I had an interesting discussion with a doctor yesterday: Because of Medicare billing practices, doctors have created workarounds that allow them to receive the same payments as they did a few years ago. Doctors' payments have been going down, while insurance companies profits have been rising. Think of a balloon...you have a certain amount of air (Medicare reimbursements) and if you want one side to be bigger than the other, you squeeze the one you want smaller. For example: you go in with a laceration, the doctor puts on butterfly strips and sends you on your way. The doctor then bills insurance for an office visit plus a couple of other things. However, in that same scenario, you really need sutures, the doctor can only bill for the sutures (procedure of stitching you up), no office visit. Have you noticed lately that if you go to doctors office and they order some type of procedure, the procedure isn't done then, it is scheduled for another day? I always thought this was a scheduling thing but it has more to do with billing than anything else. The end result is that the consumer pays more in money and it time. You've got two co-pays now and you have to take another day off of work.
"Because of Medicare billing practices, doctors have created workarounds that allow them to receive the same payments as they did a few years ago." This is why many are advocating a universal system for all payments. Not only would this cut down on backdoor fees/workarounds it would also reduce costs associated with administrative fees. One of the main reasons different practices do not accept certain types of coverage is that they use a payment system that is not compatible with theirs. If their was 1 system every company and doctors office/practice/hospital was required to use this could be avoided. I remember from my heathcare economics class it was discussed that the average visit to the hospital or doctors office would be cut by 11-25% due to this change.(Note: This is not the "single payer system" it is 1 billing program used by every insurer, practice, etc...kinda like saying...HEY EVERYONE, YOU HAVE TO USE EXCEL!)
