patrick.net

Awesome, let's have more of these.

Their website is getting a lot of traffic, keep trying if you do not get a response.

zzyzzx says

Even with the loss of some patients, Ciampi expects his practice to perform just as well financially

Uh huh.

Wait a bit, he'll be on food-stamps. Mr. & Mrs. How-much-a-month maybe can scrape up $50 for an earache sure, but they won't be so crazy about paying for an MRI out of pocket. My brother is one the "just scraping by" folks who has very little insurance and tends to shop for cheapest and pay cash. So he finds the place that will let him pay off a few tooth extractions over an entire year. Sounds fine until you are the doctors office having to "finance" for your patients and chase them down when payments are late, or eat the loss when they don't pay up.

If you want to really save money, be your own doctor for basic problems.

zzyzzx says

Patients with an earache or strep throat can spend $300 at their local hospital emergency room

Bullshit, ERs in south Florida have a minimum of $1200.
They charge you $1200 if all you did was come in and register, got a quick triage where they check you blood pressure and temp, then tell you to sit in the waiting room. IF you leave before you are called, you can expect a $1200 doctor bill regardless. They get away with it, because everyone thinks that ER rooms are abused by the poor. The weird Irony is, the poor get ER visits for free anyway. So this abuse is abuse on people with real emergencies who have to pick up this unwarranted gouged out tab.

Just more stupid shit you would have expected a bill called the "Affordable Healthcare Act" would have addressed.

That being said, I've been saying since 2008 that is cheaper to go to an honest doctor and pay out of pocket than to be an insurance racket sucker.

Vicente says

but they won't be so crazy about paying for an MRI out of pocket.

Those are still less than the deductibles and copay with insurance.
My wife was seeing a doctor before we got insurance, X-Rays were %75, and an MRI was $300.

Vicente says

zzyzzx says

Even with the loss of some patients, Ciampi expects his practice to perform just as well financially

Uh huh.

Wait a bit, he'll be on food-stamps. Mr. & Mrs. How-much-a-month maybe can scrape up $50 for an earache sure, but they won't be so crazy about paying for an MRI out of pocket. My brother is one the "just scraping by" folks who has very little insurance and tends to shop for cheapest and pay cash. So he finds the place that will let him pay off a few tooth extractions over an entire year. Sounds fine until you are the doctors office having to "finance" for your patients and chase them down when payments are late, or eat the loss when they don't pay up.

If you want to really save money, be your own doctor for basic problems.

There are already tons of MDs that have opted out of the insurance network and they do fairly well - some of them provide super bills that you can send to your insurance to get some back but they are not affiliated with any insurance. Most of those who I have seen charge far more than this guy, but that is mostly the bay area so things are more expensive here. Also a lot of practices who do take insurance as well as hospitals can give you cash discounts of up to 30%-90%.

Vicente says

Wait a bit, he'll be on food-stamps. Mr. & Mrs. How-much-a-month maybe can scrape up $50 for an earache sure, but they won't be so crazy about paying for an MRI out of pocket. My brother is one the "just scraping by" folks who has very little insurance and tends to shop for cheapest and pay cash. So he finds the place that will let him pay off a few tooth extractions over an entire year. Sounds fine until you are the doctors office having to "finance" for your patients and chase them down when payments are late, or eat the loss when they don't pay up

Actually there are financing companies that do this, not the doctors' office.

mell says

There are already tons of MDs that have opted out of the insurance network and they do fairly well - some of them provide super bills that you can send to your insurance to get some back but they are not affiliated with any insurance

I am also pretty sure that this is the case, except I doubt that very many of them post their prices. I also think this is just a way to get you to do the insurance company paperwork and wait several months to get whatever back from the insurance company. Nothing wrong with that, I think at least some people would prefer to have that option.

Actually there are financing companies that do this, not the doctors' office.
^^^^^^^^^^^^^^^^^^
And like any other debt collector, they buy bad debts at a steep discount. Our maverick doctor is right back to collecting a fraction of the spend. It is like Jerry McGuire, without the cute girlfriend and deep pocket client.

