|My son woke up today with a case of Pink Eye. Nothing life threatening. Get some drops, goes away.|
Wife takes him to doctors office. It's Sunday, so it is one of these clinics.
Doctor conducts all kinds of eye and other tests, then ... prescribes the drops. My wife is incredulous, and asks, "He really needs all these tests? It's pink eye."
So it's finally time to pay the bill. My wife lets them know we have high deductible catastrophic coverage only, and she will be paying directly, out of her checkbook.
There is a sudden wave of remorse, and the doctor amends the invoice to a 'level 1/general visit' ... which is what it always should have been to begin with. He just voids all the nonsense tests.
I guess that was him being a nice guy? I should just shut up and accept his huge sacrifice?
Because, when he thought he was a billing some nameless insurance corporation far over the horizon and outside of the room, my son was just a billable opportunity to pad an invoice with obviously un-needed tests, but when he had to look the person he was screwing over with all the uneccessary padding, suddenly they weren't necessary and he felt remorse.
This is exactly what has screwed up health care; the ability of providers to invoice third party payers directly.
Not the way health insurance used to be in the 60s(ie, before the crisis), for those who had it. Back then, a doctor would treat you, look you in the eye, and hand you a bill for service. If you had insurance, you took your bill home, sat at a desk, and filed a claim with -your insurer- for reimbursement. You paid the doctor directly. There was no 'Ring Around The Rosy' in the commerce of health care. Commerce between you and doctor. Commerce between you and your insurer. Period.
Same thing with my dentist; when I dropped my crappy dental coverage and self insured, suddenly he started charging me less. A lot less.
And now..,.Obamacare is going to institutionalize this nonsense.
I swear, its like living in a tribe of totally insane monkeys.
When a doctor asks if you have insurance, the sane answer would be 'None of your fucking business; what do I owe you?'
If everybody answered in that fashion, commerce would be restored in health care and costs would be under control.
It was MEDICARE/MEDIACAID that introduced this nonsense. As long as health care providers back offices had to accomodate direct third party payers, then private insurance providers might as well be included...not to mention, it was lucrative to bill third parties and not have to directly look patients in the eyes and get involved with filthy commerce.
The government, well meaning or not, created the crisis in health care costs. Without their fatfingering -- or at least, with more intelligent fatfingering(there is no reason MEDICARE/MEDICAID could not have operated without direct third party billing, in order to control costs for everyone in the market)-- there would be no health care costs crisis. They perverted the marketplace with this ring around the rosy nonsense.
Health care insurance under a reimbursement model keeps patients directly involved with monitoring costs. Few patients today getting care have any idea at all what they are being charged for their care.
Of course human beings like that arrangement; it is 'convenient' at the point of service. It is only the economic consequences -- the crisis in costs -- that human beings don't like.
The response in MEDICARE/MEDICAIDE? An attempt to dictate prices, which of course leads to displacement and out and out fraud. A total mess.