Doctor stops accepting insurance, posts prices online

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SlyPokerDog

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SOUTH PORTLAND, Maine — Dr. Michael Ciampi took a step this spring that many of his fellow physicians would describe as radical.

The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.

The change took effect April 1.

“It’s been almost unanimous that patients have expressed understanding at why I’m doing what I’m doing, although I’ve had many people leave the practice because they want to be covered by insurance, which is understandable,” Ciampi said.

Before the switch, Ciampi had about 2,000 patients. He lost several hundred, he said. Some patients with health coverage, faced with having to seek reimbursement themselves rather than through his office, bristled at the paperwork burden.

But the decision to do away with insurance allows Ciampi to practice medicine the way he sees fit, he said. Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls.

“I’m freed up to do what I think is right for the patients,” Ciampi said. “If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense.”

Ciampi expects more doctors will follow suit. Some may choose to run “concierge practices” in which patients pay to keep a doctor on retainer, he said.

Gordon Smith, a spokesman for the Maine Medical Association, wasn’t so sure, saying most patients either want to use the insurance they pay for or need to rely on Medicare and Medicaid.

Even with the loss of some patients, Ciampi expects his practice to perform just as well financially, if not better, than before he ditched insurance. The new approach will likely attract new patients who are self-employed, lack insurance or have high-deductible plans, he said, because Ciampi has slashed his prices.

“I’ve been able to cut my prices in half because my overhead will be so much less,” he said.

Before, Ciampi charged $160 for an office visit with an existing patient facing one or more complicated health problems. Now, he charges $75.

Patients with an earache or strep throat can spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50, he said.
Ciampi collects payment at the end of the visit, freeing him of the time and costs associated with sending bills, he said.

That time is crucial to Ciampi. When his patients come to his office, they see him, not a physician’s assistant or a nurse practitioner, he said.

“If more doctors were able to do this, that would be real health care reform,” he said. “That’s when we’d see the cost of medicine truly go down.”

http://bangordailynews.com/2013/05/...rance-posts-prices-online/?ref=relatedSidebar
 
What a concept. Don't take insurance so you can spend your time actually practicing medicine. Fire the staff whose jobs are to collect from insurance and the government, and the care costs less.
 
What a concept. Don't take insurance so you can spend your time actually practicing medicine. Fire the staff whose jobs are to collect from insurance and the government, and the care costs less.

To a point I agree, but there's still a barrier to entry for the poor, even if prices are lower. I don't disagree that insurance is a racket, though... but think of the mass unemployment if every doctor decided to do this all at once. :ghoti:
 
The poor can fill out their own paperwork and collect from the govt.
 
What a concept. Don't take insurance so you can spend your time actually practicing medicine. Fire the staff whose jobs are to collect from insurance and the government, and the care costs less.

Causing unemployment to skyrocket.
 
Causing unemployment to skyrocket.

Don't you think jobs should contribute to productivity rather than just be process-oriented? There was a study by Donald Marron--the former head of the CBO--that regulatory compliance costs were $1.72T in 2012, or 11% of GDP. That's nuts. Over a dime of every dollar simply goes to making sure you're doing what the government wants? That doesn't include taxes.

Imagine the jobs that could be created, the wealth that could be created if even half of that figure could be used for productive purposes instead of paper pushing. This economy would be growing by leaps and bounds if that were the case.
 
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Agreed. I'm not saying this to be an ass (although I'm sure that's how it will come across), but the level of economic ignorance on this board is as astounding as it is depressing.

4368-smash-wall-head.gif
 
This incident will become more and more common. You're going to see all kinds of ways physicians are going to exit the system due to Obamacare. As more and more refuse to deal with the constraints of Obamacare, HHS will simply require that to be licensed (even though it's a state certification, the Feds will withhold funds), physicians must take a certain percentage of patients who have the public option. Physicians will then drop out of the system and become "Medical Consultants".

This piece of legislation is going to be a clusterfuck of the first order.
 
Stossel had a doctor on a few weeks ago who runs a major clinic in Cleveland (I think). They stopped taking insurance a while ago and post their prices online. They do a great business, and a lot of employers are just paying the fees so their employees can be treated.
 
This incident will become more and more common. You're going to see all kinds of ways physicians are going to exit the system due to Obamacare. As more and more refuse to deal with the constraints of Obamacare, HHS will simply require that to be licensed (even though it's a state certification, the Feds will withhold funds), physicians must take a certain percentage of patients who have the public option. Physicians will then drop out of the system and become "Medical Consultants".

This piece of legislation is going to be a clusterfuck of the first order.

And then laws will be passed to require certificate / license renewals to practice this type of "consulting", and those yearly renewals will be high cost.
 
Stossel had a doctor on a few weeks ago who runs a major clinic in Cleveland (I think). They stopped taking insurance a while ago and post their prices online. They do a great business, and a lot of employers are just paying the fees so their employees can be treated.

