Compare Doctors Without Health Insurance

[eflatminor]

@dblack, do you think that this demand will change with the implementation of the health insurance exchanges (part of the PPACA) by 2014? It seems that as healthcare becomes accessible to all citizens, it will become more of a traditional market.

My two cents...

No, the demand will not change. The demand has always been there but the markets have been unable to respond to all customers because of government meddling. State governments, and now the federal government, have been dictating the terms of coverage (trying include everything under the sun) and the prices that can be charged for decades. That kind of central oversight ALWAYS leads to skyrocketing costs and poor results. Even more central planning via the PPACA will not solve the problem. It will make it worse.

Consider the evolution of any luxury good that eventually becomes mainstream: the automobile is a good example. What it was first designed, only the rich could experiment with it leaving the poor to look on in awe. But as manufacturers began to innovate in a way that made the auto affordable to the masses (e.g. Ford), there developed fierce competition centered around appealing to these masses (mainly through improving the apparent price to value relationship). Do you imagine something like this could happen with healthcare?

I do not. You stated the reason why when you wrote: "But as manufacturers began to innovate..." and "fierce competition". While those things did happen in the automobile market, they are prevented from happening in healthcare because of the central oversight. There is little reason for players in the healthcare and healthcare insurance industries to innovate or to strive to be more efficient when the government dictates what will be covered, who must be covered, and what prices must be charged. Also, the federal law requiring private companies over a certain size to provide employee health coverage is a big part of the problem. That should end today!

If we want to see prices drop (or at least stop rising in excess of the rate of inflation), we must allow real competition to take place, accept that some entities will fail, and allow the consumer real choice. If one insurance carrier wants to offer cheap coverage only to healthy people and only for a catastrophic injury or illness, they ought to be able to do that. If another wants to offer coverage with all the bells and whistle to people with pre-existing conditions, that ought to be able to do that at a price they deem reasonable. With today's state departments of insurance and now the federal government, along with the FDA and all the other involved agencies, that is not possible. Innovation and efficiency is therefore severely curtailed.

A free market will fix this, not more central planning.

 

[KissMy]

I always get a price up front before I make an appointment. If you don't & you give them your insurance card the price will be 4 times higher. My last doctor visit was $40 cash. That was the total, not a co-pay. Their regular charge for the doctor visit is $125.

 

[bamitchell54]

@dblack, @eflatminor, @kissmy the anecdote provided by KissMy is a perfect example of the type of information consumers should and could have access to.

@dblack, @eflatminor, I think that you are right, legislation likely will not bring about the required change, but there are variations in the market that could be taken advantage of to create a demand for certain kinds of services. Like the story presented by KissMy, if this knowledge could be made publicly accessible, driving customers to the doctors that have a competitive advantage (e.g. charging $40 total for an office visit), regulatory/deregulatory forces would not be required to produce the changes we all need. And given the pace at which the tech industry is capable of innovating, something like this could happen quickly enough to avoid the destructive influence that the healthcare industry at large could have on a service providing such information.

 

[uscitizen]

The price should be the same for all.

Why?

why not?
Should a gas station charge a person more for gas if they look like they can pay more?

Should a well dressed person pay more for a meal than one who does not dress very well?

 

[dblack]

The price should be the same for all.

Why?

why not?
Should a gas station charge a person more for gas if they look like they can pay more?

That's not what's going on though. They're charging less, or more, depending on how much of a pain in the ass it is to get paid. I know if I was doctor, I'd give a break anyone who cut me a check at the end of an appt. - as opposed to dealing with an insurance company with every incentive not to pay me the amount billed, or to force me to jump through excessive hoops to collect.

In reality, what's going in with doctor's giving cash discounts is that the amount they bill the insurance companies isn't usually what they get paid. Insurance companies generally negotiate (demand) discounts and essentially lawyer up everything to their advantage.

 

[eflatminor]

Should a gas station charge a person more for gas if they look like they can pay more?

Two thoughts:

1) The gas station should be able to charge whatever it likes to whomever it likes. If anyone doesn't like that, go to another station.

2) The analogy is dissimilar to how doctor's work today. It's about HOW they get paid. It would be like offering to pay for your gas with cash on the barrel head...vs. telling the station that a third party will pay for the gas...and that third party requires a TON of paperwork and compliance with a myriad of governmental agencies. Of course the station would offer a reduced price for the guy willing to pay in cash!

 

[dblack]

not to mention, many gas stations give a cash discount, and charge more for credit customers for similar reasons.

 

[eflatminor]

not to mention, many gas stations give a cash discount, and charge more for credit customers for similar reasons.

Good point.

