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eileen's avatar

I bet this explanation can knock out 90+% of the diseases in the diagnostic codes used by insurance carriers. Imagine people, if they knew, dropping their full coverage to just major medical, much of which are paid by auto insurance carriers. The pot would boil over. Major medical makes sense. Full coverage is fear based and a huge factor in driving up the costs of medical care.

Peer to peer payment for a doctor's time and materials would be a lot less expensive and get rid of all these middle men (or women) each taking their cut of the insurance dollar. The doctor may get as little as $.15 out of the dollar. In a $100,000 bill, $15,000 is a lot of money. But what if out of that $15,000, $7500 went to overhead, including billing specialists, and the necessary personnel that the doctor needs to carry out the procedure. So in a peer to peer system, you may pay the doctor $10,000, and out of that comes the cost of doing business. So the doctor may very well get more money. But even if it is the same, the overhead is a lot less and people won't be paying several hundred dollars a month to a big nameless entity, the bottom layer being nothing more than a collection agency, hmm, like the IRS. And the doctor would be free to treat appropriately including telling you to go home and take 4g of Vitamin C and come back if that doesn't work, instead of automatically prescribing a poison because that is the only way the said doctor can be paid.

We all blame the doctors for the breakage of the health care system, but how many of them are frustrated because the standard of care dictates that they do first X, then Y, and finally Z, when the doctor knows full well from his clinical notes that none of those will work. Who sets the standard of care? Oh yeah, that nameless entity that masquerades as health care experts, that we pay hundreds of dollars a month to only to be denied a procedure that the treating doctor thinks is the best.

Laura Hayes's avatar

An excellent and needed article to counter the propaganda, thank you!

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