North Carolina man defends self-pay patient status

Marc Landry, a contributing columnist to the NewsObserver in the Raleigh-Durham, North Carolina area, authored a piece a few days ago defending his status as a self-pay patient against those that would call him a ‘free-rider.’ Marc became uninsured in 2010, and described his experience as a self-pay patient.

Landry: Confessions of a healthcare ‘free-rider’

[I’ve been described as] a “free rider” because I have no health insurance. [The] words are intended to propagate a myth that the uninsured get all of their health care in hospital emergency departments and are a drain on the system.

…Yet when I see a doctor, I pay with my credit card as I walk out the door. I alone pay the bills when they come in. I don’t even get a tax deduction as, fortunately, the amounts do not warrant itemizing. 

While some uninsured people undoubtedly use ERs, workers at walk-in clinics tell me that between 20 percent and 25 percent of their patients are “self pay.” I am not alone.

I lost my health insurance in June 2010 when the company I worked for lost its contract and ceased operating in the area and when my wife’s employer went bankrupt.

When you lose your health insurance and you are a 60-year-old diabetic, you quickly learn that no health insurer wants to provide coverage…

The last resort was the N.C. Health Insurance Risk Pool operating as Inclusive Health, which had both a federal and state program. I qualified for both. The only option I could afford was a high-deductible plan under the federal program with a monthly premium of $276. The annual deductible was $4,500… The program’s customer service department could never definitively answer whether a procedure was covered or what my out-of-pocket expense would be.

…My health is relatively good so I saw no prospect that I would meet the annual deductible. I’d be paying for all services out-of-pocket with or without insurance. What really convinced me that Inclusive Health was a poor deal was when I discovered that many health care providers have special prices for uninsured patients that are often lower than the prices “negotiated” by my insurer.

I canceled the policy…

Landry realized, as many self-patients do, that traditional insurance simply doesn’t provide the value they need for their health care dollars.

His experience as a self-pay patient is fairly typical. Of special interest should be that he is diabetic, but being a self-pay patient doesn’t seem to have prevented him from getting the care he needs.

Many are understandably worried that having a chronic condition can mean huge out-of-pocket expenses unless insurance picks up the cost of treatment, but with careful management many persons with chronic conditions are able to avoid expensive medical problems.

One part of Landry’s efforts to take care of his health and be a prudent self-pay patient appears to be relatively regular visits to what are often called convenient care clinics or retail health clinics. Staffed by nurse practitioners or sometimes physician assistants, they generally offer a high level of care for relatively minor illnesses and injuries as well as assistance with monitoring and managing chronic conditions like diabetes.

While there are many advantages to convenient care clinics, for the self-pay patient there are two that should stand out – they offer posted prices, and those prices are often less than what a patient might pay at a doctor’s office, especially if the doctor’s office isn’t ‘cash-only’ or at least ‘cash-friendly.’ Real prices that are affordable – the self-pay patient’s best friend!

Probably the best known of these convenient care clinics is MinuteClinic, owned by CVS Pharmacy.  On their web site you can find the prices for several common treatments, including monitoring diabetes, high blood pressure, and cholesterol for $79, and treatments for pink eye, ear ache, strep throat, and urinary tract infection for between $79 and $89.

Other national chains include Healthcare Clinic (owned by Walgreen’s), and Target Clinic (owned by, you guessed it, Target). There are also numerous regional and local operators of convenient care clinics, you can find the one nearest to you at the web site Healthcare 311.

By using a convenient care clinic like the ones Marc Landry appears to be using, self-pay patients with chronic conditions can manage and monitor their health and make sure they get the treatment they need, which means huge savings on top of better health!

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4 Responses to North Carolina man defends self-pay patient status

  1. Dave says:

    Let’s extend this thought one idea further—is insurance not a substitute for cash, until one can amass such a position. Five years ago that was Rush Limbaugh’s argument when he needed a heart evaluation and was hospitalized ending his visit by writing a check. Why are the wealthy who have the assets and desire to opt out knowing the financial risks required to have health insurance? I can understand state law reqts for auto insurance and a bank’s position for home ownership if it is being financed, otherwise just another freedom being destroyed.

  2. seandparnell says:

    I agree, Dave – in some regards health insurance is simply a financing mechanism for needed healthcare. Some people, primarily the wealthy, have no need for external financing because they can afford to get the care they need. If Bill Gates has health insurance it’s probably pure waste for him.

    • Dave says:

      It’s just another means of wealth redistribution, just like the youth who will see significant premium increases with very little need for the system. If I understand, they are hallucinating if they think a young, single adult is going to opt for $2000 annual policy when they can choose a $95 tax penalty at filing time and then file for a policy under the “Cannot Deny Coverage” provision when injured in a car accident. It is riddled with unintended consequences.

  3. Nee says:

    I have visited each of those clinics and spent money there as well. Not as nice as keeping your doctor, but this is the way it is. There are going to be many more unintended consequences for O’care. That’s for sure.

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