How pathetic that the payors have succeeded in preempting common sense. “If it’s not covered, I must not need it.”

Let’s hope it doesn’t take long to undo this 20-year-old lie that was managed care. The payors themselves, and the businesses who buy their policies, have admitted that HMO’s are a disaster. Witness the rise in consumer-driven policies.

Docs allowed ourselved to be devalued under the HMO regime–we’ve got an opportunity to reclaim our importance as clinicians. How?

Most patients have been isolated from the true costs of the services they consume for more than a generation. Even the uninsured get a distorted version of the real costs–those that actually pay, that is–by being given inflated charges that are created so that Medicare can claim it gets the lowest available rate.

In other highly competetive markets, cash payment–greenbacks, not credit cards or even checks–gets the best rate, as it should. Instead, the government distorts the market by using force of law to demand the lowest rates while not paying on terms normally expected for that rate.

As traumatic as it might seem, the outpatient medical practice market would probably be better off if it rejected direct payment from insurers and demanded cash, and posted prices publicly for common services. It seems to work for a lot of other businesses.

It is a tough battle against a pervasive democratic socialist agenda that seeks to keep people dependant on government. Democratic leaders and trial attorneys prefer that the poor and unfortunate view themselves as “victims” so that they can stay in power — not because they really want to offer any solution.

I agree with 11:49

Physicians have been very poor in organizing for anything in their best interests. I think the figure for AMA membership is around 50% only. Someone correct me if I am wrong. Only half of doctors in my state belong to my state specialty chapter, with annual donations to the political action committee is less than 75$ per physician. Trial lawyers spend far more in political advocacy than physicians. I guess CJD is just reacting to hysteria and misperception — what he always accuses us of. I guess he would really have to worry if we stopped seeing patients and really got serious about political advocacy.

“It is a tough battle against a pervasive democratic socialist agenda that seeks to keep people dependant on government. Democratic leaders and trial attorneys prefer that the poor and unfortunate view themselves as “victims” so that they can stay in power — not because they really want to offer any solution.”

Uh, it’s a Republican Congress and Republican President cutting your Medicaid, Anonymouse. You are a walking talking point for the RNC, aren’t you?

Enough from everyone named “anonymous.” Your arguments are respectable–why not identify yourselves?

Nevertheless, Anonymous 9:24 is right: “As traumatic as it might seem, the outpatient medical practice market would probably be better off if it rejected direct payment from insurers and demanded cash, and posted prices publicly for common services. It seems to work for a lot of other businesses.”

It’s up to us to declare “enough.” An office-consultation fee isn’t sky-high and unaffordable when compared with many other consumer costs: one month of digital cable? “Sports collectibles” on ebay? Dinner for 2 at Red Lobster?

I’m hopeful the high-deductible, HSA-backed policies on the way will enable us to reclaim control over our transactions.

“I’d happily pay extra for a doctor who would not presume to keep me waiting and who I could treat like my cleaning lady without fear of offending his/her professional ego.”

So what’s stopping you from doing that now? Or is the privilege of treating your doctor like a cleaning lady not really worth that much after all? Talk is cheap.

“Enough from everyone named “anonymous.” Your arguments are respectable–why not identify yourselves? “

Are you kidding? With all the Lawyers lurking on this Board? Identify myself? As if I don’t have enough problems avoiding the Lawyer Sodomists at work? It’s the best thing about this site. We can be honest about the Ass reaming we feel from the lawyers every day at work without fear of reprisal.

I did not join AMA because it lost its credibility long time ago.

At the heart of the problem is a medical delivery system that is centered on treatment instead of prevention. Though it was never design that way our system is one where “good health is bad for business”.

I routinely explain health care to me clients by comparing it to the US Post Office. Both have a seemingly endless demand for their services and have resigned to simply asking the customers to pay more and more for the same service.

This is much simpler than how the rest of the business world works. In every other business the climate is “innovate or die” In the same way that new solutions like FedX, DHL and email are shrinking the numbers of customers for the Post Office, new health care solutions are immerging like HSAs and WebMD to bring about fundamental change in the way consumers learn about their health.

Smart consumers are gravitating toward solutions that give them control of Primary Care issues and Prevention that give them real choice. Providers like revolutionhealthsystems.com and myMedLab.com are stepping up to take the role of educating consumers and making the most of their health care dollars.