Is it fair that people who pay immediately and directly are charged twice to ten times as much as insurance companies are for the same exact service from the same doctors?

We helped a couple from Montana that just wanted to check to see if they had colon cancer. They have insurance, but their deductibles are so high that they wind up paying for most of their care directly. They asked us to find them a fair price for the screenings. We tried and tried, but we could not find a price less than $3,300 within a hundred miles when the national average price paid for the service is about $2,300. Meanwhile, on FairCareMD the average price for the same service is $1,209, or 46% less than the national average. Sunnie called the couple to say, “sorry, we can’t help you” but after a short talk, she learned that the couple was visiting the East Coast soon. With a stronger network back East we helped the couple get what they want for well below average in the city they were visiting, saving them over $3,000!

Which leads me to the next question:

Is it fair that doctors don’t feel safe sharing reasonable fees with the public?

No doctor we have spoken to likes the lack of pricing transparency, but many don’t feel they have any choice. Warm, caring, wonderful practices like the one that helped our couple from Montana fear that insurance carriers will take advantage of low publicly published pricing to lower their rates.  Worse yet, they fear that they will be charged with Medicare fraud just for publishing a fair price online.  This is exactly why we designed our pricing system the way we did – with a list price that not bad, but not as low as possible.  What you don’t see is that behind the scenes there is a lower price that, if you propose it, the system will automatically accept.  While not everyone uses this price masking feature of our system, it is there to ease providers into the hot tub of price transperncy that is FairCareMD.

For the providers who have been on FairCareMD long enough to know that it is not dangerous (we have had no issues to date with the basis of this fear) you can find great deals for real care here too.  Many are what you would call a “Special” so that they are not comparable to a typical service.  This is a second tactic for dealing with this concern. Fact is that deals made on FairCareMD are never comparable to those paid for by insurance or the government.  This is because they are all for care paid for at the time of service without a lengthy, laborious collection process.  This is “substantively different” from what your insurance company pays for.  Speaking of which…

Is its fair that up to about 35% of your insurance premium has nothing to do with your medical care?

Did you really want to pay for insurance company marketing, administration, network management, “care management”, contracting, executive compensation, and up to 14% profit?  Does any of that have anything to do with keeping or getting you healthy?  The inefficient marketplace and system is a huge burden on those paying for insurance.  In our experience we cut about 30% of the fat out of the system just by enabling direct contracting for care.

Much about how medicine works today is unfair.  We are bringing fairness to medical pricing.  We would love it if you joined us in this effort..  You can Register as a patient, Sign up as a provider, or Join us as a Market Maker to bring FairCareMD to your town and make your own network.  We need all of you to make this work, so sign up today!

Tags: Affordable Care, change we can make happen today, direct pay, improving provider reimbursement, reducing out of pocket spending, the problem with health care, Transparency in Medical Pricing