Listen up.... Hill & Bill, ObamaManCan't and McAin't....

Finally the medical profession is taking responsibility for providing affordable healthcare to their patients.

There is a doctor in the Clearwater/Tampa Bay Florida area that has taken the bull by the horns and will forever change how primary/preventative/routine/minor surgery healthcare is delivered.

His plan is quite simple.

A single person pays the doctor $160 per month for pre-paid Doctor's Care. A household of two adults and 4 children pay $315 per month.
It's that simple. Then when you need the doctor you go to your doctor and pay nothing. No co-pay. No claim forms.

THIS IS NOT MEDICAL INSURANCE.

It's a pre-paid fee for service plan.

This is the way it should be.

The Doctor and his/her patient should come to agreement on the services provided and fee charged for those services and totally eliminate the third party payor system known as the insurance company.

I'm on this plan and I can tell you I don't even miss $160 bucks per month and there's something quite refreshing about going to the doctor and paying NOTHING when you leave and getting NO BILL.

The plan is not perfect but it's a start in the right direction.

The cost of catastrophic medical expenses still need to be addressed in case of a serious hospitalization. This is where hospitals need to developed affordable payment plans and or the person carry high deductible major medical coverage.

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Gary Spicuzza, *SAFE
Copyright 1956
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*Self Appointed Financial Expert

Your doctor's fee plan is a popular one among chiropractors, tanning salons, and pest control companies. I don't see why it isn't used more often.

My mother's doctor has a membership model practice. The doc limits his caseload to 600 patients. Although he is still at the trough of the insurance companies, from each client he gets $1500 annually as a membership-type fee. In return, the patients get the type care and attention that they should be getting anyway. The doc returns phone calls personally, is able to see patients himself without farming them out to a PA, and can keep better family hours for himself because he isn't up till 2 am most days writing useless reports for insurance companies.

I have several friends who are doctors. Many of them tell me that they want to get out of healthcare because seeing patients and getting paid fairly is no longer what doctor-ing is about. It's about playing the game of the insurance companies, whose last intention in the world is paying claims and taking care of their stakeholders.

I like having 911 service and ambulances to get me to the hospital. I'm just not comfortable with all that happens once I arrive at the er doors.

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Yep, I totally agree.

The elimination of the third party payor system is the first step for doctors, hospitals and other medical providers to charge fees based on what the market will bear and NOT based on what the insurance company will pay.

People will drive 5 miles out of their way to buy gas for 10 cents a gallon less because that money is coming out of their pocket but they NEVER challenge the inordinate fees charged by the medical profession AS LONG AS THEIR INSURANCE IN PAYING THE BILL.

It's a pathetic mind set.

And the health insurance companies don't give a damn how high the medical bills are as long as employers and individuals are dumb enough to pay the inordinate medical insurance premiums needed to pay claims and make a profit.

__________________
Gary Spicuzza, *SAFE
Copyright 1956
No Rights Reserved
*Self Appointed Financial Expert

"People will drive 5 miles out of their way to buy gas for 10 cents a gallon less because that money is coming out of their pocket but they NEVER challenge the inordinate fees charged by the medical profession AS LONG AS THEIR INSURANCE IN PAYING THE BILL."


Yep, not long ago I went to the doctor looking for relief from cold symptoms that lingered without improvement for about two weeks. The talking lab coat told me that I had a cold. He promised relief from 12 pills. I took the md's script to get it filled at the pharmacy around the corner. The pharmacy tech told me my bill would be $177 - for 12 pills.

I stood there at the counter and had an out of body experience for about 10 seconds.

The tech went on to tell me that my insurance company would not pay for the drug. I surely was not paying $177. I went back to my doctor and told him to get me something that I could afford. I didn't have some freaky, obscure jungle parasite. I had bronchitis.

He wrote me a new prescription whose cost to me was $16. I asked the pharmacist on my second trip to the counter how much my bill would have been without the insurance...$65. Still too much.

The insurance companies, pharmaceutical companies, and the doctors are bringing on their own downfall. It seems that each is holding out for an eventual end that they know is coming. Until that time comes, everyone is going to get all that they can.

