A Different Way

to look at Life, Health, Business and Politics

Archive for February, 2007

When Doctors Compete – You Win

Posted by Marietta chiropractor on February 28, 2007

Politicians love to talk about the rising cost of healthcare.If the trend of rising prices doesn’t change, the implications for consumers and the economy could be devastating.While many government imposed solutions are promoted every election cycle, maybe it’s time to allow the free market to have a chance.

The 1990s ushered in Managed Care, which was supposed to control the cost of health care.Insurance networkswere to keep prices down by controlling providers. Sadly, what actually happened is that health care costs have continued to rise at staggering rates while limiting consumers’ choices and diminishing the quality of care they receive.

By limiting consumers’ choice of providers, insurance companies actually discourage people from getting the care they need when they need it.Instead of going to his own chiropractor, dad just might take over-the-counter pain relievers until his problem is so bad that he misses work and requires more expensive interventions such as physical therapy, potentially dangerous prescription pain killers or even surgery.Or, instead of being able to go to the family doctor on a regular basis and prevent potential problems, families end up waiting until a full-blown crisis arrives requiring significant medical help and expense.

It’s obvious that the current system favors insurers’ short-term financial objectives over the long-term health and well-being of consumers.Experience has shown that insurers will change provider networks routinely to reduce costs while premiums continue to rise.Again, the end result is less care (quality and quantity) and higher premiums.Yet, politicians of both parties continue to promote insurance as the only solution to the health care crisis.

With little fanfare, doctors are starting to run their practices more like a business and showing a real willingness to compete for your business.This competition is taking place on several levels.Some offer affordable financial plans and fees while others specialize in a limited scope of services.Medical Homes of America (www.goprivatedoctor.com) based in Georgia offers unlimited care at a low annual fee, which enables their clients ready access to routine medical care.Regitz Chiropractic (www.regitzchiro.com) in Lancaster, Pennsylvania offers a “box-on-the-wall” practice where practice members determine the fee that is appropriate for them and their familyMedical boutique practices have sprung up all over America offering specialized services from plastic surgery to laser eye surgery.In short, doctors of all stripes are growing tired of the hassles of dealing with a third party re-imbursement structure that limits their ability to practice and serve their clients effectively.

While some providers choose to remove themselves entirely from the insurance “game”, others are choosing to opt out of networks in order to provide quality care while allowing their patients to use their insurance benefits.Either way, these providers often choose to accept somewhat lower compensation than to give less than quality care.

So, why don’t insurers participate in free market solutions to lowering health care costs?Well, one reason might be that our national addiction to insurance is fed by fear of rising costs and the potential for financial devastation should a health crisis ever occur.Many Americans take low paying jobs simply to provide health insurance for their family.Another reason might be the misconception that insurers can control costs by pressuring their network of providers.And while they may lower what they pay their network providers, they end up shortchanging the people who pay their premiums.

Given all this, how can competition alter the course of health care in America?Fewer restrictions by states on how health care providers can establish their fees would give consumers more choices in how they pay their doctor.Professional groups generally oppose this because doctors don’t like to compete for your business.Insurance companies can participate in this revolution by adopting an “any willing provider” posture.As long as a provider is licensed in a given state he/she is presumed to be competent to practice.This one change would foster a level of competition and service not seen in decades.

What can consumers do to help these changes happen sooner?Since state legislatures generally regulate how professional practice, the best first step is to contact your own representative.Tell them you want more competition in the health care marketplace.Support “any willing provider” statutes in your state.Support legislation that removes barriers to pricing by health care professionals.Tell your employer that you want access to any licensed practitioner with your health insurance policy.

Finally, be responsible for your own health.Choose a policy that gives you maximum control over your own health care decisions.And, choose the provider you want before the need arises.Discuss their fees, policies and philosophy of practice.Competition always lowers costs and improves service.Look for ways to make your doctor be better.You’ll be glad you did.

ABOUT THE AUTHOR:Dr. Tim Langley is a chiropractor, economist and business owner.His practice, Langley Chiropractic Office is located in Marietta, Georgia is home of “The Membership Practice” which lets his clients limit the upside financial risks of chiropractic care.You can learn more about Dr. Langley at www.marietta-chiropractor.net or contact him at 770-289-9711.

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The Case for Cash – When Health Insurance Isn’t

Posted by Marietta chiropractor on February 23, 2007

Why in the world would you want to pay cash for health care instead of using your insurance?  Well, there are several reasons.  Let’s explore a few.

Probably the best reason for paying your doctor directly is lower insurance premiums.  These days, the trend is to go to the doctor (or the doc-in-a-box) for every little ailment or sniffle.  The justification for doing so is “I pay alot for my insurance.  I’m going to use it!”  In a backward sort of way, that might make sense.  And at the same time one person is using that logic, so are most other insured individuals and families.  Because insurance premiums are based on how much you use it, the more you (and everyone else) use you it, the higher your rates will eventually be.

Privacy.  Unknown to most Americans is an organization commonly referred to as the MIB.  No.  Not Will Smith and Tommie Lee Jones, the “Men In Black”.  But, the Medical Information Bureau.  At least 15 million Americans have files with the MIB that contains a variety of information ranging from prescription drugs you may have taken to different therapies you may have received.  Future insurers and employers could have access to this information just as they do with credit reports.  With estimates of erroneous credit reports as high as 40%, the potential for misuse or abuse of your medical history is very real.  This information is generally reported when an insurance claim is filed by your doctor’s office.

It can be cheaper.  It’s costly for the doctor’s office to file insurance.  Many have simply stopped offering the service in order to reduce their cost of doing business.  Instead of building practices around what insurance will cover, large numbers of practitioners from chiropractors to dentists, even medical doctors, are offering lower fees to patients that pay cash at the time of service or who prepay for their care.

Finally, better care.  By paying your doctor cash, you eliminate the temptation for doctors to offer “extras” just because your insurance will pay for it.  By paying cash, you make sure you get just what you need and nothing more.

To summarize, paying your doctor at the time of service or even prepaying for care will lower your insurance premiums, lower the cost of care, protect your privacy and ensure that you get the best care possible and only the care you need.  Ask you doctor about lower fees for paying cash or prepaid care plans.

Posted in Alternative health care, Finance, Health care, health insurance, Insurance, Uncategorized | Tagged: , , , , | 15 Comments »