AUGUST 17, 1999

THIS ARTICLE WAS PUBLISHED IN OVER 40 NATIONAL NEWSPAPERS

 

FROM THE HART

A SIMPLE CHOICE FOR MEDICAL CARE
By BETSY HART
Scripps Howard News Service

      Congress is currently considering a so-called Patient's Bill of Rights. It is a measure that would, in the name of empowering patients, allow people to more easily sue their health insurance providers. But Congress should forget encouraging even more expensive and useless litigation. Instead they should take a look at something called SimpleCare. It could give them a lot of ideas for health care reform that works.

     SimpleCare is the brainchild of two physicians in Renton, Wash., partners who owned several busy medical clinics there but were still losing money. Drs. Vern Cherewatenko and David MacDonald finally figured out that more than 50 percent of what they charged patients was eaten up by the various costs of health insurance plans. So, they came up with the idea of cutting their charges in half for patients who paid by cash (or check or credit card) at the time of service and didn't have or involve medical insurance. The plan caught on like wildfire. Soon it meant that for a majority of their patients the doctors were no longer spending precious time and money complying with and fighting with the insurance bureaucracy. They even started making a profit again.

     The doctors then figured that what worked in Renton could work nationwide. They did some research and found that millions of Americans can afford reasonable doctors fees, just not expensive, low-deductible health insurance plans. So last year they started the non-profit American Association of Patients and Providers (AAPP), a consortium of doctors across the country who pledge to significantly drop their fees, usually 30 to 50 percent, for cash customers.

     While under SimpleCare doctors individually set their own rates, a typical short visit to a physician might be about $35. Doctors nationwide are beginning to sign-up, and pharmacies and medical labs are coming on-board, too. Soon SimpleCare hopes to offer an inexpensive high-deductible "catastrophic" health insurance policy as well.

    But even before hearing about SimpleCare, I'd seen this work myself. You see my family is covered under a medical savings account, or MSA. Congress has made a limited number of these available to the self-employed. It means we buy the catastrophic health-care policy of our choice but pay routine medical bills ourselves out of a special tax-deductible savings account.

    I'd found that my doctors, the pediatrician, the internist, the allergist, were happy to cut their charges by 30 percent or more when I told them I would pay the bill myself at the time of service. In fact the hospital where I delivered my latest little bundle of joy dropped their all-inclusive fee from almost $6,000 to $3,000 for me!

     Yes, $3,000 is still a lot of money, but anyone who thinks they are not already paying such bills is mistaken. A typical employer-sponsored health care plan for my size family would likely cost $5,400 or more a year, and much of that is coming right out of the employee's back pocket.

     By contrast, my family's catastrophic policy costs $1,800 a year. Even if in a typical year we spend another $1,500 on out-of-pocket expenses, which are tax deductible to us, we're still way ahead. Our lower costs allow us to save money for the years we have big expenses like a baby, though at $5,000 of qualifying expenses for the family our insurance kicks in anyway. Plus whatever is not tapped for medical bills from our special savings account keeps growing tax free. We choose the doctors we want, the care we want and we don't mess with insurance for the day-to-day medical expenses of life, just like we don't use our auto insurance for spark plugs or even the minor fender bender. It also means we have an incentive to shop around and spend our health-care dollars wisely.

    Congress should allow people to take home in their paychecks, tax-free, what their employers currently spend on them for their health care and should also expand MSAs so they are available to everyone. It's true such inventive ideas as Medical Savings Accounts and SimpleCare will not solve all of America's health care problems. Some folks will always need a medical safety net. But such innovative thinking is a big step in the right direction of really ensuring patient's rights.

    And the greatest of all these rights would be the right to control one's own health care choices. But, of course, that's one patient's right the bureaucrats don't seem to like.

    SimpleCare can be found on the web at "simplecare.com" or by calling toll-free 888-469-1112.

( Betsy Hart, a frequent commentator on CNN and the Fox News Channel, can be reached by e-mail at: mailtohart(at)aol.com.)

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