April 5, 2004
Some doctors in Mississippi and other states are so frustrated by the red tape of managed health care that they are daring to dive headlong into a bold new concept: cash payments.
Quitting the insurance game, they say, relieves their offices of paperwork and administrative expenses, which they believe have driven up the price of care to patients and wasted precious professional time. Some wanted to spend more time with patients without managed care bean-counters peering over their shoulders.
One patient, in a story reported by The Associated Press today, said when he leaves the exam room, he writes a check for $50 and he's done no forms, no ID numbers, no copayments.
This is traditional medicine. This is what America was like 30 years ago,'' said the 55-year-old patient.
Is this the health care wave of the future? Probably not. Most people are content with monthly premiums and $10 copays; nine out of 10 doctors contract with managed-care companies.
But experts such as Dr. Arthur Caplan, chairman of the medical ethics department at the University of Pennsylvania Medical School, say the move to cash-only doctors is an indictment of a collapsing health care system. Insurance and managed care were supposed to streamline instead what they've done is add so much paperwork and bureaucracy they're driving some doctors out.''
To be sure, paying cash is a different way of doing business today, and some people say cash-only doctors are driven by the desire to practice medicine without interference, free from the intrusion by third parties into the patient-physician relationship.
The cash-only movement isn't just changing the way people pay, it's changing the way some doctors work. Because of managed care's low reimbursement rates, doctors on insurance contracts must limit their time with each patient.
With the cost and quality of health care always in the forefront of debate, it could be argued that anything that strengthens the relationship between physicians and patients is worth exploring.