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The new insureance.

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Rickey60

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Our state did not expand Medaciade And I fall in that gap. That's why mines so high If I made a few 1000 more would be 75 a mounth. I try to beat the system by being a slacker but it looks like that may have come back to bite me. It seams this law is very fluid .I hope they figger out how to make the exchange web site work. If it was ever intened to.
I know what you mean. The market place only gave me 1 choice and it would cost me $21,000.00 per year and that is with a nice tax credit. I am retired and don't even make that much a year. Go figure.
 

skychaser

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Maine doctor cuts prices in half by refusing health insurance

http://www.upi.com/blog/2013/05/29/...-health-insurance/3571369847964/?spt=mps&or=2

"A Portland, Maine, physician announced on April 1 that he would cut the middle man and deal directly with his patients, no longer accepting insurance in any form.

"I’ve been able to cut my prices in half because my overhead will be so much less," Dr. Michael Ciampi told the Bangor Daily News. Before, Ciampi charged an existing patient $160 for an office visit addressing one or more complicated health problems. Now, he charges $75.

Ciampi lost a few hundred of his 2,000 patients who had insurance and didn't want to deal with the hassle of paperwork for reimbursement, but he expects to make up the loss by attracting the self-employed, the young and others without insurance or with prohibitively high deductibles.

Now that he no longer accepts any form of private or government-sponsored insurance, he posts prices on his website, payable at the end of the visit. Patients with an earache or strep throat could spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50.

"I’m freed up to do what I think is right for the patients," Ciampi said. That includes making house calls and negotiating lower prices for patients with financial difficulty.

Gordon Smith, a spokesman for the Maine Medical Association, wasn't so sure, expressing concern for patients who rely on Medicare and Medicaid.

But Ciampi believes more doctors are likely to follow suit and cut out insurance entirely, even opening “concierge practices” in which patients pay to keep a doctor on retainer.

“If more doctors were able to do this, that would be real health care reform,” he said. “That’s when we’d see the cost of medicine truly go down.”
 

Brown Thumb

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My sister is a doctor and has her own practice and does the same thing.
she is not happy with what is going on.
Last I knew 50 bucks to fix you up and sends you on your way. No Ins. Involved.
She does very well, so well another doctor opened up in town doing the same thing.
 

Carlos Danger

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I saw this article back in August by a doctor about paying cash. Let's just hope they don't outlaw direct payment for care like they did in Canada....

Jeffrey Singer: The Man Who Was Treated for $17,000 Less


  • By Jeffrey A. Singer
  • August 21st, 2013

Every so often I have an extraordinary and surprising experience with a patient—the kind that makes us both say, "Wow, we've learned something from this." One such moment occurred recently.

A gentleman in his early 60s came in with a rather routine hernia in his lower abdomen, one that is easily repaired with a simple outpatient surgical procedure. We scheduled the surgery at a nearby hospital.

My patient is self-employed and owns a low-cost "indemnity" type of health insurance policy. It has no provider-network requirements or preferred-hospital requirements. The patient can go anywhere. The policy pays up to a fixed amount for doctor and hospital bills based upon the diagnosis. This affordable health-insurance policy made a lot of sense to this man, based on his health and financial situation.

When the man arrived at the hospital for surgery, the admitting clerk reviewed the terms of his policy and estimated the amount of his bill that would be paid by insurance. She asked him to pay his estimated portion in advance. (More hospitals are doing that now because too often patients don't pay their portions of the bills after insurance has paid.)

The insurance policy, the clerk said, would pay up to $2,500 for the surgeon—more than enough—and up to $2,500 for the hospital's charges for the operating room, nursing, recovery room, etc. The estimated hospital charge was $23,000. She asked him to pay roughly $20,000 upfront to cover the estimated balance.

My patient was stunned. I received a call from the admitting clerk informing me that he wanted to cancel the surgery, and explaining why. After speaking to the man alone and learning the nature of his insurance policy, I realized I was not bound by any "preferred provider" contractual arrangements and knew we had a solution.

I explained that just because he had health insurance didn't mean he had to use it in every situation. After all, when people have a minor fender-bender, they often settle it privately rather than file an insurance claim. Because of the nature of this man's policy, he could do the same thing for his medical procedure. However, had I been bound by a preferred-provider contract or by Medicare, I wouldn't have been able to enlighten him.

Hospitals and other providers make their "list" prices as high as possible when negotiating contracts with health plans and Medicare regulators. No one is ever expected to pay the list price. Anybody who has seen an "Explanation of Benefits" statement from a health plan will note a very high charge from the provider, and an "adjusted charge" based upon the contracted fee schedule, which usually leaves the patient with little or nothing in out-of-pocket expenses. The only people routinely faced with list prices are those few people who have insurance like my patient's—that doesn't include a pre-negotiated fee schedule with contracted providers—or those who have no insurance.

Most people are unaware that if they don't use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the "list" price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.

