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To: neolib who wrote (199845)	5/3/2009 1:22:36 PM
From: i-node	Read Replies (2) \| Respond to of 306849

>> Yes, no billing is more efficient. Hence my comparison to Safeway. Realistically, you're not going to have a "no billing" situation. Unless we move to totally socialized medicine, in which case the resultant system is totally unlike the existing one, from the ground up (with a substantial decrease in quality of service along the way). It really is just the nature of the US health care system. I don't think even Obama, socialist that he is, is so blind as to think he can take over 1/6 of our economy without a huge economic disruption that would destroy his chance at reelection. So, wherever we end up there is likely to be some kind of billing as we now have. I should note that the telephone, utility, auto repair, etc, don't discriminate against me by a factor of 2 if I offer to pay cash at the time of service. You're really confused about what is happening here. I know how you're seeing it, but it is just a convoluted view of the relationship. I assume you mean that if you don't have insurance you don't benefit from repricing. But you do understand that repricing is just a negotiated deal between the payer and the provider for sending the business to him? No provider is REQUIRED to "participate" with any insurance. And in fact, most providers would be better off not doing so. But they choose to have access to the patient base that participation brings them. There is no discrimination involved; the provider agrees to discount his fees to the payor in exchange for the referrals he gains. I must admit, that before I spent the last couple decades dealing with these issues, I had the same view that you do. But I've been there as many physicians opened their doors; no matter how many times you say, "You want to think twice before participating with United Health", they'll do it because they want the patients. And even though a provider loses money on just about every Medicare patient, you cannot get them to say, "I don't see Medicare patients". It isn't happening, because they need these patients to cover fixed operating costs for their practice. The market resolves these issues. The fact that you have to bill this person or that is pretty much immaterial. That's the way the business works. As a CPA, I billed my clients monthly. Today as a software company, we bill our clients, every month. It is just the way it is.