Private Care Subsidizing Managed Care?

Arthur H. Mensch, MD
Article Type: 
Spring 1997
Volume Number: 
Issue Number: 

Dear Dr. Faria,

I have read with great interest the recent articles in the Medical Sentinel concerning MSAs as a way to provide insurance coverage for patients. I too agree that the only ethical way to keep down the cost of medical care is to get the patients back into the loop in terms of financial obligation. Then rational and ethical decisions concerning the patients’ care could be returned to the patients and their physicians.

Unfortunately, several obstacles stand in the way of implementing MSAs and other forms of self insurance on a widespread basis. The current practice of managed care companies forcing medical care providers (physicians, hospitals, etc.) to extend them deep discounts forces these providers to charge all other payers, including self-pay patients, fees which are substantially higher in order to make up the difference. Thus, the cost of care to patients in MSAs and self-pay individuals with high deductible policies is unfairly inflated to the point where they are actually subsidizing the managed care companies.

A necessary addition to any MSA legislation, therefore, is a provision that prohibits providers of medical care from charging anyone paying out of pocket for medical care more than the lowest fee extended to any other payer (i.e., managed care companies). This would reduce the financial burden on patients in the self-pay category. It would keep the cost of premiums for the insurance part of the MSAs down. In addition, it would allow providers to resist giving deep discounts to managed care This type of legislation was proposed several years ago in Virginia, but unfortunately, it was defeated with the help of the Medical Society of Virginia which ill-advisedly opposed it. Another example of organized medicine acting against the best interest of patients and physicians.

Arthur H. Mensch, MD
Alexandria, VA

Originally published in the Medical Sentinel 1997;2(2):41. Copyright ©1997Association of American Physicians and Surgeons (AAPS).



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