Bangor Daily News – by Jackie Farwell
SOUTH PORTLAND, Maine — Dr. Michael Ciampi took a step this spring that many of his fellow physicians would describe as radical.
The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.
The change took effect April 1.
“It’s been almost unanimous that patients have expressed understanding at why I’m doing what I’m doing, although I’ve had many people leave the practice because they want to be covered by insurance, which is understandable,” Ciampi said.
Before the switch, Ciampi had about 2,000 patients. He lost several hundred, he said. Some patients with health coverage, faced with having to seek reimbursement themselves rather than through his office, bristled at the paperwork burden.
But the decision to do away with insurance allows Ciampi to practice medicine the way he sees fit, he said. Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls.
“I’m freed up to do what I think is right for the patients,” Ciampi said. “If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense.”
Ciampi expects more doctors will follow suit. Some may choose to run “concierge practices” in which patients pay to keep a doctor on retainer, he said.
Gordon Smith, a spokesman for the Maine Medical Association, wasn’t so sure, saying most patients either want to use the insurance they pay for or need to rely on Medicare and Medicaid.
Even with the loss of some patients, Ciampi expects his practice to perform just as well financially, if not better, than before he ditched insurance. The new approach will likely attract new patients who are self-employed, lack insurance or have high-deductible plans, he said, because Ciampi has slashed his prices.
“I’ve been able to cut my prices in half because my overhead will be so much less,” he said.
Before, Ciampi charged $160 for an office visit with an existing patient facing one or more complicated health problems. Now, he charges $75.
Patients with an earache or strep throat can spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50, he said.
Ciampi collects payment at the end of the visit, freeing him of the time and costs associated with sending bills, he said.
That time is crucial to Ciampi. When his patients come to his office, they see him, not a physician’s assistant or a nurse practitioner, he said.
“If more doctors were able to do this, that would be real health care reform,” he said. “That’s when we’d see the cost of medicine truly go down.”
Decent rates. I’ve seen some of the bills that my doctor bills the insurance. An office visit is 150.00. A little cheaper here.
I’ve been saying for years that doctors shoudl have to do the same thing as restaurants. Put a “menu” of prices outside so that you can see what you are going to pay before you even go in. That way you can shop around for a reasonable price for the exact service you need. It will also force doctors to compete, or price to their local economy. Or even set their own “family rate”, or other incentives for steady repeat business.
Free market competition has been missing for years in the medical field with prices set by medicare/medicade, and the insurance companies.
Competition should also drive insurance rates lower since it gives the customer the information of costs beforehand, and customers that choose lesser priced providers, can get discounts or rebates on their policies.
It will also increase the quality of healthcare overall, because marginal or poor physicians would no loinger be able to run srvice mills where they have patients in 5 rooms at once and be able to bill the premium government set price for all of them at the same time. Patients who never see a bill directly, pay less attention to, or have less patience with sub par health care.
When I was a child in grammar school my family doctor came to the house and charged ten dollars for the call. Often left the medication at no charge and had one of his own concoctions for cough called the purple passion. So cool
If hospitals would offer an insurance investment program & collaborate together within regions it would eliminate the Middle Elitist Healthcare (Obamacare especially) Insurance completely, saving an enormous amount of overhead & keep patient care in house in-lieu of the Insurance company Doc-In-the Box syndrome. The Investors become the insured! Profit sharing could also be offered based on the investment level &/or usage. A contract would be required to keep the Elitist Greed Hoard out of the program. Meaning if you’re worth a certain amount of money you are self insured & can’t participate in the program & gain investment control. Fine tuning needed but very doable. Creates competition from Group To Group also; etc., etc.,
“Some patients with health coverage, faced with having to seek reimbursement themselves rather than through his office, bristled at the paperwork burden.”
I have medical insurance and the amount of paperwork that’s required when visiting a doctor’s office is staggering, taking up at least five minutes to fill out, so what paperwork ‘burden’ are they talking about when switching to a doctor who doesn’t take medical insurance?
His prices are far to reasonable. Since the government could never compete with these free market prices, they will simply outlaw the practice.
Is this the start of the “family doctor” again?? It is nice to see a doctor stand up and say enough is enough.