We don't have a HEALTH care system in the US. You only get care when you are SICK.
I have a patient who came to see me for a complete evaluation. I knew they had thyroid issues, so we ordered thyroid tests. Now the lab doesn't want to pay. Why? Actually, after 3 sets of paperwork and multiple signatures, I have yet to figure it out.
Medicare won't pay, as many other insurers won't, for a condition that has not yet been confirmed. By statute, I should not be ordering a test with a diagnosis until I know the patient has that diagnosis.
That's right, you can't order a screening test for most conditions and expect that it'll get paid for.
WOW - RIGHT!?
So most doctors engage in a little bit of fraud - they code for the thing that they think it is, and if it turns out wrong, no big deal... except it's now part of the record, which impacts future information.... etc.
Yes, there are some tests that are allowed as screens - mammograms, for example. But PSAs are only paid for if the diagnosis of an enlarged prostate is used.... until they actually have cancer.
People say to me - why would I pay for a doctor? I already paid for that with my health insurance.
NO, you really haven't paid for much of what I do.
Do you need what I do? Certainly I'm not for everyone. However, if you understand that investing in the single most important thing in your life - YOU - is worth considering, then we should talk.
Bruce L. Feldman, MD
Dr Bruce is an advocate for health. You need to be your own health advocate. His blog offers his opinions and insights on numerous topics he believes might be of interest. Hope you agree!