- Joined
- Apr 16, 2005
- Location
- Sharon, SC
This debate is all fine and well and most know my thoughts on it.
But if we want meaningful reform lets discuss if health "insurance" is even a valid business practice.
I'll give you a brief anecdote. I have a good friend I grew up with since kindergarten, he was a trailer park baby who is now an MD. Dr. Brown worked his ass off from the time he was in grade school, he didnt party, he went to a special governors school, got dual undergrads from a highly respected private school (which gave him a full academic scholarship) in 4 years and finished at the very top of his med school. He is now married to a doc who comes from a family of docs. His father in law is the focus of this little anecdote.
After a successful and lucrative career he semi-retired to rural ass Wyoming and opened a local general practitioners office tending to the local ranchers and farmers who otherwise were traveling 4 plus hours to see a doctor. He had his own ranch and built his DR office there on the ranch and had office hours 2 days a week where he solely saw 5 patients an hour for up to 10 hours a day. He charged a flat fee of $50/ visit and then billed any materials at cost to his patients. He wasn't trying to get rich, merely give back and the $5,000 per week allowed him to pay his 2 nurses and his scheduling girl.
Fast forward to 3 years ago and a large corporate farm bought one of the local ranches and what used to be done by a family of 6 working long hard days, now employs 45 employees who all visit the wanna be retired part time doc. These new "employees" demand he accept insurance, to date it had never been an issue. He refused initially but after he was brought before the state attorney general he eventually conceded.
Now the insurance company pays him in 90-120 days, but he has to "front" the money to his employees every week. If the paperwork isn't perfect they reject the claim, and sometimes even if it is they reject it just to buy time...time is money after all. The rural country doc now employs 2 full time insurance filing clerks. These cost him even more money. But all is not lost, when he bills the insurance company they see it as acceptable for a $125-$150 office visit and material mark up of 220% is legal according to WY insurance law. So the average person who walks in and pays cash in his unique little office, comes in for some stitches (in an example he recently shared with us) and he charges them $50 for the visit and roughly $150 for the material between antiseptic, bandages, needles, thread, and a sucker for the rancher to lick on his way back to work. Same patient comes in and that bill to {insert insurance company X here} is over $1,000...or 5 times the amount he could have otherwise charged.
So it is clear that insurance customers are subsidizing a higher cost, then add on the necessary PROFIT the insurance company has to make...and it all adds up to lots of folks getting rich that otherwise have no tie to the patient/provider service.
I think a catastrophe plan makes way too much sense. Why should I pay $400 a month when no one gets more than the flu twice a year...I'll save that money and pay for my actual costs like a good responsible adult. I will willingly pay an annual premium for the horrific chance I or one of my family are diagnosed with cancer and need $400k chemo courses. I suspect even as prevalent as cancer is a plan could be designed to make this work for everyone.
But if we want meaningful reform lets discuss if health "insurance" is even a valid business practice.
I'll give you a brief anecdote. I have a good friend I grew up with since kindergarten, he was a trailer park baby who is now an MD. Dr. Brown worked his ass off from the time he was in grade school, he didnt party, he went to a special governors school, got dual undergrads from a highly respected private school (which gave him a full academic scholarship) in 4 years and finished at the very top of his med school. He is now married to a doc who comes from a family of docs. His father in law is the focus of this little anecdote.
After a successful and lucrative career he semi-retired to rural ass Wyoming and opened a local general practitioners office tending to the local ranchers and farmers who otherwise were traveling 4 plus hours to see a doctor. He had his own ranch and built his DR office there on the ranch and had office hours 2 days a week where he solely saw 5 patients an hour for up to 10 hours a day. He charged a flat fee of $50/ visit and then billed any materials at cost to his patients. He wasn't trying to get rich, merely give back and the $5,000 per week allowed him to pay his 2 nurses and his scheduling girl.
Fast forward to 3 years ago and a large corporate farm bought one of the local ranches and what used to be done by a family of 6 working long hard days, now employs 45 employees who all visit the wanna be retired part time doc. These new "employees" demand he accept insurance, to date it had never been an issue. He refused initially but after he was brought before the state attorney general he eventually conceded.
Now the insurance company pays him in 90-120 days, but he has to "front" the money to his employees every week. If the paperwork isn't perfect they reject the claim, and sometimes even if it is they reject it just to buy time...time is money after all. The rural country doc now employs 2 full time insurance filing clerks. These cost him even more money. But all is not lost, when he bills the insurance company they see it as acceptable for a $125-$150 office visit and material mark up of 220% is legal according to WY insurance law. So the average person who walks in and pays cash in his unique little office, comes in for some stitches (in an example he recently shared with us) and he charges them $50 for the visit and roughly $150 for the material between antiseptic, bandages, needles, thread, and a sucker for the rancher to lick on his way back to work. Same patient comes in and that bill to {insert insurance company X here} is over $1,000...or 5 times the amount he could have otherwise charged.
So it is clear that insurance customers are subsidizing a higher cost, then add on the necessary PROFIT the insurance company has to make...and it all adds up to lots of folks getting rich that otherwise have no tie to the patient/provider service.
I think a catastrophe plan makes way too much sense. Why should I pay $400 a month when no one gets more than the flu twice a year...I'll save that money and pay for my actual costs like a good responsible adult. I will willingly pay an annual premium for the horrific chance I or one of my family are diagnosed with cancer and need $400k chemo courses. I suspect even as prevalent as cancer is a plan could be designed to make this work for everyone.
