New York, NY – State Bureaucrats Fight Doctor’s $79 Flat Fee for Uninsured

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    New York, NY – The state is trying to shut down a New York City doctor’s ambitious plan to treat uninsured patients for around $1,000 a year.

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    Dr. John Muney offers his patients everything from mammograms to mole removal at his AMG Medical Group clinics, which operate in all five boroughs.

    “I’m trying to help uninsured people here,” he said.

    His patients agree to pay $79 a month for a year in return for unlimited office visits with a $10 co-pay.

    But his plan landed him in the crosshairs of the state Insurance Department, which ordered him to drop his fixed-rate plan – which it claims is equivalent to an insurance policy.

    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.

    “I’m not doing an insurance business,” he said. “I’m just providing my services at my place during certain hours.”

    He says he can afford to charge such a small amount because he doesn’t have to process mountains of paperwork and spend hours on billing.

    “If they leave me alone, I can serve thousands of patients,” he said.

    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.

    “The law is strict on how insurance is defined,” said an Insurance Department spokesman.

    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.”

    One of his patients, Matthew Robinson, 52, was furious to learn the state was interfering with the plan.

    “The whole point is, he [Muney] found a way of paying his rent, paying his workers, and getting to see patients for the price,” said Robinson.

    “How can the state dictate you’ve got to charge more?”


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    61 Comments
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    Anonymous
    Anonymous
    15 years ago

    For all libs who can’t wait for socialised medicine this is the way govt work red tape everywhere. Now imagine you need an emergency operation you will wait 2 year till the govt gives an ok

    Anonymous
    Anonymous
    15 years ago

    This proves that the Gov. doesnt care about anybody all they want is power like you didnt know it already. Dr. fight it till the bloody end!!

    AuthenticSatmar
    AuthenticSatmar
    15 years ago

    This is what’s wrong with govt.

    Anonymous
    Anonymous
    15 years ago

    Price controls, long a destroyer of the medical profession, are becomming more popular under Omaba. To put it in lerspective, can you imagine if a plumber could only charge what the govt said they could chagre for a service, what about a lawyer, a sheitel macher. Any if you decided you wanted to set your own rates they go after you.

    Abe
    Abe
    15 years ago

    Although it sounds bad, there are laws for a reason. Thngs have to be controlled, and sometimes the law will interfere with a good thing.

    Anonymous
    Anonymous
    15 years ago

    To all to you liberals wh can’t wait for socialized medicine, I can’t wait to hear your screams. My cousin in Toronto, had lung cancer and it took 8 weeks to get an appointment for an MRI to diagnose that he had small cell pulmonary carcinoma, by that time it was already too late. And no, he was not a smoker, never! Welcome to socialized medicine, sure it keeps costs down, patients die before they are treated.

    Anonymous
    Anonymous
    15 years ago

    the weird thing is obama wants to do a similar thing http://www.reuters.com/article/reutersComService_2_MOLT/idUSTRE5216OP20090302

    Anonymous
    Anonymous
    15 years ago

    To #6 Even socialized medicine has levels. I lived in Canada and have relatives there. If you really need a test right away, you can get it but you have to be willing to pay to get to the top of the list!! 2 different levels!! If you shmear you get!! It also depends who your doctor is and if he/she has connections!! If he is the head of the department you have no problems! You’re in!! No Wait!! When you have an emergency. they will admit you immediately no questrions asked!! I hurt myself last year in Canada, went to the hospital,Emergency Room did not pay a cent, came home to Brooklyn, submitted to my insurance and everything was paid.!! So much for socialized medicine!!!!!!!

    Anonymous
    Anonymous
    15 years ago

    the government hates competition!!

    Anonymous
    Anonymous
    15 years ago

    HASEM SHOULD HELP WE SOULD NOT HAVE TO GO TO THESE TOP DOCTERS AMEN.

    $1,000 a pop !
    $1,000 a pop !
    15 years ago

    He can serve thousands ? WoW !!! I want to be a doc too.
    1,000 Patients X $1,000 = $1,000,000
    This is a great business plan. If he can see 4,000 patients he makes 4 million dollars a year ! Add a few assistants and he is a multi multi millionaire.
    This is not a complaint. It clearly shows where all our insurance money is going. To the insurance companies executives who do nothing but shuffle paper and mail forms ! Very few physicians make even $300,000 anymore. Only the most successful specialists make over $500,000. May this Dr. be blessed with hatzlucha. Then more Drs will do the same and prices will fall due to competition. Good job !

