Here's how to make healthcare affordable... the future of medicine?

[Kaotic]

Check out the prices of this cash-only, no insurance, price-displaying business model. $350 for an MRI vs. $2,611 national avg.

I love the idea but I wonder about the level of service, the doctor/clinician's salary/income vs. a traditional doctor's practice and the sustainability of this business model. Regardless..this is how healthcare should work...



An antidote for Obamacare: Cash only medicine with transparent pricing and no insurance — the future of medicine?

https://goo.gl/YZjwi8

The Clinica Mi Pueblo clinics offer “general medicine services at the most affordable prices possible” and that claim is supported by the very affordable prices listed above. For example, the national average cost for an MRI is $2,611, but only $350 at the clinic. The median national cost of a colonoscopy is $1,626, but only $450 on the price list above. The US average “fair” cost of an ultrasound is $263, but only about half that amount at the Clinica Mi Pueblo.

How does Clinica Mi Pueblo offer these medial services at the “most affordable prices possible”? Here’s how: the clinic operates on a cash-only basis, with transparent prices that are listed both on the clinic’s website and on the wall at each clinic. Further, the clinic accepts no insurance, and it will not submit insurance claims on patients’ behalf. If patients have insurance, they can easily take the paperwork the clinic provides and file an insurance claim on their own. Reducing the costly, time-consuming mountain of paperwork associated with insurance, Medicare and Medicaid is one of the main reasons that cash-only medical clinics can keep their costs down and prices so low and affordable. That’s the same business model that keeps surgery costs so low/affordable at the Surgery Center of Oklahoma, the “free market-loving, price-displaying, state-of-the-art, AAAHC accredited, doctor owned, multi-specialty surgical facility in central OK” that has been featured on CD many times over the years.

So how does the cash-only, no insurance, price-displaying business model of the Clinica Mi Pueblo compare to medical coverage under Obamacare? Well, deductibles for individuals enrolled in the lowest-priced Obamacare health plans will average more than $6,000 in 2017, and families enrolled in bronze plans will have average deductibles of more than $12,000. Importantly, the deductible is the amount of money patients must personally pay out of pocket for health services before Obamacare insurance policies covers any medical costs. And what about the monthly Obamacare premiums? A 40-year-old unsubsidized bronze Obamacare plan patient will pay slightly more than $350 per month this year for their “health coverage” with a deductible of more than $6,000. And that’s supposed to somehow be “affordable” health care? In contrast, spending $350 per month out-of-pocket at Clinica Mi Pueblo, instead of going toward an Obamacare plan that provides almost no actual medical care, would actually purchase quite a lot of actual medical services.

[cyberswede]

1. American Enterprise Institute? please.

Founded in 1938, AEI's stated mission is "to defend the principles and improve the institutions of American freedom and democratic capitalism—limited government, private enterprise, individual liberty and responsibility, vigilant and effective defense and foreign policies, political accountability, and open debate".[4] AEI is an independent nonprofit organization supported primarily by grants and contributions from foundations, corporations, and individuals.
https://en.wikipedia.org/wiki/American_Enterprise_Institute

[Demsrule86]

2. Seriously?

Have you ever watched botched?

[Demsrule86]

3. This is a right wing source...you should self-delete.

It is total bullshit too.

[Kaotic]

5. Clinica Mi Pueblo has generally good reviews on Yelp..

not perfect but some happy customers...

How is it bullshit?

https://www.yelp.com/biz/clinica-mi-pueblo-wilmington

[WinkyDink]

8. Let's see them do some Memorial Sloan-Kettering level cancer treatments, and ask their prices, OK?

[Demsrule86]

16. Really?

How much they charge for chemo or hospitalization? This is bullshit.

[Kaotic]

20. They are a clinic...not a hospital

It's not a full service medical center. They have limited services which probably helps keep prices down. The clinic is not affiliated with AEI...why the hostility?

[Jake Stern]

17. Truth be told:

Because there's some bizarre stigma on DU that seems to suggest that doctors that don't take insurance must be back alley quacks.

[pnwmom]

28. The site is a right wing site and the author of this piece is a rightwing economist who has

written articles against things like equal pay for women.

