Health Care, the American way... (Full Version)

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Yachtie -> Health Care, the American way... (5/29/2013 9:37:25 AM)

SOUTH PORTLAND, Maine — Dr. Michael Ciampi took a step this spring that many of his fellow physicians would describe as radical.

The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.

Before, Ciampi charged $160 for an office visit with an existing patient facing one or more complicated health problems. Now, he charges $75.

Patients with an earache or strep throat can spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50, he said.

Ciampi collects payment at the end of the visit, freeing him of the time and costs associated with sending bills, he said.

That time is crucial to Ciampi. When his patients come to his office, they see him, not a physician’s assistant or a nurse practitioner, he said.

“If more doctors were able to do this, that would be real health care reform,” he said. “That’s when we’d see the cost of medicine truly go down.”



It will be interesting to see just how well he does. I'd expect, though, that if enough practitioners do it, government shall make it illegal.




mnottertail -> RE: Health Care, the American way... (5/29/2013 10:07:11 AM)

Seems like the insurance companies are causing massive overhead in our system. I am not astounded, to find that is the case.




Rule -> RE: Health Care, the American way... (5/29/2013 10:08:01 AM)

The man is a hero and no doubt of above average intelligence for physicians, I suspect.

However, I doubt that he will survive: no doubt the insurance companies have already slated him for assassination.




joether -> RE: Health Care, the American way... (5/29/2013 10:17:54 AM)

Yeah, when more doctors do that; we'll see a higher percentage of medical bankruptcies not from individuals but from the offices themselves. Try to imagine how much it costs to become a medical doctor. Second some states practically require one to only collect from someone that could pay before treatment. Third, any self-respective conservative Republican would have to be automatically against this idea because it would allow the government to help out the poor / disadvantage in obtaining good health coverage.

What's next, low cost dental care? That would truly piss off Republicans....




MyMasterStephen -> RE: Health Care, the American way... (5/29/2013 10:37:31 AM)

It never ceases to amaze me...

I need to go to see the doctor, with an earache or strep throat or anything more complicated, and it doesn't cost me a penny.

A couple of weeks ago I crushed my finger when gardening, and went to the Accident & Emergency department of my local hospital. The finger was checked, x-rayed to make sure nothing was broken (all was good) then interviewed again where I was told that no treatment was necessary. All done inside an hour. And the cost of this trip? Zilch.

No I don't have health insurance. I have the National Health Service. Much maligned, and straining under the load, but still working pretty well.




Rule -> RE: Health Care, the American way... (5/29/2013 11:00:41 AM)

quote:

ORIGINAL: MyMasterStephen
I need to go to see the doctor, with an earache or strep throat or anything more complicated, and it doesn't cost me a penny.

[sm=rofl.gif]

Truly?

[8|]

Hey, since all that stuff costs you zilch, you must have some fair pennies saved... So it strikes me that you can afford to invest in a lucrative business opportunity. It so happens that I recently acquired the Eifel tower (the mere de Paris wants it demolished so that the location can be used to build a highrise). Anway, the value of the scrap metal is estimated at six million euros. Unfortunately, I had to use the money intended for demolition to finance a heart and big toes transplants for my ailing father. So I am willing to let you have the tower for what I paid for it myself: 600 thousand euros. How about it? It is a bargain!




freedomdwarf1 -> RE: Health Care, the American way... (5/29/2013 11:12:32 AM)


quote:

ORIGINAL: Rule
quote:

ORIGINAL: MyMasterStephen
I need to go to see the doctor, with an earache or strep throat or anything more complicated, and it doesn't cost me a penny.

[sm=rofl.gif]

Truly?

[8|]

Hey, since all that stuff costs you zilch, you must have some fair pennies saved...

Just because we don't need medical/health insurance because we have our National Health Service doesn't automatically mean we have heaps of money squirrelled away. lol.

Now, if we were paid anywhere near US wage levels, we just might have some spare cash to throw around.
Alas, the income and cost of living diferentials are somewhat wider than most people think.




Aibo -> RE: Health Care, the American way... (5/29/2013 11:17:41 AM)

It's similar to what MyMasterStephen said also here, but yes there can be additional charges for admittance and subsequent visits.
But those are not higher when I need lets say brain surgery than for a sprained ankle.




eulero83 -> RE: Health Care, the American way... (5/29/2013 1:38:14 PM)

sorry for the naive question, but if a person has healt insurance was charged 160$ or was the insurance company to pay?
because if that's the case I don't see this as a big problem for patients.




fucktoyprincess -> RE: Health Care, the American way... (5/29/2013 1:49:59 PM)

Most of my doctors in New York do NOT accept insurance and that has been true for years (probably at least 15-20 years)...this is not something new....maybe in Maine it is.....




vincentML -> RE: Health Care, the American way... (5/29/2013 1:51:49 PM)

Yep, good old fashioned American family medical practitioner. I hope Dr Ciampi's patients are pooling their money in case they need an MRI scan.