    Not Doctor Aryeh
    Not Doctor Aryeh
    15 years ago

    I served on the Board of Health a number of years ago, and this is EXACTLY why I decided NOT to go into medicine!

    Anonymous
    Anonymous
    15 years ago

    To #10 When you are sick do you go to a shoemaker?? Or do you go to the best man who can cure you?? Why waste time?? You need the refuah quickly!!

    deepthinker
    deepthinker
    15 years ago

    This man is a clear and present danger to the whole Government medical bureacracy.

    He threatens the livelihoods of tens of thousands of paper-pushing Government employees, and he is waking up the sleeping masses to the Government ripoff scheme.

    He must be stopped by any means available!

    Fetzel
    Fetzel
    15 years ago

    That’s why you people have to learn from us, the English. Take an example from the NHS. Now THAT’S called healthcare!

    Anonymous
    Anonymous
    15 years ago

    If all doctors would do this, it would be beneficial to everyone (except for the money hungry insurance companies.) 35 years ago I was able to afford a decent insurance plan on a very minimal salary. Now I can’t afford any health insurance and I earn much more.

    A
    A
    15 years ago

    I place the blame squarely at the feet of the insurance industry. The government shares in that blame because they’ve allowed the insurance companies to dictate policy in these matters. I don’t know why anyone here would defend any of the political parties, be they republican or democrat, conservative or liberal, they’ve all accepted bribes in the form of campaign contributions or humongous fees for speeches at island paradises or [fill in whatever form the bribes take]. They’re all greedy pigs scarfing at the trough of money.

    Charlie Hall
    Charlie Hall
    15 years ago

    This is not about health care, it is about insurance. States have long regulated insurance, and what this doctor is in fact proposing is a health insurance plan. Insurance companies have to show they have reserves in case they mis-guess their claims load, and furthermore they must contribute to risk pools to cover people who have paid premiums whose insurer has gone out of business (as some have done). This well-intentioned doctor appears to have done none of these things! What will happen to his patients if, chas v’shalom, the doctor dies suddenly or is disabled? . One major reason insurance is so expensive in NY is the mandates for things like assisted reproductive technology that were pushed aggressively by us in the frum community. Does the doctor’s $79/month include ART treatments?

    The attacks on so-called “socialized medicine” are completely off the mark; the state is simply trying to enforce a consumer protection measure

    Anonymous
    Anonymous
    15 years ago

    On the topic of socialized medicine there needs to be better discussion. Obviously a moral society should do its best to see that everybody is covered, hence universal healthcare. Obviously government control is the worst type of people you can have in charge see U.K. and Canada for example. In short you need to have a system like the chartered public schools where it is paid by the government and run privately. This will be the most effeciant and moral healthcare system in the world.

    Anonymous
    Anonymous
    15 years ago

    “Does the doctor’s $79/month include ART treatments? “

    That’s sort of the point, Charlie. No one expects this to be insurance, and no one expects this ? internist to be doing ART.

    Anonymous
    Anonymous
    15 years ago

    if socialized medicine was so bad, then why in the world do Canadians now have longer life expectancies and lower infant mortality rates than the USA? Why does the W.H.O now rank the USA 37th world wide in healthcare, below such countries and columbia and costa rica, for example? Try learning some facts before you spew right wing mishegas.

    Anonymous
    Anonymous
    15 years ago

    Charlie,

    According to your argument, If I prepay for any service it is a form of insurance and needs regulation;

    My local car service gives a coupon for every local ride and coupons entitles you to a free ride, is that legal?

    I have an anual snow contract to have my parking lot plowed every time it snows (if it snows) and I prepay for the year, is that insurance, is that legal?

    In a democratic society people are allowed to take risks as long as they know what they are getting into and they dont put others in danger or jeopordize other people’s wellbeing or property, It’s none of the governments business.

    BTW in Canada and your above age 52 you can’t get Dialysis treatment due to rationing

    Government is not the solution to our problems, Government IS our problem
    Government is not the solution to our problems, Government IS our problem
    15 years ago

    For all you lovers of socialized medicine I ask you, is there ANYTHING that the govt does that they could do BETTER than the private sector? I will help you by answering … NO!

    Are you happy with how they have handled Social Security? You know, that would be the 15.5% or so that you pay into what is supposed to be your retirement fund when you need it? Instead its paying for the people who need it now which is why when the Baby Boomers, Gen X, Gen Next, etc., are ready to ready to retire there will be nothing there.

    Do you really want some govt offical deciding for you Mi Yich’ye u’mi yamus? If you are older they can/will decide you arent worth the “risk” of investment (meaning to pay for your surgery, docs visit, medicine, etc) and they will not “authorize” necessary procedures. This means they are telling you to DROP DEAD!

