A Little Bit About Insurance

Thyroid Disease
Thyroid Disease
January 5, 2015
New Technology Helps Relieve Pain
February 17, 2015
Show all

A Little Bit About Insurance

Health Insurance?

One of the most common questions we get from new patients is “Do you accept my insurance?”  They are under the impression that if we don’t they can’t come see us.  This could not be further from the truth! Our office offers affordable fees for patients with or without insurance.   We can check on your plan and let you know what coverage you have, including what your deductible and co-payments are.  The deductible is the portion of your medical care that you must pay out of pocket before the insurance pays anything.  After that insurance will pay a portion of the bill based on what your co-payment is.  The co-payment is the amount that you have to pay out of pocket every time you visit the doctor even after your deductible has been paid.  Most of the time our fees are less than people’s co-payments.

The media is filled with people talking about health care, health insurance, Obamacare, pre-existing conditions, etc. It can be a very spirited and contentious debate. But what does it really mean for the average person trying to earn a living and get decent medical care?

As a physician I have seen my patients’ insurance benefits go down and their out-of-pocket expenses go up each year.  When I began practice nearly 20 years ago, dealing with insurance companies was much easier, but even then the doctor I worked for, who had been in practice for nearly 30 years, was already talking about how insurance coverage was not what it used to be.   An insurance company is motivated by profit and that means maximizing the money coming in and minimizing the money going out.  Over the years they have found ways of paying less for services by either denying claims or by cutting the amount they pay to doctors for their services.   Doctors accept the lower fees because being on the list of participating providers drives more patients to their offices.  However, with lower insurance payments, doctors are forced to see more patients in less time. It takes time to listen to a person, find out what is wrong and more importantly what is causing the problem. It takes time to explain to patients how they should be making changes that will help them be healthier and prevent or reduce future health problems. And it takes time to prescribe the right treatment. Doctors are being squeezed and patients are at risk of being shortchanged while paying higher premiums. The quality of health care is being compromised at the benefit of the insurers.

Doctors are left with few options. Many are leaving private practice to work in hospitals, run by big corporations. Where once doctors would build their practices over generations often seeing parents and then their children and grandchildren and building caring relationships that last, now all too often they are over-booked trying to fulfill their corporate quotas and watching the clock. Many doctors who are unwilling to compromise patient care are choosing not to accept insurance anymore. These doctors provide quality care to patients who pay them out of pocket for service that they and their doctor agree is necessary without having to ask permission from, or be restricted by, the corporate insurance business.

We should all be aware of how changes in the insurance system are affecting the quality of our health care and we should ask ourselves: is this the kind of health care system we want?


Comments are closed.