If you have medicaid, no Dr will see you. Why don't you pay up out of pocket?

[Dr McSteamy]

http://www.msnbc.msn.com/id/32127373/ns/us_news-the_elkhart_project


stuff we already know. Dr's hate medicaid. it's a ripoff, and most don't accept it.

so people like this girl, whose hair is falling out, have to go to remote corners of the world to see a dermatologist who will take medicaid.


but the other side of the issue is, why are people so cheap?
They are willing to spend absolutely zero dollars max on health care.

you only see the doctor maybe once or twice a year. Why not just pay the cash, and stop inconveniencing yourself driving 200 miles to see a derm who will provide your free health care.....

if the doctor won't take you because he gets 40% less from medicaid, just pay him the 40% extra, and stop buying so much fast food with your poverty money.

---

Members don't see this ad.

 

[Instatewaiter]

I am not positive but I think that a doctor is not allowed to charge anything on top of what medicare/medicaid pays him/her. I think it's illegal.

Someone correct me if I am wrong.

 

[physasst]

http://www.msnbc.msn.com/id/32127373/ns/us_news-the_elkhart_project


stuff we already know. Dr's hate medicaid. it's a ripoff, and most don't accept it.

so people like this girl, whose hair is falling out, have to go to remote corners of the world to see a dermatologist who will take medicaid.


but the other side of the issue is, why are people so cheap?
They are willing to spend absolutely zero dollars max on health care.

you only see the doctor maybe once or twice a year. Why not just pay the cash, and stop inconveniencing yourself driving 200 miles to see a derm who will provide your free health care.....

if the doctor won't take you because he gets 40% less from medicaid, just pay him the 40% extra, and stop buying so much fast food with your poverty money.

Yeah, cause poor people spend SO much money on fast food....You've obviously never been poor.

Try hamburger helper and ramen noodles. I know, I lived off of them for 6 months after getting out of the military.

 

[deleted6669]

it's true there are folks who can afford healthcare/meds, etc but decide to spend it on cigarettes/alcohol/cell phones/cars/etc like the 55 yr old guy I saw today who is a chain smoker with htn and cad who says he can't afford his asa and atenolol for 5 dollars/mo at walgreens yet spends that easily on cigarettes every day. I said, fine, keep smoking, skip breakfast once/week and buy your meds because they are the only thing between you and a major heart attack next week....I think that might have shaken him up enough....we'll see....
but there are also folks who legitimately don't have 5 dollars for each of their meds or 40 bucks for a pcp visit because they have 600 month total which goes to rent and food. that means "discretionary spending" buys things like a new pair of pants and some underwear once/yr.
also consider that very few pcp visits are really only 40 bucks. that gets you in the door and gets you an exam. what about an ekg, cxr, lipid panel, baseline chemistries/tsh, lab draw fees, radiologists overreads, etc etc? pretty soon your little 40 dollar visit is looking more like 100 bucks....I have great insurance and just spent close to 500 dollars out of pocket for a single visit to an after hours urgent care center(not er) for evaluation of an extremity injury in a family member(we had not met our yearly deductible yet). that's a 15 min visit, 1 extremity xray( 3 views), a splint and a sling. pretty ridiculous. we paid our visit copay up front and kept getting bills for xray rads over reads, additional fee for ortho phone consult(apparently this isn't covered by the copay) which amounted to:
"hey dr smith, look at this xray on your pacs system, do you think this is a surgical fx?
"no, outpt management should be fine".

 

[deleted6669]

Try hamburger helper and ramen noodles. I know, I lived off of them for 6 months after getting out of the military.

you got hamburger helper?...hey you lucky dog!
when I was in medic school it was top ramen and heinz vegetarian beans and living in an apt with no hot water and a neighbor who threatened us when we asked him to turn down his stereo at 2 am.....good times.....and my piece o' crap 12 yr old junker(toyota celica) that ate all my extra money in repairs.....I used to sleep in that car when I went to ems conferences to avoid having to get a hotel room....being on call most nights for a dollar/hr as an emt-basic was lots of fun too....our system ran 911 with the full time crews and "routine" transports were on call folks. so not only was it a buck/hr, EVERY call after midnight was bs.....if it's "routine" why can't it wait until 8 am?

 

[MOHS_01]

I am the ONLY derm who sees medicaid patients around here. Patients drive over four hours to see me sometimes -- for things their PCP should have been able to diagnose and treat. While I have largely limited my practice in other ways, I cannot punish the kiddos for their parent's issues -- which is what I feel like happens when people refuse to see pediatric MA patients.

MA pays for ****. While it varies from state to state and according to the CPT series, it is horrible for my specialty. From a business standpoint, I would be better off paying the patient to see someone else and booking their slot with a paying patient. Their no show rate approaches 40% -- and that is with reminder calls the day before. It is a practice killer, financially.

I'm not sure how much longer they will be able to sustain the system on guilt or altruism....

 

[docB]

I'm not sure how much longer they will be able to sustain the system on guilt or altruism....

The guilt and (misplaced) altruism is pushing us into a whole new system that will likely be sustained by the destruction of the country.

 

[Regnvejr]

Around here, if you are on Medicaid, you're luckier than most. About 30% of my practice is self-pay because everybody else ignore these patients. I get patients from the entire state. Needymeds.com is my biggest friend. My patients and I will see it as a big step forward to get the Government involved in universal coverage and kick out the insurance companies who have made it their business to deny coverage. They had their chance and they failed; I'm fine with kicking them to the curb.

 

[RGMSU]

Second to what physasst said. Yeah, most folks can afford an office visit every once in a while. There are a lot of people though who can't afford a procedure that costs thousands even when they desperately need it. You don't have to be "poor" to fall into this category either. Being dependent on paying out of pocket for healthcare is a bad idea for about 95% of people in the real world, especially if you actually get sick chronically, which of course is difficult to predict.

 

[Medgskl]

It is illegal to pay OOP if someone has medicaid.

 

[VA Hopeful Dr]

It is illegal to pay OOP if someone has medicaid.

Only if you are a medicaid provider. Drop that and you can very much take cash.

 

[DrMason]

Three years ago, I stopped practicing full-time and opted out of Medicare and Medicaid at the same time. Otherwise, this is nothing to think about for most residency grads of today. Most enter groups, where the RVU's are same for all policies. At these places you cannot choose out MC/MA and the payback is hospital getting money directly from government.

From that time, I only did part time some cosmetics (Botox, Fillers), hormones (T, E, HCG) and selective stress tests, self pay.

Before you charge anyone cash, you must have opted out of Medicare and I would also advice to leave out of MA. When you advertise services and make clear it is direct pay, onl those who agree will show.

Working two days a week along with starting up our stone mason company and I easily made more money than the years I was on Q4 call and Q7 weekends; mon-Fri and chart time. I probably work less than half as much.

Unless you work for yourself you WILL likely have to accept what they tell you to. And going private and trying to make money on insurances these days is getting harder and harder.

Otherwise, high-deductible policies and HSA is something that would work. Politicians and insurance companies hate that, because it would strip them of power. If you are a physician feeling good about Obamacare, you are either a corporate slave or not quite truthful..