Alchemist wrote: 
My PCP is leaving private practice for a hospital job.  He is citing similar reasons.  The main difference is that where you wrote "government mandates", he's saying "insurance company antagonism".

The only new government mandates that I can think of from the last decade is HIPAA.  In this age of personal information for sale, HIPAA is well worth the extra work.  But since deregulation, insurance companies seem to serve nobody but themselves.

I want assurances that Medicine is being practiced by skilled, qualified people, and not hacks and poseurs.  I want insurance to be an equitable business relationship, not a hostage situation.  I want my practitioners to see Medicine as a higher calling, and not as the road to riches.

I know that a freshly-minted MD who isn't independently wealthy has a huge tab to pay off.  Maybe that's part of the problem too.  IMHO education is the single best investment that any person or nation can make.  I believe that the society that makes access to knowledge proportional to one's ability to learn, and not one's ability to pay will see a return on investment that far beyond the monetary amount.

 BlueHeronDruid wrote: 
Does she also charge an annual "subscription" fee?  The "boutique practice" I referred to earlier works as you describe, also charges an annual fee of up to $15,000, depending on the level of service desired.  Hospital and prescription costs are not included.

 Alchemist wrote: 
This is why my physician (and friend) practices without a net. No insurance accepted. Meaning: she can spend time and attention with her patients (who can afford to pay up front) and have only an office assistant. Her practice is growing - but not among Medicare recipients, as you'd imagine. One schedules appts. with her by the quarter-hour or more. Our insurance pays a bit towards this. But her attention is priceless. 

 Alchemist wrote: 

It kinda makes you long for the good old days, like 1941.  My mom told me my birth cost my parents $14.

(and that was one of the more expensive vets.) 

My wife is a physician, and I hear no end of the ever increasing paperwork and government mandates that interfere with her ability to help patients.  She says if she had known back in college how bad things would get she would have chosen a different field (and this is from a tireless patient advocate).  She read Hillary's entire health care reform screed and noted not a single clinician (a doctor who sees patients) contributed!  

The government has screwed up medicine, and it will only get worse if they seize more control.

 bokey wrote: 
That's comparable (times 2) to what we pay, and for what it's worth to us, I guess it's warranted.  I think I said this before, so stop me if you've heard it - my last procedure at Stanford was an outpatient thing.  Into the OR at 8am, on my way home at 1pm.  I still don't know how they justified charging almost $47k for that, but it only cost me something like $213.  And because of it, I get to live for a few more years.  I guess I shouldn't complain.

 OlderThanDirt wrote: 
  My dad  pays a little under $300 a month for medicare and Aetna as a supplemental, but he was an uber geek for  defense contractors during the glory days of retirement funds and has some crazy benefits, the likes of which no American will ever see again. I don't know what the same coverage would cost some guy trying to scrape up the payments out of what is left of his IRA.

 ScottFromWyoming wrote:
Wouldn't surprise me. 

OlderThanDirt wrote:

 bokey wrote: 
There are many doctors in our area who will not take new Medicare patients, even those with private, supplemental "Medigap" policies.  L's doctor left the group with which she had practiced for several years to start her own "boutique" practice.  L discovered that finding a new doctor that would take her was not easy, and practically impossible without the supplement.  Our cost for the supplement plus Medicare part B is about $650 per month.  Makes me wonder what all those MC deductions from our salaries are being used for.

 rosedraws wrote: 
 It's abused by doctors and is difficult for the elderly to understand.

 It's far from perfect, but is a heck of a lot better then the VA , IRS or SSA in my experience.

ScottN wrote:
This is so well said.

My questions:

- Isn't Medicare a totally successful program?

- Is it really not feasible to run a National Health Care that way?

- What are the current costs to the government, brought on by the uninsured?

sherbeari wrote:


Thanks. My pharmacy checks for generic substitutes already. Of course none of mine are generic yet. I'm not hurting THAT bad yet, it's just one more straw, y'know?

c.

 cc_rider wrote:

 

There is very select list of generic prescription drugs that you may be able to fill at Walmart and Target for $4 each. If you have trouble paying, "needy meds" may be able to help. If you live in CA, you can also get a "California Rx card" .

Just thought I would throw that out there for you.

 cc_rider wrote:



 
 It's a great system they have.  " They" add the shit to our food that clogs our arteries and pollutes our bodies, then "they" charge us astronomical amounts to fix (or better yet, control) the damage  if we want to live .

bokey wrote:

I am planning to leave my current employer in a few months, maybe less. It is very likely I will just go 'bare' for the foreseeable future. I will TRY to put money aside, maybe create another account for the purpose, but I will have $200-$300/month prescription expenses without insurance. Still, it'll be a fraction of what health insurance would cost. My employer pays all of it right now, which is a huge reason I have not had a raise as long as I can remember.

I have arrived at the conclusion health insurers are some of the worst bunch of crooks ever to come down the pike. Besides the brain trusts in Washington, of course.

c.

Health care just keeps getting more and more out of reach for average Americans.
.

Prescription Data Used To Assess Consumers
Records Aid Insurers but Prompt Privacy Concerns
By Ellen Nakashima
Washington Post Staff Writer
Monday, August 4, 2008


  "When an insurer makes an online query about an applicant, Ingenix or Milliman's servers scour the data and within minutes or less return reports to a central server at the company. The server aggregates the information going back as far as five years, including the drugs and dosages prescribed, dates filled and refilled, the therapeutic class and the name and address of the prescribing doctor.

Then comes the analysis.

Ingenix's MedPoint tool provides insurers a "pharmacy risk score, " or a number that represents an "expected risk" for a group of people, such as 30- to 35-year-old women who have taken prescription drugs, Stenson said. Higher scores imply higher medical costs. "
  (click here)