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Doctor reduces fees for laid-off workers
Dr. Michael Rosenfield
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TEXT OF STORY
Kai Ryssdal: For the 3.5 million people who have lost their jobs since this recession started, it's not just the loss of a paycheck they have to worry about. Most Americans get their health insurance through their employers, too. So when the pink slip comes, the new budget calculations a lot of people have to make include how to pay the medical bills. One Seattle doctor is helping his patients try to do that. From KUOW in Seattle, Ruby de Luna has our story.
RUBY DE LUNA: Dr. Michael Rosenfield is physician with a small family practice in Seattle. About nine months ago, he and his staff noticed that some regular patients stopped coming in. Others hadn't picked up their prescriptions. And more patients were heading to the emergency room. He remembers a parent who took her baby to the ER for an ear infection.
MICHAEL ROSENFIELD: And I read the report carefully, and I kept thinking to myself, there's nothing here that would make me feel like it would be an emergency situation.
When Rosenfield's staff called the mom, they found out her husband had been laid off.
ROSENFIELD: She felt that she wasn't going to be able to be seen because of lost insurance.
It became clear to Rosenfield the economy was affecting his practice. So he sent out letters to his patients and introduced a new payment plan for those who lost their health insurance. They don't get billed. But they pay upfront, usually between $40 to $60 for each visit, depending on their financial situation.
Rosenfield: Good morning. How are you?
Risha: I'm good.
A patient named Risha has been coming to Rosenfield for more than a decade.
RISHA: When I got the letter, I got a sense of relief.
Risha lost her health insurance when she was laid off two months ago. And she has a thyroid problem. That got her scared.
RISHA: What would I do if, you know. Would our entire savings be wiped out because of one trip to the emergency room?
Risha wasn't the only one thinking "what if." Rosenfield was bracing to take a financial hit. But it's actually saving him money. It's reduced the amount of paperwork he has to file. And since patients pay him directly, he spends less time chasing after insurance companies for reimbursements.
ROSENFIELD: Let's say they pay $50 when they're seen. That's $50 that we can deposit into our account without having to touch the account five times before getting reimbursed.
The new payment plan was also a way to make sure that patients don't skip on medical treatments. Rosenfield worries about patients with chronic illnesses like diabetes. He says they may feel fine, but they may not realize their diabetes is in fact out of control.
ROSENFIELD: And they would end up with a sore on their foot and have to have an amputation, they would have renal failure and to see that the potential for their health care just to fall apart would be devastating.
And costly. The Kaiser Family Foundation estimates that as companies continue to cut jobs, as many as 6 million Americans could lose their health coverage this year. Rosenfield says the reduced fee is a small program, but it's his way of helping out.
ROSENFIELD: Our job is to treat people not just for the laceration or for the diabetes, but to help treat the fear. And if we can do that by telling them you can come here, it's OK, we'll see you for an amount that's affordable then you've treated a part of what's wrong with them.
About 150 patients have used Rosenfield's new payment plan. But some patients have told him their jobs may not be secure for long, and they might take him up on his offer of help.
In Seattle, I'm Ruby de Luna for Marketplace.
My parents, who are immigrants and former small-business owners, did not have health insurance when I was growing up. I remember my parents writing checks directly to the doctor. The cost of care was relatively affordable, though we were lucky to have never suffered serious injury.
As an adult with health insurance, I've learned some things I was never taught in school: 1) Keep meticulous records, i.e., write everything down and keep every receipt. The insurance company is bound to lose some of your information. 2) Ask BEFORE you get treated how much a procedure might cost. I feel bad having to "second-guess" my doctor's orders, but I realized it was necessary after I got hit by hundreds of dollars in lab fees after a routine gynecological exam. 3) Doctors are reimbursed by procedures performed. There is no financial incentive to keep one healthy.
Two things:
1) we have been taught, that health care means being healthy. Health care, unfortunately, is defined by many as what you do after you get sick. As the saying goes, prevention is cheaper than the cure. But, that means the cure makes for more profit.
2) anyone who wants to figure out what hurts the economy, needs to read that paragraph where the doctor admits, health care costs less when the middleman is removed. If your paycheck didn't have health insurance removed, would that increase your spending or savings? If your company wasn't spending that money it spends on your insurance, where would it put that money?
We talk about American companies competing globally, and don't discuss what they have to pay extra for health insurance. Of course, anyone who has dealt with the Veteran's Administration, can tell you what single payer health care can be like. But, does it have to be bad, in a country as advanced as America? Can't we handle it better, with our technology? Do it have to become political? Will ideologes kill it just to promote their idea of smaller government, or see it instead as a way to make business better?
I lost my insurance 2 years ago when my son was born. I thought it would be a big problem, but it was not. The key is to view it as insurance, not an all you can eat steakhouse. I purchased a major medical only plan for myself and son for under $760 per six months with Blue Cross and Blue Shield.
I then went to the doctors we used and paid them at the time of the visit. I was way ahead. By negotiating, my costs were actually less than when we had comprehensive benefits from my wife's employer when you factor in the max out of pocket and the deductions each pay period for premiums.
Eliminate employer/ gov paid insurance and make it like car insurance with reasonable deductibles and penalties for those with unhealthy lifestyles and it is affordable.
The key to this story is the statement that by eliminating the administrative work the physician could reduce what he bills patients. As a health care provider, when I think of the wasted time and money expended to get reimbursed for providing services, I am completely disgusted.
