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Well, we are now required to have insurance, so what's your way around that? In many cases it's more than before. When I was on the state plan, it was income based (ie cheap) and it didn't cover many of my doctors (like my gyn that I had gone to for 20 years) so I self-payed. I've been self-paying my physical therapist for years, because I like and trust them. Same with my naturopath.
Now I'm forced into a more expensive plan I really can't afford. At this point I can't self pay anymore. What's your solution, since you think I am overestimating my value to the practice?
What do you do? I have no idea....this is what we voted for and chose as a country and society. I'm just a small business owner with 25 mouths to feed (with me eating last) trying to work through the same system.
Since you and I are both patients, you and I are both getting a raw deal since we are forced to purchase something we may or may not use. Or sometimes CANNOT use. There are 3 parties involved (the patient, the insurance company, and the doctor) and I am merely highlighting my perspective which may or may not be consistent with other docs. People are slow to figure out that the insurance companies are the only ones winning in our current system. When we let a 3rd party pay the bills, they get to make the rules....no matter how convoluted they are.
Once a week I have a similar conversation with a patient and I explain it with an old story. A guy in a restaurant asks the waiter for some butter. The waiter goes by several times and after 30 minutes, the guy gets mad and says "Do you know who I am? I am the president of blah blah blah and a bigshot and I want my butter!" The waiter says, "Do you know who I am? I'm the guy with the butter!"
The insurance companies have all the butter if you sign up for their product, they are in control. As I have said before, insurance companies are not our friends.
This always brings up the question "what about catastrophic emergencies I cannot afford?" This is what insurance is for. Just like your homeowners insurance is there to pay when the house burns down. The problem is that our entitlement culture is asking medical insurance to pay for every ingrown toenail. This gives the insurance industry even more control. Strangely, nobody expects their auto insurance to pay for their oil changes, or expects their homeowners insurance to pay to paint the kitchen. What about grocery insurance?? How does anyone eat without grocery insurance? Entitlement. Insurance should be something you never hope you need.
This particular doctor isn't an optometrist. He's an opthamologist, which makes him a specialist, not a general eye doctor.
Just for clarification on this.
An optometrist is not a physician. He is trained to prescribe eyeglasses and fit contact lenses. Some states may allow a limited ability to prescribe medications.
An optician fits and sells eyeglasses and contact lenses using a prescription from an optometrist or ophthalmologist.
An ophthalmologist is a physician who went to medical school, then did a residency in diseases and surgery of the eye. He can prescribe medications for things like glaucoma. Some may sub-specialize and treat things like retinal disease, do primarily LASIK, or take care primarily of children.
This always brings up the question "what about catastrophic emergencies I cannot afford?" This is what insurance is for. Just like your homeowners insurance is there to pay when the house burns down. The problem is that our entitlement culture is asking medical insurance to pay for every ingrown toenail. This gives the insurance industry even more control. Strangely, nobody expects their auto insurance to pay for their oil changes, or expects their homeowners insurance to pay to paint the kitchen. What about grocery insurance?? How does anyone eat without grocery insurance? Entitlement. Insurance should be something you never hope you need.
Amen. Can you imagine the price of oil changes if the shops had to submit every bill to an insurance company, figure out co-pays and deductibles, and wait for payments?
An optometrist is not a physician. He is trained to prescribe eyeglasses and fit contact lenses. Some states may allow a limited ability to prescribe medications.
An optician fits and sells eyeglasses and contact lenses using a prescription from an optometrist or ophthalmologist.
An ophthalmologist is a physician who went to medical school, then did a residency in diseases and surgery of the eye. He can prescribe medications for things like glaucoma. Some may sub-specialize and treat things like retinal disease, do primarily LASIK, or take care primarily of children.
Optometrists are not physicians, correct. But they are doctors. Their doctorate is in optometry, not in medicine. It's still an 8-year course that can also involve a 9th year in residency (but isn't required). They are qualified and authorized to diagnose and prescribe, though both are limited. It's comparable to the old General Practitioner (GP) vs. the Surgeon. Both are doctors, both can prescribe and diagnost, but the GP typically is not trained to perform surgery. In vision care, the GP is the optometrist, and the surgeon is the opthamologist. Both are doctors. Just not of medicine. They're doctors of optometry with the opthamologist having an additional 3+ years of specialized training.
What do you do? I have no idea....this is what we voted for and chose as a country and society. I'm just a small business owner with 25 mouths to feed (with me eating last) trying to work through the same system.
Since you and I are both patients, you and I are both getting a raw deal since we are forced to purchase something we may or may not use. Or sometimes CANNOT use. There are 3 parties involved (the patient, the insurance company, and the doctor) and I am merely highlighting my perspective which may or may not be consistent with other docs. People are slow to figure out that the insurance companies are the only ones winning in our current system. When we let a 3rd party pay the bills, they get to make the rules....no matter how convoluted they are.
