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Physicians fight back against Obamacare.

Physicians fight back against Obamacare.

Dr. Ryan Neuhofel, 31, offers a rare glimpse at what it would be like to go to the doctor without massive government interference in health care. Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that’s as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn’t accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat’s milk. “Direct primary care,” which is the industry term for Neuhofel’s business model, does away with the bureaucratic hassle of insurance, which translates into much lower prices. “What people don’t realize is that most doctors employ an army of people for coding, billing, and gathering payment,” says Neuhofel. “That means you have to charge $200 to remove an ingrown toenail.” Neuhofel charges $50.

Neuhofel is not alone in this. The article describes other doctors who have done the same. As the bureaucratic mess from Obamacare expands and becomes increasingly impossible for anyone to handle, we are going to see this happen more and more.

Genesis cover

On Christmas Eve 1968 three Americans became the first humans to visit another world. What they did to celebrate was unexpected and profound, and will be remembered throughout all human history. Genesis: the Story of Apollo 8, Robert Zimmerman's classic history of humanity's first journey to another world, tells that story, and it is now available as both an ebook and an audiobook, both with a foreword by Valerie Anders and a new introduction by Robert Zimmerman.

 
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"Not simply about one mission, [Genesis] is also the history of America's quest for the moon... Zimmerman has done a masterful job of tying disparate events together into a solid account of one of America's greatest human triumphs."--San Antonio Express-News

14 comments

  • Pzatchok

    My dentist has done ‘personal’ pricing for years.

    For years I did not have insurance and he gave me special pricing. Far lower than he charged the insurance companies.

    After I got insurance again the prices went right back up. And the insurance company was happy to pay because he was still cheaper than others in the area.

    I even found the hospital did the very same thing. I needed stitches. Charged me one low price. Years later my son needed stitches and since he was covered by insurance then they charged the insurance company out the fanny.

    I will now only go to someone or someplace that is willing to make a deal. Whether I have insurance or not.

  • Jim

    The whole article is really a condemnation of the insurance industry, rather than Obamacare. You are right that because Obamacare expanded the health insurance market (it always was a boon to the business of insurance, rather than a government takeover), that direct primary care model will also expand. But direct primary care started growing in the late 90’s (note the reference to Milton Freidman in 2001), when even then doctors began to recognize more and more of their time was spent on billing issues with insurance companies- well before Obamacare. Most of the doctors interviewed did not even mention Obamacare, although the author draws that conclusion. And you may be able to negotiate an office visit with a carton of eggs once in a while, but try that when you need a lung transplant. So some type of “insurance” will always be with us. But if the objective is to reduce that bureaucratic nightmare that health insurance has become, maybe just one insurance company would be the answer- a single payer system.

  • wodun

    Kinda funny how Obama railed against insurance companies and big pharma to get Obamacare through and demonized anyone who disagreed with him as being in their pockets but then it turns out these insurance companies and big pharma were actually big financial supporters of Obama personally, were consipiciously absent fighting against Obamacare, and stand to make a lot of money because of its passage.

  • Jim

    I really think that if the right spent much less time demonizing this President, and rather would stick to facts such as rather than reducing costs the ACA will line the pockets of big insurance, the argument can be won. Or could have been won…I think the ACA is here to stay now. Now we need to make it the best we can- I think Boehner is kind of taking that stance.

  • Pzatchok

    The ONLY way to control medical industry costs is to take over the whole of the industry and cut out the insurance industry except for those who want to pay astonomical sums for extra care.(Like it is in England).

    They first need to control the cost of schooling for those in the medical industry. Thus take over the schools teaching techs,nurses, and doctors.

    Then they need to control the costs and availability of general health care. Thus they need to set up community health centers. We do not have enough general practitioners yet.

    Then they need to take over the hospitals to control the cost of long term services and surgeries.

    And at some point in this gradual take over they would have to take over the medical supplies industry.

    And to start this whole thing off they need to stop patients from suing everyone for everything that doesn’t go right.

    the ACA did nothing to control costs except slap a band aid on the industry by forcing everyone to get insurance. In 15 years the whole thing will be broke and they will be talking about the forced take over of the industry totally.

    Welcome to the feel good legislation of the left all for their only real goal of power.
    No real solutions just power grabs.

  • What are you suggesting but a power grab? To take over the medical industry is to steal it from the people in that industry.

    Why is that the only solution anyone today ever thinks of is a power grab? Why not let freedom decide? Remove the restrictions and regulations and let people compete freely, using their brains and passion to devise the best solutions, for themselves.

  • Pzatchok

    I totally agree with you.
    The government should only be regulating safety. Safe practices, materials, facilities and drugs.

