What’s a Deductible?

What happens when you have a society that was trained to believe that when you have health insurance that everything is covered?  Chaos. 

Duke University Health System is fielding 1,500 patient calls a day, most of them asking why they got a bill since they’re insured.

Really? Duke has “also seen patient interest-free payment plans rise from $19 million in June 2010 to $43 million in January.”

So, this is an issue.  The ONLY way to get costs down is to have people know the prices for things and then shop around.  I believe insurance should be catastrophic ONLY but that does not mean these high deductibles should be so high.  That is a scam run by the insurance companies.  They kept raising the monthly rates and then made it seem like you are getting a deal if you pick the lower monthly rate options.

To summarize:

  1. We do need our population to understand and embrace catastrophic plans.
  2. We need our our population to know that each medical interaction will cost them personally so they shop around and bring the prices down.
  3. We need to expose the absolute greed of the insurance companies who raised BOTH the monthly premium rates and the deductible amount because they can.
  4. The monthly premium and deductible amount need to come down to where they were before Obamacare, if not more.
  5. And yes, there is subset of our population who need subsidies (Medicaid option, etc) but that doesn’t mean they shouldn’t pay something and have a little skin in the game.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “What’s a Deductible?

  1. RSW
    March 7, 2017 at 9:32 am

    Fuck Duke.

    I’m sure a huge percentage of those calls are about the outrageous facility fees they charge, even if you’re seen at the freestanding office across the street from me, two counties away from the mother ship.

    • Doug Farrago
      March 7, 2017 at 1:33 pm

      True as well

    • politovski
      March 7, 2017 at 10:41 pm

      Having recently taken my wife there to be seen by a specialty clinic, I would say that that indeed is the case. Also, they decided not to accept our insurance, even after they had initially agreed to do so. So, we were cash pay. And, let me tell you that specialty labs, genetic testing, 2 EMG’s, a muscle biopsy, and every random goofball who wants to come in the room and generate a bill (OT, PT, resident, fellow, attending, et cetera) can rack up quite a bill. The only good thing was that they cannot charge interest. Unfortunately for us, no real diagnosis.

  2. Steve O
    March 7, 2017 at 8:34 am

    From Black’s Law Dictionary:
    What is INSURANCE?
    A contract whereby, for a stipulated consideration, one party undertakes to compensate the other for loss on a specified subject by specified perils. The party agreeing to make the compensation is usually called the “insurer,”…. the other, the “insured”…, the agreed consideration, the “premium;” the written contract, a “policy;” the events insured against, “risks” or “perils;” and the subject, right, or interest to be protected, the “insurable interest.”

    It is a means of protection from unanticipated but possible events. It is not a trash can.
    Patients desired insurance reform over the last 30 years. They have not gotten it, and much of it is their own fault. Insurance and savings go hand-in-hand; if you stand to lose no more than $5,000 through a policy, you must retain the means of paying up to $5,000

    What we have now is a system that siphons off a majority of the money to nonplayers for their maintaining the health insurance architecture. A lot of money goes in; a little goes to productive purposes. It is not insurance. It is the equivalent of going to a restaurant, eating, and then screaming until the owner writes off the bill, or someone in the restaurant pays it on your behalf.

    Americans do not like to save; in many cases, they cannot, given their lifestyles and incomes. Therefore, they have things they like to get for free. Healthcare is one of them. Up until 1985, the median US household saved 11% per year (!!). By 1995, it had fallen to about 0%, where it hovers.

    The whole story is too complex to even annotate here. But this is not insurance – protection against a catastrophic possibility. It is a mess, and it is likely unfixable, without Direct Primary Care.

    Law Dictionary: What is INSURANCE? definition of INSURANCE (Black’s Law Dictionary)

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