There are lots of claims as to why medical costs can't be reduced. The entire insurance industry has sold the consumer on the idea that the only means of lowering costs is what we're living with, less coverage, more exclusions, shorter hospital stays. And consumers eat it up. We compete with one another for better coverage based on our health, age, habits and region. But it's time for the medical profession itself to kick in and help solve the problem. We've taken the claims of "rising costs of medical equipment, the cost of medical schools and the infamous claim of rising costs of malpractice insurance" as justification for the medical community's unwillingness to lower prices.
A recent sports injury got us back in the soup of calling around for a specialist who took our insurance AND would see us before next year's new year's celebrations. We found one doctor's practice that offered us an earlier date if we would see a PA. We took it. The PA ended up prescribing some physical therapy after an exam, but the charges by the physician office are the same as if we'd seen the physician. The argument goes that we pay for the service, not for who provides it. What?
The place to start with reducing costs for insurance companies is to start a tiered reimbursement rate. If a person sees a nurse or a PA who can provide services once provided by doctors then cost and therefore reimbursement should be lower. This approach will save consumer money, increase consumer access, and based on the medical community's own pushing for use of these professionals, makes no difference to consumers in the quality of care. It will also serve nurse providers and PAs well as their pay will rise with their responsibilities and they will get their piece of the MD salary pie. It is ridiculous that we pay physician office visit prices when the entire visit from booking to going through never involves a physician.
Insurance companies have left physicians to their free market economy of charging whatever the market will put up with. Instead of continuing the only good part of HMO's which was the power of the consumer to offer its numbers in exchange for a bulk rate that was less than market, we've thrown up our hands and said more privatization is the answer. Except that insurance companies say NO to insureds all the time. How 'bout saying no to the same cost whether a patient sees a nurse or PA or doctor. These rates should not be the only untouchable part of medical care.
