Medical care

I remember back in the early sixties when Congress was debating Medicare. The doctor that my family used was really against it. He said the country could not afford it. He was a sole practitioner, owned his own one story office building, had one employee, a lady that dressed in a white uniform and acted as the receptionist. He did not accept appointments or file insurance forms.

When I started working I would used doctors in Atlanta and would pay them by check at time of service, and I would file my own insurance forms and the same with the prescriptions. Somehow that changed and now the doctors and drug stores do the filing. I guess that changed for me when I signed up for a PPO plan instead of the regular insurance. With the PPO I had to use an in-network doctor or provider, or pay more. After that I made sure all my providers were in-network. I saw them and they accepted whatever the insurance company had agreed to pay them.

I assume different insurance company agreements with doctors paid different amounts for the same service. So the doctors and other providers were getting paid different amounts for the same service to different people, depending on what insurance company they were with, or whether they were on medicare, uninsured or out of network. That hardly seems fair. Some of the plans pay less than it cost the provider to perform the service. Insurance companies say they can’t pay more without raising their premiums. Same with Medicare. Tax revenues and premium income is not there even to sustain current levels of payment.

Now the employers who have paid the premiums to the big insurance companies are saying they can’t afford the payments and want to either drop coverage of their workers or make the workers pay more. The workers say they can’t afford to pay more.

Where matters go from her seems to be anyone’s guess.