    Let the market place decide the price and availability.

    The fastest way to hold prices steady or even lower them would be to protect the medical industry from over litigious lawyers. That way they don’t need insurance protection at every level of the system.

    But the only way the Dems will let that happen is if all the workers become government union workers. Doctors to janitors. Its the only time they might have the courage to go against the big money of the insurance industry.

  • Pzatchok

    They could have just expanded medicare/medicaid to cover more low income people.

    But that would not have taken control of the industry like they did with the ACA.

    Medicare/Medicaid was never designed to be profitable. That fact that it never made a profit was an excuse.
    They were both designed as a government safety net to help low income citizens. They were not and never were designed to make money.

    They could have just raised the fees/taxes we already pay for those services. No one would have raised a stick about it.

  • As I’ve noted previously, I have a primary care physician who doesn’t take insurance. His fees are very reasonable, and he does basic lab work himself, resulting in further savings. On occasions I’ve had to use other medical providers, I always negotiate the fees. Not having insurance will usually save you 30% right off the bat, and further reductions are possible. Another bonus is neither he not I are limited in our discussions. I might bring up 3 or 4 concerns during the same visit, and I’m charged the basic rate, rather than individual billings for each topic of discussion. He is exercises his professional judgement, and I get good care for a reasonable price. Of course, this means that politicians and bureaucrats don’t have leverage on us. I think that’s called ‘freedom’.

  • Blair,

    Where are you located? And do you have any health insurance at all, such as coverage for catastrophic injury or sickness?

  • JGL

    The reasonable market solutions are in Dr. Ben Carson recently promoted health savings accounts that accrue value and are transferrable to heirs combined with a catastrophic ellement. This would suppose that people would have a degree of responsiblity for themselves, the government does not like this solution because it removes “them” from the power that that would represent over the people. This kind of thinking goes directly to the creation of the welfare state model which is designed under the cover of “compassionate caring ” to create dependency on government which translates into votes for the politicians that pursue such offensive policies.

    For anyone to suggest that to give up and give the government absolute power in such matters, which is what Obamacare represents in its full blown form, is to surrender your freedom and to admit that the people are owned by the government. This is not what America is about!

  • Hi Robert,

    I live in Beaverton, OR. I don’t have any type of health care insurance. The last time I looked at major medical plans (about 3 years ago), the cheapest I could find for my area was about $150/month. All of the plans I looked at included coverage for some preventive care, but I have a primary care physician for that. If a patient has an expensive preventive care procedure coming up, like a colonoscopy, he’ll start talking with them a couple of years in advance, and encourage them to start saving for it now. It’s nearly impossible to find a plan that only covers serious injury or illness without a bunch of preventive care ‘riders’, and I expect under Obamacare that situation has only worsened.

    About the most dangerous thing I do is drive a car, and I gave up cycling years ago precisely because I’ve had a number of cycling related injuries, including multiple broken bones and surgeries. Sometimes I’ve had insurance, and sometimes I haven’t (you do get treated better at the ER if you have insurance). When I haven’t, I’ve negotiated fees with providers and paid the balance over time (pro tip: go over your hospital bill with a fine-tooth comb; you’ll probably find hundreds of dollars in questionable billing).

    The last time I had medical insurance was through an employer who self-insured, and they offered a basic plan for about a third what it would cost on the open market, because they weren’t paying for someone else’s overhead.

  • Blair,

    Thank you for the additional information. For me, your approach wouldn’t work. As a caver who also does a lot of outdoor activities, I have always needed some form of insurance to cover accidents. Moreover, at my age I also need some form of insurance to cover catastrophic illness.

    When I was younger I always went with the cheapest insurance plan with the highest deductable for sickness. This saved me a lot of money, since as a young person the need for health insurance is less. Sadly, Obamacare has made this wise approach impossible.

  • Hi Robert,

    Thank you for the reply. I would like to have a straight insurance plan that only covered major medical expenses with a high deductible, but those types of plans are being phased out. I engage in outdoor activities like camping, hiking, and shooting, but my ‘insurance’ is that I’m experienced in them and take precautions. Yes, accidents can happen, but they are rare enough that I can afford to pay for them. I’m approaching the time in my life when my body is starting to break down, but wonderful things can be done with diet and exercise, although those things only stave off the inevitable. I have no doubt you practice this.

    My thinking is that by the time you’re in your mid-twenties or so, you should know what you’re getting into, and plan accordingly. Most people have decades to plan for their middle and advanced years, whether it be medical or financial needs. It’s not like it’s a secret. I’m an advocate of self-insurance through foresight and planning, but I also realize that almost no one operates that way. ‘Quam minimum credula postero’ is the motto for our society.

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