Category Archives: The Practice of Medicine

I’ve Been Saying for a Long Time

THAT RETIREMENT IS A death sentence. That was just from my opinion of all the old folks dropping on the golf course. Turns out I was righter than I knew. I never intended to retire. Even if I change careers sometime in my “golden years” it will be just that — a change, not an end. I would actually like to earn a living at writing, instead of playing at it as a hobby that occasionally pays. In the ’90s, I made a significant chunk of my income freelancing at the keyboard. Indy publishing offers the notion that I might be able to do that again and maybe more.

Wave of the Future

YEARS AGO, WHEN the so-called Affordable Care Act was only a glimmer in Hillary Clinton’s eye, my primary care physician allowed as how, were he to stop taking insurance, he’d be able to eliminate a good 60% of his office staff and be able to charge $40 for an office visit. (At the time, he was charging insurance companies $120. The co-pay with my carrier was $20.)

One year, I ran the numbers. I was spending, or was having spent on my behalf (including “insurance” premiums) a round $12,000. Adding up the actual charges as reported on the insurance paperwork, the cost was under $10,000. The rest was profit and overhead for the unsurance company. Whose rates, BTW, despite an official inflation rate of plus-or-minus zero, never stayed the same year-to-year.

The year before Obamacare went through Congress like shit through a greased goose, I made a deal with my employer. They were going to stop offering health insurance as a bennie, because they couldn’t afford the continual rate increases. So I made this pitch: Pay me what you’re paying the insurance company now and I’ll make my own arrangements. After a bit of dickering which essentially allowed them to cover what they were losing in the way of a tax deduction, we settled.

I’ve been cash-for-services ever since. Despite having a five-figure hospital bill in 2011 and spending right around $900 a month on meds, I’m still coming out ahead on the deal.

Now. Picture all the people who didn’t see this mess coming and didn’t get out from under soon enough. Now, their insurance premiums are skyrocketing, they’re losing their coverage, or they’re losing hours at their jobs, or losing the jobs altogether.

Remember what I say about so-called “unintended consequences”: they don’t exist. All consequences must be taken as intended. Obama and the Democrats in national government MEANT for this to happen.

But people will still want medical care. And there will still be those willing and able to provide medical care services at reasonable market prices. What won’t happen is that people will willingly take on the additional burden of paying the overhead and profit for a “service” company they don’t need. Or… will shortly find they don’t need.

I think you’re going to see a lot more of this.

I also suspect that you’re going to witness a major crash in health insurance companies, PPOs, HMOs, and hospital networks built around aggregating private medical practices. You heard it here first.