We Think We Know The Answer… But How Has Your Insurance-Free Medical Experience Been?

At the end of their recent article about cash-only medicine, The New York Times asks, “With all the changes in health care and insurance, has your doctor stopped accepting insurance? If so, what has been your experience — both with the care and with your insurer? The article title is warily slanted — “Dealing with Doctors Who Only Accept Cash” — but the writer shared their own wonderful story about a cash-only doctor who drove an hour and a half to successfully take care of a sick baby.

Paul Sullivan says that back in October, he and his wife were at their wits’ end because their 4-month-old daughter wouldn’t sleep for more than an hour at a time throughout the night. They consulted books, saw their pediatrician, but no dice. Then his wife called a pediatrician who specialized in babies with sleep problems.

The next day, this doctor drives an hour from Brooklyn all the way to their house. The doctor spent an hour and a half talking to them and examining their daughter. He prescribed medication and suggested his wife adjust her diet. Two days later, their baby was sleeping through the night.

But the catch for Sullivan was that this pediatrician didn’t accept insurance. He took their credit card info and gave them a form that they could submit to their insurance company. He said insurance usually paid a portion of his fee, which was $650.

As you’d expect, their insurance company didn’t want to pay anything. Here’s how they figured it: A) They said a fair price for our doctor’s fee was $285, based on where they lived. Then, get this, the company said that this lower fee wasn’t enough to meet their out-of-network deductible, so basically they were SOL.

Of course, we’re not in the business of doing boutique $650 appointments. However, we are going to point one thing out… Sullivan writes, “While we were none too happy with the insurance company, we remained impressed by the doctor: he had made our baby better and was compensated for it, all the while avoiding the hassle of dealing with insurance.”

The trick for is finding enough hassles to get rid of, so that doctors can charge reasonable rates, and offer this type of quality care to the general public.