Talked to my AME at length today

[knot4u]

Not to be a grumpy jerk, but only if we lived in a different timeline, where everyone on the planet was connected to some kind of network that had a database in which you could enter search terms, and have it produce pages and pages of results right to you, in seconds! If you really want to be on the fringe, that earth would also have the ability of every single person on the planet to carry such information on a tiny terminal in their back pocket.



Believe me, the one in Metairie taught me all I needed to know about raising the flag.

Given @derg s experience a database like that would also be accessed by the folks at the FAA, and if the medical practitioners are just using medical coding as a tool to fleece the insurance companies with bogus diagnosis info it could do irreparable damage to your career. If you could trust people to not take advantage for profit your utopia might work, but humans will almost always dispose of their morals for money as long as they're not going to get into legal or financial trouble.

 

[guywhoflies]

I appreciate the sentiment but if you’re not aware search engines have turned into useless nonsense so unless you have a proper keyword to get thru the stupidity of new google theres almost zero chance of finding anything anymore
“off insurance doctor” produced lots of news articles and urgent care clinics

do they call themselves/the business a “concierge medical practice?” “secret cabal of medicine for not poor people?”

I would google “concierge doctor near xyz”. I’ve even seen a few ads for concierge doctors here in Tampa.

 

[bp]

I would google “concierge doctor near xyz”. I’ve even seen a few ads for concierge doctors here in Tampa.

thanks, good idea. I live in a rather working class area and it’s not something i’ve ever encountered or conceived of being broke most of my life, given the nature of the biz on display here it’s not naturally something i’d think that would be advertised if the clientele is so limited.

 

[MikeD]

Always a good idea to never have your doctor and your AME, as the same person.

 

[derg]

Always a good idea to never have your doctor and your AME, as the same person.

Yeah, but Dr. Forred was awesome, I broke the rules.

 

[MikeD]

Yeah, but Dr. Forred was awesome, I broke the rules.

He was a rarity, as was Battersby.

 

[derg]

He was a rarity, as was Battersby.

“You smoke? Want one? How’s your hearing? Alright, see ya”

 

[pwttogfk]

Not only is my doctor a private pilot, I hired one of his CFIs. I’m not too worried about him cooking my books.

Also, wouldn’t it be great if there was some simple way to broaden the risk pool, reduce costs, and improve outcomes? Definitely not something every other country in our income bracket has figured out.

 

[BobDDuck]

thanks, good idea. I live in a rather working class area and it’s not something i’ve ever encountered or conceived of being broke most of my life, given the nature of the biz on display here it’s not naturally something i’d think that would be advertised if the clientele is so limited.

Even in less affluent areas, you'll find concierge medical services. I had one when I was living in Dayton, Ohio 15 years ago.

 

[bp]

Even in less affluent areas, you'll find concierge medical services. I had one when I was living in Dayton, Ohio 15 years ago.

wow color me uninformed, hadn't even heard of this until it was mentioned here. you could swing it on rj money?

 

[Pilot Fighter]

Always a good idea to never have your doctor and your AME, as the same person.

It can work if you have had a long relationship.

But, you’re 99% correct.

 

[BobDDuck]

wow color me uninformed, hadn't even heard of this until it was mentioned here. you could swing it on rj money?

If I recall it was about $150 a month in 2008 dollars. Wasn't cheap on an RJ Captain salary back then (I think I was making $60k a year maybe?) but it was doable. Not sure where you are in the world, but I was looking at it in Hawaii last year, and was seeing most options between $3000 and $5000 a year and they almost all took FSA/HSA dollars, so it would be pre tax at least. Didn't do it because we may be moving soon and I didn't want to start a long term relationship with a doctor right now, but I will totally do it once I'm location stable.

 

[JordanD]

I appreciate the sentiment but if you’re not aware search engines have turned into useless nonsense so unless you have a proper keyword to get thru the stupidity of new google theres almost zero chance of finding anything anymore
“off insurance doctor” produced lots of news articles and urgent care clinics

do they call themselves/the business a “concierge medical practice?” “secret cabal of medicine for not poor people?”

Google is essentially useless now, no matter how many different ways you try to phrase your search or narrow it down.

 

[tlove482]

Why is the dentist taking your BP??

They take it cause they can't use the numbing stuff on you if it's over a certain amount. I think it raises your BP even more.

 

[derg]

Even in less affluent areas, you'll find concierge medical services. I had one when I was living in Dayton, Ohio 15 years ago.

There's been a meltdown in the US medical system for decades, but this was really my first "loud, up front and close" collision with it because I've always enjoyed really good insurance coverage and just went to the doctor when I didn't feel well.

But seeing what I've seen, hot damn, if it's this bad for a person with exceptional coverage, the average joe is completely effed and my AME is right, the whole system needs to be shut down and rebuilt for the patient, not the private equity bros buying up medical practices.

Even my veterinarian got bought by a private equity firm, shot prices through the roof and even owning a pet has been made into an exorbitant expense.

