John --
I agree with you in principle.
But years ago we were all "non-par" -- that was at a time when almost all insurance was "indemnity". In those remote times patients actually paid the doctor, and the insurance company indemnified the patient.
That system made sense, except for several problems
1. The insurance company couldn't control the doctors
2. If the insurance company didn't please the patient, we would have to intercede somehow anyway -- a sort of early version of "prior authorization", though in effect, it was "retroactive authorization", and even then it was pretty onerous.
3. Trying to collect Medicare deductibles, copays, and balance payments was a nightmare. All of the checks went to the patients, and a lot of them were too demented or otherwise damaged to figure out what the check was for. They just thought they got a government check, and they spent it. (Or their kids or caretakers did.)
I don't suppose that would be a problem in Sun City -- but it was in rural Oregon.
