
Doctor stops accepting insurance, posts prices online - nick007
http://bangordailynews.com/2013/05/27/news/portland/south-portland-doctor-stops-accepting-insurance-posts-prices-online/?ref=relatedSidebar
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psychotik
This is how doctors in India (and a lot of other countries) work, and it's
super efficient. His prices feel very competitive to me. I would carry a high-
deductible insurance plan for catastrophes but this would otherwise be a great
option.

More doctors need to follow this lead.

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tlrobinson
Agreed. Why does every little doctor visit need to be paid for by _insurance_?
That's not the point of insurance. Auto insurance doesn't cover car washes and
oil changes.

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tzs
Failing to wash my car or change my oil does not lead to theft or covered
accidents, so the insurance company does not care.

Failing to get routine medical care, on the other hand, does increase the risk
of conditions that insurance does cover. Hence, the insurance company does
care about my routine medical care, and so covers it to encourage it.

This is why my health insurance company constantly sends me emails with
fitness tips and other health suggestions, whereas my auto insurance company
has not once sent me any tips on washing my car.

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jerrya
Really? I mean, I would think so, but I see a lot of major insurance plans
with very high copays and/or limited to no coverage for annual physicals which
would not be the expected behavior of insurance companies felt your annual
physical saved them money.

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danielweber
Annual physicals are, for the vast majority of people, completely useless in
terms of health.

Lots of common things people imagine "save lives and money" do neither.
Vaccines and pap smears are great, but most things aren't.

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shanelja
As someone who comes from the United Kingdom where the tax payer funded NHS
takes care of most medical fees, it strikes me as ridiculous that any country
could expect their tax paying citizens to pay for the privilege to carry on
living.

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johnsoft
I've always wondered, why do people use this argument for medical care, but
not food? Both are necessary to carry on living, and both are provided by
people who themselves work full-time and need to keep the lights on somehow.

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jackowayed
The cost of food is very predictable and pretty flexible. Anyone who needs to
can eat well on <$100/week as long as they have access to a reasonably-priced
grocery store and facilities to cook and store food. (Also, note that even our
barebones welfare state includes foodstamps.)

On the other hand, medical costs can vary wildly and randomly. A perfectly
healthy person who's been following health best practices might suddenly
develop a serious condition that is treatable, but only with five to six
figures of treatment.

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kefka
Foodstamps, for a single white male, is $207 a month in Indiana.

And 3 months ago, I was cut. Paperwork's "lost in the system". No job. No
unemployment. Living on the scraps of money I had in goods that I sold.

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healthenclave
This is both great news and sad one. The great news is the doctor is doing the
right thing by moving towards a direct pay model - which works great for
regular visits. But this also goes to show the SAD state of health affairs.

I believe we can also a lot of this problem with the aid of technology and
make doctors more efficient and help them only worry about their patients.
Well you can't eliminate the need of insurance but it can certainly be made
much much more easier.

A lot of Family Practitioners don't want to deal with insurance companies is
not because they don't get paid well by them (yes they pay only a fraction of
the bill) but because the paperwork and stress of dealing with them isn't
worth it.

Now with the upcoming ICD-10 implementation the docs are going to have a
nightmare. ICD-9 has around 18k codes for the classification of various
disease and with the implementation of ICD-10 this number goes to 80,000 !!!!

The bigger problem is that most solutions (EHRs) are usually created not
created by people who deliver healthcare. There are a few EHRs created by
doctors but are not implemented very well.

Using things like Eligible api (to know what procedures can be performed as
per the patient's insurance plan) are helpful but are not complete in the
sense of unifying the workflow for doctors.

The other big thing that is severely lacking is the patient engagement and the
data from Quantified self. When you walk into the office of a doc - all that
information (FitBit, Nike FuelBand, etc , etc) doesn't help the doc provide
personalized medicine to the patients. Nor does the patient has much
engagement in managing their health (apart from taking the pills)..

ZocDoc(s) and PracticeFusion(s) are doing their parts but are still half baked
solutions.

Hopefully we will be able to change that !

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qwerta
This is how it works in Ireland. You pay GP, dentist and other small items out
of your pocket and send your bill to insurance company. Hospitals and other
large stuff is passed automatically and you will not even see the bill. Prices
are fixed, GP visit is 50 euro (~70 dollars), MRI scan is about 200 Euro (~270
dollars).

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ewbuoi
My doctor works like that and I love it. I've never had to wait in a waiting
room or anything, appointments start promptly and last as long as they need to
(I've had an appointment last over 2 hours). She charges $220/hr, but after
insurance reimburses me it costs less per hour than a doctor at a traditional
clinic, which was about $15 for a quick 15 minute appointment.

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Dnguyen
What happens when a not-so-good doctor charges very cheap and start a price
war? Or to make it affordable, the doctor cuts corners? Who's to tell the
doctor to what to do? Who watches the watchmen?

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jackowayed
There are laws and medical licenses for this reason. There are always
incentives to cut costs, whether administering medicine for cash from patients
or for insurance payments.

At least with this model, the patient is choosing the doctor, paying him, and
receiving he care. So if he cuts corners in a way that makes the patient less
satisfied (eg. very short appointments, cramped/dilapidated office, bad on-
time performance, office in a bad part of town), the patient can choose to go
elsewhere. If it's the one place the patient's insurance will cover thanks to
the reduced price from cutting those corners, the patient has no real choice.

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munimkazia
Off topic, but is anyone else concerned about the fact that the URL has a
ref=relatedSidebar in it? The website will probably get a lot of hits from an
incorrect referal in their traffic monitoring tool. I hate it when stuff like
this happens.

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RobAley
If its internal links within your own website you need to track, use cookies,
they are much less likely to get "passed around" like that ref link, or update
the url to the canonical one once they land on the . Its asking too much of
your visitors to analyse a url and work out what they should and shouldn't
post, even if they understood what they were doing.

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kondro
Australian doctors generally use a combination of this type of technique.