 

[Richman]

There's been a meltdown in the US medical system for decades, but this was really my first "loud, up front and close" collision with it because I've always enjoyed really good insurance coverage and just went to the doctor when I didn't feel well.

But seeing what I've seen, hot damn, if it's this bad for a person with exceptional coverage, the average joe is completely effed and my AME is right, the whole system needs to be shut down and rebuilt for the patient, not the private equity bros buying up medical practices.

Even my veterinarian got bought by a private equity firm, shot prices through the roof and even owning a pet has been made into an exorbitant expense.

I actually learned that lesson about 25 years ago with my late-BiL, who was an internal medicine MD. There really were (are) two groups of people. Those who went to doctors, and those who had no-kidding advocates who were looking out for you and your health in a serious, no BS way, without worrying about the flavor of the month, the latest Rx snake oil or coding something right for insurance. THESE are the people that help you make good choices and can get you in to see the right people in time for it to matter.

I re-learned this lesson a few years ago, when I was with a specialist for some routine follow-up something I monitor due to family history . He was kinda hemming and hawing about a course of action, and I finally told him "Look, I am a person of some means. If insurance wasn't an issue, what would you do". His demeanor changed abruptly and he said "oh, if that was the case, we'd do XX". I didn't stick with him much after that. Really irritating.

Urgent care is a waste of time unless you need a Drs note. You a likely not going to die from anything they can likely fix, and if you are, they'll call 911 (no kidding, seen it happen). Maybe some antibiotics for an infected scrape or strep throat. They are barely above the aspirin isle at Walgreens. And they're never open when you might need them.

The problem with health care is legion, but more government isn't likely to fix it (certainly if the VA is any indication). Parasites will attach themselves to whatever vein of money is set up, and you will lose most of whatever money sent through to leakage. That's the problem today, and it certainly will be a problem if it's government funding it.

This "leakage" (or "shrinkage" as they say in the retail industry), is the primary cause of most problems today, both public and private. It's just not called "corruption", because a lot of that money lands on a lot of people, including everyday folks.

 

[drunkenbeagle]

The problem with health care is legion, but more government isn't likely to fix it (certainly if the VA is any indication). Parasites will attach themselves to whatever vein of money is set up, and you will lose most of whatever money sent through to leakage. That's the problem today, and it certainly will be a problem if it's government funding it.

Do you mean government in general, or the US Government specifically? Because every other western country's government has been able to figure it out.

Removing the profit motive from several levels of health care is what needs to happen. Medicare is reasonably efficient. We pay more (as taxpayers) for Medicare Advantage, so an insurance company can deny care, and therefore make more money. Why does anyone think that is good policy? You pay more in taxes, so a company can get more from the government, to be able tell your grandma she can't have a surgery she needs. Why?

There are plenty of better models to learn from. Most have a public option (basically Medicare for all), and the option of choosing a private insurer instead. Everyplace that does this, has a system where it costs much less, for better outcomes.

 

[Richman]

Do you mean government in general, or the US Government specifically? Because every other western country's government has been able to figure it out.

Removing the profit motive from several levels of health care is what needs to happen. Medicare is reasonably efficient. We pay more (as taxpayers) for Medicare Advantage, so an insurance company can deny care, and therefore make more money. Why does anyone think that is good policy? You pay more in taxes, so a company can get more from the government, to be able tell your grandma she can't have a surgery she needs. Why?

There are plenty of better models to learn from. Most have a public option (basically Medicare for all), and the option of choosing a private insurer instead. Everyplace that does this, has a system where it costs much less, for better outcomes.

I hope you're not including the UK or Canada in that mix. Both are trainwrecks, but in different ways. The Commonwealth countries do not have it figured out as well as some other places. The UK especially is a dumpster fire. Canada's is a trainwreck on a rural road, in that it really only affects those who have to deal with it.

As for other, better models, then we agree.

The biggest problem is peeling away the money from the people who are already getting it. That probably includes upending billions in equity of existing "providers" and putting 50-150k of middle class workers on the street. Those will not be insignificant hurdles.

 

[drunkenbeagle]

I hope you're not including the UK or Canada in that mix. Both are trainwrecks, but in different ways. The Commonwealth countries do not have it figured out as well as some other places. The UK especially is a dumpster fire. Canada's is a trainwreck on a rural road, in that it really only affects those who have to deal with it.

As for other, better models, then we agree.

The biggest problem is peeling away the money from the people who are already getting it. That probably includes upending billions in equity of existing "providers" and putting 50-150k of middle class workers on the street. Those will not be insignificant hurdles.

I can only attest personally to Germany and The Netherlands, though I have used UK-based private insurers before (back when they were in the EU). I would not describe either as being a train wreck. Compared to the US, quite the opposite. The US is considerably worse than a trainwreck.

There's already a shortage of workers in healthcare, in particular, the actual providing of care to people. We could absolutely use some of the savings to pay to retrain workers in the areas that could best be described as overhead. But yes, everyone profiting from the current system will be violently opposed to any changes. That isn't a good reason to give up on fixing it.

Creating a viable public option is really the only way things will ever improve. Otherwise, the for-profits have zero incentive to do so.