There was some talk here in the hospital last weekend about some dr's bidding on employers to be that company's primary dr.
 
Sounds like an indirect way of economic discrimination . . . maybe that is OK if we view the medical field only as a private business that should be allowed to profit as it see fit. Personally, I take a more philosophical view about national health care.
 
Sounds like an indirect way of economic discrimination . . . maybe that is OK if we view the medical field only as a private business that should be allowed to profit as it see fit. Personally, I take a more philosophical view about national health care.

Then let the nation hire some doctors who are willing to work for the nation.

Otherwise, it's slavery.
 
Then let the nation hire some doctors who are willing to work for the nation.

Otherwise, it's slavery.

Guessing your definition of slavery and my definition of slavery are 2 different things.

How much would it cost our country to hire Drs to take care of the hurt, sick and elderly. Would like to see the budget proposal for that.
 
Guessing your definition of slavery and my definition of slavery are 2 different things.

How much would it cost our country to hire Drs to take care of the hurt, sick and elderly. Would like to see the budget proposal for that.

My definition of slavery is when you TAKE someone else's labor.
 
Sounds like an indirect way of economic discrimination . . . maybe that is OK if we view the medical field only as a private business that should be allowed to profit as it see fit. Personally, I take a more philosophical view about national health care.

So, physicians should have no choice how they practice? "Swing low, sweet chariot..."
 
I think it sounds sensible enough for regular check up/minor health issues, but having had a family member with severe medical problems, I don't think that approach works in that situation. It's difficult enough to navigate the health care system, but being seriously ill and trying to figure out coverage and the insurance claims process would be a disaster.

Purely from a customer standpoint, if I planned on switching doctors and was considering two different docs, all things being equal, I'd pick the one who handles insurance claims to avoid the hassle.
 
I think it sounds sensible enough for regular check up/minor health issues, but having had a family member with severe medical problems, I don't think that approach works in that situation. It's difficult enough to navigate the health care system, but being seriously ill and trying to figure out coverage and the insurance claims process would be a disaster.

Purely from a customer standpoint, if I planned on switching doctors and was considering two different docs, all things being equal, I'd pick the one who handles insurance claims to avoid the hassle.

I think self-selection is an intentional part of the tactic.
 
...so, doctors are starting to follow the MMJ model?! :dunno:
 
I think self-selection is an intentional part of the tactic.

I'm guessing that you were referring to the second paragraph of my post? Obviously, no one knows when they might suddenly get diagnosed with a serious, fast moving disease and they might regret the choice they've made. That said, more often than not in that situation, you'd probably get referred to a specialist anyway (and the specialist could handle the insurance.)
 
I'm guessing that you were referring to the second paragraph of my post? Obviously, no one knows when they might suddenly get diagnosed with a serious, fast moving disease and they might regret the choice they've made. That said, more often than not in that situation, you'd probably get referred to a specialist anyway (and the specialist could handle the insurance.)

You would buy catastrophic health insurance with a $15,000 deductible. You doctor would refer you to a hospital. Your insurance pays, and you end up with $15K of debt, which shouldn't bankrupt you.
 
You would buy catastrophic health insurance with a $15,000 deductible. You doctor would refer you to a hospital. Your insurance pays, and you end up with $15K of debt, which shouldn't bankrupt you.

Right on. I'm thinking more of my case, where I have insurance through work and going to that doctor would mean that I'd personally have to make insurance claims and work with the insurance company to figure out what's covered and what's not.
 
You would buy catastrophic health insurance with a $15,000 deductible. You doctor would refer you to a hospital. Your insurance pays, and you end up with $15K of debt, which shouldn't bankrupt you.

"Catastrophic health insurance" . . . there is a loaded term.
 
Right on. I'm thinking more of my case, where I have insurance through work and going to that doctor would mean that I'd personally have to make insurance claims and work with the insurance company to figure out what's covered and what's not.

Your paycheck would be bigger. Your doctor bills would be $75 for most things.

Look at the guy's prices:


Many things $20. $200 for a house call.

Health care isn't expensive - insurance and govt. interference are
 
Your paycheck would be bigger. Your doctor bills would be $75 for most things.

Look at the guy's prices:

http://www.ciampifamilypractice.com/Our_Prices.html

Many things $20. $200 for a house call.

Health care isn't expensive - insurance and govt. interference are

This is where I am at on it.

Some people have amazing insurance. See union workers and select other individuals. However, most don't. I know where my wife works they have a HSA plan that she would have to pay $300 a month for, just to have the plan, then pay a negotiated rate when she or the family had a dr's visit. one of her co workers has the insurance and pays $1000 a month for the plan and prescriptions and such.

Howver, one area I see that could be a tough go is in the catastrophic cases. I just got out of the hospital, and my bill before insurance was $60k. How would a non insured patient pay for something like that?
 

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