Anonymous Doctor @AnonymousDocto2
Some unfiltered views from inside the medical profession. Whats wrong, Whats right, What needs to be fixed, and What seems unfix-able. United States Joined April 2018-
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How the us healthcare system takes advantage of those in immediate need for help. npr.org/sections/healt…
Grieving about our broken healthcare system. Yesterday my father called to tell me that he couldn’t get MRI of his sacrum because Aetna denied prior auth. He has multiple myeloma. Excruciating back pain. He’s a physician too.
Many of my patients have figured out Costco Pharmacy offen offers better pricing than CVS. But not one has figured out that physician fee schedules vary widely. Most often the independent doc will cost you less out of pocket than one employed by a hospital. It’s a secret. Shhh
Most of us know to save $ on Eggs buy them at costco. Bulk purchases & sale in a free market lower cost. Few realize that seeing a doctor employed by a large hospital system will cost you MORE. Hidden fee structures hurt patients and line pockets of hospital administrators.
Buying a car? Don’t negotiate off the MSRP. Use the Dealer Invoice Pricing. Imagine if we had dealer invoice pricing marked on every bottle/tube/injection of MEDICATION!?! What a game changer!! And a simple bit of legislation could make it happen.
Sometimes at the end of my day... I feel like #Lego
Patient needs cardiac cath. Insurance denies auth. I request peer2peer. 1/2 hr of my time that is not reimbursed. Insurance can’t set up peer to peer?!? I send patient to the ER so they can have procedure done. More stress, time & expense. Frustrated patient. Broken system.
Who is there to help PATIENTS learn they can get the same care for less $? Their doc cares about them... but not likely if they are getting paid more $$. Hospitals? Nope. Your insurance company seems logical. Nope. NOBODY. NADA. ZILCHO. You are on your own America. Good luck
Medicare is far from perfect but they seem to be the only player in the room offering transparency and a consistent fee schedule. CMS DOES act as a fiduciary to the tax payer. Private payers pay large groups/ hospitals 2-3x the fee schedule of a solo doc & keep it confidential.
“Like a good neighbor, State Farm is on your side”. Maybe so. But Aetna, Emblem, Oxford, Humira, Oscar, etc... are NOT on your side. They are on their own side, and working hard to get your money in their pockets.
#HealthInsurance companies can only keep 20% of premiums by law. Higher provider fee schedules = higher premiums = more $$ in the 20% pool. What is their incentive to drive costs down? NONE. They are not your fiduciary. They make more $ when they agree to pay hospitals more.
Great article by @sarahkliff helping to expose hospital pricing disparity. Isn’t it a new law that fee schedules need to be disclosed by hospitals? Please share disparity in negotiated fee schedules too!! vox.com/2019/1/22/1818…

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