Automan Empire says

And like any other debt collector, they buy bad debts at a steep discount. Our maverick doctor is right back to collecting a fraction of the spend. It is like Jerry McGuire, without the cute girlfriend and deep pocket client.

I am sure that some of that goes on, but I am talking about the type where you get a loan to pay the doctor or dentist directly and the doctor or dentist isn't in any way involved in the financing.

CaptainShuddup says

ERs in south Florida have a minimum of $1200.

I'm sure that almost everything else is cheaper in Maine than it is in South Florida.

sbh says

I saved a ton of $ on premiums over the last five years (after telling my ins co to fuck off)

So your plan if you get a major illness that has huge costs is what? Sponging off everyone else?

zzyzzx says

“If more doctors were able to do this, that would be real health care reform,” he said. “That’s when we’d see the cost of medicine truly go down.”

Alas Obamacare goes in the opposite direction, requiring everyone to buy insurance instead.

Vicente says

If you want to really save money, be your own doctor for basic problems.

That is also prohibited, and Obamacare makes it even worse than prior law by saying HSAs can no longer be used to buy OTC products without an Rx. If you really want to save money, go to Mexico, or Costa Rica, or some other country where the government doesn't increase the price of healthcare.

In housing, government props up prices by means that have been explained at length on PatNet (Fed, Fannie & Freddie, HAMP, FHLB, FHA, tax deduction for mortgage interest). In medicine, government props up prices via unfunded mandates (Rx) and subsidies for insurance. The goal is the same: higher markups mean more $ for politiicans' patronage networks (lobbying, revolving door opportunities, investment opportunities, advertising on commercial news, public relations, etc.)

bob2356 says

So your plan if you get a major illness that has huge costs is what? Sponging off everyone else?

Dude you don't get it do you. AINT NO FUCKING BODY GETTING HEALTHCARE when they got a major illness and can't afford their copay, coins and deds.
Open heart surgery will clean out your lifesavings, and on top of that. When you pull money from your 401K you'll be burdened with income tax on top of that.
Now explain how you plan on financing a major ailment under the current and the insurance system "Yet to be", and I'll fuck off, I'll even whistle while I do it.

People with no money in the bank and or bad credit, will DIE!

But make no mistake the IRS will make damn SURE they pay their monthly premiums for the whole family.

I enjoy these little non-stop articles that basically are trying to indicate: " See? Here's PROOF that ( name whatever democratic legislation) is wrong because I found someone who says so! So there!

Too bad. Obamacare is here to stay. And like most things conservatives are against will once again prove to me an invaluable program that proves to be of a great benefit to society despite all the counter-claims by the right.

It's still fee for service; that only gets you so far. It certainly does wonders for self rationing (which is needed), but does nothing to address preventative measures.

Vicente says

Wait a bit, he'll be on food-stamps. Mr. & Mrs. How-much-a-month maybe can scrape up $50 for an earache sure, but they won't be so crazy about paying for an MRI out of pocket.

He's a family doc, they don't do mri's, they just see office patients. The way it works with cash only docs, there are quite a few, is you pay cash and they give you a superbill for you to send to your insurance company. Expect to see more and more cash only.

edvard2 says

I enjoy these little non-stop articles that basically are trying to indicate: " See? Here's PROOF that ( name whatever democratic legislation) is wrong because I found someone who says so! So there!

Too bad. Obamacare is here to stay. And like most things conservatives are against will once again prove to me an invaluable program that proves to be of a great benefit to society despite all the counter-claims by the right.

Tell that to all the people who are now only working 30 hours per week.

curious2 says

If you really want to save money, go to Mexico, or Costa Rica, or some other country where the government doesn't increase the price of healthcare.

Mexico has universal public healthcare. That system is not dependent on employers and insurance companies, it's considered a right of citizens.

Vicente says

Mexico has universal public healthcare. That system is not dependent on employers and insurance companies, it's considered a right of citizens.

