Fed Up With Obamacare, Doctors Increasingly Prefer Cash For Care

Maybe Obamacare and other government health mandates are a good thing. They are forcing doctors and patients to find a mutually rewarding, economically feasible way around the morass of regulation. Good news! Here's the article:

Obamacare’s most intrusive changes to the healthcare marketplace — including the individual mandate whereby Americans must secure health insurance or pay a fine and its massive expansion of Medicaid — are less than a year from taking effect.

Many doctors have decided that they’re not interested in seeing how those changes play out in their own practices. Nearly two-thirds of doctors say that they or their colleagues will retire earlier than planned over the next few years, according to a survey conducted by consulting firm Deloitte.

Others are considering a departure from the current system of third-party payment. Instead, they’re exploring direct payment, with patients paying for care on their own.

Patients should welcome this development. Not only does the move toward direct payment have the potential to reduce health costs — it could also yield higher-quality care.

Even before Obamacare, direct-pay practices were growing in popularity. According to the Center for Studying Health System Change, direct-payment practices increased from 9.2 percent of the market in 2001 to 12.4 percent by 2008.

Nearly 7 percent of doctors say they are planning to change to some form of direct-pay care in the next three years, according to a survey of 13,000 doctors done for the Physicians Foundation. The consulting firm Accenture projects that one in three doctors in independent practice will adopt “subscription-based care models.”

One direct payment model that’s growing in popularity is “concierge” care, whereby doctors charge a monthly or annual fee for care — and bypass the administrative headaches associated with insurance and government programs altogether. The American Academy of Private Physicians — which represents cash-only doctors — estimates that the number of concierge doctors has shot up 30 percent in just the last year.

Examples of these practices abound.

Qliance, for instance, offers primary and preventive care for less than $90 a month in several cities in Washington state. In January, the company raised $8.6 million to expand beyond its home state.

One Medical in San Francisco charges patients between $150 and $200 a year for same-day appointments, online prescriptions, and email access to doctors. And in Portland, Oregon, patients at the Multnomah Family Care Center can pay a one-time enrollment fee and then monthly membership and provider fees that average less than $60 a month for preventative care. Others include Atlas MD, MedLion, Simple Care, and Paladina Health.

The direct-pay model does force patients to shoulder more of the upfront cost of their care. But the long-term savings it can generate are substantial. Qliance, for example, says it can trim as much as 30 percent off health costs by combining its services with a high-deductible plan for major medical bills.

High-deductible plans are usually paired with health savings accounts (HSAs), which allow consumers to set aside money tax-free for health expenses. HSAs empower patients to take charge of their care — and can make visits to direct-payment practices even more affordable.

At Access Healthcare, a cash-only practice, fees can be lower than the co-pays a patient would otherwise cover under a traditional insurance plan. The cost-lowering potential of direct-payment practices is heartening because the current third-party payment system has failed to stem our burgeoning health cost crisis.

Indeed, third-party payment is largely to blame for the untamed growth of health costs. Back in 1960, only about half the nation’s health spending was paid for by a third party, according to the Centers for Medicare and Medicaid Services. By 1980 that had risen to 77 percent. Today, it’s 88 percent. Not surprisingly, as consumers’ out-of-pocket share of health costs has declined, their demand for care has exploded.

Our tax regime encourages such over-consumption. Employer-sponsored insurance benefits are not taxed. So a worker receives a full dollar’s worth of health benefits for every dollar his employer pays for insurance — compared to less than 85 cents for every dollar his boss spends on wages. As a result, health costs have grown at double the rate of inflation elsewhere in the economy.

That’s not sustainable. Direct-payment could check that cost growth, particularly in the primary care realm, by empowering doctors and patients to negotiate mutually agreeable prices, free of interference from insurers or the government.

Reason magazine recently profiled Dr. Ryan Neuhofel, a Kansas doctor who posts his prices online and doesn’t accept insurance. A 30-minute house call runs $100. That may seem high to those used to $30 co-pays. But that $100 house call may end up being cheaper, after taking into account sky-high monthly insurance premiums, steadily rising annual deductibles, and out-of-pocket maximums — not to mention the time and expense that both doctors and patients have to devote to filing claims.

Obamacare will only add to the cost-inflating administrative burden that third-party payment places on doctors. Direct-payment allows physicians to reject that burden and focus on what they do best — treating patients.

Outstanding! Why hasn't this come up before?

http://www.forbes.com/sites/sallypip...cash-for-care/

Hey ASSHOLE, Obamacare doesn't really take effect for another year.

Docs have preferred cash for quite a while ... Ever since Medicare reimbursements started dropping more than a decade ago, private plans began using Medicare rates as the benchmark for physician payment.

It's far cheaper for them to take cash than having to fuck with all the paperwork and wait for payment. I was offered a 300 dollar discount on an EKG if I paid cash. Long before Obama was elected.

If anything Obamacare helps expedite the payment process, make it more efficient and ultimately less costly.

The catastrophic care/HSA model has been around for a long time. You act like this is some kind of fucking revelation.


This bullshit, as is most of your regurgitation, is REAL old news.

You continue to whine, moan, bitch and present misleading (at best) positions about health care. You don't know shit, but that doesn't stop your cut and paste circle jerk.

