It is both simple and complex: Taxes and the very wealthy

[nate]

Lol... yeah, well, you're the expert.

[ABC]

ok

[mp170.6]

The problem is insurance cost. Not the cost of education. However that should be addressed as well. I think single payer can still provide high salaries for doctors. 

 

What type of insurance cost are you referring to?

 

The thing with doctors is that some are workaholics and embrace the 60 or 70 hour work week, have more patients, and earn significantly more in return.  Their salaries would likely be fixed under a single-payer system no matter how many hours they work.  At that point, the incentive to work extra hours and have longer careers is removed.  Our shortage of M.D.'s will increase dramatically.

[nate]

I strongly disagree that insurance companies are keeping costs down. I think it is the opposite plus I think they are keeping health care away from many people. 

 

I can emphatically tell you that you are wrong and such a practice is not only against the law but also terrible business.

[mp170.6]

nate and I have argued about insurance before, so no need to rehash that.

 

My personal preference would be for insurance companies NOT to be involved with ordinary office visits in return for lower insurance premiums.  Have people pay cash for those visits. 

 

The bureaucracy of getting claims approved wastes doctors' time, increases costs, and makes everyone miserable in the process. 

[nate]

You are still living in the 90s.  There is no bureaucracy involved.  They submit it electronically and it gets approved at the negotiated rate.

[ABC]

What type of insurance cost are you referring to?

 

The thing with doctors is that some are workaholics and embrace the 60 or 70 hour work week, have more patients, and earn significantly more in return.  Their salaries would likely be fixed under a single-payer system no matter how many hours they work.  At that point, the incentive to work extra hours and have longer careers is removed.  Our shortage of M.D.'s will increase dramatically.

 

Malpractice. That's what a heart surgeon and anesthesiologist told me. 

 

Solution: no fixed salary.

[mp170.6]

You are still living in the 90s.  There is no bureaucracy involved.  They submit it electronically and it gets approved at the negotiated rate.

 

You really believe there is no bureaucracy anymore? 

[ABC]

I can emphatically tell you that you are wrong and such a practice is not only against the law but also terrible business.

 

Yet there are countless examples that show otherwise.

[mp170.6]

Malpractice. That's what a heart surgeon and anesthesiologist told me. 

 

Solution: no fixed salary.

 

That's a myth that I, too, used to believe. 

 

I stumbled across a website where a doctor posted scanned copies of his malpractice insurance paperwork.  He was a surgeon and only paying $5,000 a year.  

[nate]

You really believe there is no bureaucracy anymore? 

 

I was recently in a workgroup specifically aimed at provider relations for smaller providers like family practices.  The response was overwhelmingly positive.  They all just have one office manager that handles everything from taking appointments, to submitting claims to collecting payments.

 

There are several software companies that offer software that do all they need, they just do minimal data entry and it goes.

[nate]

Yet there are countless examples that show otherwise.

 

Would love to see one.

[nate]

That's a myth that I, too, used to believe. 

 

I stumbled across a website where a doctor posted scanned copies of his malpractice insurance paperwork.  He was a surgeon and only paying $5,000 a year.  

 

No but malpractice insurance drives up insurance and medical costs a ton.

 

For example if someone comes in with a knee injury that is obviously torn ligaments, the malpractice insurance requires that the Dr take an xray first to make sure it isn't something else before they take a MRI.

[ABC]

You really believe there is no bureaucracy anymore? 

 

I recently shopped for insurance and talked to several specialists who love their jobs except for the way insurance interferes. I also spoke to the people in the office who handle the insurance and they went on and on about the bureaucracy that they face daily with insurance companies. 

[ABC]

That's a myth that I, too, used to believe. 

 

I stumbled across a website where a doctor posted scanned copies of his malpractice insurance paperwork.  He was a surgeon and only paying $5,000 a year.  

 

I've seen that but I doubt he was a surgeon. The two I spoke with gave me astronomical numbers.

[nate]

So anecdotal hearsay... got it.

 

I am the director of exchange operations for a major health insurance company, I guarantee you there is no bureaucracy.

 

Doctors do however constantly submit claims for a higher price than what they have negotiated which causes constant rework.

[ABC]

Would love to see one.

 

google.com

[nate]

you have the burden of proof, not me

[ABC]

So anecdotal hearsay... got it.

 

I am the director of exchange operations for a major health insurance company, I guarantee you there is no bureaucracy.

 

Doctors do however constantly submit claims for a higher price than what they have negotiated which causes constant rework.

 

Ah, now it makes sense. 

 

lol

[ABC]

you have the burden of proof, not me

 

no i don't. there's reality and there's your world. 

[nate]

what are you, twelve years old?

[mp170.6]

I was always accustomed to the usual co-pay at the pharmacy.  $10 or $20 or whatever.  One time I forgot to show my insurance card and the total was $3.68 or something like that for the exact same prescription.  Come to find out, many generic drugs cost about the same. 

 

How do you justify stuff like that, nate?  It's obviously a rip-off.

[nate]

I was always accustomed to the usual co-pay at the pharmacy.  $10 or $20 or whatever.  One time I forgot to show my insurance card and the total was $3.68 or something like that for the exact same prescription.  Come to find out, many generic drugs cost about the same. 

 

How do you justify stuff like that, nate?  It's obviously a rip-off.

 

Actually, that is the fault of the pharmacy,  not the insurance company.

 

RX insurance is very straight forward.  Everything is in a bucket.

 

Generic 1 might be 10 cents per pill

Generic 2 might be 15 cents

Generic 3 20

Brand 1 $1 per pill

Brand 2 $5 per pill

Brand 3 $15 per pill

Brand 4 $25 per pill

 

etc

 

What the pharmacy is supposed to do is charge the rate for that pill UNLESS the retail price is less than the insurance price.  So your pharmacy was just taking advantage of you.

 

This is very common by the way.  You should always ask what the cost would be if they didn't charge the insurance rate.

[mp170.6]

I was recently in a workgroup specifically aimed at provider relations for smaller providers like family practices.  The response was overwhelmingly positive.  They all just have one office manager that handles everything from taking appointments, to submitting claims to collecting payments.

 

There are several software companies that offer software that do all they need, they just do minimal data entry and it goes.

 

Overwhelmingly positive?  Doctors absolutely despise insurance companies.  

 

Just one office manager to handle everything?  What do you suppose all the other ladies do in the office? 

[mp170.6]

Actually, that is the fault of the pharmacy,  not the insurance company.

 

RX insurance is very straight forward.  Everything is in a bucket.

 

Generic 1 might be 10 cents per pill

Generic 2 might be 15 cents

Generic 3 20

Brand 1 $1 per pill

Brand 2 $5 per pill

Brand 3 $15 per pill

Brand 4 $25 per pill

 

etc

 

What the pharmacy is supposed to do is charge the rate for that pill UNLESS the retail price is less than the insurance price.  So your pharmacy was just taking advantage of you.

 

This is very common by the way.  You should always ask what the cost would be if they didn't charge the insurance rate.

 

 

If all this is true, why don't insurance companies send mailers and get the word out, so customers don't get ripped off at the pharmacy?  As you said, it's very common.