She had all the cards. Specialists don't need to accept it. This was in CA. Medicaid pays much lower rates than medicare, and very few doctors will take it. Medicare is still widely accepted, even though many doctors refuse it. Medicaid is a different ballgame.
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And problem here is that orthopedic surgeons make $500K-$680K per year, but you pay much more, because the hospital takes a cut, they have staff, there are nurses who assist, etc. And your fee for that procedure has to cover all their salaries.
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Had a 10 minute appt with a podiatrist, and was charged $1500. They had a nice office in downtown SF, there were some secretaries, etc. I was paying for all of it. We employ 16 million people (10% of our labor force) in healthcare. And many of them earn outrageous salaries.
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I'm willing to consider anything as long as it has a good chance of reducing the health care share of GDP from 19% to 10% over, say, a 20 year time frame. Everything is on the table. I'd like to start with billing reform -- no surprise bills, know the price ahead of time.
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When you go to a mechanic, they give you an estimate. The idea that you have to sign a paper saying you are responsible for anything the hospital charges you, and there is no estimate of what that will be, and if your insurance declines you owe the balance - that's criminal.
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That almost sounds like a voluntary market transaction. What a dream!
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Whenever it doesn't work like a market you know there's some mystery force distorting it. Sure, hospitals love the situation where they can surprise bill you *but they're not alone - every business would love to have the option to do that* but can't due to market discipline.
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