… once respected, independent professionals, doctors and pharmacists in the employ of their Private Equity overlords are now merely “hired hands” expected to work uncompensated overtime in support of Management goals.
Hey, you guys have been voting for this nonsense since 1980.
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They can always quit and form their own organizations.
Especially the doctors are not powerless.
“The way the system is going, I didn’t see any other solution legally available to us,” Dr. Wust said.
I get he is extremely educated but good grief Charlie Brown average people need more support from you than you give them if suddenly you are figuring it all out.
Not if their Private Equity overlords own the exam table, the stethoscope, with a non-compete and confidentiality agreement to boot.
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Therein lies the problem for the private equity owner. Non-competes generally only work within a certain distance from the former employer. As doctors and pharmacists are well paid, they can move beyond that distance to a new location and then generally do as they please.
Unless corporate structure is the only show in town, county, state (maybe the last is a bit of a stretch…for the time being) Meet the new boss…same as the old boss.
For sure, health care professionals have plenty of autonomy. Theoretically. If they don’t have to generate income. How many patients would flock to the doors of say, a primary care physician, even, let alone a specialist, who decided to listen to what their patients claim to want…time with the doc and no insurance/Big Business intrusion? In practical terms, paying their provider directly for their time and deal with insurance companies themselves (includingany denial of a claim.
You would be amazed how many folk choose to believe that the amount paid by their insurance company is what the cost of their care ought to be or even…get this … that if their insurance company doesn’t pay, it’s somehow a cost that shouldn’t have been charged for in the first place.
Interesting article in NYT’s The Daily (also available as a podcast). Many doctors absolutely loathe their jobs because their corporate overlords won’t allow them to actually care for their patients.
Some years ago, a psychiatrist named Wendy Dean read an article about a physician who died by suicide. Such deaths were distressingly common, she discovered. The suicide rate among doctors appeared to be even higher than the rate among active military members, a notion that startled Dean, who was then working as an administrator at a U.S. Army medical research center in Maryland.
That’s what I like about Medicare. The doctor has to tell you up front if the procedure he’s recommending is covered by Medicare or not (i.e. Advance Benefit Notice) If he doesn’t warn you it may not be covered, he doesn’t get paid.
Few Americans can afford to pay for ineffective health care at unlimited price gouging rates.
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Well, here you have it…the assumption that just because a third party payer (Medicare, employer provided group health plan…or some iteration of “socialised medicine”), the health care is automatically ineffective or unnecessary.
That’s another reason physicians are so frustrated with trying to provide optimum medical care for a demanding population. Add in the automatic assumption that fees are what they are because of the of price gouging, I could see why someone with a commitment to doing their best for their patients with these attitudes so prevalent would sit in their garage of a Monday morning with their car engine running and a hose from the exhaust venting into where they’re sitting rather than driving off joyfully to another week of the same ole.
No. Medicare approves procedures based on good medical practice, though I’m sure some doctors disagree. For-profit insurers are denying payment for procedures that Medicare would cover about 13% of the time. You have to fund excessive Executive Compensation somehow. The financial interests of your $30 MM/yr health insurance CEO are directly opposed to your’s as a patient.
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I don’t have a problem with a doctor telling me “I think you need this $5,000 procedure, but your insurance doesn’t cover it. What do you want to do?”
The problems are caused by doing the procedure anyway, having the reimbursement denied, with the patient now stuck with a $5,000 bill for healthcare that hasn’t resulted in any measurable improvement in his health. You can quickly go bankrupt if that’s happening very often.
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Whilst that’s true for MA plans, if that’s the comparison you’re choosing for “for-profit insurers”…but it’s not automatically a given with employer-provided group plans. Depending upon the plans offered by an employer/chosen by employee, someone who elects just the bare bones trad Medicare with no supplemental insurance coverage would most likely see significant gaps in coverage.
This is what a good many folk on the consumer side of the counter don’t realise when comparing plan costs (to them) and covered benefits. Every insurance plan is different when it comes to levels of rebursement and procedures covered…and oftentimes these are determined by the prevailing trends in a given community.
Seriously…how much should an office visit cost? One thing that third party payers don’t take into consideration is how much does it cost to provide the care the consumer claims to want. Heck, I couldn’t put an exact dollar amount on what it cost to provide the dental care I was responsible for offering…but I made sure I didn’t tailor it to what a third party payer felt was appropriate.
Which is the exact reason the employee doctors formed a union.
There’s no way for an employee to compare employer provided health plans. They won’t tell you up front how much a procedure costs and how much the insurance reimbursement is. Proprietary information (Medicare does provide that info up front.)
I don’t know what you mean by “bare bones trad Medicare with no supplemental insurance coverage”. The medical procedures covered are the same whether you have a supplement or not. The only issue with the supplement is who pays the 20% co-pay and low large your annual deductible is. With the insurance company denials, many people are now correctly seeing Medicare Advantage as inferior coverage – despite the Silver Sneakers gym membership. { LOL }
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If a doctor accepts the Aetna insurance plan, as a patient I’m assuming he’s OK with the Aetna reimbursement rate. There’s no way for me to calculate what an office visit should cost.
Same thing with Medicare. There’s no law requiring that doctors or hospitals accept Medicare, but the vast majority do – like well over 90%.
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