Inexpensive do-good doctor being pressured by NY Insurance board to stop what he's doing

This guy operates clinics in all 5 boroughs. For $79 a month, you get unlimited visits with a $10 co-pay for basic in-office medical care. The doc says he can do this, in the middle of freakin' New York City no less, because he doesn't have to spend much on paperwork and billing. The NY Insurance Dept wants him to drop his fixed-rate plan because it's equivalent to selling insurance, which he isn't licensed to do.

Muney insists it is not insurance because it doesn't cover anything that he can't do in his offices, like complicated surgery. He points out his offices do not operate 24/7 so they can't function like emergency rooms.
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The state believes his plan runs afoul of the law because it promises to cover unplanned procedures - like treating a sudden ear infection - under a fixed rate. That's something only a licensed insurance company can do.
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A possible solution that Muney's lawyer crafted would force patients to pay more than $10 for unplanned procedures.

They are waiting to see if the state will accept the compromise. Still, Muney is unhappy because, he said, "I really don't want to charge more. They're forcing me."

http://www.nypost.com/seven/03042009/news/regionalnews/state_slaps_dr__do_good_157907.htm

and I'm frankly surprised that they would run the story at all, considering that it portrays insurance companies in a less-than-flattering light.

I hope it's true, if only for the value of giving the Big Insurance a black eye.

Occasionally, they run off the leash and do things that would make Rupert pissy, though. Like being the only major rag to run a BUSH KNEW cover. That was a shocker.

If you Google the terms, many come up - including this one:

http://www.medscape.com/viewarticle/703900?src=mpnews&spon=18&uac=85749DJ

It's the one I will use in my ongoing battle with teabaggers at a forum on my local Gannett fishwrap's website. Thanks.

You're welcome.

Then it's the Post you want, not some academic egghead commie journal.

because he intends to show how government,in this case the NY Dept of Ins., can mess up your health care.

The Insurance companies do NOT want any competition which would force them to lower their prices.

How do we make these cases go viral! It would be great if Rachel Maddow covered this. We need to see more examples of what the Insurance companies are doing.

It's the NY State Department of Insurance taking this action. No insurance companies involved, at least not in what's being reported here.

For the same reason for profit Insurance companies are threatened?

He is not offering or trying to compete with the state. Someone was losing money and they went after him.

even though I am not a violent person and I don't believe violence resolves anything.

My first thought on reading this would probably get me arrested if I even wrote it down.

Health insurance companies need to be dismantled. Period.

And screw the NY Insurance Department.

this is only effective for the "small stuff".. what about when that lump he examines, needs further study. Even a kind & beneficent doctor cannot help when lab tests & biopsies & surgery are required.

It's the routine office visit that often leads to discovery of a very awful medical consequence.. (Bill Moyer's show last night covered this magnificently)

But even minor no-frills medical treatment is getting subsumed into megacorp citadels, where the meter is already running in the hundreds before you sit down in the waiting room. These sorts of cheap basic clinics were readily available when I was younger, not so much anymore. And now we know one of the reasons why. It's criminal.

catching something early can prevent many larger issues. The ear infection, for example.

In terms of care, something is better than nothing (I don't feel quite that way about the various, ill-defined 'reform' plans floating around - but that's not the topic here).

I suppose it could be argued that if you can't afford the treatment for a serious illness, you might as well remain ignorant of it - I know that as an uninsured (and apparently uninsur-able) person, I don't really want to know if I have cancer - since there's no way I could pay for treatment.

But for most things, catching it early can mean the difference between a quick cure or a major problem. In that regard, this doctor's 'plan' would be more than adequate.

to be at that celebrity's beck and call? I saw one doctor interviewed who has about 20 clients paying $200,000. each for a year.

!!

Good question tho.

:mad:

Cuomo in 2010!

The point is that they can drastically reduce what they charge without the paper work and headaches of insurance. It's cash and carry.

This is actually how hmo's started -- almost all of them started as "pre-paid" medical scheme. They worked very well.

Blue Cross and Blue Shield started out as non-profits and were forced to become for profit, and were raided and/or destroyed by for profit insurance companies.

I belonged to one here in CT 25 years ago. Everything was in one building - your doctor visit, your xrays, your lab work and your pharmacy. Specialists were there too.

