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DOCTROIT  Advocating for the cash paying patient  

Why we need DOCTROIT

PATIENTS

For years insurance companies have obtained significant discounts on physician fees that are not available to patients.  This means that when you, the cash paying patient, have services you are paying the full charge.  Thus the individual patient with limited resources, pays more than the big insurance plan.  It is not a fair system. 

DOCTORS

Doctors don't like the current system either.  The insurance plans determine payment levels for doctors.  Looking out for doctors is not in their interest.  The insurance plans have to serve the needs of their paying customers - typically employers. When they set fees and payment rules they have to be very restrictive.  Physician services are like a commodity where the market has determined some minimum payment that every doctor must accept - via insurance payments. 

For a doctor who wants to spend more time with patients, or to provide better service through increased staff (faster phone answering, Nursing care over the phone, personalized letters to you, etc) or with a nicer space for you to be treated in, or any number of other improvements, they find that the economics work against them.  The insurance-based reimbursement system today limits their ability to provide a better service and command a better price for those of you who desire something better.

Staffing and other expenses to deal with payment processes, computers, insurance companies, and regulations eat up 15% of the revenues of a primary care office.  This is a source of frustration for all  involved. 

Cash paying patients eliminate most of this cost.

EMPLOYERS

When an employer pays for health insurance for their employee about 15% of their bill is absorbed by the overhead required to simply run the insurance plan, the employer benefits administration, etc.  Add that to the 15% spent by the primary care doctor and we see that there is a huge opportunity to reduce the total cost of health care.  Much of that cost has probably been well-spent.  Insurance plans secure a better charge structure, work to limit utilization, and verify that an individual is covered.  Eventually these elements should be worked into the cash paying structure.  Medical Savings Accounts may be part of that answer.