To say that dealing with an insurance company is a complicated and painful process is an understatement. And that’s just as a policy holder. If you’re a provider, like a physician, it’s much worse. That is why many doctors are eschewing the acceptance of insurance altogether and moving to an old school fee-for-service system.
As you can imagine, those in the insurance industry and the federal government are none too happy about this. If doctors choose cash, how will bureaucrats have control?
The Texas Tribune and New York Times chronicled the story of one physician in the Lone Star State opting for this cash-based medical care model.
Under the current health insurance system, physicians who treat covered individuals submit claims for the services they provide and receive reimbursements to cover their costs. Private insurance providers and government-subsidized health programs like Medicare and Medicaid each have their own rules and regulations for filing claims, including specific time frames and billing systems.
Health providers who treat poor children and people with disabilities also face heightened scrutiny from state and federal agencies responsible for rooting out possible fraud, leaving some providers on edge that they could be subject to unwarranted or costly investigations.
With this approach doctors are more able to tailor their services to the market they serve. Some limit their services to low-cost diagnoses and procedures, providing access to quality care at affordable prices and in a speedy manner. For Dr. Gustavo Villarreal, whose practice is in the city of Laredo along the Mexican border, a flat $50 fee gets you access to a walk-in visit with treatment from a real doctor without the hassle of dealing with an insurance company.
Many in the insurance industry and in Washington are afraid that this will limit the amount of doctors willing to get on board the high-hassle, low-profit ObamaCare bandwagon.
Some health care specialists worry that if too many practitioners choose this path, the state could be left struggling to find doctors to accommodate patients with insurance as the federal health care overhaul is making such coverage mandatory…
With Americans required by law to have health insurance, many who rarely visited a doctor will now be banging on the doors of physician’s offices across the country. What they’ll find is an already overburdened system straining under the yolk of increased costs, decreased earning potential and mountains of new regulations and filings to sift through. All this is leading many doctors to opt-out of providing care for these new patients.
The left doesn’t like that.
One writer for Ebony Magazine who lives in New Jersey was astonished to find that she had a hard time finding a doctor who would accept her new ObamaCare insurance plan.
As a proud new beneficiary of the Affordable Health Care Act, I’d like to report that I am doctorless. Ninety-six. Ninety-six is the number of soul crushing rejections that greeted me as I attempted to find one. It’s the number of physicians whose secretaries feigned empathy while rehearsing the “I’m so sorry” line before curtly hanging up. You see, when the rush of the formerly uninsured came knocking, doctors in my New Jersey town began closing their doors and promptly telling insurance companies that they had no room for new patients.
My shiny, never used Horizon health card is as effective as a dollar bill during the Great Depression. In fact, an expert tells CNN, “I think of (Obamacare) as giving everyone an ATM card in a town where there are no ATM machines.” According to a study 33% of doctors are NOT accepting Medicaid. Here in Jersey, one has a dismal 40 percent chance of finding a doctor who accepts Medicaid – the lowest in the country.
That from a “proud” member of the ObamaCare fan club, a supporter of the system and I assume, of the President himself. As she found though, there is good reason for these physicians to say no: they don’t get fairly paid by the government for the care they provide to those in the system.
However, physicians say they are rejecting Medicaid patients with good reason. One doctor explains, “the state reimburses… only about $23.50 for a basic office visit [of those insured by Medicaid]…
That’s less than half of what that physician would receive for the same visit from a traditional private insurer. This, as she found, leads to long searches for health providers and longer waits for care. But this should come as a surprise to no one. We saw this exact same situation play out in Massachusetts after they enacted Romneycare.
When the Massachusetts law kicked in, wait times to get an appointment at primary care physicians’ offices increased significantly, and they’ve remained high ever since, according to an annual survey from the Massachusetts Medical Society. And Massachusetts has the second highest physician-to-population ratio of any state.
When patients couldn’t get doctor’s appointments they once again turned to emergency rooms. A Harvard study found all 11 of the emergency rooms that researchers studied in Massachusetts became busier after the law went into effect.
In countries that have taken the next step in liberal takeover of the health care system, the single-payer model, wait times for basic procedures and services, like MRI scans, are significantly longer than they have been here. If liberals want to increase the availability of health care services, they should empower, not hamstring medical professionals.