"If anything Obamacare helps expedite the payment process, make it more efficient and ultimately less costly." BS assupurhead. Name one government regulated agency that is run efficiently? And the statement "ultimately less costly" is a chicken shit way of saying in the near future when Obamacare proves to be a total piece of shit, liberals will find a way to blame the Republicans.

Again, you're a fucking idiot.

The HIT provisions alone make the system more efficient and a shitload less costly. the healthcare providers who have invested in a robust HIT system will attest to that.

You probably need to do some homework. we'll be here when you come back, bub.

You see, SaTex, Assup is an incoherent, blithering idiot. Doctors accepting cash is not new. However, because of Obamacare, more and more doctors are preferring that rather than put up with all the regulations. They are developing more and better ways to provide health care, at closer to real market prices, than before. No one said this was a new phenomenon, just that it is expanding. Assup's intellectual capability is too limited to grasp concepts such as these. He the kid at the children's table who spills his milk and blames someone else. Pay no attention to him.

Yeah, Whiny, I the kid at de table.

The regulations were horrid long before Obama was elected (twice). Obviously you have a very short memory. The oppressive regulations under Obamacare wont take effect for another year. Doctors have been going out of business for decades...

But these guys are developing more and better ways to provide healthcare at closer to real market prices? What the fuck is the REAL market price for healthcare? Who determines it? You are totally clueless on this issue. Yours argument is just more tilting at windmills, like most of what you espouse on here.

Obviously you're as ignorant as you are inaccurate.

and an asshole.

Duh, Assup, the MARKET determines the market price. Gawd, you are as stupid as I think you are. The fewer external pressures on the market, the closer we can get to real market prices. Do you know nothing? I guess that is the case.

HAHAHAHAHA.

As naive as you are stupid on this ... hell, most every subject.

External pressures like insurance plans? Pharmas? Device manufacturers? Hospitals? Long term care corporations? States and counties?

I suppose then you believe that we should negotiate large national group contracts with the pharmas, right? Let the market determine the price we pay, right?

Ignorant motherfucker. You can't have it every way ... But according to the men's room wall in Salina, you'll take it every way.

So busy insulting me that you don't realize you've brought a limp wrist to a gunfight.

The corner awaits, Unaliar.

It is not surprising, knowing your single minded train of thought about this that you would post, once again a not exactly neutral, non-partian article and blame it on Obamacare even the the law has not yet fully taken affect. This is not the first time that the Koch Brothers supplicant has dished upon this subject. Even conservative publication Forbe's (which I have a very high level of respect for) has acknowledged her rather biased commentary.

http://www.forbes.com/sites/rickunga...are-attacks/2/

The futile search for relevance gritsboy's engaged in continues to consist of random bumping into walls and tripping over Corneyhole's dick. Ahhhh, life in the corner!

You see, SaTex, Assup is an incoherent, blithering idiot. Doctors accepting cash is not new. However, because of Obamacare, more and more doctors are preferring that rather than put up with all the regulations. They are developing more and better ways to provide health care, at closer to real market prices, than before. No one said this was a new phenomenon, just that it is expanding. Assup's intellectual capability is too limited to grasp concepts such as these. He the kid at the children's table who spills his milk and blames someone else. Pay no attention to him. Originally Posted by CuteOldGuy

Of course they are so they can cheat on their taxes.

Uh, when did I ever claim to be "fair and balanced"? I am decidedly biased in favor of individual liberty and personal responsibility. I think it is cool how many doctors are going to find their way around Obamacare. God bless them, and more power to them!

Only a matter of time before the Democrats try to punish and control those who "go around" Obamacare...............

The left can't stand free markets or citizens acting freely.

It is logical to expect doctors to try to end run Obamacare; but the critics in this post whine that you are making this up because Obamacare isn't in full force yet.....................they are truth deniers......they have to deny/lie about the growing disaffection (and adverse consequences) of Obamacare. They are trying to buy time; because they know once fully implemented, it will be despised by most.

Why do you think Obama is trying to stall implementation until after the 2014 elections????

"The Obama administration now says a special system of exchanges designed to make it easier for small businesses to provide insurance (bullshit) will be delayed an entire year -- to 2015."

Joe Klein: "One thing is clear: Obamacare will fail if he doesn't start paying more attention to the details of implementation, if he doesn't start demanding action. And, in a larger sense, the notion of activist government will be in peril -- despite the demographics flowing the Democrats' way -- if institutions like the VA and Obamacare don't deliver the goods."

Only a matter of time before the Democrats try to punish and control those who "go around" Obamacare...............

The left can't stand free markets or citizens acting freely. Originally Posted by Whirlaway

Since when was healthcare a free market.

Assup point was that COG was spining a lie by trying to lie blame doctors wanting cash payments on Obamacare.

You stupid fucs want a true free market, everybody would have to drill their own water well. That would be just great....some things are just better when done to scale. Healthcare is one of them.

COG wasn't spinning a lie; he was telling the truth..........doctors and consumers will try to end run Obamacare in many ways, including cash payments.

Would you have changed your argument if I used the term "more free markets"? I don't think so - Don't tell me you think Obamacare has freed up the healthcare market ?