So we canceled the surgery and started the scheduling process all over again, this time classifying my patient as a "self-pay" (or uninsured) patient. I quoted him a reasonable upfront cash price, as did the anesthesiologist. We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services. He underwent his operation the very next day, with a total bill of just a little over $3,000, including doctor and hospital fees. He ended up saving $17,000 by not using insurance

This process taught us a few things. First, most people these days don't have health "insurance." They have prepaid health plans. They pay premiums to take advantage of a pre-negotiated fee schedule arranged for and administered by a third party. My patient, on the other hand, had insurance.

Second, even with the markdown for upfront "cash-pay" patients, none of the providers was losing money on my patient. Otherwise they wouldn't have agreed to the prices. With the third-party payer taken out of the picture, we got a better idea of the market prices for the services. It is the third-party payment system that interferes with true price competition, so "market clearing prices" can't develop.

Take the examples of Lasik eye surgery or cosmetic surgery. These services are not covered by insurance. Providers compete on the basis of quality, outcomes and price. And prices have continually dropped as quality and services have improved—unlike the rest of health care.

When my patient returned for his post-op visit we discussed the experience. It was clear to both of us that the only way to make health care more affordable is to diminish the role of third-party payers. Let consumers and providers interact through market forces to drive down prices and drive up quality, like we do when we buy groceries, clothing, cars, computers, etc. Drop the focus on prepaid health plans and return to the days of real health insurance—that covers major, unforeseen events, leaving the everyday expenses to the consumer—just like auto and homeowners' insurance.

Sadly, we are heading in the exact opposite direction. ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?

Dr. Singer practices general surgery in Phoenix, Ariz., and is an adjunct scholar at the Cato Institute.

 

BigBonner

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I farm and last time I checked ( years ago ) for health insurance , it was going to cost me alone $800 per month .
My wife has high blood pressure and no one will insure her not even life insurance .
When me and my wife haves to go to a doctor , I pay out of my pocket . It is usually $75 to $100 per visit . Maybe four visits per year . This is fine .
But here is my worry , If I had any health problems like three of brother's and one sister has , I would not be able to get any government help and I have can't afford no insurance .
One brother diagnosed with MS , One with Cirrhosis of the liver , one with prostate cancer and my sister had leukemia but had a bone merle transplant .

I pay anywhere from $500 to $7000 a year in taxes .I can't afford any more bills .
My point is , Cheap office visits are fine unless something bad happens .
I would have to sell everything me and my family have worked for to pay medical bills .
Even after paying for insurance the deductible could be $2000 for each of us = $4000 a year .

Paying the deductible would be bad enough .
 
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rose

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85% of income, deductible around 12 thousand. Do not qualify for any subsidies.

When you read the promo's of bummer care it all sounds good on paper. I'm sure many who voted for it were clueless. The reality is it does not make everyone able to get insurance (not that I even want it). The huge deductibles on the poor would mean they couldn't even use the ins/so that money goes into the ins companies as gratis. Looking up profits for the companies for 2013, not doing too bad. This is nothing but a dog and pony show.
 

Southern Planter

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The law was written by the insurance companies themselves.

The gentleman campaigned on socialized medicine. I have no problem with socialized medicine at all, I'm going for the VA, which is as socialized as it gets. I have spent much time in Mexico, which believe it or not has excellent health care, financed by a national lottery.

Fred Reed, (fred on everything) writes about how his wife broke a leg in a town far from home. They went to the clinic, she was fixed up first rate, and they did not even ask her her name! No paperwork whatsoever. If a country with one billionth our GNP can do that, we can too.
 

webmost

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The law was written by the insurance companies themselves.

The gentleman campaigned on socialized medicine. I have no problem with socialized medicine at all, I'm going for the VA, which is as socialized as it gets. I have spent much time in Mexico, which believe it or not has excellent health care, financed by a national lottery.

Fred Reed, (fred on everything) writes about how his wife broke a leg in a town far from home. They went to the clinic, she was fixed up first rate, and they did not even ask her her name! No paperwork whatsoever. If a country with one billionth our GNP can do that, we can too.

No we can't. It ain't in us. Anything we touch we have to swaddle up with red tape. That's our way of doing business.
 

Mad Oshea

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The trade embargo did that. They need our $ or get kicked to the curb. SAD TO SAY. But here-- pay, pay,pay. It's our companies that did it because they dont want to pay a real pay check to AMERICANS .And yes I agree.. (NOT BAMA)
If I don't pay I get finned or lose My tax refund on the cost. Now I can't hire anyone to help Me in My co. because of this very thing. My opinion "YES" -----I'v got a head ach........................................
 

FALaholic

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What gets me is, we have a multi billion dollar defense budget. Yet our current taxes can't pay for free medical?

Fy2010_spending_by_category.jpg
 

FmGrowit

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This subject is becoming too politicized and from my experience in dealing with prohibited topics, the topic will continue to digress.

If you want to talk politics, please start a group and invite those who might share your opinions. If you join a group and don't like the tone of the conversation, you are free to stop participating in that group.
 
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