Further info on the "Obama" books issues

[jim rosenthal]

I'd like to hear more about how supply and demand works in medicine.

[Boatsb]

Someone comes to my house demanding my possessions I will supply him with the need for projectile removal.

Seriously the ER has become a GP for many without healthcare because they can not supply the money for a doctors visit and demand the healthcare anyway.

[Rickysa]

Seriously the ER has become a GP for many without healthcare because they can not supply the money for a doctors visit and demand the healthcare anyway.

My 5yo daughter has a severe allergy to peanuts/tree nuts (among others)...we came home from work recently to find her face swelling up like a balloon.

The babysitter assured us that nothing unusuall had been injested, but it was off to the emergency room for us (after giving her a dose of antihistimine...didn't use the epi pen)

It was about 5:00 and the ER was full....of folks with stuffy noses and tummy aches.

I had to practically yell "anaphylaxis" in order to jump the line of folks using the ER as their primary care physician.


and I'm not really sure why....it isn't $$ I think, as many MDs in the area take their "insurance"

[Boatsb]

I should have mentioned many choose not to pay for healthcare but go to the ER.

Hospitals need to be less charitable with our healthcare money. Why should someone who does not have insurance get free healthcare when I have to pay?

[Brian Degulis]

I'd like to hear more about how supply and demand works in medicine.

I live in the Tampa FL area I deal with a health care company that is considered one of the better ones. They are very busy and have not been able to accept new patients for several years. When I go there for simple routine things I can expect to wait 30 min's to an hour past my scheduled appointment time. The physician spends around 5 minutes with me and for this my insurance company pays $175 and I pay $25. So that's $200 for 5 minutes or $2400 per hour.

If you allow them they will make an appointment to discuss blood test results. So that's $200 for the physician to tell you everything is fine.

A few months ago I banged my elbow and I had a golf ball size lump show up the next day. I forget the medical term for it but the slang is Popeye Elbow it's pretty common. So I describe the problem and make an appointment to see my physician. She takes a look and says we have to send you to an orthopedic surgeon to get this drained. So again 5 min's $200 and this time they can't even do anything. I described the problem pretty well you would think they would have told me that I need to see someone else on the phone. But then they couldn't get that $200.

If I treated my customers like that I would be out of business. Unless there are an insufficient number of companies providing the product I build then I could get away with it.

I think most everyone has stories similar to the above. It seems painfully obvious that there is a shortage of health care services. If more are created then health care providers will be forced to compete for business and will have to start practicing good customer service at fair prices.

That's how supply and demand works in all business including health care.

Brian

[Sparky1]

Brian, that's the neat thing about insurance, you have to go to your PCP to get a referral to go to a specialist. Otherwise, they won't pay.

I went to my PCP several years ago as a follow up to an ER visit with my first kidney stone. I told them when I made the appointment that I had already been to the ER and had a diagnosis. I sat in their waiting room for about a half an hour, then I laid in the floor for about 15 minutes until another patient said they'd give up their spot to get me in.

I finally got into an examining room, and they didn't so much as take my temp or blood pressure. I waited for the doctor to come in and show me some dandy brochures on kidney stones. Needless to say, I wasn't a happy camper having wasted that much time... not to mention being in excruciating pain!

After they collected their fee, they referred me to a urologist.

[thoward]

Brian, what kind of doctor is it? That is high for a GP.

Just so you can see, this is a exam fee schedule copied from Florida Medicare Part B. The first line is what we can charge and the second is what we get paid. Each column represents different areas in Florida due to cost of living. The 99201 is a very basic exam say 5-10 min. The 99205 is usually life reserved for major exams of about an hour where life or limb is at stake.


99201 37.36 35.49 40.81
99201 23.22 22.06 25.37 #

99202 64.04 60.84 69.97
99202 44.54 42.31 48.66 #

99203 94.51 89.78 103.25
99203 68.89 65.45 75.27 #

99204 143.27 136.11 156.53
99204 113.45 107.78 123.95 #

99205 179.84 170.85 196.48
99205 147.34 139.97 160.97

Florida has limited us to 200% of Medicare for MVA auto insurance. That is going to set the max rate we can charge. I believe you are in a 3rd column area so the max going rate for an average exam will be 206.50. Medicare you would get 103.25 and Blue Cross or United you will a little more than Medicare. If your insurance pays $200 for average exams then you have "gold plated insurance" or they have not done a very good job at fee management.

[Brian Degulis]

My insurance pays $175 I pay $25 and yes it's pretty good insurance It's a group policy that I provide for all my employees and they're family's and believe me it's not cheap.

But the point I'm trying to make is not about insurance. Regardless of who's paying the bill the cost is much to high. The service is very poorly managed waste full and designed to exploit every dime out of every situation. It's like this because it's not competitive.

BTW my opinion of Chiropractors is much much better. I use them at times and thought the level of service was good and the price fair. I should also note that my complaints are not with the physicians themselves it's with the health care facility's they work for.

Brian