I like the idea of returning to the way we were before WWII and the wage freeze
- paying the doctor what he needs, possibly through a retainer relationship.
There was a doctor in NYC who tried to set up a business model where his
patients paid him $70 per month (he calculated that amount based on office
overhead and his income) and they had the right to visit him X number of times
per month. The various one-payer systems (Medicare, insurance) called in the
insurance regulators, claiming that he was operating as an insurance company.
I have friend who recently retired from being an Ob/Gyn. He worked in ABQ but
followed his wife to Winslow. There he worked for what his patients could give
him - many times including livestock (mostly chickens). He told me that he
made more money through that informal system than he made here through the
whole office/insurance/hospital privileges/etc. system.
My wife once found out (through having to bully the insurance company to pay
the doctor) that her Ob/Gyn (different one) pocketed a whopping $125.00 for the
emergency surgery he did for her. This was after the cost of having an office,
paying the hospital to use it, processing the insurance, and paying
malpractice. We figured he was probably worth more than $25.00/hour.
The whole insurance/government regulation/government fee structure we've built
ever since medical insurance was used to hide salary increases has gotten us to
where we are today - a mess.
On Apr 23, 2012, at 2:53 PM, Nicholas Thompson wrote:
My fantasy is that we all get together to form a Dr/patients association and
conspire against the insurance companies.
n
From: friam-boun...@redfish.commailto:friam-boun...@redfish.com
[mailto:friam-boun...@redfish.com] On Behalf Of Pamela McCorduck
Sent: Monday, April 23, 2012 1:33 PM
To: The Friday Morning Applied Complexity Coffee Group
Subject: Re: [FRIAM] Old Folks Only: Medicare Plan F
Robert, nearly none of my Manhattan doctors takes Medicare, and that's been
true for about a decade. Luckily, Joe is still working, and we pay for the
Columbia faculty medical plan, but when that stops, I don't know what we'll do.
I can't blame the docs--the fees from Medicare are negligible compared to
Manhattan expenses.
Free market medicine working so, so well.
What you're complaining about, Nick (and I agree) is a result of docs taking on
far too many patients, giving them too little time, again a function of the
crackpot non-system we have. With single-payer, we would immediately save
thirty percent at least of what we shell out, and patients and doctors could
split that savings. As most of you know, we are surrounded in Santa Fe by
people who have no insurance at all.
I had dinner the other night with the guy in charge of Google's medical records
effort... Google's defunct medical records effort. As they were getting
acquainted with the general non-system, they realized that privacy laws would
keep them from verifying that their record-keeping programs actually worked!
Impossible to penetrate the silos that exist from one medical center to the
next. Google pulled the plug.
Is it do-able technically? Of course. The Veterans Administration does it
handily. Will it be done in our lifetimes? Unlikely. So the next time you hear
someone tell you how much money we're going to save through electronic medical
records, you can smile. Wryly.
On Apr 23, 2012, at 2:39 PM, Nicholas Thompson wrote:
Hi, Robert,
I find the local medical situation terrifying. My daughter had to be admitted
to St. V. for an emergency a couple of X-masses ago, and I swear to god there
were blood splatters on the wall behind her bed in her room. I am fighting
allergies so bad right now they are preventing me from singing in the Chorus I
sing for, and all the medical people I talk to are clueless. The feed-back
from patients to doctors is non-existent. There’s no way a Doctor can tell
when he prescribes you medicine whether it has killed you or cured you.
Either way, you don’t come back. I think folks like you could get rich in
the Obama technocrat age AND do a heluva lot of good by designing feedback
systems so Doctors actually find out whether they have killed you or not.
As for hip surgery. I have been a “candidate” for hip surgery for years but
never elected. But arthritic hips are different from osteomyelitic hips.
One good thing about medicare is that it doesn’t give a rat’s ass where you get
your medical care. So, I went to Boston for high end carotic surgery a few
years ago…. Massachusetts General Hospital, Harvard …., the whole nine yards.
It didn
‘t cost me a dime. I had relatives in Boston, so that helped a lot.
Good luck with this, Robert.
Nick
Ooops. I forgot I was exiled. N
\
From: friam-boun...@redfish.commailto:friam-boun...@redfish.com
[mailto:friam-boun...@redfish.com]mailto:[mailto:friam-boun...@redfish.com]
On Behalf Of Robert Holmes
Sent:
