Who is left holding the bag?

01/16/2010 at 5:27 AM Leave a comment

We have always tried to help patients that do not have insurance. Currently we severely discount a visit if they have no insurance and they pay in cash. It is such a significant discount I have had several people tell me that they would not have put their treatment off so long if they knew our fee was so reasonable. One lady even said that we should advertise it. She missed the point that it is below our break even point and the last thing we need is an influx of new patients at that rate.

Nevertheless is serves its purpose. These are patients that we have known for years if not decades, they come in for non trivial issues that do not waste our time. ( see next post for more on this). Hopefully when the economy improves they will have access to insurance. ( BTW–The point of cash is solely so  that we avoid billing and bounced checks.)

Then the other day one of my dear patients came in and we got talking about health insurance. She was angry about the cost of the insurance. ( I am too.) So she decided not to insure. She had access to insurance and could afford it but decided to save the money from the premiums and use that for care.  There are several problems with this approach. The biggest is that she could have something catastrophic. Then there is the issue that she waits until several things go wrong before coming in, so she does not get regular timely care for her blood pressure. She also gets no maintenance care, after all mammograms, colonoscopies, paps all cost money.

But the part that irked me that day was that I was inadvertently financing her plan. Our discount was intended for people that were struggling or had no access to insurance, not those that are choosing to take a risk. There is no way to sort out these patients but she should be paying full freight. She doesnt want to pay full freight ( who does) but she is able to. This is the part of health care reform that is focused on requiring insurance by all. Otherwise you have a group of people that are gambling. But they are gambling with state funds. Because if they have an accident and go to shock trauma and incur a bill of $100,000 (not hard to do). They wont pay it. They dont have that kind of money. We end up paying for it.


Entry filed under: Doctor's Rants, true story. Tags: , .

special circumstances I said what?

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