- Before insurance there was more accountability. The patient paid and saw what I did. It allowed us to really function as professionals and allowed a market place. We couldn’t afford technology and if you got sick you were screwed. So we created health insurance which we needed but it took away accountability between doctor and patient.
- My major issue is pre-authorization is strangling me and my colleagues.
- The insurance companies do not want patients to live. They make more money if the patients die.
- More and more patients are sent out of state. They will find someone in network. They get referred to a physician who is not a specialist in that area.
- Totally. I don’t have patients, I have contracts the insurance companies and so do the patients and I am the middle man.
- Yes. The reason it has is because it is a struggle. The general public believes that as a physician you can negotiate with an insurance company. The general public doesn’t read EOB’s. The general public doesn’t realize that what you charge is not what you collect. Imagine. Going to your lawyer, having him charge you a thousand dollars so for a service and you telling him you are only going to pay $300 and he had to accept the fee. That is what it is like dealing with insurance payers. In the old days when insurance companies paid reasonable fees, Medicare was the outlier for being the lowest fee schedule. And physicians accepted this fee schedule as it was their duty. And because the other payers helped to even out the score. Over time the tables have turned and now Medicare which still remains a low fee schedule is now one of the best. And so doctors’ ability to provide charity to provide charity car has been reduced.
- Yes. They have too much power to dictate what I can and cannot do. This is disproportionate to their mandate. Their job is to provide the funds. They have too much power. They use this mandate, their interest is profits and any way they can increase it they can do it. Many physicians who are good people and do a good job have been penalized. Don’t paint everyone with the same brush.
- The pot is not infinitely deep but you have to be efficient and but the way that costs are being constrained is not efficient and it gets in the way of my relationship with the patients.
- We need to cut out the middle men, the insurance companies and put those billions back into the system. Half of the staff does case management and discharge planning and it doesn’t help the patients. The nurses are charting, not taking care of the patients.
- Yes. It used to be in the days of yore you provide the services you thought were appropriate. People were happy and there was no restraint. Now there are restraints via insurance companies willing to pay what they are entitled to and what we can offer.
- I think that the insurance companies are the problem. All of the third party payers have caused the price problem. No one can afford $2000 for an MRI. There is a complete disconnect between the cost of health care and the patient. The costs are uncontrollable. There needs to be tort reform. Too much defensive medicine. The doctors are just doing it to cover themselves. If you don’t do it and get sued, it’s an issue. I would make people who lose these cases pay the doctor.
- I am sick of the paperwork.
- I make occasional compromises on formularies.
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