I tried something new at a doctor's office today. I'm trying out a new GP in a nearby community, someone with great patient ratings. I went to see him today, not because I needed anything, but to put myself in his office system so that if I do need something, there's some chance of my getting an appointment before I die of whatever it is. My more local doctor never seems to be available any more in an emergency. Though I can generally get in to see a P.A. on a same-day basis, and his P.A.'s are very nice, they haven't had much of a track record in the last couple of years diagnosing anything usefully. So I'll see how things go with the new guy.
The really new thing is that I told the office staff to treat me as self-pay. I told them I have insurance, but I'm not going to burden you with the knowledge of who it is, so you won't have to worry about whether you're complying with your contract. Just tell me what the prices of things are going to pay, and I'll pay you cash. If I get remotely close to my deductible, I'll gather up my bills and send them in and see whether my insurance company will acknowledge them, but you don't ever have to fool with that part of it.
Like magic, for the first time I can remember, I got a prompt and unequivocal answer to my question "How much is this visit costing?" It was a very reasonable fee, which I paid on the spot by check. The doctor recommended a standard blood panel, which would cost about $400 if I went through Blue Cross, but will cost only $84 if I self-pay. In the past, I've had similar blood panels done through a doctor's office to whom I had incautiously confessed my affiliation with Blue Cross. Suddenly it became "illegal" for them to treat me as self-pay, even though I'm going to pay in cash, because (as always) I'm nowhere near my deductible. Apparently the only way out of this trap is never to tell them you're insured in the first place. Some offices won't take you as a new patient on that basis. They aren't likely to get my business. What do you guys want from me? A cash retainer to prove I won't stiff you on my bills?
I'm faintly hopeful that, as more people are shoved into the new style of mandatory health plan with very high deductibles, they will begin to approach things my way, so we'll see more of a transparent, cash-basis market at least for ordinary stuff like exams and blood tests.
The doctor seemed sensible, had practical advice to offer about various minor ailments, and didn't pester me with any questions about spousal abuse or guns in the home. It was such a rational and worthwhile experience that I got through the whole thing without exploding with rage about Obamacare!
On that subject, though, here is the latest thinking from the President's apologists: When he told us we could keep our plans, that was 99% true, and it was shockingly unfair to make a fuss about the tiny, unimportant sense in which that was a lie. The people who aren't getting to keep their plans are an insignificant sliver of the marketplace, most of whom aren't even going to see their premiums go up, so don't believe what you read. Besides, the old plans are terrible; nobody in his right mind would keep them if he were offered something better. But when we ask the President to support bills in Congress to ensure that we'll keep our plans, it turns out that letting us do that would be a dagger at the very heart of Obamacare. If even a minuscule fraction of the market doesn't sign up for the new plans, the entire creaky edifice will crash and burn. And it won't be a few customers, it will be a stampede, because almost everyone will want to keep his old bad plan instead of taking the priceless gift of the wonderful new plans. Also, although the financial harm suffered by this inconsequential backwater of the market, just a few Americans, 15 million tops, is hardly worth mentioning, the fact remains that denying this stupendous influx of revenue to the grand nationwide Obamacare experiment will starve it of its lifeblood and leave the brilliant social experiment in smoking ruins.
