Free Market Medicare
Whereas a well-baby visit to a pediatrician might only require a 10-minute office visit and be reimbursed by private insurance paying market rates, a senior enrolled in Medicare who has multiple problems might require an appointment lasting half an hour or more just to monitor all the health concerns. And Medicare pays about 30% less than private insurers, despite the fact the office visit takes twice as long. No wonder doctors run from such patients.
Yet, for upfront fees ranging from $500 to $15,000 per year, patients can now have the undivided attention of physicians willing to allot them all the time they need to navigate the health care system. Concierge physician practices can do this because they limit their practice to only a few hundred patients willing to pay large, upfront fees. [link]
I think this is just the beginning. As more and more people are pushed into government plans that pay below market, the rationing probems are going to get worse and worse.
The only way people in these programs are going to be able to get prompt, high quality care is to pay out of pocket.
I’m not sure how they get around Medicare’s prohibition on extra charges for Medicare covered services. These doctors are probably practicing completely outside the Medicare system.
The obvious solution here is to create Health Savings Accounts for the elderly.
Being outside of Medicare is hard but not impossible. The Mayo clinics in Scottsdale and Jacksonville do not take Medicare, for example.
Up to 50% of office visits are unnecessary. Electronic communication between doctors and their patients is cheap only if you leave out third parties. Everyone (yes, everyone) can afford this type of care. “Prepaid” healthcare is unsustainable in this country. Let insurance companies do their job: traditional catastrophic coverage spread over large populations. Let General Physicians deliver comprehensive care directly to their patients.