Oh wait. That would be like Insurance, wouldn't it? [8|]

Cost
MRI equipment varies in cost, depending on the strength of the scanner. Scanners with more strength produce more detailed images; therefore, these scanners cost more. MRI machines can range in cost between $1 and $3 million. Construction of MRI suites can easily add another $500,000 to the total cost. An extremity MRI machine alone costs $300,000 or more, and can only be used to scan hands, feet and knees. Purchasing a used-extremity MRI scanner can cost as much as $150,000.

Reimbursement
While Medicare, most HMOs and private insurance companies, as well as Workers' Compensation carriers, will cover at least some of the cost for a patient to have an MRI exam, government-sponsored health plans are now reimbursing less for the equipment charge. When the cost of the procedure is not covered by a patient's health plan, or a patient is uninsured, the provider will usually advise a patient of the costs at the time an appointment is scheduled. An MRI examination can cost several thousands of dollars, as it includes a charge for using the MRI machine to perform the scan, in addition to a professional charge for a radiologist to view the images. The equipment charge alone can cost somewhere in the range of $3,500. Add another $350 fee to that for a radiologist to take a look at the images and interpret the data. Another factor to consider when it comes medical facilities being reimbursed for the study is that many insurance companies require pre-approval before covering the cost of an MRI exam.






vincentML -> RE: Health Care, the American way... (5/29/2013 1:54:02 PM)


quote:

ORIGINAL: fucktoyprincess

Most of my doctors in New York do NOT accept insurance and that has been true for years (probably at least 15-20 years)...this is not something new....maybe in Maine it is.....

So, FTP, you have to apply for re-imbursement if you have insurance??




playfulotter -> RE: Health Care, the American way... (5/29/2013 1:58:15 PM)

quote:

ORIGINAL: Yachtie

SOUTH PORTLAND, Maine — Dr. Michael Ciampi took a step this spring that many of his fellow physicians would describe as radical.

The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.

Before, Ciampi charged $160 for an office visit with an existing patient facing one or more complicated health problems. Now, he charges $75.

Patients with an earache or strep throat can spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50, he said.

Ciampi collects payment at the end of the visit, freeing him of the time and costs associated with sending bills, he said.

That time is crucial to Ciampi. When his patients come to his office, they see him, not a physician’s assistant or a nurse practitioner, he said.

“If more doctors were able to do this, that would be real health care reform,” he said. “That’s when we’d see the cost of medicine truly go down.”



It will be interesting to see just how well he does. I'd expect, though, that if enough practitioners do it, government shall make it illegal.


This sounds great (I really agree with the concept behind it) but what happens when someone has a problem this General Practitioner can't treat? What if they need to go to the hospital?...They will still need to pay for medical insurance each month for a true medical emergency which is what the word "insurance" actually means.....or they can do what has become "The American Way" for too many for too long and go to the emergency room and never pay and then all the people who do pay for insurance pay more...




DaddySatyr -> RE: Health Care, the American way... (5/29/2013 2:01:38 PM)

If Americans weren't so fucking litigious, the cost for a doctor doing business would be significantly reduced (something like an average of $300,000 per year per doctor).

Also, I wonder if Dr. Ciampi has been practicing long enough that his student loans are paid off?

I am in the camp that doctors aught to go back and read the Oath, once in a while but the hard truth is that it costs them about $500,000 per year just to break even. Most of that is insurance premiums. So who's really fucking the American people? A bunch of lawyers (whether they work for insurance companies or whether they write sweetheart laws).



Peace and comfort,



Michael




fucktoyprincess -> RE: Health Care, the American way... (5/29/2013 2:06:15 PM)


quote:

ORIGINAL: vincentML


quote:

ORIGINAL: fucktoyprincess

Most of my doctors in New York do NOT accept insurance and that has been true for years (probably at least 15-20 years)...this is not something new....maybe in Maine it is.....

So, FTP, you have to apply for re-imbursement if you have insurance??


