When the uninsured need more than maintenance care

Several of my posts have dealt with people paying cash for health care services. My reader whose health coverage via her husband's start-up didn't cover maternity, and she was pregnant when he joined the company! The health care cynic who paid for two children being born via credit card.

So I naively thought that if you've got the cash, and you need the care, well you just get it.

Apparently it's not so simple.

Check out this post from Kevin MD on the difficulty the uninsured have getting specialists to see them.

The problems come from multiple places. I mean who can blame a general care doctor from wanting to avoid being held to the same standards of care as a specialist...so it makes sense they would avoid taking cash patients.

Or for that matter if they're going to be held responsible for the care of their referrals, and fewer and fewer specialists will actually take cash patients, then who can blame them for not wanting to take that risk either?

And it's no comfort to hear that our own government is so slow and resistant to paying claims that they're part of the problem too.

But come on, all I can think when I read this story is that we really are saying that some lives are more valuable than others, more worth proper medical care, and most likely the lives that are disposable are of those who make less money.

Yikes.

Comments

[Bob]

all I can think when I read this story is that we really are saying that some lives are more valuable than others, more worth proper medical care, and most likely the lives that are disposable are of those who make less money.

That's a bit of a stretch, but whatever . . .

An example I like to use to illustrate the point of the self insured vs. those with third party pay plans is a 5 start restaurant. Two people walk into the restaurant and order expensive meals. One has the ability to pay for anything on the menu, the other has neither the ability nor the intent to pay.

At the end of the meal the paying client pays the waiter and leaves while the non-paying customer simply leaves.

How many times can this situation occur before the restaurant (a) starts demanding payment before ordering or (b) goes out of business?

People forget health care is a business. It's time more started realizing that fact and the repurcussions created by those who do not pay for services rendered.

[Bob]

Guess I either need to start proofing more, or finding a way to edit responses.

That's 5 STAR restaurant . . .

[Elisa Camahort]

Plenty of businesses do just fine giving people payment plans...from the car dealer to the mattress store. So if doctors want to be treated like businesses, fine.

And then there's the case when it's our own government programs that don't pay as expected, or very very slowly anyway, as mentioned in the article.

It seems like this problem is easy to pin on defaulting patients, but that there's more to it.

[Bob]

Most payment issues with taxpayer funded programs (Medicare, Medicaid) have to do with improper coding. Public programs march to their own drummer requiring those patients claims to be handled differently. There is much more back-and-forth (between provider and payor)with taxpayer plans than with private carrier plans.