Mexico has a good combination. The government provides a universal public floor, as you've described. Individual persons can also buy private insurance if they choose, but they are not required to buy insurance. Many pharmacies also sell without an Rx, so anyone can buy what medicine they need without having to buy permission first. And, medical professionals charge reasonable fees, partly because they don't have to pay the AMA-driven accredited medical cartel in order to get licensed. (The AMA represents fewer than 20% doctors, but its lobbying dominates much of the medical sector, including the endorsement of Obamacare which most doctors oppose.) If you adjust for education, which remains the best predictor of longevity, they live about as long while spending 1/10th as much on medical.

Gee, just a couple things missing from the doctor's "price list":

MRI
Chemotherapy
Pacemaker
Heart transplant
Kidney transplant
Bone marrow transplant
Open heart surgery
Tracheotomy
etc.
etc.
etc....

Duh, gee George - we don't need no fancy insurance. We could just pay cash for everything.

Fucking simpletons...

Ear Cleaning $30.00
(flushing of ear to remove wax)

Murine earwax removal kit - $10 at Walgreens

Ear Popper $15.00
(use of ear popper device to clear blocked Eustacian Tube)

Plug your nose and blow - $0.

Cryotherapy $30.00
(freezing of warts, skin tags, and some pre-malignant skin lesions)

Compound W freeze kit: $16.99

Electrical Muscle Stimulation $30.00
(LaserTouchOne device applied to spasmed muscles to treat pain)

Bottle of Ibuprofen: $3

edvard2 says

And like most things conservatives are against will once again prove to me an invaluable program that proves to be of a great benefit to society despite all the counter-claims by the right.

You'll be against it to when you get your first $400 bill for that routine Doctor check up, that will follow after you already paid your office visit and thought that was the end of it. You know like it was before AHA.

EBGuy says

It's still fee for service; that only gets you so far. It certainly does wonders for self rationing (which is needed), but does nothing to address preventative measures.

Removing the idea of insurance from the transaction, shifts the risk assessment back to the consumer, rather thenthe lie that if you give the insurer gobs of cash, they will play capitalist for you and assess risk and price and value, to your own health, for you.

The majority of the crap that people glom under the label "preventative measures" is a bunch of bullshit, anyways.

If the government came out and apologized for the mistakes they made in creating the original food pyramid, and stopped subsidizing the fuck out of sugars, humans with a lick of sense would solve the majority of their "health problems" themselves

SBH, it sounds good on paper, but you still haven't addressed what would happen to you and your finances in the event of an unforseen, costly health event.

I am reminded of a former employee who was very pro tea party, chik-fil-A, and guns, and profoundly anti Obama, Obamacare, welfare, etc.

Her father (who she called Daddy when approching age 50, the man smoked like a coal locomotive) developed aggressive malignant cancer.

Suddenly she was spending half of each day on the phone to every agency, assistance program, charity, etc; gleefully spending other peoples' money without a second thought. All the while, the little Fox anti-welfare talking points kept slipping from her mouth unabated, like turds from an incontinent butt.

Before the cancer was discovered, the man looked ready to cack at any moment; it was a major undertaking to exit his minivan and walk 25 steps to the door. His prognosis was less than 1 year to live, but suddenly "to each according to his need" became an imperative, "each" being defined as "ME." Six figures were spent in 2 months on this guy.

CaptainShuddup says

You'll be against it to when you get your first $400 bill for that routine Doctor check up, that will follow after you already paid your office visit and thought that was the end of it. You know like it was before AHA.

So far there is little proof that the outcome your describe would actually occur.

The bottom line is that you really need to follow the money trail. Why would there be so many supposed "grass roots" organizations telling their followers to be against this plan? Because the corporations whom sponsor them want to keep on making bigger and bigger profits and therefor it is in their best interests to try and convince followers via their engineered grass roots organizations that nothing good will come of this. Its really and truly about money. That's all there is to it.

Likewise there have been many, many major pieces pieces of legislation from the past that were also pissed all over by outside interests.

sbh says

Cap'n:

My point is that I have the $ to pay for major medical costs and choose to forgo overpaying for insurance because we don't have a true marketplace for individuals like me. I estimate I've saved over 100k in premiums alone in the last four years.