    The facts are that the number of people reported not have health insurance are skewed. A number of those people dont want insurance for whatever reason while most of them are ILLEAGALS. Others are not interested in going on Medicaid.

    Are you interested in paying MORE taxes to cover this mess? Countries with socialized medicine have much higher tax rates than we do. Bad enough most of us pay around 40-45% of our income for assorted taxes (all included), this boondogle of a program will increase it to where it is in other countries — OVER SIXTY FIVE PERCENT! This means if you are making 50k, your “take home” pay would only be 27.5k!

    Don’t get caught up on the Obama line of “rich” people paying for it. The “rich” (even on his language of over 250k) pay most of the tax revenue in the country and there still isnt enough. What Obama will have to do is lower his “rich” to 100k, then 75k. This means the liberals out there are making “class envy” where if you dont fall into that “class” you are jealous to the point where you say “yeah, those money grabbing pigs, tax em! The problem with that is those people are the ones who own small businesses which hire people. If they have to pay more taxes, they wont hire!!

    The govt would save more money by allowing us to deduct the cost of our personal out of pocket health insurance as well as co-pays, deductable, etc., on our taxes. I pay about 10k in health insurance annually before co-pays and deductables. That would be a very nice deduction to come off the top of my taxable income.

    Unlike #32 up there, we on the right believe in the power of the people to take care of themselves with less govt involvment. The govt by the way already has its own healthcare — its called MEDICAID! He also seems to be swallowing the part about people not being able to afford healthcare. The problem with that which once again the folks on the left refuse to say, is that NO ONE is denied medical coverage when showing up to a hospital ER. Anyone who thinks I am not telling the truth should walk into any ER and see for themselves. Listen to how they answer when they are asked if they have insurance! Is anyone turned down if they dont have insurance??? NO!

    Socialized medicine takes away the CHOICE we have of doctors, hospitals, and treatments. Do you want some suit or a computer program that relies on stats making a desicion on your mother’s life, your father, your sister, etc. If you CHV have a Premie they could decide the odds of survival are not good so they wont “cover” certain necessary procedures which Derech Ha’teva means kiss your kid good bye. Obama’s plan wont even allow you the option to deicde to have private health insurance (such as blue cross etc) or have private care. The current administration is the most extreme left wing we have ever seen in this country.

    Please, wake up, shtey oif, this is not a matter of the government. They are taking more and more and we will be left with nothing. We dont want to be “wards of the state” like most Europeans/ Russians were. I would think we had enough of that.

    Remember it was President Reagan who said, “Government is not the solution to our problems, Government IS our problem!” The people are the solution.

    Anonymous
    Anonymous
    15 years ago

    Health care should NOT be controlled by profiteers like insurance companies. Not everything needs to be run “like a business”. The government needs to back the people not these greedy bastards.

    Nurse Rachet
    Nurse Rachet
    15 years ago

    Dr. Muney,
    I encourage you to continue the good fight and here is food for thought. Look at the INSURANCE wall street created called Credit Default Swaps which is nothing more that insurance that is designed to pay out if people default on their mortgage, which is why so many BIG Wall Street firms and banks need our Tarp money to bail them out now. Take your fight all the way to the Supreme Court declaring you are offering Health Care Swaps just as Wall Street were allowed to sell Credit Default Swaps in the market. Keep up the good fight, We as healthcare professionals know what happens when Government runs anything…just like our coming Depression, we can thank our Government and those regulators who turned their backs and looked the other way while America was getting fleeced. Insurance companies, frivolous lawsuits and fraud in the system is why people can not afford health care. IT IS NOT THE HONEST PROVIDERS.

    docwife
    docwife
    15 years ago

    I pay $ 150.00 to a grocery store a month for food. Is this insurance I will not go hungry? Get real. The reason for all this fuss toward the Doctor is the Insurance company is being cut out of the deal by the doctor offering his service without their being able to control the doctor, patient and perhaps even denial of payment. (This sets a precedence for future litigation (case study) and we can’t have this says the insurance company.) They (the insurance company) want your monthly fee, and they still get to deny payment to the doctor who provided the service if they want to. Wait until the government control’s yr health care! ( There will be a new diagnosis. (You are old, You just die. Claim denied.) Who ever started this insurance companies controling health care is a greedy twit , and the bigger idiots for agreeing are the providers: doctors, hospitals, etc. When the insurance companies want to go to school for 8 years to be able to diagnose you and treat you and write Rx’s for you, then they can collect your money. Until then, they need to BACK OFF !!!!!

