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Good thread. You guys got it covered no doubt.
Generally speaking, urgent care facilities have a little more resources than a doctors office and are great for routine problems such as sore throats, sprains without limb deformity, small lacerations, back sprains in the young, etc. Many of these conditions are self-limited and require only symptom control. Urgent care facilities allow people the luxury of rapid evaluation of minor problems without having to schedule an appointment with a primary doctor - expect to pay more for this convenience.
However, urgent cares are not well equipped for chronic, progressive problems where a strong patient-physician relationship and continuity of care become important to establishing the diagnosis. Emergency departments often fall short in diagnosing chronic or complex illnesses because our tests and training is geared toward acute life-threats.
Many common conditions such as diabetes, hypertension, seizures, and asthma can be treated using generic medications that are $4 per month at Walmart. CVS has similar discount programs for generics. Keep in mind there IS NO DIFFERENCE between the effectiveness of generic vs brand name medications.
In addition, there will soon be a wave of medications coming off patent this year which will help with costs. Some of the "statins" that are commonly used for high cholesterol are on this list which is good news for many Americans.
"Real men have always needed to know what time it is so they are at the airfield on time, pumping rounds into savages at the right time, etc. Being able to see such in the dark while light weights were comfy in bed without using a light required luminous material." -Originally Posted by ramairthree
My experiences are contrary to Belmont's. I have good insurance and have had several major problems and a good many minor problems over the years. When I get sick I go to the doctor, if I do not know what is going on I do not wait for it to get worse. I learn about my condition and do what is required to get better. I have been blessed by being treated by many good doctors, only two I would not go back to. They have saved my life a couple of times. Some things I have learned: Much medicine is defensive, the docs are ordering tests to protect themselves from lawyers. Medicine is expensive, a physician's education is expensive, the machines are expensive, the liability insurance is expensive, regulations add cost and often, people who can pay have to pay for their treatment and the treatment of others who can't pay. When the hospital runs out of money it closes, they have to get paid somehow. The government and lawyers have distorted the market to the extent that few things make sense. The answer to this problem is not more government and more lawyers. The answer is for the government to get out of the way of the doctors, let them treat patients and set up free market incentives to grow a patient centered system of health care.
I am all for paying cash or using my HSA debit for medical services and avoiding the medical practitioners needing to bill the insurance company etc and waste all that time and effort etc IFF the insurance companies would accept my receipts when it came time to reaching the deductible.
We have a higher deductible catastrophic plan so everything gets paid by us in the end anyway as we normally don't get near the deductible (last year we did with my broken ankle and a febrile seizure in our daughter which was a 911 / ambulance ride that turned out to be nothing but it is the first time I can remember every hitting any deductible on any insurance that was not a birth year for a kid).
I would be happy to just pay fee for service if there were a way that I could substantiate my payments for services in case those payments got large enough to hit our several thousand dollar deductible and the insurance company would accept that.
The other big thing is that the charges are often less for someone covered by insurance due to contracts with the insurance companies and self-pay people get MSRP only type pricing.
I would just pay if I got the same price or better than the insurance company gets for the same service.
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The healthcare problem in America (i.e rising costs) will only be solved when we follow the following steps:
1) Agree as a nation that access to healthcare will never be equal across the socioeconomic spectrum, and it is not the governments role to provide a basic level of care. That means that a larger portion of our individual income and estate will be used to fund our own individual healthcare needs.
2) Begin to bring the power of free market competition to the healthcare industry by increasing the financial responsibility of consumers that incentivizes individuals to conserve their healthcare dollars. While consumers will have to apply more of their disposable income toward healthcare, costs will be contained as providers must control their prices to compete in the marketplace. This is probably best achieved through expanded pretax flex spending accounts that can be invested when unused to create a type of healthcare retirement account (similar to a 401K).
3) Incentivise the development of low cost, catastrophic only insurance for rare illnesses that would exhaust healthcare savings accounts. These could compete across state lines and have no government mandated coverage.
4) Gradually phase out Medicare and significantly curtail Medicaid eligibility.
3) Pass meaningful liability reform but don't expect major savings until we fundamentally change how physicians are trained to use resources and technology.
Last edited by Sensei; 08-11-11 at 00:11.
6) Early and persistent education, starting from elementary school, in regards to general health issues, smoking, nutrition, obesity...
7) Incentives for active commitment to healthy lifestyle, such as reduced fees for gym memberships, swimming pools...
8) Reduction of productivity-based reimbursement for physicians, or, at least, adjustment of productivity formulas to patient's outcomes.
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