I was in HIP as a kid in NYC. We went to a private primary care doc but HIP had a specialist center in Jamaica. I don't remember what the deal was for drugs back then.

Why did HMO's go bad ??

I also grew up on HIP also in Jamaica, Queens. Actually, this was just before they began building HIP centers. The HIP primary care docs were generally solo practitioners working out of their houses. They had centers for specialists, and admitting privileges at hospitals, but we rarely went.

The thing to keep in mind is that almost the entire health care system was non-profit, except for the individual doctor's actual practice. Hospitals had names like "Mercy" or "St. so and so" or "Brooklyn Jewish" or "Methodist", etc. Almost all hospitals were non-profit. HMOs were also non-profit. Blue Cross and Blue Shield, the two biggest insurers were non-profits.

The Reagan administration basically made it impossible for BS-BC to continue to operate as non-profits by revoking their non-profit tax status, even if they continued to operate on a non-profit basis. For profit corporations were encouraged to by them up and run them as for profit businesses.

Even those that tried to resist were raided and destroyed by for profit insurance companies or health corporations. Google HIP of New Jersey. It tried to remain a non-profit, but it was persuaded to hire a for profit health management company. Within about a year, the for profit company had bankrupted it, and it went out of business.

This is why I am against co-ops as an alternative to public option. Unlike most people who are against them, I do think they will work, just as HIP and BS-BC worked. The problem is that if they work, the for profit system and the politicians in their pockets will definitely destroy them just as the destroyed the non-profit systems of the past.

By contrast, try as they might, they haven't been able to destroy Medicare.

to people who need it because he's not an insurance company?

Forgetting the aspect of this that is totally sick and twisted, how can they stop him? He has a medical license, he's dispensing proper care and he's charging his patients a reasonable fee. This is bullshit.

K&R and I hope this guy becomes the center of the Health Care debate. On one side we can have the crazy Nazi lady and the other this Doctor who is trying to help people who need it.

He paid $2000 up front, $100 a month, and $10 co pays. He gets all his medical care for that. The $2K is an annual fee.

that if a doctor does the fixed-fee all-you-need service, and he's doing the treating of the patients, then it is definitely not like what an insurance company does.

An insurance company isn't the patients doctor, or performing the healthcare service, they are a third party not performing any service other than payment to the service provider.

The entire concept is different, and the fact that it seems this government "Department of Insurance" is going after a doctor charging a fixed rate for all-his-or-her-patients-need over-a-time-period service (with some limitations), kinda puts this Department of Insurance in the "private mercenary" category, and doubly insulting, getting paid by public dollars to do so.

I'm no lawyer, but it seems to me this is the very kind of corruption RICO was sold to us as designed to prosecute.

What he's doing can be looked at as something similar to membership. You pay your dues and you get to use the pool, the greens, and the Sunday brunch is $5 a plate, instead of $15. And you pay whether you use it or not.

Also insurance companies assume risk. The risk that he assumes is miniscule, maybe even non-existent. The worst would be someone coming in every day for treatment, which still nets him $4600 to offset the cost.

One situation that illustrates how the definitions of insurance and warranty don't fall into bright-line categories is the matter of Credit Default Swaps. Around 2000, when the popularity of CDSs were exploding in the financial industry, the NY Insurance Department looked into regulating them. They demurred, saying they weren't a type of insurance. 8 years later, after CDSs played a big part in cratering the financial system, the NYID stepped up, declaring their intent to assert oversight. They've since backed off again, because the feds are taking up the task. It shows how malleable the notion of "insurance" can be for regulators.

Doctors have been doing this for awhile now, and they all run into the same problem, it seems. The insurance companies are pissed off about it, so they pressure the state into attacking these guys.

For $5 a week, I could help myself to however much coffee I wanted at the office. I guess if I paid a flat rate for the service - regardless of how much I used it or whether I took milk or sugar, it's insurance. Sort of like how gym memberships aren't really memberships, they're insurance.

I don't fully understand the logic, but I'm not going to argue with the State of New York. I am sure they are smarter than me.

Our YMCA charges a set monthly membership fee that includes any personal use of the facility - plus an additional fee for group classes - to pay for the professional instructor.

This doctor thing is no different. $79 a month is the membership that pays for the facility, and the person pays $10 addition fee if a professional is required.