Physicians Thinking of Eliminating Middle Men

It was recently reported that many physicians are thinking about being directed paid by patients, cutting their bills by at least 40 percent. Now, think of how much more of a price cut we could have by eliminating mandates and regulations.


Wow, what goes around comes around. Physicians were responsible for the creation of insurance companies in the first place, because they didn’t want to have to deal with billing their patients!

Here’s a quote from an article on the topic:
“What we recognize as modern medicine, Cohn writes, began in the 1920s. That’s when doctors and hospitals, having only during the previous decade learned enough about disease that they could be reliably helpful in treating sick people, began charging more than most individuals could easily pay. To close this gap, which worsened with the advent of the Great Depression, the administrator of Baylor Hospital in Dallas created a system that caught on elsewhere and eventually evolved into Blue Cross. The Blues were essentially nonprofit health insurers who served local community organizations like the Elks. In exchange for a tax break, Blue Cross organizations kept premiums reasonably low.”

And here’s a link to the article on

Yes, Dori, you are right, what goes around, comes around. Low prices=compassion for the health care consumer.


[QUOTE=Dori Schatell;18961] That’s when doctors and hospitals, having only during the previous decade learned enough about disease that they could be reliably helpful in treating sick people, began charging more than most individuals could easily pay.
And here’s a link to the article on[/QUOTE]

Looks to me we would be back to the problem we started with. I suppose I might hear it about Health Savings Accounts and catastrophic insurance. However, a lot of people are having enough of a problem saving already for one thing, paying for care is a disincentive to get preventative care, and I’m not ever going to trust the tender mercies of a health insurance company.

I’m with you, Plugger. This nation keeps forgetting that what we need is health care, not health insurance. A multi-billion dollar industry that funnels hundreds of millions into lobbying has hijacked the entire debate. The whole point of insurance–as you noted in a different thread–is to take in more money than you pay out (while offering a profit to investors). The only ways to do this in healthcare are to:
– Not take sick people
– Take sick people, but don’t actually pay for any care
– Jack up the premiums to cover your lobbying expenses

Since this has been a banner lobbying year, I wasn’t too surprised when our office’s health insurance premiums went up 21% for next year. <Sigh>

The answer isn’t about insurance companies. A REAL answer, that might improve outcomes, would involve getting rid of insurance companies entirely. But since they’ve bought Senators and Congressmen, that’s not going to happen.

They have a hard time saving for medical expenses because they are being taxed to death. Before Medicare, a gall bladder operation was $170. After Medicare, the expense jumped to $3000.00. Health insurance is not supposed to be for every small issue. It is used to protect assets and life savings.

Where did you get your data on gall bladder surgery? When you throw out numbers without sources, it makes your argument less believable.

On page 6 of this source the cost of gall bladder surgery is listed from 1950-1983. It says that the cost of gall bladder surgery in 1965 was $803 (not $170 as you say). Medicare came into being in 1966. The table doesn’t provide the cost of gall bladder surgery that year but states In 1968 it was $1150 (not $3,000 as you say).

To keep costs in perspective, you have to also look at wages. In 1966, the year Medicare took effect, the average wage was $4,938.36. In 2008 the average wage was nearly 10 times that at $41,334.97.

If you want to find out how inflation has affected the cost of any goods or services, you can find a calculator on the Bureau of Labor Statistics website.

I don’t think any sane person would argue that Medicare is the cause of increased costs in healthcare. Most providers believe that Medicare pays too little for what they do. However, I’m glad that there is a Medicare program to pay for dialysis and transplantation and that there are so many providers that accept Medicare. Without Medicare, millions of people who were not well insured and/or wealthy would have died between 1973 and now.

And before you say that providers are going to drop out of Medicare to start “concierge” practices, there are only a limited number of Americans who can afford to pay the full cost of their healthcare. More could probably afford to pay an extra fee to have more time with their doctors and maybe that would make those doctors and patients happy, but what about those who are unfortunate enough to not have big bank accounts?

Data is limited on the number of these practices, but they’re mostly on the East and West coasts and dialysis or transplant patients are not prohibited from using them.

First, the reason that people cannot afford their medical expenses is because of mandates and regulations instituted by politicans to win votes from special interests. You state that many on dialysis would have died between 1973 and 2009, how do you know that when it did not happen? Quite honestly, I think health care is way, way overused in the United States. In addition, wage numbers can be easily distorted by having excessive numbers of individuals at the very low end or at the very high end of the scale. I am going to take some time to read the numbers and I am going to have some Chemists look at the numbers, also, to make sure I am correct.


I know that many people would have died if Medicare had not been extended because they were dying before and that’s why their loved ones lobbied to get Medicare extended. Do you honestly believe that over half a million people would be dialyzing today if there was no government supported program of health insurance for people with ESRD? I don’t.

If you think healthcare is way overused in the U.S., where are your data for this? Do you think dialysis is overused? Do you think people are on dialysis who don’t need it? If so, where are your data for that? Or do you think that some people that are on dialysis and who could not survive without it should be allowed to die? Who would you suggest tell them (or their families) that? What criteria would you use for who should get dialysis? Would only young working age Caucasian males with good finances or good insurance get dialysis like history tells us were offered dialysis most often before Medicare was extended to those with ESRD? I agree that some people overuse hospital ERs – some who don’t have health insurance to see doctors – but there are many people who don’t see doctors for years even if they do have health insurance.

Why would you ask a CHEMIST to look at numbers – What numbers are you suggesting that a chemist look at? If you’re talking about financial figures, why not an accountant, an economist, or an actuary? If you want to see ESRD data, the USRDS is the most complete data source we have right now.