You must be new here, basically you are parroting everything I have said since 2007. As a Family of 4 we never spent more than 2 grand on anything healthcare related all combined, from 1997 after our last kid was born, through 2007, when this idiotic debate even started.
We never had insurance, anytime we got sic and went to the Doctors we never paid more than $75 for the whole affair. We would just go to the Pharmacia and get antibiotics for a few dollars, again no insurance what so ever. Last year my wife had a run in with an ailment. And she got treatment all the way upto the point where we were referred to have an operation done. Again we were more than willing to pay out of pocket. It was set up for three weeks in advance, on the day I took her to have the procedure done. The administrators at the outpatient hospital, (Which every single one of those in South Florida are now owned by Memorial Hospital monopoly) they turned us away because they realized we did not have insurance.

These Clinic/Hospitals depend on surgery complications to raise the bill by as much as 500%, and since we were paying out of pocket. They couldn't see how they could distort an agreed upon operation for $1500 into a $35,000 emergency crisis. So they turned us away.

I realized then that if you don't have insurance and don't play their game, then you will die. So I got insurance through a company I contract for. And still ended up paying $1500 more out of pocket, 3 grand in total, for the operation. Which we had to wait another month for the insurance to kick in. In the meantime a serious growth was still growing inside my wife, that all involved agreed that it should have been removed months ago, when all of this was first diagnosed.

I got the Gold plan and was paying almost $1500 a month, and they still nickle and dimed us to death. In March I downgraded my plan to the silver plan and only pay about $380 a month now, but that $380 does dickall to cover any medical expenses. Our Doctor visits now (afuckingka Preventive Healthcare) end up costing us about 5 times more by time we get all of the never ending trickling bills for that one office visit where the Doctor had his lackey nurse draw our blood, and Googled the diagnosis.

I'm about ready to go back into the wild for my healthcare. Because it doesn't matter what health plan you have, if you don't have your copay. You can't get most treatments and you'll have to suffer.

I don't understand, how the Doctor refers us to specialist, we go, then our insurance company doesn't pay because they feel like it was some arbitrary test ran out of hypochondria. I suffer from a deviated septum, have a hard time breathing, and my snoring has me outcast from own bedroom some nights. If I want to get that fixed, I'll have to do it on my own dime.

edvard2 says

So far there is little proof that the outcome your describe would actually occur.

It's happening now, I'm your proof, have you guys even been to a doctor lately?
I bet not, you're probably healthy 20 something to 30 something males like I was and didn't need to see a Doctor for 20 years. So you just assume, it's still this kiddie magazine rack happy fun time place where the nurse gives you candy.

You'll see Kid, you'll see. You'll all see...
muha-ha-ha harrumph!

No.. I probably won't see. I am in fact in my mid-30's but have had a variety of health issues already. So far its been fine. Using your personal experiences to represent the whole isn't exactly a accurate assessment.

What people who have been against a government healthcare system from day one need to realize is that no- it won't be nor could ever be perfect. But what they need to be doubly aware of is why the law was passed for the most part anyway: To save taxpayers, corporations, and the government money.

A good example are some friends of our family. One of them had some serious health issues and for reasons unknown, did not have health insurance. They went bankrupt because the bills wound up being well into the 100's of thousands of dollars. Their home was foreclosed, their cars were flat bedded, and they had to sell their business for pennies on the dollar. One needs to take a look at what happens when someone goes bankrupt.

First of all the banks, car dealerships, and other capital interests tied to that family will take a big hit. They can only try and recover part of their losses via seizing assets worth much less than the amount owed. Secondly, this expense will eventually cost everyday private citizens money as well seeing as how that lost capital will come from somewhere else anyway. Lastly since that family now lacks purchasing power with ruined credit, they aren't going to be buying any cars/homes/ nice things for years, which in turn means they aren't contributing to the national economy.