Once a week I have a similar conversation with a patient and I explain it with an old story. A guy in a restaurant asks the waiter for some butter. The waiter goes by several times and after 30 minutes, the guy gets mad and says "Do you know who I am? I am the president of blah blah blah and a bigshot and I want my butter!" The waiter says, "Do you know who I am? I'm the guy with the butter!"
The insurance companies have all the butter if you sign up for their product, they are in control. As I have said before, insurance companies are not our friends.
This always brings up the question "what about catastrophic emergencies I cannot afford?" This is what insurance is for. Just like your homeowners insurance is there to pay when the house burns down. The problem is that our entitlement culture is asking medical insurance to pay for every ingrown toenail. This gives the insurance industry even more control. Strangely, nobody expects their auto insurance to pay for their oil changes, or expects their homeowners insurance to pay to paint the kitchen. What about grocery insurance?? How does anyone eat without grocery insurance? Entitlement. Insurance should be something you never hope you need.
I don't expect insurance companies to pay for every ingrown toenail that I have.
By the same token, I don't see health care as a privilege that only the wealthy and well-to-do should be getting in this country. I think the free market system has done a poor job of allocating resources in this sector of the economy. I have been unusually fortunate myself because of personal circumstances. My father was both a state and federal employee for the last twenty years of his working life and my health needs were met most of the time by the state employees health insurance fund. After law school, I married my wife and she went to work for local government and I continue to have my health insurance expenses paid for by the same insurance fund. However, I see literally dozens of my colleagues who are not so fortunate, struggling to pay for health insurance. Before the ACA, many literally couldn't find insurance. The state bar association offered a plan that was so poor when I read through all the exceptions and riders, I just thought to myself "I'm damned lucky I don't have to be on that thing".
What I wish for is a plan similar to the one available for state employees to be available to all the citizens of my state. The plan requires payment of deductibles and imposes surcharges for diagnostic tests like CTs and MRIs because of their prevalence. The most expensive providers in the state are not part of the plan, but I would guesstimate that perhaps 75% to 80% of the providers in Utah will take my insurance.
I don't think what I want is unrealistic. It probably would involve the expansion of some primary care services.
It isn't clear to me exactly what you are advocating. However, a "cash-based system" simply isn't going to fly in this day and age. Its a non-starter. Perhaps, dentists can get away with that because a large segment of the population is sadly doing without dental care.
I don't expect insurance companies to pay for every ingrown toenail that I have.
By the same token, I don't see health care as a privilege that only the wealthy and well-to-do should be getting in this country. I think the free market system has done a poor job of allocating resources in this sector of the economy. I have been unusually fortunate myself because of personal circumstances. My father was both a state and federal employee for the last twenty years of his working life and my health needs were met most of the time by the state employees health insurance fund. After law school, I married my wife and she went to work for local government and I continue to have my health insurance expenses paid for by the same insurance fund. However, I see literally dozens of my colleagues who are not so fortunate, struggling to pay for health insurance. Before the ACA, many literally couldn't find insurance. The state bar association offered a plan that was so poor when I read through all the exceptions and riders, I just thought to myself "I'm damned lucky I don't have to be on that thing".
What I wish for is a plan similar to the one available for state employees to be available to all the citizens of my state. The plan requires payment of deductibles and imposes surcharges for diagnostic tests like CTs and MRIs because of their prevalence. The most expensive providers in the state are not part of the plan, but I would guesstimate that perhaps 75% to 80% of the providers in Utah will take my insurance.
I don't think what I want is unrealistic. It probably would involve the expansion of some primary care services.
It isn't clear to me exactly what you are advocating. However, a "cash-based system" simply isn't going to fly in this day and age. Its a non-starter. Perhaps, dentists can get away with that because a large segment of the population is sadly doing without dental care.
I'm not advocating anything. I have no ideal solution. My post was directed towards people who are astounded they have to pay anything at all.
A cash based system is already alive and well in many areas. I think a cash system would bring the costs down over time by pushing out the bloated middle man (insurance company). This would also create competition and we would finally know who the customer is....the patient. Right now nobody knows who the customer is because of the twisted 3-way relationship between the insurance company, patient and doctor. How do people afford an attorney without attorney insurance? Certainly they don't (gasp) pay cash?
I'm not advocating anything. I have no ideal solution. My post was directed towards people who are astounded they have to pay anything at all.
A cash based system is already alive and well in many areas. I think a cash system would bring the costs down over time by pushing out the bloated middle man (insurance company). This would also create competition and we would finally know who the customer is....the patient. Right now nobody knows who the customer is because of the twisted 3-way relationship between the insurance company, patient and doctor. How do people afford an attorney without attorney insurance? Certainly they don't (gasp) pay cash?
