Have to disagree. If you're welfare-level poor then you're on medicaid and it's almost impossible to find a GP or specialist who will treat you. You are stuck with going to the ER and they will stabilize you and then literally wheel you out of the hospital.
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I had a friend with a fractured ankle who needed surgeries and after 2 years of trying to find a specialist who would treat her on medicaid, she resigned herself to living in a wheelchair. Pretty sure her foot is amputed now. You do not get a high standard of care on medicaid.
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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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Here's how you revamp the profession to solve this: Dedicated diagnosticians; refer you to treatment; treatment is required to list prices up front with limits, etc. If they need the option to charge more for contingencies, LIST THEM - IN ADVANCE.
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