Compensation. What one offers another in trade for goods or services. Most often today, it’s money. That is, I pay the service station money in exchange for gasoline. Or, I pay the tavern in cash in exchange for beer.
Occasionally, the compensation may be something besides money. Then it becomes a sort of barter. One party trades a good or service in exchange for another; wheat for milk. Dental work for electrical work. Whatever.
Another example is health care. Rather than our employer compensating us in cash, they instead compensate us in insurance.*
Imagine, if you will, if our employer compensated us in groceries rather than cash–just like health insurance. What would our world look like?
For one, we would have plans. Each company would have one, and it might be different from the one your spouse has, or the one you left at your last job.
You would be forced to buy groceries at approved providers. Specific purchases would be required, others would be covered and others yet wouldn’t be. After some small deductible, you could shop for however much food you wanted.
The plan would assume you eat 3 meals a day with snacks–though WHICH snacks would certainly be stipulated.
Because the plans would be the result of an actuarial table, it would assume that we all eat the same stuff at the same amounts.
You would shop for an entire year, if you could. You would want to avoid the deductible for each visit. You would lose out on the flexibility of “day of’ shopping. Grocery stores would cease to be incented to provide food for all tastes; they would instead focus on selling to the “provider”. No need for pharmacies, flower shops, fresh sushi and beer -n- wine. Fresh lobster? No need. Kellogg Frosted Flakes? Not when generic will do.
Everything would change. In a second.
And we’d hate it.
So why do we accept compensation in the form of health insurance when we wouldn’t accept it in the form of “food insurance”? Especially knowing that we could have this:
Apex, N.C. — A medical practice in Apex does what few in America do: It doesn’t accept payment through health insurance coverage.
Dr. Brian Forrest opened Access Healthcare in 2002 to make health care more affordable for people without insurance.
“We can pass those savings directly onto the patients,” Forrest said. “(Our) prices are generally 80 to 85 percent less than what they’re going to be in traditional medical settings.”
And how does he do this?
“We don’t file or accept insurance of any type,” Forrest said recently, noting that eliminating the paperwork involved with insurance claims saves his practice about $250,000 a year.
“If you were to go to a traditional office, you see someone who’s filing insurance, somebody who’s doing the billing, somebody who’s doing the coding,” he said.
And the service? How does it compare?
Patient Cathy Boggs said she has used Access Healthcare for eight years and called the care Forrest and his staff provide excellent.
But really, how is the “doctor patient” relationship?
Not dealing with insurance allows more time with patients, Forrest said, noting that he schedules just one patient per hour.
“Having more time improves quality,” he said.
No question, this is the wave of the future…
The direct-pay model accomplishes what many people want out of health care reform – increased access for the uninsured, decreased Costs and price transparency – and he said another 250 such practices nationwide will open up with or convert to the model in the next 18 months, including more than 10 in North Carolina.
Medical care, just like shoes, aquariums, bubble gum and baseball bats, reacts to an open competitive free market by providing higher quality at lower prices.