 

[atlasshrugged]

@uscitizen, also untrue. The informed customer is the motive force directing progress in a competitive market. If you meant to say that groups that have a professional monopoly do not like informed customers, I might agree with you.

Indeed. Doctors, through the their professional monopoly and its control of the regulatory apparatus, have managed to virtually eliminate competitive pricing pressure. They've "groomed" a compliant customer base and convinced them that it's somehow beneath human dignity to ask how much their services cost. They've promoted, and are now enlisting the power of the compulsory state to mandate, an irrational financing scheme (comprehensive health insurance) that puts them at the tip of an ever-growing pyramid scheme.

It's the perfect scam. Everyone involved makes a "killing", the doctors, hospitals, pharmaceutical companies, insurance companies, etc... Everyone except for taxpayers and health care consumers, who are slowing being drained of life for the power and wealth of the ruling elite.

Killed competition? Then why do doctors value their referral sources so much? Your argument is bogus. Healthcare costs are high because you aren't just paying for the doctors time, you're paying for the dozens of people who developed each drug or piece of lab equipment, the nurses recording your info, the computerized medical system's developers, the pharmacist who fills the prescription, the administrative people who determine payments from your insurance, the fees connected with government testing of every drug and machine, and countless other things.

If everyone involved in medicine makes a "killing," then why doesn't someone undercut them and take away their customers? Private practices are free to charge whatever they want.

 

[atlasshrugged]

I do not have health insurance and am looking for a doctor. Is there a way to compare doctor pricing short of having to call each one individually and ask what each charges?

The central planners do not wish to see competition in the field of medicine...or education for that matter. If doctors where to establish and promote prices, it would mean they're COMPETING for your business...and we can't have that.

Be a good little sheep and throw yourself at the mercy of the state. They know what's best for you. Heck, for all of us...

Why would doctors not want competition? If the prices were artificially inflated, all it would take is one doctor to come in and advertise lower prices. He'd take all of their business?

 

[atlasshrugged]

Should a gas station charge a person more for gas if they look like they can pay more?

Two thoughts:

1) The gas station should be able to charge whatever it likes to whomever it likes. If anyone doesn't like that, go to another station.

2) The analogy is dissimilar to how doctor's work today. It's about HOW they get paid. It would be like offering to pay for your gas with cash on the barrel head...vs. telling the station that a third party will pay for the gas...and that third party requires a TON of paperwork and compliance with a myriad of governmental agencies. Of course the station would offer a reduced price for the guy willing to pay in cash!

Texaco is ten cents cheaper per gallon if you pay with cash. But you're right on this one. Getting money from insurance or government is the toughest challenge for doctors.

If we were charged a flat rate, you can bet that doctors would expect us to pay up front and be reimbursed by our insurance providers.

 

[dblack]

@uscitizen, also untrue. The informed customer is the motive force directing progress in a competitive market. If you meant to say that groups that have a professional monopoly do not like informed customers, I might agree with you.

Indeed. Doctors, through the their professional monopoly and its control of the regulatory apparatus, have managed to virtually eliminate competitive pricing pressure. They've "groomed" a compliant customer base and convinced them that it's somehow beneath human dignity to ask how much their services cost. They've promoted, and are now enlisting the power of the compulsory state to mandate, an irrational financing scheme (comprehensive health insurance) that puts them at the tip of an ever-growing pyramid scheme.

It's the perfect scam. Everyone involved makes a "killing", the doctors, hospitals, pharmaceutical companies, insurance companies, etc... Everyone except for taxpayers and health care consumers, who are slowing being drained of life for the power and wealth of the ruling elite.

Killed competition? Then why do doctors value their referral sources so much? Your argument is bogus. Healthcare costs are high because you aren't just paying for the doctors time, you're paying for the dozens of people who developed each drug or piece of lab equipment, the nurses recording your info, the computerized medical system's developers, the pharmacist who fills the prescription, the administrative people who determine payments from your insurance, the fees connected with government testing of every drug and machine, and countless other things.

If everyone involved in medicine makes a "killing," then why doesn't someone undercut them and take away their customers? Private practices are free to charge whatever they want.

There's no competition regarding pricing - because customers don't care. For the most part, they're either "covered", or looking for freebies. Hardly anyone pays out-of-pocket, and that's the problem.

You make a reasonable point that they compete in other ways, but they don't compete on cost efficiency, which is why health care costs keep going up.

 

[dblack]

I do not have health insurance and am looking for a doctor. Is there a way to compare doctor pricing short of having to call each one individually and ask what each charges?

The central planners do not wish to see competition in the field of medicine...or education for that matter. If doctors where to establish and promote prices, it would mean they're COMPETING for your business...and we can't have that.

