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To: neolib who wrote (199867)	5/3/2009 3:18:39 PM
From: i-node	Read Replies (1) \| Respond to of 306849

The reason providers stiff people lacking the club discount is because they often fail to collect from them, and that group has no negotiating position. You do realize that providers are not allowed by law to discount FFS charges, right? That they are required to charge the same to self-pay patients as they do Medicare? They can't just arbitrarily say, "Oh, you're a self-pay so we'll cut your fee to what ABC Insurance allows"? Although, I see docs do it routinely. But by law, they're not allowed to do so. They give a discount, that is far from "losing money". Sorry, you don't know what you're talking about. For most specialties it would be impossible to survive on what Medicare pays. For example, the UCR for a Lap Cholecystectomy here is $970, while Medicare pays $578 (at my locality). A surgeon cannot even pay his malpractice insurance and office overhead based on that $578 payment, let alone generate any take-home pay. I happen to consume around $30K of surgical expenses/year at good discounts, and the provider still makes money. If you are a Medicare patient and your provider "still makes money", it is only because he/she has a patient mix that permits it. As one who often advises physicians on this subject, I can tell you that we advise extreme caution when taking on Medicare patients, since it is impossible to make a decent living with only Medicare patients. Your hospital could not pay its bills, either, if it had only Medicare patients. Without the subsidy provided by commercial insurance, there is almost no portion of the medical community that could make a decent living. You would have a bunch of nonprofit organizations, that's it. I know your position isn't unusual, but it is one that stems from ignorance rather than awareness. No offense.