Yes. The doctor provides me with a generic form that I separately send to my insurance company. And only I deal with the insurance company (the doctor doesn't deal with them unless they have a specific medical inquiry). As a result, sometimes I am covered in full, but often I am not. And obviously for periods of time in my life when I didn't have insurance I didn't get any reimbursement at all. I prefer to have a choice of my doctors and can afford to do this, but for the record, I support a one-payer system for health care because our current system is beyond inefficient. It gives some people (like me) extraordinary care (because I pay EXTRA above and beyond my insurance) and then leaves others with NOTHING. I am actually willing to give up some of my extraordinary care to have a system with universal access. (Just another bleeding heart.)




vincentML -> RE: Health Care, the American way... (5/29/2013 2:07:21 PM)

quote:

If Americans weren't so fucking litigious, the cost for a doctor doing business would be significantly reduced (something like an average of $300,000 per year per doctor).

The usual right wing rot. Not you, Michael. The blame the Lawyers ploy. Ciampi graduated from Tufts Medical School. No backwater college that. He has more than one office. He has been in the biz for almost two decades. I guess he is doing alright. and now he is shifting office costs to his patients along with major surgical risks.




vincentML -> RE: Health Care, the American way... (5/29/2013 2:09:00 PM)


quote:

ORIGINAL: fucktoyprincess


quote:

ORIGINAL: vincentML


quote:

ORIGINAL: fucktoyprincess

Most of my doctors in New York do NOT accept insurance and that has been true for years (probably at least 15-20 years)...this is not something new....maybe in Maine it is.....

So, FTP, you have to apply for re-imbursement if you have insurance??


Yes. The doctor provides me with a generic form that I separately send to my insurance company. And only I deal with the insurance company (the doctor doesn't deal with them unless they have a specific medical inquiry). As a result, sometimes I am covered in full, but often I am not. And obviously for periods of time in my life when I didn't have insurance I didn't get any reimbursement at all. I prefer to have a choice of my doctors and can afford to do this, but for the record, I support a one-payer system for health care because our current system is beyond inefficient. It gives some people (like me) extraordinary care (because I pay EXTRA above and beyond my insurance) and then leaves others with NOTHING. I am actually willing to give up some of my extraordinary care to have a system with universal access. (Just another bleeding heart.)

[:D] Thank you, FTP




vincentML -> RE: Health Care, the American way... (5/29/2013 2:10:49 PM)

quote:

This sounds great (I really agree with the concept behind it) but what happens when someone has a problem this General Practitioner can't treat? What if they need to go to the hospital?...They will still need to pay for medical insurance each month for a true medical emergency which is what the word "insurance" actually means.....or they can do what has become "The American Way" for too many for too long and go to the emergency room and never pay and then all the people who do pay for insurance pay more...

And who provides the research and development for new tchniques and devices?




DaddySatyr -> RE: Health Care, the American way... (5/29/2013 2:13:43 PM)

quote:

ORIGINAL: vincentML

quote:

If Americans weren't so fucking litigious, the cost for a doctor doing business would be significantly reduced (something like an average of $300,000 per year per doctor).

The usual right wing rot. Not you, Michael. The blame the Lawyers ploy. Ciampi graduated from Tufts Medical School. No backwater college that. He has more than one office. He has been in the biz for almost two decades. I guess he is doing alright. and now he is shifting office costs to his patients along with major surgical risks.


Surely, you have it a bit wrong. I'm blaming the American people for being litigious; for thinking that God forbid, someone who's trying to help them has made a mistake and they've just hit the lottery.

As a result, a doctor needs to "protect" himself to make sure he doesn't lose his house over an honest mistake. He turns to insurance companies. They're, essentially, "run" by lawyers.

I'm not sure but, I would bet that better than half of the members of congress have a law degree; not that they ever practiced but, I'll bet they're lawyers. They write the laws that make a doctor, making an honest mistake, open to lawsuits.

It's a crazy, screwed-up system where someone (I am going back many years ago because this isn't what the case is now) devotes their life to helping their fellow man and they have to worry about which of their beneficiaries is going to fuck them, next.



Peace and comfort,



Michael


I need to add this: If it were legal, I would be more than willing to sign a release form, abdicating my rights to sue someone who's doing their best to help me. This would enable doctors to cut their operating costs significantly.




vincentML -> RE: Health Care, the American way... (5/29/2013 2:17:09 PM)

quote:

Surely, you have it a bit wrong. I'm blaming the American people for being litigious; for thinking that God forbid, someone who's trying to help them has made a mistake and they've just hit the lottery.

Doctors fuck up and the only way to get outside review is to go to court, as far as I know.

quote:

I need to add this: If it were legal, I would be more than willing to sign a release form, abdicating my rights to sue someone who's doing their best to help me. This would enable doctors to cut their opperating costs significantly.

Really? You would go into an OR without legal protection? Wow!




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