Most places I encountered want a return customer rather than a one time patient, which I think @dunerat is getting at. I’ve seen this from my insurance world perspective as well. There’s a certain level of risk involved with seeing these type of patients.
What you say is true, @Woodman, showing up with cash in hand is probably the best case scenario a doctor’s office can hope for in a non-covered patient, and it’s rarely the case when they see it. Most often, they’ll provide a discount in hopes that this customer returns to their office to part with more of their cash (Oh, and get medical care. That’s important, too, I guess.). The best gold mine they could ever hit is a non-covered patient who can afford to visit the office often because A) they aren’t getting paid the lower insurance rates and having to waste time just getting the claim paid. B) they control the prices, the visit frequency, and how they want to deal with the patient without any insurance company dictating how they proceed. C) they get paid immediately.
Most carriers use Medicare as a guideline for minimum care standards. Sometimes private insurance starts covering something that Medicare later picks up, but most times it’s the other way around. Most PPOs and insurance carriers also use Medicare reimbursements as a floor for pricing arrangements.
My point in bringing those up is that when market forces can apply directly, the price goes down. When they can’t, it goes up.
This is true, and if you don’t take Medicare, or any insurance for that matter, you can have a successful business. This is a route many providers will take to avoid the ACA. Look at the network of private providers in Canada for an example of the future of medicine. And look at Europe for people actually being charged with crimes for avoiding the public health system.
Here are a couple articles mentioning what I’m talking about.
A payment plan isn’t quite the same as cash, same as buying a car with a loan won’t get a cash discount neither will buying healthcare with a payment plan. I have often gotten cash discounts on things, open box appliances, cars (OK, one car), medical care, whatever.
In my mind, in a perfect world, we would have fully tax deductible medical costs paid directly by people then catastrophic insurance that takes over at whatever level you decide is catastrophic. 5k, 10k, 20k, then the government would take over after 1 or 2 million. Also changing the law on funneling health care for the indigent to county hospitals and clinics. If you can’t pay for the ultra suite in the new birthing center then you get the birthing bay at county.
The problem with the ACA system is we’re asking people who can’t pay for an office visit every year to pay for insurance every month. This just doesn’t make sense, it would make more sense to just pay the claims directly than to subsidize the insurance companies to take on the risk. Or even just run indigent no pay hospitals and clinics for those who can prove need.
When my oldest daughter moved back home after her one year in the ghetto, we had to wait to add her to our insurance during open enrollment, so of course she got sick. We were able to pay our family doctor cash for her office visits. They were considerably less than he charged our insurance for a less complicated visit with me. I know many people who do this because they work for themselves and can’t afford the new insurance prices, even here in Texas where we used to have a great low income/low price health insurance program.
The only reason medical prices are so high is Medicare the Medicare repayment formula which tells doctors what they will be reimbursed for any given procedure or visit. When you can’t charge a post-surgical patient for any follow-up visits or procedures for 90s days after the original procedure, this means someone has to pay for it… so the insured pay for it, even with the negotiated contractual prices. If doctors were forced to compete like vets have to, prices would be much cheaper.
Socialism as practiced by most countries in reality has an awful lot with high tax rates to provide extended public services, including nationalizing or heavily subsidizing businesses to provide those services formerly provided by the private market.
I have not seen a country push socialism, or a more “share the wealth” attitude that didn’t raise taxes. And the countries in Europe are starting to run out of other people’s money.
The ACA is not socialism, but it is other people’s money. And it’s not going to work. As evidenced by Obama doing things that simply aren’t allowed in order to delay something that people called Cruz a terrorist for trying to delay.