Be a good little sheep and throw yourself at the mercy of the state. They know what's best for you. Heck, for all of us...

Why would doctors not want competition? If the prices were artificially inflated, all it would take is one doctor to come in and advertise lower prices. He'd take all of their business?

No, he wouldn't. That's the point. Why would anyone go with the 'lowest bidder' if they're insured? If someone else is footing the bill, I'll go with the best someone else's money can buy.

 

[dblack]

Why would doctors not want competition?

The same reason anyone would not want competition.

 

[eflatminor]

I do not have health insurance and am looking for a doctor. Is there a way to compare doctor pricing short of having to call each one individually and ask what each charges?

The central planners do not wish to see competition in the field of medicine...or education for that matter. If doctors where to establish and promote prices, it would mean they're COMPETING for your business...and we can't have that.

Be a good little sheep and throw yourself at the mercy of the state. They know what's best for you. Heck, for all of us...

Why would doctors not want competition? If the prices were artificially inflated, all it would take is one doctor to come in and advertise lower prices. He'd take all of their business?

In a free market, you'd be correct. In a market where customers are not concerned with the price of the service provided (due to government meddling), there is no impetus to compete on price, which is a big reason why healthcare costs outpace overall inflation...by a long shot.

 

[Greenbeard]

I do not have health insurance and am looking for a doctor. Is there a way to compare doctor pricing short of having to call each one individually and ask what each charges?

Is moving to New Hampshire feasible?

NH Health Cost

If not, write your state rep.

 

[auditor0007]

I do not have health insurance and am looking for a doctor. Is there a way to compare doctor pricing short of having to call each one individually and ask what each charges?

Call them up; they'll get back to you after they look up how much they need to charge. They don't even have rate charts for their services. They have to figure out how much they get from the insurance companies and then they make up a price for you. I know, because I had to go without insurance for a while.

If you look around, usually you will find a decent doctor who won't overcharge you. Even today with insurance, I still pay cash for some services because I never meet my deductible and the discounted rate I am charged through my insurance is more than if I pay cash. As an example, I have to have an ultrasound done of my liver every year, to check for tumors because I have cirrhosis of the liver. If I went through my insurance, they would send me to the hospital to have it done. The hospital would charge somewhere in the vicinity of $1200, and my insurance would discount that to around $750, for a 45 minute ultrasound. I go to an imaging center that does it for $220. I do the same with all my lab tests. I spend about $600 per year on lab tests. If I went through my insurance, my discounted price would be about $900 for the same tests.

 

[Noomi]

I do not have health insurance and am looking for a doctor. Is there a way to compare doctor pricing short of having to call each one individually and ask what each charges?

You should move to a country where health care is free. Like Australia.

 

[Katzndogz]

And if it's free, that means no one pays, right?

 

[atlasshrugged]

Indeed. Doctors, through the their professional monopoly and its control of the regulatory apparatus, have managed to virtually eliminate competitive pricing pressure. They've "groomed" a compliant customer base and convinced them that it's somehow beneath human dignity to ask how much their services cost. They've promoted, and are now enlisting the power of the compulsory state to mandate, an irrational financing scheme (comprehensive health insurance) that puts them at the tip of an ever-growing pyramid scheme.

It's the perfect scam. Everyone involved makes a "killing", the doctors, hospitals, pharmaceutical companies, insurance companies, etc... Everyone except for taxpayers and health care consumers, who are slowing being drained of life for the power and wealth of the ruling elite.

Killed competition? Then why do doctors value their referral sources so much? Your argument is bogus. Healthcare costs are high because you aren't just paying for the doctors time, you're paying for the dozens of people who developed each drug or piece of lab equipment, the nurses recording your info, the computerized medical system's developers, the pharmacist who fills the prescription, the administrative people who determine payments from your insurance, the fees connected with government testing of every drug and machine, and countless other things.

If everyone involved in medicine makes a "killing," then why doesn't someone undercut them and take away their customers? Private practices are free to charge whatever they want.

There's no competition regarding pricing - because customers don't care. For the most part, they're either "covered", or looking for freebies. Hardly anyone pays out-of-pocket, and that's the problem.

You make a reasonable point that they compete in other ways, but they don't compete on cost efficiency, which is why health care costs keep going up.

Even if the patients don't care, the insurance companies do. If prices were artificially high and another doctor undercut them, the insurance company would choose the new doctor as the preferred provider and all patients with that insurance would flock to the new doctor. Doctors do compete in cost efficiency, people just need to realize how many people are actually involved in their healthcare and how much time and effort doctors spend in school becoming good doctors.