Originally Posted by
BCR
The entire labyrinth of unethical medical billing is always, at its core, a way for doctors to make more money. I agree it’s corrupt and idiotic. If there was even a way to eliminate it, and let’s get real, when have we ever eliminated a lobby like the AMA when it comes to something of that nature. That’s akin to taking on the NRA over handguns, forget AR-15s.
They’re never going to be down for anything that reduces that maze. And it would be a straight dem vote to do it as the AMA is as right as the bar associations are left, and the dems will simply go single payer if they ever have that level of control, so it’s kind of a theoretical discussion.
The arguments against single payer systems is wait lists and that qualified individuals decide not to opt for medicine as a career. If they’re making less through reduction of billing practices or Medicare for all, it’s still going to reduce their salaries. So it’s essential to do that stuff even in a single payer system for tax and efficiency reasons, but as far as the arguments regarding care and quality, fixing the issue druffs way or medicare for all will have the same impact. It would be more efficient druffs way, but it’s never happening.
Well I'm glad I mostly have your support on this issue, but I will say that the AMA could easily go for a teardown/rebuild of the medical billing mess if it were to also introduce free market competition.
Doctors aren't particularly happy with the situation right now, either. Yes, they're gaming it to make the maximum money, but they're doing it because they feel like they've been held hostage by insurance companies. In turn, insurance companies feel like doctors are screwing them (which they often are), and that patients sign up for healthcare only when they know a big procedure might be needed soon (which they often do). I knew someone who ultimately died of cancer, but became aware that they probably had cancer before the official diagnosis came down. They rushed to sign up for insurance, got approved (this was pre-Obamacare), and got like $700k worth of medical care before ultimately dying from that cancer.
Not that I'm defending insurance companies, either. They also have their own level of both incompetence and corruption, some of it due to the belief that they have to be shitty back in order to fight shitty behavior by patients and doctors. When the smoke clears, often it's the honest man getting screwed, and that's a tragedy.
Anyway, doctors are consolidated into groups these days in order to fight what they perceive to be underpayments from insurance companies. This also lessens choice for the patient (you basically have to be careful not to alienate that office if it includes every single specialist in the area), and quality of care tends to go down in these mega-groups.
If a free market healthcare model is introduced, where doctors can charge what they want, and insurance pays a flat amount for each service/procedure/test, then the best/most popular doctors could charge well above that and still get patients, while other doctors will be happy to take insurance-only pricing. Then there would be some in the middle, who would charge a little above insurance pricing, but low enough out-of-pocket to where typical families can still afford them.
This system would also somewhat remove the incentive for doctors to rush through patients, as the better doctors could see fewer patients by simply slowing down and having a higher price to begin with.
If such a system existed, I would utilize a mixture of the expensive, middle-ground, and cheap doctors. If I just needed a blood pressure prescription, I would see the cheapest doctor possible. If I had a weird set of symptoms which were likely difficult to correctly diagnose, I would see the best doctor possible, even if he was expensive. If it was something where I felt I needed someone competent, but not the very best, I'd go to a middle-of-the-road doctor (such as a well physical).
Last year, I would have paid a lot of money to have seen one of the top ENT doctors and one of the top psychiatrists, but it didn't work that way. I had to accept who was able to take me. I was even willing to pay out-of-pocket to an out-of-network doctor if he/she were really good, but the simple fact was that the availability was minimal. After a lot of searching and many hours of research, I ended up finding a decent psychiatrist (whom my insurance took, fortunately), and finally found a good ENT who could take me, but he was 55 miles away and there was a lot of traffic in that direction during business hours.
Anyway, I know I'm rambling here, but the healthcare solution is so much more complicated than either party is currently making it out to be, and it's tilting to hear both sides pretend they have a solution.
At some point the Dems will have majorities in all three branches, socialized medicine will pass, it will be an epic fail, Republicans will capitalize upon it and win subsequent elections, and then it will be repealed. Then at some point after that, some real reform MIGHT happen. The problem is that few politicians even understand what really needs to be done.
Reply With Quote