Then what? We will have even greater dwindling md ranks because the barrier to entry into the profession is higher than the perceived return once the degrees are earned.

I hope my boy has a strong constitution.

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Eliminating the middleman (insurance companies) will be a great start, but I don't see this happening anytime soon. Too much money are involved, and neither doctors, nor insurers are interested in a change...

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Never spend your money before you have it. -- Thomas Jefferson

spencer24, I doubt the spread between medical insurance premiums paid into insurance companies vs claims paid out and expenses is more than 1% per year on average industry wide.

To the private insurance companies medical insurance is nothing more than an insurance product like any other form of insurance.

They have their mathematical Einsteins figure the cost of the medical policy based on the statistical risk of claims paid and figure in a profit.

THEY DON'T CARE if it costs a family of four $1,200 per month to provided the medical insurance based on what their mathematical Einsteins figured the pricing needs to be to support the product.

Also, it certainly is not the fault of the insurance industry that medical costs for an appendectomy, for maybe a two hour, relatively speaking, minor surgical procedure, and one night in the hospital, costs $25,000.

It would take the insurance company just over 21 months of premium at $1,200 per month to just break even on that one singular claim paid.

The Doctors, Hospitals and other Medical Providers ARE IN THE BEST POSITION to end the third party payor system but for them to do so would mean they would have to take an extreme pay cut because no clear thinking person would pay, nor could they charge the inordinate fees that are paid by insurance.

It's a vicious feeding frenzy cycle.

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Gary Spicuzza, *SAFE
Copyright 1956
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*Self Appointed Financial Expert

To put dollar and cents numbers to my comments above take a look at the ACTUAL medical charges from a client of mine who had a four hour surgery on their neck March 2008.

I have removed all the personal identifying information.

The surgeons bill for the 4 hour procedure was $35,808.80

That works out to an hourly rate of $8,952.20 PER HOUR.

The hospital bill for a 50 hour confinement was $58,845.02

That works out to an hourly rate of $1,176.90 PER HOUR.

The one (1) and ONLY reason the doctor/surgeon and the hospital can get away with charging those kind of fees is because medical insurance is paying the bill.

The above fees are not all inclusive they are only the largest.
Total fees and medical provider expenses exceeded $100,000.

The United States Gubment CANNOT fixed this problem.
They can only make it worse.

The Doctors, Hospitals and all other Medical Providers are going to have to start charging reasonable fees based on what the free market system would pay for their services.

Not based on an artificial Third Party Payor System whereby the expenses are paid by the insurance company and the patient doesn't give a damn how high the bill is as long as it's not coming out of their pocket.

I'll say it again because I enjoy reading my own rants!

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Gary Spicuzza, *SAFE
Copyright 1956
No Rights Reserved
*Self Appointed Financial Expert

Give this whole medical insurance thing another four years. The next President will take it apart, put it back together, and have enough parts left over to come up with a plan that would guarantee every American the right to spare automobile tires, light bulbs for their fish tanks, and bags of peanut M&M's to eat while they're standing in the unemployment lines.

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Purposefully bumping this topic to the top of the message board so the General Public can see with their own eyeballs exactly what type of fees are charged by the medical profession.

...and the ONLY reason YOU don't give a damn is because the medical insurance company is paying the bill while you drive 5 miles out of your way to save 10 cents on a gallon of gas...

But why do YOU do that?

Because that money is coming out of your pocket.

Please study the medical claims I posted above, then get out your calculator, divide your annual income by the total medical bill;...how many years would you have to work to pay that bill?

Does it make dollars and sense now why medical insurance premiums are so high?

I'll say it again....DOCTORS, HOSPITALS and OTHER MEDICAL PROVIDERS are in the best position to solve the feeding frenzy of the medical insurance third party payor system.

With a little innovation from the medical service providers and thinking outside the standard paradigm everybody can win.

__________________
Gary Spicuzza, *SAFE
Copyright 1956
No Rights Reserved
*Self Appointed Financial Expert