Excellent and thoughtful replies there folks. Now at $4 a gal for gas how much do you think Medicare and all privates should increase their fees for some poor primary to get in her Jeep with 10" of snow, loose two short visits on either side of her trip just to give some poor half bed ridden old lady (somebody's mom and grandma!) a good old fashioned housecall. I'm not in the least bit embarressed to say in light of reduced fees, inflation, doubling of malpractice in just the four years we've been open, I think our actual charges are not high enough, no less the fact that none of the majors can even meet them.
I have a quick question for all of you and I want a honest reply and if the answer is no I want you all to promise to go do this for at least two if not four fiscial quarters. When was the last time any of you regularly watched for the quarterly reports of all these insurance companies??? Just go to their own investor side of their websites, and simply use their own data. I have been paying extra attention to UHC because they are the cheapest paying of all of the Majors in our area. Way below present day medicare each and every year we have been here. And as the practice manager who shops for employee bennies I can tell you that they undercut most plans by about $100 per month to cover a family of four. No wonder more and more employers want to give them a try. And where do they get all this profit and undercut most other plans, by squeezing their PCP's
. That's how.
On average for every quarter I've ever checked UHC posts at least 3/4's of a BILLION dollars worth of profit each and every quarter! Ya I know, I had to do a double take and check the first time too, I just couldn't believe it. And remember this is after they pay their obscene compensation packages and other slush money, lobbist, and other funny funds, this is actual publicly reported profit! This is money that will never be seen by you or I whether as people in the healthcare profession or as consumers of such services either. These people are PURE EVIL. How dare they squeeze both us and our patients so while they are literally rolling in it like pigs at a feeding trough. And this is just one of the two largest carriers in this dirty business. Remember all the others be they BC/BS affiliates, CIGNA, AETNA, WellCare, Humana, Keiser, should I continue??? Each and everyone of these dirty bastard companies are doing like wise.
And let's not forget that part of what they all want to do is make more and better paying jobs and titles for themselves and their friends inside the company and this is all before the posted profits. Then there are all the other pigs at this feeding orgy like the large manufacturers, Big Pharma, now the CCHIT level software vendors who work both sides of this street so well, playing doctors office of of insurance carrier so we have this billing software arms race going on. "I'll just sell arms to both sides and make money in the middle" Hey is it the carriers or us who are supposed to be the Sneeches with stars on our bellys, I forget now???
One of the most profitable small companies here in our area is a medical recovery firm called Med-Rev. Unreal, more parasitic lose for us for someone else to make money on. Anyway, when all these greedy and inhuman SOB's who literally kill people with denying care and cheat docs and patients every day, finally get properly cut back down to size and have their bank accounts and profits raided like we have ours, then and only then will I be willing to listen to anyone wanting to do anything but raise our fees without us having to do anything but say, "yes you're welcome, yes you're right we were giving you pretty darn good services under some of the most obscene conditions and pressures. Thanks for understanding and finally paying up".
And remember when we contract directly with our patients with no insurance, then the entire concept of "insurance fraud" and give backs for improper coding and all the like goes right out the window. Oh and the research is clear, on average almost all docs do "undercode" already, so there is really not a reason needed to be asking for P4P or give backs, we are already cheating ourselves for fear of running amuck with these SOB's. They don't need nor deserve any more give backs. It is my contention that the AMA themselves is guilty of colluding with the gov't and the carriers for having their stupid little coding system in the first place. Heck you guys are supposed to be private contractors, they can't tell you how to document, code or bill and god damn thing, that in and of itself in a clear violation fo free trade. I don't care to bill with with 99213 and 4's, I want to use a two tiered office visit system. Or a time based one or what ever the heck you care to use. The AMA should get out of the business of assisting our oppressor and you should all be angry as hell at them for colluding with the enemy! How 'bout them apples?
But in the end we need the right to act and work collectively against a large corporate monster that has those same rights. Then and only then will we have the semi-equal leverage to fight back against these animals, these piggies. Without us having an equal say to hammer out what is measured how and when, what kind of out put for what kind of pay, it is all just a means to continue to keep us all tied up in knots and reduce your fees ever downward. It's a great sounding catch phrase, George Orwell would have been very impressed, but in the end it is just anther new set of tricks to pick your pockets and bleed you dry, while they stuff their fat faces ever more.... That's all. Sorry I'm not buying it and I never will until all the other conditions are met first. (and even then....)
Good Night and Good Luck,
Paul
