The Reason For The Delay In Treatment

A new Gallup poll of 1000 people showed that 29% of them have delayed their healthcare due to costs.  Terrible, right?  Remember, though, this is just a survey.  Let’s dig deeper.  

It also “found those who have no coverage are most likely to forgo treatment — with over half the respondents in that category reporting a delay” and “those enrolled in Medicare or Medicaid are least likely to wait”.

It is obvious that you can take any conclusion you wish from this.  It’s also obvious that when the person doesn’t have to pay anything then he or she will get the treatment.   When they have to pay out of their pocket for everything then the odds they won’t. 

Does this mean they can’t afford it?  Maybe.  Maybe not.  The ones getting screwed are the ones with massive premiums and then also have the massive deductible.  My guess is they really are having trouble affording care and that is due to a combination of the lowlife insurance companies who were emboldened by the Affordable Care Act (how stupid was that name?). 

The answers are not simple but they are out there.  We need lower premiums and lower deductibles and then people need to “Amazon” or shop around for lower prices.  By using pre-tax dollars (HSAs) they cut the price even further. Can this be done?  It’s being done everyday with the health ministry plans.  Would that solve it all?  No.  Some people WILL NOT value their health no matter what and pay more for their car’s maintenance than their own health maintenance.  

These are some of the things this survey will not tell you. 

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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] 

  8 comments for “The Reason For The Delay In Treatment

  1. Dave Mittman,PA
    December 19, 2018 at 10:44 am

    We need to realize that visits to a clinician, even with insurance, costs people hundreds of dollars. A co-pay of $30 and an Rx of $30 and transportation is mandatory in NYC. What about time taken off work or for childcare.
    I am not saying everyone should get everything for free but I am talking about people covered by insurance fully for $1,500 a month. On an average income it’s hard to do. So you forgo some visits, even if you notice something until later-either it goes away or it’s worse.

  2. Jennifer Hollywood
    December 19, 2018 at 9:38 am

    Health ministry plans/health share plans do not accept all persons. I recently had a patient that they declined to accept. The plans also can accept a person and exclude pre-existing conditions. So if you have a pre-existing condition, it may not be covered. These plans are NOT the answer for all people. They also do not cover all services-many exclude annual physicals and vaccines for example.

    • Doug Farrago
      December 19, 2018 at 11:54 am

      It’s the model that works. They make money. The cost is cheap. It is what the old catastrophic plans were. It can be tweaked. First, these “high risks” groups that you mention can be taken care in another way (Medicare look-a-like). Second, why should vaccines and physicals be covered? That’s how we got into this mess in the first place.

      • Jennifer Hollywood
        December 19, 2018 at 12:26 pm

        I agree that routine physicals should NOT be covered. Our population needs to be retrained about the value of health care and needs to plan to pay for these annual physicals. But I have also seen DPC doctors reporting their own children’s physicals coming in at $450 after the doctor adds in additional charges to the preventive charge for vision check, hearing check, depression screen, nutrition counseling etc. That is ridiculous and needs to be fixed.

        For children, vaccines can be quite costly with the cash pricing being about $650 the first year of life. IMO, the government should cover all vaccines since they not only serve to protect the individual but also to protect the population.

        My daughter had cancer as a child and therefore will never be able to get insurance if they are permitted to exclude based on pre-existing conditions. My husband had a heart attack at 54. Nonsmoker, athletic, non-obese with familial hypercholesterolemia and strong family history. He also cannot get any plans with exclusions. These catastrophic plans are simply NOT available to them. We have tried to get a VERY high deductible plan to get the rates down, and they just don’t exist. So the model only works for healthy people.

        • Doug Farrago
          December 19, 2018 at 3:38 pm

          Gotcha. Well, I still think those that are “excluded” can be subsidized in a high risk plan that tax payers help. The immunizations are free here in Virginia. The $650 is abhorrent and why everyone needs to have a DPC doc

  3. Gabriela Eyal
    December 19, 2018 at 8:44 am

    Medicare patients do pay. Medicare pays only 80% of the cost. Medicare recipients have also paid upfront their entire life for the care they receive in their senior years.

    • Doug Farrago
      December 19, 2018 at 11:56 am

      $1800 a month with a $8000 deductible? NO. They are the highest utilizers (due to age) and so in comparison they pay the least as far as how much care they are getting.

    • Pat
      December 19, 2018 at 1:53 pm

      “Medicare recipients paid upfront their entire life” is not going to fly. The obvious fact is that the average retiree takes more out of Medicare than they put in, or it would not have had cost overruns ever since it’s inception.

      People live longer, so Medicare costs go up. There is unrestrained demand, therefore we have price inflation without end. And all the answers have been stupid core measure, rate cuts, and any other trick to avoid paying for care delivered.

      Retirees have wrecked the national debt with their refusal to allow any serious Medicare reform, driving us further toward fully nationalized health care, and poor-mouthing all the way.

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