Tuesday, February 7, 2012

Can Money Buy You Good Health?

They say that money can't buy you love or happiness, but I am beginning to think that it might actually be able to buy you good health, or at least better health if you live with chronic illness.

I know nowadays there is a lot of talk about the uninsured and those with health insurance.  Correspondingly, you hear a lot about the two different health care systems serving these groups: the publicly funded health care system (think county hospitals and clinics) and the insurance funded health care system (think doctors in private practice, medical centers, etc.)

Having medical insurance and chronic illness, I've spent a good portion of my time and energy access care in the insurance funded health care system over the past eight years.  I've learned a lot of things about how this system care works, enough to write a whole series of blog post.  But perhaps my most perplexing discovery is that there is actually a third health care system that doesn't get a lot of attention, that of the cash-only or self-pay medical practice.

As the name implies, these are physicians and other health care professionals charge up front for their services.  So if you can't pay (or charge the bill to your credit card) you can't be seen.  They don't accept your insurance--in fact many don't belong to insurance networks and have opted-out of Medicaid and Medicare. Most will provide you with a superbill so you can submit their charges to your insurance company, but since their rates are usually above and beyond what your insurance carrier considers "reasonable and customary," you will only be reimbursed for a fraction of what you paid them.

So, in essence, this third health care system is for those who have money, lots and lots of money.

I don't have lots and lots of money, so in the past, whenever I have stumbled upon one of these medical practices, I have steered clear and not given them a second thought.  Which is all well and good except that, as time has gone on and the insurance driven medical system has failed to provide me with adequate care for my chronic illnesses, I now am getting referred to this third system of care because its members provide the services I am seeking.  In this system reside the experts in things like pain management, rare diseases and disorders and novel and cutting edge treatments that pick up where conventional approaches fall short. 

Yes, it seems that here in Los Angeles many of the doctors who are at the top of their fields convert to this kind of practice.

Now I find myself wishing I had the money, the golden ticket, to access this third level of care.  I'm drawn by the allure of better treatment that could potentially make a significant difference in my quality of life.  Granted, I don't think they could cure me, but from what I have heard, it seems like these upper echelon providers could reduce my chronic illness burden and help me regain some of the day-to-day functioning I have lost along the way. 

With all the hype, I have to wonder, 'Could being treated by one of these cash-only healthcare providers be the difference between living disabled and living more able-bodied?'

Unless I win the lottery or become the recipient of some fortune from a deceased distant relative, I guess I will never know.

So what do you think?  Can money buy you good health?  What is your opinion of cash-only or self-pay medical practices?  Are you able to access this top tier medical system or is the admission price preventing you from getting the kind of medical care they provide?  

Please share your answer to this Question of the Week below in a comment or over on the Oh My Aches and Pains! Facebook page.   

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Migrainista said...

I absolutely agree that money can buy you better health. Obvious our genes also play a role but there is no way to deny that our environment also plays a big role. Money has A LOT to do with the kind of environment we live in.

I've also recently run into the situtation you are writing about. My migraine doc sent me to a chiropractor who also does medical massage and accupuncture. He said that she is the best and that they have worked together to figure out the best way to treat his migraine patients. Unfortunately she is private pay...so there goes that.

Anonymous said...

I know that rich people or people who are at least, well off are able to obtain better health care. This is true not only in the U.S. but also, in countries that have government funded health care. I've talked to people in Canada that get treatment in the U.S. and people in England who go to India when they have anything serious going on or are too old or too sick to be put at the top of the waiting list under their system of socialized medicine. There really are death panels that decide who get treatment first and who gets it last. In the U.S. it is health insurance corporations that decide and they aren't much better than the government when it comes to providing care for those who can't afford it on their own. No matter the system, the same people end up on top and it's having cash that insures the best quality of care.

Pam, www.boomerback-beat.com

Chris Dean said...

I couldn't agree with Pam more! It is so frustrating to see the inequality in the health care of people based on the have-have nots priciple.
Sadly, the medical profession, like everything else in our society, is big business. Funny, I always thought "health care" should be about people's health...silly me!

Iesadora said...

We live in LA county, and the closer to 'LA' you go to see these cash only doctors don't forget to add 30% to what ever dollar amount you have an idea of lol My dentist is in west la and she is nnnoooooot cheap, but I've gone to her all my life (I'm the reason she started seeing children =D) so I wouldn't go anywhere else unless I have to.

Lenka said...

I was just thinking this yesterday. Not only doctors, but medication. I keep having issues with insurance denying medication prescribed by my doctor. So it becomes a game- we will try this that probably won't work, because then they may cover the other one that works better. If I had money, I could bypass the whole mess! I could use the most effective treatment regardless of paperwork. It's a real bummer!

Not to mention how much energy it takes just managing the whole insurance, doctor, referral system. How relaxing to just pay and be done :)

When I win that lottery...

jhylands said...

Its the age old problem that its so hard to become a doctor. That means very few people can become doctors. Very few people becoming doctors mean there aren't enough doctors to go around. Then it comes down to how do you ration the doctors you have. Do you like in the US allow people to bid for them (i.e let the doctors set the price using the free market's price mechanism) or do you use some other method where a single institutions is responsible for their distribution. It would be better if more general practices could be automated allowing GPs to be freed up to become more specialists.(http://www.wired.co.uk/news/archive/2013-02/11/ibm-watson-medical-doctor) It would also be better if the education system aided more people into becoming doctors. There is also the big problem of the cost of researching solutions, although I have seen some TED talks recently that give me hope that drugs can be tested on a far larger and more mechanised scale. (http://www.ted.com/talks/geraldine_hamilton_body_parts_on_a_chip)(https://www.ted.com/talks/roger_stein_a_bold_new_way_to_fund_drug_research) (can't find a link to the other one).