insurance

Transparent pricing is literally the least we can do to improve US health care

willo Here's how I see it, Opinions Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 2 Comments

There are very few actions or aims of the current administration of the United States Executive Branch with which I agree, but one such rare alignment won a legal victory this week when Judge Carl J. Nichols ruled against the insurance-dominated medical establishment in favor of American patients.

The U.S. District Court ruling† agrees with the White House that it is reasonable to force medical service providers to publish a full accounting of negotiated prices for their services. Disclosing the price a patient would pay if s/he elects to pay cash will also be required.

Insurers say their negotiated prices are their own secret treasures to share with providers, and that we—the consumers, the patients, the worried loved ones—don’t deserve to know what they are. I say that insurers offer so little value relative to the enormous fees paid to them that their wishes are irrelevant and a distraction from the goal of almost all Americans to have better health care with fewer going bankrupt to pay for it.

I believe that the administration of the U.S. medical care system could be improved in almost every way. That said, cost transparency requires no bipartisan agreements on contentious issues such as rationing of care or how much in dollars a government owes each citizen in the provision of health care.

Price transparency will cost almost nothing save a few hours of administrative work by hospital staff. Typing up and publishing these lists will take a minuscule fraction of the labor hours currently spent on insurance billing. In exchange, and, for the first time in decades, cost-conscious consumers of health care—the ill, the injured, the infirm—will have at least a passing chance to vote with the pocketbook by taking business to more efficient providers. Continue reading →

Health care system makes me sick: negotiating bureaucracy through a haze of pain

willo Here's how I see it Tags: , , , , , , , , 3 Comments

In April, I wrote a post about my doctor’s departure from the American health insurance system.

In short, he now operates his practice as “direct primary medical care.” You sign up for his service, pay a set monthly cost, and come in, call, email, or text when you have a health issue. It’s so simple, and yet the experience feels revolutionary.

Urgent need? He’ll respond to your text right away.

Wondering if a symptoms requires an office visit (and time off work, fighting traffic across town, etc.)? You can spend as much time as you need explaining your concerns on the phone. There’s no push to make every question an office visit, unlike with providers who are only reimbursed by insurance for in person consultations that correspond to specific codes.

There’s also no bureaucracy, and no paperwork. Unless you have labs, there’s no need to take out your wallet. Remember, you’ve paid up front for whatever care you need. You pay cash for lab work done in the office, but, without insurance markups, these costs are reasonable—perhaps a few dollars.

I almost forget how wasteful, time consuming, and inefficient it is to get care elsewhere. I forget, that is, until I’m not feeling well, and I visit a specialist’s office or a local hospital. That’s what I did the other day, and it all came rushing back to me. Continue reading →