    Phill
    Phill
    15 years ago

    Our government no longer serves the people. Politicians do not care about YOU, YOUR FAMILY, or THIS COUNTRY. All they care about is getting rich off the backs of us Schmucks. Just another prime example of this.

    EDWARD
    EDWARD
    15 years ago

    This sound like an excellently plan. What can we do to get this start in all America, not just New York City. I’m ready to help get it started.

    Canadian patient
    Canadian patient
    15 years ago

    I’m Canadian and what Dr. K states is the truth. Canadian healthcare is not all its cracked up to be for many reasons. One affecting my immediate family is the profound doctor shortage, not only is there a shortage of trained physicians, Canadian family doctors,were for many years opposed to helpers. Nurse practitioners are very new to the system. It’s not like if a doctor is not taking new patients that you might be able to at least see the NP. They are still rare (although this is slowly changing

    Anonymous
    Anonymous
    15 years ago

    I am so happy doctors are starting to do something about the insurance fraud and pharmaceutical theft against the public going on in this country. The statement above “…doing something only a licensed insurance company can do” just shows how far things have gone, where the people who have gone into medicine to help others are being “run” by businesses and profit crazy investors who car little other than making money. Medicine has devolved into an inverted supply-demand bottleneck where demand is (obviously) high and urgent when necessary, so placing business men and insurance companies into the scheme has really corrupted things. They have us where they want us and can charge anything they wish. I wish more doctors can follow his example, and put the power back where it belongs…in the hands of the physicians. The AMA is no help either…they are in cohoots with these guys and deliberately prevent people from becoming doctors so there is artificially high demand. Doctors need to work ridiculous hours to make large salaries, and are too tired to help patients sometimes. The lucrative salaries of specialist also draws money and power hungry people into medicine rather than doctors who really care about their patients. Companies who have raped the ideas of R&D of university and tax paid scientist, and then after standing on the shoulder fo giants, labeled their own patent on it with their high paid lawyers have also milked the public for anything they could. Now they sit on all their patents thickets and prevent any further developement and innovation with their “trade secrets”. We need major patent reform for medical devices and drugs, medical education reform in this country to fix this mess. Our legistlators have greivously been on the sides of big pharm, medical product companies, and insurance for way too long. Put R&D in the universities where it belongs. Put doctors in the drivers seat where they belong. Put medical patents into the control of their individual creators not their corportate buyers, and make sure that if these any company that is going to make money from this knowledge from the public, had better be willing to divulge this knowledge “to” the public for their perusal (but not profit). This doctor is the first step to at least give simple care which does not require expensive equipment or drugs. They are shameless in going after him and it just goes to show how corrupt or deludedly entitled they are (and they know it too!).

    Anonymous
    Anonymous
    15 years ago

    The insurance companies are ticked because he is willing to give REAL medical care at a FAIR price…and he’d probably have full schedules of patients because of it. To the insurance companies that means fewer people they can FLEECE for sub-standard care at high cost! I work in healthcare and I’m telling you…get rid of the INSURANCE companies and Dr’s will have to compete; raising the standard of care and lowering the cost. Win-win for patients and Dr’s…leaving insurance companies out in the cold. Too bad it will NEVER happen, especially now that the Fed is getting involved. Watch for healthcare standards to plummet and costs to skyrocket!

    JoePlatio
    JoePlatio
    14 years ago

    People making com’nts sound like . The state insurance dept. sounds more like ins. companies are running it. This doc’s method might make a good model, but should not stop there perhaps hospital should make fixed rate also. (standard procedures and peripherals 1 pkg.) This would be better than what many doctors are doing. (They are limitng patients to a fixed no., then chrging an amount (ex. $1600.00 & up) for exlusive patient care. That is you get posh waiting rooms with short waiting and you see the doctr. All others (one’s that don’t pay the xtra fee) go to a regular waitng rooms and see a nurse or other medical practitoner and no doctr-even if you have insurance. Also give thought to what the government spokespersons say. They are correct about the uninsured, the rate at which medical costs are rising, the strain placed on the social security system, And they are correct that the current system has not done a thing about self policing. (ex. do you really believe the Amer. Med. Asn. is going to tell doctrs to curb their chrgs? remember doctrs fees are due in part because of their insurance costs.) Be careful of many of the comments made just because it sounds good.

    Vince Czyz
    Vince Czyz
    14 years ago

    This is a fabulous idea. And here is another reason it is NOT insurance: if I get hurt in some other state and need immediate medical attention, my plan at AMG won’t help. I hope AMG will fight the state’s interference … I am sure he will find he has a groundswell of support.