The wise optometrist tackles the issue of health care

My little brother is an optometrist, so you’d better believe he’s got an interest in the healthcare debate that’s raging across the country right now.

Now, my brother is the bright one in the family. Want proof? He’s an optometrist who makes a good living by contributing something to society (good eyesight) while I’m a public relations guy who doesn’t contribute one damned thing. When he comes up with a good idea it’s worth hearing.

In a nutshell, my brother has noticed that we’ve been spending a lot of time talking about health insurance reform rather than true health care reform. The whole issue boils down to dollars and cents – the goal appears to be to both make health care more affordable and get insurance to people who need it.

Those two expenses – the costs of health care and insurance – are rather intertwined. There’s a school of thought out there that suggests that dropping health care costs will make insurance more affordable.

With that in mind, here’s my brother’s idea – simply pass legislation that will allow medical providers the option of offering a discount to people who pay for services up front. That’s a simple suggestion, to be sure, but it could well achieve quite a bit.

Could doctors already do that? Well, not really. Just ask a medical provider who’s tried to get away with charging two separate prices for identical procedures when Medicare is involved. If a doctor wants to collect, say, $100 for an office visit, he might charge $300 in hopes of collecting that much from Medicare or Medicaid. And you’d better believe there will be hell to pay if that Medicare patient or someone carrying private insurance is charged $300 while someone who is paying at the time of service is charged $100.

What happens? Everyone gets charged $300 and health care costs have magically risen. My brother’s suggestion, then, is to break that cycle by allowing doctors the freedom to discount their fees if they so choose.

What follows from that? You’d better believe that health insurance providers – both public and private – start figuring out how to pay up front in order to avoid paying higher costs after services are rendered and insurance forms are filed. In theory, then, health care costs have just dropped and insurance rates ought to drop, too (if, of course, competition among them is allowed and encouraged – that’s another discussion for another time, however).

The question, of course, is would doctors choose to offer a discount. My brother seems to think so – he’d rather accept, say, $50 for an office visit rather than charge $200 and deal with the headaches of filing a bunch of insurance forms. Other doctors would, hopefully, feel the same way.

There’s a good reason to think they might. If doctors like my brother charged $50 up front for a visit, you’d better believe they’d see their businesses boom while others charging $200 for the same thing would watch their patients vanish. That’s called competition – something we used to value here in the United States.

While such market-based solutions may seem quaint in this day and age where the government is invited to poke around in our private affairs, such an idea may gain some traction with the public. Who do you trust more to do something about increasing medical costs? Insurance companies, the federal government or physicians?

Seeing how I detest both Congress and the medical insurance industry, I’d be inclined to listen to what physicians have to say about health care costs. Oddly, it appears that group is rarely consulted in the current debate.