There are also literally millions of Americans who go bankrupt WITH health insurance too. All because of the zillions of feet of red tape and weird policies enacted by various healthcare organizations over the years. Many parts of the healthcare plan will serve to put a stop to those measures which in turn will mean again- less bankruptcies.

In a country that runs on capitalism its important that your consumers can actually spend money and thus help grow the economy. If millions of Americans go bankrupt over healthcare then that's millions of people without strong means to contribute to that economy.

We're still under that system, and it goes into hyperdrive under AHA, unless you have some official documentation that proves otherwise.
Don't forget, BCBS Florida Blue, is a AHA approved insurance plan. As far as I've been able to tell nothing will change next year, but perhaps higher premiums, and possibly higher deds.

All of the official AHA articles only make claims to make healthcare more accessible to everyone. Which is a misnomer, it wont be healthcare, just more people with premiums. After Obama got elected the narrative on the AHA went from affordability to "Everyone will pay their fair share". The problem with that was, it was Insurance executives and Hospital execs and their Lobbyist, determining what a "Fair share" is.

Don't talk "Capitalists" boogeyman bullshit to me, I'm old school "Down with the man" living in a "99 percenter, against the 1 percenter" world.

Two different concepts all together. Us Down with the man, knew damn well who the man was. We certainly didn't need Warren Buffet and Michael Bloomberg telling us it's those other guys. When in reality is, we're all the 1%, every one who shops at big name retailers, buys online from the top traded companies, those of us who give these companies tens of thousands a year through our 401K contributions. These companies are people, not some Lord Vanderbilt Society prude, who has a 30 acre repository for every dollar being pulled from the economy and he's just keeping it for him self. It's the companies that own every thing in town and are the only game in town that are the problem. They wouldn't be possible if it wasn't for the 99% shopping there, and investing in those companies, arguing about the superiority of those products that are making them as powerful as they are.

If you aren't buying cellphones, clothes, food, cars, gas, electronics, from a company where the owner of the company is on location, then you are the 1%.

If it weren't for the 99% misleading the argument, we would have more Mom and Pop operations, the real employers, who pay more than chump wages, and don't dole out hours based on HR policy that circumvents the latest Liberal legislation of Labor laws.

Vicente:

I doubt he will be on food stamps. This cash-pay model is just that. You pay cash (or credit card, check, etc.) at the time of service and for the full charge. You don't get to wait to be billed. You don't leave without paying. And you do get to know what you will be expected to pay beforehand. And if you "don't have the money" you generally don't get service, just like most other professional services. If anything, the present system makes the doctor "finance" the costs of care, since he is eating overhead and waiting on an insurance company to pay, assuming they actually do pay. With the current high-deductible plans that don't have an HSA tied to the front end, the insurance company is selling a pricing club membership but paying nothing.

Unless this doc practices in a desperate area where no one has any money (doubtful, So. ME does well) he should do fine. Of course some patients will walk. You expect that. But enough will stay and he will likely pick up others without insurance who see the value in reasonable and fixed prices for cash on the spot.

edvard2 says

A good example are some friends of our family. One of them had some serious health issues and for reasons unknown, did not have health insurance. They went bankrupt because the bills wound up being well into the 100's of thousands of dollars. Their home was foreclosed, their cars were flat bedded, and they had to sell their business for pennies on the dollar. One needs to take a look at what happens when someone goes bankrupt.

Yep, and Captain Shuddup, you are lucky as shit. That could easily have happened to you. You gambled on your family's future by not having health insurance, all the time clucking about how much money you were "saving". Then when the shit hit the fan, you lucked out and were able to get insurance AFTER you found out there was a major illness in the family. Well a lot of people weren't that lucky, couldn't get insurance, and went bankrupt.

Any kind of system where people are expecting to pay nothing when they feel good, then opt in when they get sick, doesn't work. Period.

sbh says

And if we could only get Americans to give a damn about their health (as opposed to the remedies to their poor health), especially those bro-pappy southern states, we might become as healthy as Europeans.

You know what would help? If a salad didn't cost MORE than a hamburger.