[BCBacon]

4. Surgery Center of Oklahoma does the same thing.

Cash only. Prices on the website. Costs dramatically lower than similar entities that accept insurance.

https://surgerycenterok.com/pricing/

[WinkyDink]

7. Do you have ANY conception of what insurance is or does, or Medicare, or Medicaid?

[pnwmom]

34. So? Do you think people on Medicaid have money to pay these prices?

And the prices that Medicare and Medicaid negotiate with providers are dramatically lower than what individuals can get who come in off the street.

Single payer is the solution, not a la carte medicine.

[WinkyDink]

6. OMG, this is completely stupid.

[Jake Stern]

13. Why is this stupid?

While it wouldn't be much in the case of stage 4 lung cancer, for basic health needs this is actually a pretty nice model. Had a doctor like this in Missouri - refused insurance and charged a flat rate per visit. Always provided excellent care. He would spend more time with me than the doctor I now have with insurance who seems to breeze in, spend 5 minutes with me and breeze out.

Which is more offensive to you: that a clinic is running on a low overhead, flat rate pricing model or that it's touted as being an alternative to O'care?

Sorry but not going to jump on the doesn't take insurance = shady doctor bandwagon.

[Demsrule86]

18. Well that is your choice but this sort of BS is not

the answer for healthcare for the entire country..enjoy you substandard care. But if you are seriously injured or become really ill...you are screwed. My cousin died because lifesaving surgery was denied him just before the ACA went into effect. This is GOP bullshit and should not be posted on Democratic underground.

[Jake Stern]

23. And you magically know what level of quality the doctor provided?

Never touted it as the "answer" to healthcare - that would be universal coverage but you ASSUME that the care must be substandard without any knowledge of the clinic, it's staff or it's ratings all because it's highlighted by a conservative org.

I have insurance that covers catastrophic incidents as well as basic care but I would still consider a clinic like that as the costs are lower in some instances than what I would pay with my deductible.

[Demsrule86]

24. This is the GOP bullshit they use to take down the need for the ACA and universal healthcare...

sure you can have tests and treatment for minor stuff...but what if you are really sick...the is GOP bullshit from a GOP site.

[WinkyDink]

30. Because you have NO FRICKIN' IDEA of how much operations cost!!!!!! FOR EXAMPLE:

http://health.costhelper.com/heart-surgery.html

Typical costs:

•For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays and coinsurance of 10%-50% or more, which probably would reach the yearly out-of-pocket maximum. Heart surgery typically is covered by health insurance.

•For patients not covered by health insurance, the cost of the most common types of heart surgery can range from less than $30,000 to almost $200,000 or more, depending on the facility, the doctor and the type of surgery. In general, removal of a blockage falls on the lower end of the range, heart bypass surgery toward the middle and heart valve replacement on the higher end -- but costs for a heart transplant are much higher.

According to an American Heart Association report[1] , the average hospital charge for all common heart surgery and procedures -- not including doctor fee -- is $62,509. According to the report, plaque removal from an artery costs an average of $30,588, heart bypass costs an average of $117,094 and heart valve replacement cost an average of $164,238.

•For example, Pali Momi Medical Center[2] in Hawaii charges about $31,000, not including doctor fee, for removal of plaque from blood vessels -- or $18,500 for uninsured patients who pay in full within 30 days, or $21,500 for those who pay in 60. Doctor fees can add up $5,000 or more to the final bill, depending on the procedure.

•Heart bypass surgery typically costs about $70,000-$200,000 or more, and heart valve replacement surgery typically costs $80,000-$200,000 or more.

According to the United Network for Organ Sharing[3] , the total cost of a heart transplant can reach almost $800,000 or more.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~

NEXT QUESTION?

[DeminPennswoods]

9. Current medical costs are a shell game

It's pretty easy to see how hospitals/providers game the system to cover their costs. If insurance doesn't pay or doesn't pay enough, the hospitals/providers jack up the price of procedures/visits that are covered to make up the difference. Next time you get a claims notice from your insurer, check out the charges and the allowances.

[RedWedge]

10. Okay, so where's the price list for treating the issues that those tests find?

And how are those prices determined?

