Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What is “fair” payment for medical services?

Neal Biron
Policy
January 29, 2020
Share
Tweet
Share

I write this hoping to appeal to common sense. When are we going to stop putting the cart before the horse? 99 percent of the rhetoric surrounding health care costs centers on a “fair” way to pay for it, “fair” reimbursement levels, and who should pay this “fair” level of payment, when the real issue is the amount being charged in the first place. What exactly is “fair”?

The real central, causal issue is the very high cost of the care. Health care is the only thing I can think of that we buy without knowing what it is going to cost. The delivery system is convoluted and a mystery to the average person. I had 1 MRI. I got a bill for $350 from the person who conducted the MRI. I got a $600 bill from the facility where the machine is located. I got a bill from another doctor who read the MRI for $500, and another bill from a doctor who guided me through my treatment options. They were all great and did great work, and I am grateful for the treatment I received, but where is the accountability for the charges?

Can you imagine buying a TV, then getting a bill on your credit card for $50,000? Of course, it would never happen because you know the cost before you buy it. Every transparency bill sent to the MA legislature has been lobbied against by the Medical industry. Is that “fair”? My dentist wanted me to have two implants. I asked what it would cost. He told me. I told him if he could justify that price, I would do it. I never heard from him again.

Let’s face it. “Fair” means more. Where is this additional money going to come from? The answer is it comes from the patient, either in the form of premiums, deductibles, co-pays, and taxes. Yes, taxes. Where do you think the money comes from to pay the subsidies provided by Obamacare, or the various state Medicaid programs? I am in M, and the state budget for FY2019 is $43.1 billion. Mass Health alone is over 40 percent of that budget. That’s $17.24 billion of health care costs paid for by our taxes. Then there is a little thing called Medicare. In 2018, that was $731 billion, your taxes, and the individual payments made by Medicare beneficiaries.

So before we start worrying about who should pay the medical bill, shouldn’t we be analyzing and requiring justification of the bill itself? Medicine does three basic things: diagnoses the problem, treats the symptoms, and tries to cure the underlying disease. For the last 30 years, we have done nothing but treat the symptoms. It’s about time we did some deep diagnosis and start curing of the disease.

Medical costs are on a collision course with the U.S.’s sustainable economic structure. Unchecked, it will bankrupt this country.

Neal Biron is a benefits consultant.

Image credit: Shutterstock.com

Prev

Self-care for physician burnout: What does that mean?

January 29, 2020 Kevin 0
…
Next

Here are the common ways that doctors can practice medicine

January 29, 2020 Kevin 0
…

Tagged as: Public Health & Policy, Washington Watch

Post navigation

< Previous Post
Self-care for physician burnout: What does that mean?
Next Post >
Here are the common ways that doctors can practice medicine

ADVERTISEMENT

Related Posts

  • Digital advances in the medical aid in dying movement

    Jennifer Lynn
  • All’s fair in love and medical school

    Jennifer Udom
  • How the COVID-19 pandemic highlights the need for social media training in medical education 

    Oscar Chen, Sera Choi, and Clara Seong
  • Why this physician teaches health policy in medical school

    Kenneth Lin, MD
  • American physicians deserve timely payment

    Peter Ubel, MD
  • Medical trainees need knowledge and education on health care systems and policy

    Daniel Arteaga, MD, MBA and Isobel Rosenthal, MD, MBA

More in Policy

  • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

    AMA Committee on Economics and Quality in Medicine, Medical Student Section
  • Who gets to be well in America: Immigrant health is on the line

    Joshua Vasquez, MD
  • Online eye exams spark legal battle over health care access

    Joshua Windham, JD and Daryl James
  • The One Big Beautiful Bill and the fragile heart of rural health care

    Holland Haynie, MD
  • Why health care leaders fail at execution—and how to fix it

    Dave Cummings, RN
  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What is “fair” payment for medical services?
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...