Finally some goddam facts!
http://www.huffingtonpost.com/2012/07/31/affordable-care-act-no-copay-rule_n_1724167.html?utm_hp_ref=kathleen-sebelius

Now let's review them shall we?
You folks playing at home click on the link and play along...

I've highlighted the best of the best as to what AHA does, there are not assumptions or suggestions that state otherwise...

"2. Some plans can stick with the old rules, for now
Certain insurance plans (those that have not made "significant changes that reduce benefits or increase costs to consumers" since September 23, 2010) can still abide by older rules governing preventive care costs; more general information about these "grandfathered" plans is available here."

Yay Change! Well maybe not, but all of the preventative hc will be covered right?

"4. Not all appointment costs are covered
The new measure doesn't mean your doctor appointments will all be free. Coverage is only guaranteed if you go to a network provider, and the Department of Health and Human Services points out that you may need to pay additional fees "if the preventive service is not the primary purpose of the visit, or if your doctor bills you for the preventive services separately from the office visit.""

That's what I've been trying to TELL you PEOPLE!

"5. Plans may charge cost sharing for branded drugs
The Department of Health and Human Services notes: "Plans will retain the flexibility to control costs and promote efficient delivery of care by, for example, continuing to charge cost sharing for branded drugs if a generic version is available and just as effective and safe.""

In other words if a generic dodickall brand is available then that is the drug you will have to buy or pay out of pocket.

6.Contraception well OK the Dems sure fought hard for it.

"7. Covered: Well-woman visits
The new preventive care measure provides for a "well-woman preventive care visit annually for adult women to obtain the recommended preventive services that are age and developmentally appropriate, including preconception and prenatal care." The visit may include other preventive services, and "HHS recognizes that several visits may be needed to obtain all necessary recommended preventive services." (via U.S. Department of Health and Human Services)"

Better not find something, you'll get the biggest hot potato run around since the invention of the Short Sale.
But sure, a good look "Down there" is covered and is free, just not what they find, of course!

"8)Breast feeding supplies, OK really? I don't care really, I just don't get whey frivilous crap like breast feeding supplies would be covered, but other more serious ailments and procedures aren't covered as well. Especially when it comes down to it, all that is needed is a titty, a nipple and a suckling baby."

"12. Covered: HPV testing
Plans will fully cover "high-risk human papillomavirus DNA testing in women with normal cytology results," beginning at age 30 and "occur[ring] no more frequently than every 3 years." (via U.S. Department of Health and Human Services)"

OOOH that's a nasty one, but can't get checked for it no more frequently than 3 years. It can turn into stage 2 Cervical Cancer in that amount of time. This is very dangerous condition, and develops into Cervical cancer and kill 10's of 1,000's of women a year. They'll give you a DNA test to tell you if you should be careful to watch out for it, and give a screening once every 3 years, but you better not have hpv cn1, cn2, or cn3
or you'll go through the hell my wife and I endured. It was a 3 month saga and we had the cash to have a leep performed but Memorial Regional was having none of that.
And we got a 3 grand hospital bill, after we got GOLD insurance...

YAY AHA!!!!

They should call it Health Insurgence.
My spell checker is smarter than you people.

My honest posts scare the shit out political schills that's why they dislike my posts.

Plastic surgeons that do cosmetic procedures make 1-3 million a year and none it comes from insurance. That's an extreme example, but it's also a wake up call for other physicians that could benefit by free lancing.

CaptainShuddup says

Finally some goddam facts!

You wouldn't know a fact if it bit you on the ass.

Your article is 10 months old and it only deals with a few issues with regard to some of the benefits that specifically apply to women. You've never had any interest in understanding ACA; why are you all of a sudden posting this shit?

sbh says

Cap’n, tell me if I have the summary correct.

Basically any test or procedure where the doctor has to touch your junk, is covered. But all else you'll have to pay for.

Homeboy says

CaptainShuddup says

Finally some goddam facts!

You wouldn't know a fact if it bit you on the ass.

You fucking brain dead simpleton, find me some facts where AHA lowers people's out of pocket expenses, or where it says, it will pick up the tab for those who can't afford them?