from Hacker News

Doctor stops accepting insurance, posts prices online

by nick007 on 5/29/13, 5:55 AM with 48 comments

• by psychotik on 5/29/13, 6:20 AM

  This is how doctors in India (and a lot of other countries) work, and it's super efficient. His prices feel very competitive to me. I would carry a high-deductible insurance plan for catastrophes but this would otherwise be a great option.

  More doctors need to follow this lead.

• by shanelja on 5/29/13, 6:26 AM

  As someone who comes from the United Kingdom where the tax payer funded NHS takes care of most medical fees, it strikes me as ridiculous that any country could expect their tax paying citizens to pay for the privilege to carry on living.

• by healthenclave on 5/29/13, 8:35 AM

  This is both great news and sad one. The great news is the doctor is doing the right thing by moving towards a direct pay model - which works great for regular visits. But this also goes to show the SAD state of health affairs.

  I believe we can also a lot of this problem with the aid of technology and make doctors more efficient and help them only worry about their patients. Well you can't eliminate the need of insurance but it can certainly be made much much more easier.

  A lot of Family Practitioners don't want to deal with insurance companies is not because they don't get paid well by them (yes they pay only a fraction of the bill) but because the paperwork and stress of dealing with them isn't worth it.

  Now with the upcoming ICD-10 implementation the docs are going to have a nightmare. ICD-9 has around 18k codes for the classification of various disease and with the implementation of ICD-10 this number goes to 80,000 !!!!

  The bigger problem is that most solutions (EHRs) are usually created not created by people who deliver healthcare. There are a few EHRs created by doctors but are not implemented very well.

  Using things like Eligible api (to know what procedures can be performed as per the patient's insurance plan) are helpful but are not complete in the sense of unifying the workflow for doctors.

  The other big thing that is severely lacking is the patient engagement and the data from Quantified self. When you walk into the office of a doc - all that information (FitBit, Nike FuelBand, etc , etc) doesn't help the doc provide personalized medicine to the patients. Nor does the patient has much engagement in managing their health (apart from taking the pills)..

  ZocDoc(s) and PracticeFusion(s) are doing their parts but are still half baked solutions.

  Hopefully we will be able to change that !

• by qwerta on 5/29/13, 7:52 AM

  This is how it works in Ireland. You pay GP, dentist and other small items out of your pocket and send your bill to insurance company. Hospitals and other large stuff is passed automatically and you will not even see the bill. Prices are fixed, GP visit is 50 euro (~70 dollars), MRI scan is about 200 Euro (~270 dollars).

• by ewbuoi on 5/29/13, 7:14 AM

  My doctor works like that and I love it. I've never had to wait in a waiting room or anything, appointments start promptly and last as long as they need to (I've had an appointment last over 2 hours). She charges $220/hr, but after insurance reimburses me it costs less per hour than a doctor at a traditional clinic, which was about $15 for a quick 15 minute appointment.

• by Dnguyen on 5/29/13, 7:29 AM

  What happens when a not-so-good doctor charges very cheap and start a price war? Or to make it affordable, the doctor cuts corners? Who's to tell the doctor to what to do? Who watches the watchmen?

• by munimkazia on 5/29/13, 8:02 AM

  Off topic, but is anyone else concerned about the fact that the URL has a ref=relatedSidebar in it? The website will probably get a lot of hits from an incorrect referal in their traffic monitoring tool. I hate it when stuff like this happens.

• by kondro on 5/29/13, 7:14 AM

  Australian doctors generally use a combination of this type of technique.