[InCityDreams]

>Advocate for yourself or you might die! Not kidding !

Paid healthcare? As a europopulator i can choose to pay for my healthcare. Rest assured, that when i do pay, i insist on certain things. Like doing the tests i insist on...

"Plus a lot of doctors won't believe or authorize tests."

Surely, the money talks in a situation like this? I can pay for any test i like and no (socialist, here) doc would ever say no, nor would they actually give a crap.

[elif]

Unfortunately not in the USA. I assume lot of it comes down to the doctor's discretion because if the insurance company finds that the doctor is performing excessive treatment/tests, they will deny coverage, renegotiate rates with the provider, or even refuse to cover the provider outright.

I've been trying to get certain blood screenings through 3 doctors, and they were all more than happy to repeat the same basic blood panel 3 times, since it is incontrovertible, even though it would have cost less overall to get the specific blood screen I asked for.

And if I want to pay "out of pocket" it is impossible because the tests often require a doctor's prescription, and even if not, the non-insurance rate for the tests are 2-10x what providers negotiate with insurance companies.

[sleightofmind]

There is not, to my knowledge, any prohibition against you going to a doctor who only sees "fee for service" patients, to get your lab work done. That is, a physician who accepts no insurance whatsoever. These are not rare in the U.S. Get your test from such a doctor, send it back to your own physician/healthcare provider as a nudge.

For much of my 30s, 40s, and 50s I was strictly a fee for service patient in Southern California. This, of course, is no solution for someone with significant health problems. I've been blessed with good health, undeservedly so. I had cataract surgery on my left eye in 2011 for $2600 cash, up front, at the area's biggest hospital. No further charges materialized. I had no regular primary care physician at the time. To me, $2600 for a surgery, the result of which was so magically wonderful that I burst into happy laughter in the ophthalmologist's office when he removed the eye bandage, was worth far more than the $2600.

Don't overlook businesses like Everlywell or Private Labs MD that enable one to get tests performed outside your own network. I've used such a service to "nudge" my health care provider (with whom I am generally satisfied) to investigate some subject further. Admittedly, this is not much help for exotic tests.

If, like me, you are lucky enough to live reasonably near our southern border, labs in Mexico don't even require a doctor's order to perform tests. There may be exceptions to this -- I don't want to imply that I know more than I do.

I don't want to "wave away" the very real problems that exist for those who cannot afford any service outside their network, nor do I mean to ignore the very real problem of arrogant medical professionals who ignore a patient who tells them, "Listen, Doc, I've had this same test three times in the last three months." I only mean to suggest that sometimes, when it is possible, it helps to work around a stubborn physician, rather than attempting to bend said physician to your view.

[elif]

If only it were that simple!!

Because of digital record keeping and insurance laws, even if I go to a independent, fee-based doctor, the results of his test can mean that in 10 years, insurance can refuse to cover certain treatments.

It's really an inescapable web, that even my doctor is aware of and seems paralyzed to authorize a test for me because of not only the implications for my finances, but also her practice.

[elif]

Essentially, it's my opinion that US doctors are afraid of arbitrarily losing a chunk of their customers or having to negotiate with lawyers.

[9991]

Sounds like the insurance company is the customer, then.

[brewdad]

If insurance doesn't approve the test, it won't be paid for. Insurance also means US prices for tests are elevated to 10x what they "should" cost because providers expect insurance to knock the price back down to a reasonable cost. As a result, ordering a bunch of unapproved tests leads to huge out of pocket costs for patients so only the wealthiest will ever be willing to push for them.

Ironically, that same population also is the most likely to have insurance that will cover the tests in the first place. So it goes.

[smabie]

You actually can negotiate pretty easily with most hospitals / doctors. After getting the bill just say you can't pay and offer a fraction of the cost. Many times they will say yes (alternative for them is selling the debt for cents on the dollar anyways)

Source: have done this 2-3 times in the past when I was poor / used to not have self insurance.

[gtvwill]

On the other hand I have to travel 30 mins cus the 5 doctors in my town no longer bulk bill and I can't afford the cost to go see them.

The fact your ok with having to pay for a better standard of healthcare rather than just having a society which provides the best healthcare for all. Is legit cooked.

[pojzon]

Not everyone can pay. Health should not be gated behind a paywall. Life is not a microtransaction game.