A recent article on KEVINMD.COM entitled, “Keep your medical insurance, but pay the doctor with cash,” was of particular interest to me. My practice was unique in that I ran a Concierge practice side by side with a typical fee for service practice. Comparing the two practices is easy.
The Concierge practice was fun. If I needed a test or procedure, I could order it without many hassles. Concierge patients bought their freedom by paying cash and appreciated the care they received.
Fee for service/insured patients relied on their insurance company and gave up their freedom, trading it for a copay. Their care carried more overhead than the Concierge patients and they really didn’t appreciate how much back office work it took just to get them an x-ray.
You may not know it, but your doctor’s office is forced into taking insurance products and putting up with the insurers’ discounts. Did you ever stop to think that your doctor is your banker, carrying your debt until the insurance company pays him/her? Did you realize that your $10-$40 copay represented the majority of your family doc’s paycheck? I bet you didn’t know that it cost me money every time I sent you a bill.
Giving a discount for cash paying patients makes sense. The only drawback is a theoretical one. Medicare and your insurance company could look at your doctors’ discounted fee as his/her real fee and claim that your doc over charged them. Medicare could then claim that your bills were fraudulent and file criminal charges against your doc. Sound insane? It is!
Insane rules created by your insurer and government guaranteed that your doc and their patients had little recourse when it came to arguing over billing and the cost of medicine. While I was in private practice, I fought to keep cost down and to get my patients the referrals they needed. I wonder who is going to fight for your rights in the corporate world of medicine that exists today.
By the way, “pay the doctor with cash” does not mean hand your doc a credit card. Credits cards charge your doc a percentage of the amount charged. For those of you old enough to remember cash, there is no charge for the use of cash. Every little bit counts.
Here’s a true story to think about. I was standing in the check-out line at the Vet’s office. The man in front of me was told his dog’s bill was $245 and included the doc’s time and lab work. His dog had a urinary tract infection. The man paid his bill. He did not complain, he did not tell the office to bill his insurance. In my office, the bill for a UTI would have been $200. I would have gotten a $20 co-pay, billed insurance, and written off the insurers discount; collecting a grand payment of $100. Many of my patients would have griped about the co-pay despite the savings.
If you like your doc, pay your doc! Use your insurance for big ticket items.
Here is today’s joke:
A bank robber gets hold of the cash he needs but before fleeing the scene he demands the regular customers stand in a line
The bank robber ask the first guy in line: “did you see what happened here?”
First guy: “I sure did! And I’m gonna tell the police exactly what happened and what you look lik…”
The bank robber shoots him in the head and ask the next in line the same question.
Second guy: “I assure you I did not see a thing… but my wife did”
What about people who don’t have piles of extra cash sitting around to pay for medical care? Let them eat cake…and hope that cures them?????
Obviously not. The article I referred to presented what I thought was an interesting point of view. While cake can make me feel better when I’m sick, it won’t cure anything. On the other hand, some people will gladly pay whatever is necessary to take care of a pet but scream bloody murder about a copay in their docs office. I’m glad to be free of the business side of medicine.
I’ve got to admit I’m surprised at how angry this article made you.