Entrepreneurs Go Where Doctors Can’t and Third-Party Payers Won’t
Before you ever approach your doctor's office, your third-party insurer has already determined what tasks will be paid for, what tasks will not and how much will be paid. As a result, doctors are not free to repackage and reprice their services the way other professionals do.
However, entrepreneurs are developing products that doctors cannot and are doing so largely outside the third-party payer system. Here are some examples provided by a CNN news story:
- Over the past two years, the number of retail clinics in pharmacies, supermarkets and big discount stores has jumped from 200 to 1,100.
- Nearly a third of companies have a clinic or are planning to open one by 2009, according to Watson Wyatt.
- Urgent care clinics are in almost every city of any reasonable size and are usually out-of-network providers.
- A relatively small number of physicians currently offer "Web visits," but are not usually covered by insurance.
I think this is one of the great untold stories in health care. Other people — employers, nurses, entrepreneurs — are able to do what doctors generally cannot do, because they are harnessed and reined in by federal law and insurance compnay bureaucracies.
Notice that all of these innovative services are helping patients economize on time.
This is in contrast to the orthodox third party payer system, where a bureaucracy pays the bills and provider services are rationed by waiting.