During the second and final presidential debate last month, we all heard the President utter something that caught my attention:  "...We have 180 million people out there that have great private health care...these are people that love their health care..."

One thing is true:  President Trump was reflecting a conventional wisdom among those who publicly advocate against 'Obamacare' and in favor of...something else. The Republican side of the political spectrum supports private "health care" meaning the private health insurance industry. So does DOC$. With some important caveats. In fact, we'd call them "Big, beautiful caveats."

We are NOT advocates of beating up your favorite friendly physician, or even your trusted long-time specialist, over their hard-earned office visit rates. What we ARE advocates for, in a big way, is transparency on prices for imaging, tests, ortho, derma, P/T, and all sorts of other pesky procedures and treatments—and all kinds of hospital-delivered services—that are strangling our family budgets and driving people into the shadows of the healthcare marketplace due to fear of the [unknown] costs.

The insurance industry exacerbates, rather than provides relief from, these concerns. This is not ENTIRELY the industry's fault. One of the more insidious elements of the ACA, or Obamacare, is the provision that calls for 85% of collected premiums to be used for patient care or reimbursements to providers.

This sounds like a patient-centric policy—at first glance. But as we've written in a previous blog post, former New York Times reporter Elisabeth Rosenthal, currently of Kaiser Health News (KHN) revealed in her book An American Sickness the unfortunate side-effect of this policy. The 85% rule has caused insurance companies to vastly inflate the amounts of provider reimbursements. Why? In order to make their 15% share as large as possible. This 15% portion, after all, is the percent the insurer has to use to fund their ENTIRE operations:  employees, facilities and other corporate infrastructure, supplies, marketing, capital improvements (like new computers, etc.), their own benefits, and all the other costs of running a business—including their profit margin.

Add to this the fact that insurance companies implement Proprietary Pricing/Discounts with providers. They resist efforts to publicize these negotiated rates in advance and in detail, by procedure or description—even to their own policyholders. That's US! 

These and other impediments to openness (Transparency) and competition in the healthcare marketplace, coupled with high per-insured deductibles, makes the notion that "...we love our health care"  (WARNING: felony violation of cliche prohibitions ahead) a hard pill to swallow.

So DOC$ is not about beating up the good doctor to reduce his office-visit price. We ARE all about Price Transparency on the myriad of the billable items that fall subject to your deductibles, that your insurance provider can't or won't help you know more about in advance, and that can unexpectedly wreck your family finances. Or as we are so fond of saying...

Know the Cost of Healthcare BEFORE You Go In!