One of our local physicians has joined MDVip which is a physician “concierge” company. They charge an annual fee ($1650) per person for the privilege to be his patient. You still pay for the office visits, but you have his cell phone, you get same day office visits, he spends more time with you and you get a more extensive annual exam for “free”. This doctor is our internist. I don’t blame him for doing this, but I am not interested in participating because I don’t go to him except once per year. However, it is another sign of how medicine is changing. Older doctors are retiring because they no longer enjoy practicing medicine due to Obamacare, lower reimbursements, electronic medical records requirements, etc. Most people think doctors make a lot of money, but that is not true in many cases. Their incomes have been going down for years yet their expenses have risen. They have to work harder and harder to make the same money as the year before, yet many times their staff have seen some pay raises or the same pay. Would you like it if you got a pay cut or had to work more to make the same money? So, I don’t blame them for trying to change their business model or retire, so they can enjoy life like the rest of us want to do.
Americans have enjoyed basically getting any healthcare they want and go to any doctor they want (assuming they could afford it), but that has been changing drastically over the last several years. “Managed care” entered the arena decades ago, and now most insurance companies are only offering “HMO’s” (Health Maintenance Organizations). Basically the insurance companies tell you which doctors you can go to. Many good doctors have closed their practices to new patients and many are reducing the number of medicare patients they will serve. It is getting increasingly harder to get an appointment with your doctor. In fact, many good family practice and internal medicine doctors have decided to become employees of hospitals, so they no longer have to deal with filing insurance claims, deal with employees, and high office expenses.
On top of all that Obamacare has raised the deductibles to over $6,000 in most cases. I actually do not have a problem with that, but I do have a problem with our government dictating to me what insurance policy I can buy, and not allowing me to have a lower or higher deductible if I’m willing to pay for it. But, let’s not go there. How many years do you have over $6,000 in medical bills? I’ll bet it is not many for most of you. Did you know you can negotiate with hospitals as to how much they charge if you will pay them right then? This would be for tests or surgeries or any other service performed at a hospital. You can get discounts of 25-50% if you will simply ask. What if your doctor told you that he/she would charge you $125 if you pay for your visit and they don’t have to file your insurance, or $200 if they have to file your insurance, which would you choose? In other words, you are going to have to pay $200 (assuming you haven’t met your deductible) if they file your insurance, or $125 if you just pay them cash right now. I would choose the $125.
I think the better doctors should start offering a private pay section to their practices. I would rather pay cash and get my services cheaper. If the government would let us have even higher deductibles so my premiums would be significantly lower, then this would work even better. The reason it would work for doctors is they would not need as many staff whose time is totally involved with billing and filing insurance claims. They are getting paid at the time of service, so there would be no need for billing. They can devote their time totally to medicine and virtually none on running the business side of the office. They could spend more time with us, make as much or more money, and it would be better and less expensive for us.
I’d be curious to know……would you go to a doctor who had a private pay practice?