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What Carson advocated (as I understood it), was that below certain income levels, that people be given something akin to an EBT card that has a finite budget, which can be used for insurance subsidy, or can simply be used to purchase services like an HSA does.
It provides first dollar care, without having unlimited liability.
Quite a few people have proposed this.
I'm not in favor of doing this federally.
I don't think the federal government should do ANY of this... but states are certainly welcome to try it. Oregon created an "Oregon health plan" for low income people, that operated like subsidized insurance. The costs immediately spiraled far outside of predicted revenues. Now there's a waiting list to get on it that's months or years long, and even if you're on it, the last half of the year, services become rationed.
Unlimited liabilities are just not workable. Ever.
They don't lower costs per say.
But since people have to pay they shop around for the best cost themselves.
There is no standard pricing in the medical field.
Did you know that ?
I guess you wouldn't if you don't have to pay anything more than your $15.
How much does an annual physical cost ?
Is that cost different among different doctors ?
I'll wager you don't know.
In my neck of the woods, medical practices that have PPO or EPO contracts with insurers cannot offer services for the same or lower prices to the general public paying cash.
I have BCBS PPO. I receive a statement from them that reflects the MDs fee, the PPO discount and the net reimbursement. For the past 5 years+/-, I have been astounded by how little the medical practice is reimbursed for routine services like an annual pap smear/breast exam-$15.
No system actually lowers cost of healthcare. that is thru management of who gets what and now.For example Americans are use to healthcare on demandsds and often that is disappearing with mangaement .Also what service comes at time can be different like Special rooms and sections for delivery of children many americans are use to. many would say that is a waste but remember that Americans are use to choosing and paying for what they want. just as the world benefits greatly because our healthcare system has paid for 70% of medical and drug research done in the world. to make the risk versus reward their must be the market for the product which may be reduced by more managed care.There is a reason for the high outcomes in out healthcare system and it all involves money spent to produce it. Even in in single payer systems the best care is available if you have the money to pay cash.
In my neck of the woods, medical practices that have PPO or EPO contracts with insurers cannot offer services for the same or lower prices to the general public paying cash.
I have BCBS PPO. I receive a statement from them that reflects the MDs fee, the PPO discount and the net reimbursement. For the past 5 years+/-, I have been astounded by how little the medical practice is reimbursed for routine services like an annual pap smear/breast exam-$15.
Yes and that's why you have to shop around.
Same goes for dental.
$400 for a root canal vs $1500 with 10% discount for cash.
The $400 price came from a dentist that does not take insurance.
The second price from a dentist that pretty much operates 99% insurance.
It's not always how little they get reimbursed. It could also be how high they charged.
If your doctor is really only getting $15 for that then they have to be making up the difference somewhere else.
Prices for eye exams vary widely as well.
I shop every year when I go for an exam.
I don't have dental or vision coverage so I shop around since I have to pay.
I haven't experienced this (lower costs), our "plan A" went up 200 bones/year, meanwhile the "plan B", which has higher deductibles, did not change and nothing deductible/co-pay wise changed at all.
AZcardnial, We are long past due for a single payer system. That I what should have came out of the healthcare bill, at least a public option which was scrapped last minute.
That's not an HSA.
But people who use HSA's shop around for services.
Do you shop around for services ?
Or do you just go to your doctor and whatever he charges is it ?
my question is would enough people asking around and shopping for this particular procedure lower the median cost paid therefore effectively lowering the 'price.'
How does one shop for surgery? Most people are referred by their GP to a specialists who then refers to a surgeon. That surgeon is affiliated with a hospital. One would need to find a surgeon at a different hospital to evaluate the situation to compare and contrast expected fees. This does not work in emergency situations. If it's an elective procedure, one is going to have to pay for second opinions.
In my neck of the woods, PPO/EPO medical practices cannot charge the same or lower fees to customers paying cash. The PPO network is their bread and butter.
How does one shop for surgery? Most people are referred by their GP to a specialists who then refers to a surgeon. That surgeon is affiliated with a hospital. One would need to find a surgeon at a different hospital to evaluate the situation to compare and contrast expected fees. This does not work in emergency situations. If it's an elective procedure, one is going to have to pay for second opinions.
In my neck of the woods, PPO/EPO medical practices cannot charge the same or lower fees to customers paying cash. The PPO network is their bread and butter.
You don't typically use an HSA for surgery.
HSA's are associated with high deductible plans.
Yes and that's why you have to shop around.
Same goes for dental.
$400 for a root canal vs $1500 with 10% discount for cash.
The $400 price came from a dentist that does not take insurance.
The second price from a dentist that pretty much operates 99% insurance.
It's not always how little they get reimbursed. It could also be how high they charged.
If your doctor is really only getting $15 for that then they have to be making up the difference somewhere else.
Prices for eye exams vary widely as well.
I shop every year when I go for an exam.
I don't have dental or vision coverage so I shop around since I have to pay.
HSAs don't work like an independent person looking for healthcare might. They are always tied to an insurer. You must use network providers in that plan or the money you spent does not count toward your deductible. You pay the cost that the insurer has pre-arranged with the provider. I doubt that all providers in an insurer's network have the same fees for the same service. It would be of great help to HD and HSA policyholders were providers/insurers required to make the price sheet available online for inspection so consumers could shop rates within their plans. Don't hold your breath. A bill was proposed here to do just that and it was promptly quashed by the medical profession.
HSAs don't work like an independent person looking for healthcare might. They are always tied to an insurer. You must use network providers in that plan or the money you spent does not count toward your deductible. You pay the cost that the insurer has pre-arranged with the provider. Of course, some services like dental can be totally outside of your health insurance arrangement and still eligible for tax advantaged treatment.
I've never even come close to meeting 1/2 my deductible in any given year.
Since I'm paying the cash anyway I might as well shop around.
Paying cash for medical services is not widely practiced by many.
This dentist I found is old school. No insurance. You pay cash and he takes payments.
I last did this when I was in my 20's and had to get 4 wisdom teeth removed at the same time.
I was a weekly visitor to that office with my payment for a long time
Hide your health insurance status and pay cash instead
A recent article in the Los Angeles Times reported a CT scan of the abdomen costs about $2,400 for patients insured by Blue Shield of California, while the Los Alamitos (Calif.) Medical Center cash price is only $250. That is a 89% discount by my calculation.
Yes and that's why you have to shop around.
Same goes for dental.
$400 for a root canal vs $1500 with 10% discount for cash.
The $400 price came from a dentist that does not take insurance.
The second price from a dentist that pretty much operates 99% insurance.
It's not always how little they get reimbursed. It could also be how high they charged.
If your doctor is really only getting $15 for that then they have to be making up the difference somewhere else.
Prices for eye exams vary widely as well.
I shop every year when I go for an exam.
I don't have dental or vision coverage so I shop around since I have to pay.
Dental is a whole other ball of wax. Most dental plans have annual limits in the $1000/yr. range, unless the policy has a rider for braces. Many dentists do not accept insurance. They expect cash and may or may not file a claim on the patient's behalf with reimbursement paid directly to the patient. Dental work is highly competitive in my area. Younger dentists with new practices will negotiate. Established dentists with substantial practices- not so much.
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