[Ilsa]

11. You'll need to give doctors free medical school.

And everyone out will need a student debt jubilee.

[Blaukraut]

14. Doctors should be government employees and hospitals should be government run

That's the only way to cut out insurance companies completely.

[rurallib]

12. Please use them for your health care and report back

I wouldn't ever go anywhere near anything the AEI endorsed.

But if you think it is a great idea, use it and tell us how it goes.

[LexVegas]

15. "An antidote for Obamacare". Transparent. nt

[Hoyt]

19. Those rates are roughly what Medicare pays. Doctors "charge" more, but they accept

Medicare's allowable. Private, non-Medicare insurers often allow a little more, but not a whole lot more in most markets -- maybe 20% more.

They aren't going to do chemotherapy, major surgeries, etc.

[FSogol]

21. Some questions: Do they have a dollar menu?

Is it cheaper to get it with fries and a drink?

Do they turn away people with real emergencies?

Does anyone really think it only cost $450 for a colonoscopy? Is the technician making minimum wage?

The machine and room for an MRI costs around $2 million. At $350 a pop, they'll need to do about 6000 MRIs before breaking even, not counting the electric bill. How many chickens can I trade for an MRI?

How much do they charge me to go home and die?

[Nanjeanne]

22. Wonderful Idea - You've been diagnosed with cancer - go negotiate your price with your doctor

Seriously? And while you are worrying about your health, don't forget to shop around for the cheapest hospital stay, anesthesiologist, oncologist, nurse, surgeon, etc. Hey . . . get the "best" healthcare you can afford . . . and if you are a great negotiator like Donald Trump - you may even survive and get to keep your house.

[Demsrule86]

25. This is free market bullshit the GOP thinks is the answer to health care.

It is not.

[Phoenix61]

26. I don't think this will fix health care but

I don't see any problem with this. There are facilities that just do lab work, or just MRI's and no body asks why don't they treat the conditions they find.

[WinkyDink]

31. Another one who doesn't understand how insurance saves us money.

[Phoenix61]

33. What does a facility that offers limited services

Have to do with insurance?

[pnwmom]

36. And no progressive would suggest that those labs are the solution for affordable health care

as the OP suggested about this clinic.

[hunter]

27. I'm looking forward to mass market medicine.

Okay, maybe not that extreme, but I can easily picture a WalMart health clinic where the entire health exam is automated and the teenage kid or financially struggling retiree operating the machines is politlly called "doctor," and loosely supervised by an actual doctor living comfortably in India paid a fixed sum for each machine generated diagnosis and prescription he signs off on.

For what it's worth, seeking medical care and prescriptions in Tijuana is a lot like Clinica Mi Pueblo. It's a cash only business.

But none of that relates to the problem of U.S. healthcare. The biggest problem in U.S. healthcare is the MBA's and other miscreants running the system who really only care about the size of the money streams they control. The bigger the stream, the more they can siphon off as bribes to legislators, as fancy company jets, as golfing vacations with other industry players, and most importantly, high salaries and golden parachutes for themselves. Appropriate and effective medical care doesn't enter into their equations, it's not an item on their spreadsheets.

[pnwmom]

29. The author of this piece is a right winger who has written against equal pay for women,

among other things.

Please delete.

[subterranean]

32. Maybe good for people who are uninsured or underinsured

which is primarily the client base that walk-in clinics like Clinica Mi Pueblo serve. Many of their patients are undocumented immigrants who don't have access to regular health insurance. The standardized pricing is something I wish other clinics and hospitals would adopt.

However, this article, in addition to being a thinly disguised attack on Obamacare, tries to compare health care to purchases like food, clothing, housing, transportation, computers, etc. Obviously, the difference is that those costs are all predictable and controllable for the most part, whereas medical costs for an individual are inherently unpredictable. You may be healthy now, but next year you could be involved in a serious accident or be diagnosed with an expensive illness. Hence the need for a pooled risk system like insurance or single payer.

[Caliman73]

35. It isn't the future of medicine, it is medicine's past...

Cash and barter were used in the early part of US history. It didn't work out so great. I have no problem with clinics and physicians operating on this model if they can sustain it, but it is not the answer nor the future of health care.