy, as that is something that only a relatively small portion of the policy holder pool will ever experience.

 

Normally, I'm all for capitalism and the free market. But in this case, health insurance adds little or nothing of value, and merely adds another layer of profit onto the costs to the end user and society. This is without the ObamaFailCare. Now, with these "exchanges" and "credits",etc..., all it is is a gigantic give-away of tax dollars to the insurance companies. They provide very little value, for a disproportionately huge payday. Sure, they may have some "administrative" competencies. Ok, so we can hire/contract them, at commercially reasonable rates, to provide administrative services ONLY. There is no reason they should have any "profits" based on how much/how little of the premiums they do or do not spend on care. 

Thank you for everyone's contribution, but really, this post was great. Thank you.

[Pythagoras 2]

Carguy, you sound a lot like someone I know IRL. I know it's not you cuz you would recognize my username, but it's uncanny.

 

Thank you for your analysis, it really was great. I've never thought about health insurance in that context before, and you're right. It only works if more people buy it than need it. (Spoiler: that's why they're making it mandatory.)

 

I have asthma, so I need a maintenance inhaler every day of my life to breathe normally. My copay is only about a quarter of the drug's price, so health insurance covers most of it....but I'd probably do better financially if my job would pay me the full amount they spend to insure me and let me buy the drug on my own. I don't think it's fair to tax other people to pay for my meds so that's why I oppose the mandate.