07/19/2024
Health Care 2024….Are Any Of Us Happy?
Not what we want to read, but definitely what we should read!
Ever feel like just another number when you see a doc, or worse yet, a cattle being run through the pen when it’s time for your follow up or time to see a new doc for the first time?
What ever happened to health care and me, the patient? What happened to actually feeling like a human being and that the doctor I was going to see really cared?
Well, I know it’s difficult, but, please don’t just blame the docs. OK, some docs yes, hahaha.
For those of you have seen me, you’ve probably already heard this so bear with me. We are all going to be patients at some time, if not now, later. And yes, even the docs you see now have been, or will be patients too. And yes, none of us are thrilled with the current system. But, fact is, we the patients and our health care providers are the LEAST important people in our health care.
I know. It’s not a good truth, but, it’s the truth—a truth that we all have to learn to accept unless we are willing to look outside the scope of the status norm and do something different.
So, let’s talk numbers.
Health Insurance companies make billions a year, and yes, google their annual income if you’d like. Some of the big players are United Health Care, Blue Cross, Humana, Cigna, Anthem to name a few. How insurance companies can report billions in profit still amaze me.
Pharmaceutical companies also make billions a year, and yes, google their annual income as well if you like. Some of the biggest players are Abbvie, Amgen, Pfizer, Eli Lilly, Astra Zeneca, Bristol Myers Squibb, Merck, and J&J. And yes, personally, I think this is criminal as well.
But, let’s talk about you and your doc.
Let me share a story.
I actually had a woman ask me to refund her a 35.00 dollar copay after a visit because I did not prescribe any medication. I spent over twenty minutes with her explaining arthritis and her labs but apparently that was not good enough. Forget that any attorney would care less, after all, for them, it’s simply time spent. Needless to say, I was a bit taken by her request, but, despite what I thought was fair, I refunded her the 35.00 dollars.
What we have to understand as patients (and yes, I’ve been one as well) is this, when our doctor sends a bill to our insurance company for 150.00 dollars for the visit, two things are guaranteed.
1. The insurance will pay about 60% of what is billed. Insurances just tell us docs “this is what we will pay you, take it or leave it!” For any that have ever hired any other service company, that doesn't happen.
2. Also, and more discouraging, they don’t just pay without a fight. Docs, clinics, and hospitals do not get paid without multiple calls and harassment to your insurance companies. Remember,
insurance companies make more if they don’t pay your medical bills. So, yes, every doctor’s office accrues overhead expense by hiring people to simply call the insurance companies,
chase the bill and say, “Hey, hi this is Kathie calling for Dr, Drew Huffman, we still haven’t received the fifty dollars from you that you owe us for the claim we sent two months ago.”
Sadly, even getting the 60% from your insurance company is as difficult as getting all of the kids at my twelve year old daughter’s slumber party to be asleep by 9 pm. It’s just not happening.
What I want us all to appreciate is this…
We’ll pay a plumber 100 - 200 dollars cash for the first hour, more on weekends.
We’ll pay an electrician 75-150 dollars cash for the first hour, more on weekends
We’ll pay an attorney 200-400 cash per hour and almost always have to pay a retainer
We’ll spend 100 dollars on nice dinner out or a show
However, when it comes to our own health, there’s just something about spending more cash than our copay. For whatever reason, it just makes us feel uncomfortable. It makes us feel like we are being taken advantage of, like we’re paying double. I get it. But, don’t forget, we’re all happy to pay cash for a functioning toilet, for our lights turning on, for attorneys resolving our conflict and even for something like a dinner, a show, or a trip.
I understand the thought. I already pay every month for health insurance and my insurance pays my doc. Well, now you know the truth about your doc and your health insurance.
So, if you ever wonder why your doc is only spending ten to fifteen minutes with you, or, you ever wonder why more and more docs are going to cash pay only, now you know.
It’s NOT that docs don’t care. Overhead costs continually increase and the reimbursement from your insurance company decreases. Not a great formula if you’re a doc. If you don’t like the reality, then ask yourself this, what would you pay another person to have your best interest at heart?
As a doc, I apologize for the process, but your doc, especially if they’re a good one isn’t the only person that should take the blame. As a doc with thirteen years of education and twenty years of experience, I have come to learn that we get what we pay for, and, if we expecting insurance to pay our docs what they are worth, well, we’re just not knowledgeable or being realistic about the reality.
And yes, I understand that the insurance companies and the pharmaceutical companies won’t appreciate this post. But, it’s not about them. It’s about me, the health care provider and you, my client!
And, no matter what they do or say, don't forget, I’m your doc and that means something to me!
-Dr.D