I hope you don't think I expected not to have to pay! I just didn't expect an $1100 bill for that procedure when it cost me $160 last year with "worse" insurance.
I did talk to the office today and they sincerely apologized and said I should have been told as soon as they looked at my new card. They are going to discuss with the doctor and get back to me.
I agree that there is a lot of bloat on the insurance side. I also have no problem self-paying. Years ago when I didn't have insurance, I self-payed everything (which wasn't much, dental cleaning & gyn pretty much). This was in the early 90s and I found the rates to be very reasonable when I told doctors I didn't have insurance. In 2009 I had another small stint with no insurance and broke my finger before my state insurance was approved. That cost a bit but I honestly doubt it would've been much cheaper even with insurance due to deductibles. I even had a tooth pulled at that time and it wasn't too horrible.
I don't remember when this happened, pre-2000, CT instituted some mandatory malpractice insurance changes on the doctor side and it seemed like that was the beginning of the crazy rates here. My gyn "retired", saying it wasn't worth being in business anymore. The other lady in the practice took it over.
Now that I'm paying out the nose (for me - I recognize some have it worse) per month, I can't even afford a dental cleaning. For the past few years I've been buying groupon for dental cleanings but I haven't had one since 2013 and I'm trying to scrape up the money to do. I wish I could afford the dental insurance but I'm stretched too thin right now.
It's not just health, car insurance is crazy too. But they actually pay shops well. I know quite a few body guys who only take insurance jobs because they pay so well. Once I signed off on a replacement windshield and saw the glass company was charging the insurance company over $700! I had to buy one on my own once and it cost me less than $250 out of pocket.
Optometrists are not physicians, correct. But they are doctors. Their doctorate is in optometry, not in medicine. It's still an 8-year course that can also involve a 9th year in residency (but isn't required). They are qualified and authorized to diagnose and prescribe, though both are limited. It's comparable to the old General Practitioner (GP) vs. the Surgeon. Both are doctors, both can prescribe and diagnost, but the GP typically is not trained to perform surgery. In vision care, the GP is the optometrist, and the surgeon is the opthamologist. Both are doctors. Just not of medicine. They're doctors of optometry with the opthamologist having an additional 3+ years of specialized training.
No, the optometrist is not like a GP for eye care. They do not go to medical school and receive no training in general anatomy, physiology, pathology, or the treatment of medical diseases. Most of what they do is measurements for eyeglasses and contact lenses. An ophthalmologist can do everything an optometrist can do plus treat medical eye conditions as well as perform surgery.
This always brings up the question "what about catastrophic emergencies I cannot afford?" This is what insurance is for. Just like your homeowners insurance is there to pay when the house burns down. The problem is that our entitlement culture is asking medical insurance to pay for every ingrown toenail. This gives the insurance industry even more control. Strangely, nobody expects their auto insurance to pay for their oil changes, or expects their homeowners insurance to pay to paint the kitchen. What about grocery insurance?? How does anyone eat without grocery insurance? Entitlement. Insurance should be something you never hope you need.
Totally agreed. I'd much rather pay cash for routine office visits and have insurance cover the big and unexpected things.
I don't expect insurance companies to pay for every ingrown toenail that I have.
By the same token, I don't see health care as a privilege that only the wealthy and well-to-do should be getting in this country. I think the free market system has done a poor job of allocating resources in this sector of the economy. I have been unusually fortunate myself because of personal circumstances. My father was both a state and federal employee for the last twenty years of his working life and my health needs were met most of the time by the state employees health insurance fund. After law school, I married my wife and she went to work for local government and I continue to have my health insurance expenses paid for by the same insurance fund. However, I see literally dozens of my colleagues who are not so fortunate, struggling to pay for health insurance. Before the ACA, many literally couldn't find insurance. The state bar association offered a plan that was so poor when I read through all the exceptions and riders, I just thought to myself "I'm damned lucky I don't have to be on that thing".
What I wish for is a plan similar to the one available for state employees to be available to all the citizens of my state. The plan requires payment of deductibles and imposes surcharges for diagnostic tests like CTs and MRIs because of their prevalence. The most expensive providers in the state are not part of the plan, but I would guesstimate that perhaps 75% to 80% of the providers in Utah will take my insurance.
I don't think what I want is unrealistic. It probably would involve the expansion of some primary care services.
It isn't clear to me exactly what you are advocating. However, a "cash-based system" simply isn't going to fly in this day and age. Its a non-starter. Perhaps, dentists can get away with that because a large segment of the population is sadly doing without dental care.
The state/federal insurance system is probably the worst example one could give in terms of how to run the system. Enormous sums of money are spent to help the relative few state/federal workers compared to the general population that pays for the cost. These workers are the 1 percenters of health care.
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