This news has reminded me of one of my experiences expressandstar.com/news/uk-... . This is also reported in the BMJ but I don't have access to the full article.
This case was illegal because Spire Healthcare and the consultants colluded to increase prices for self-pay patients.
In my case I had seen a private consultant about sudden severe back pain using my health insurance. The authorisation was taking some time to go through but my appointment had been accepted. So to save time I booked my consultation and said I would pay the bill if authorisation hadn't come through and I would reclaim from the insurance company. I can't remember the figures so will make up an example. I received the bill for £200 and by chance recieved the authorisation on the same day which stated they pay the consultant up to £150. I sent this to the consultant and they were happy with the £150 (who wouldn't be!).
I don't think this is an isolated case. Many consultants charge a high fee but accept a lower fee from insurance companies so they get regular business. I don't think this is illegal.
I think it is worth being aware that consultants often rip-off self-pay patients. There's not a lot we can do about it but it helps to know what is going on. In a way insurance companies are doing a good job in keeping consultant fees reasonable, imagine paying USA fees. Consultants have got around this by dual pricing.
As an afterthought is might be an idea to ask a consultant 'my insurance company only pays up to £x for a consultation, is this OK?' before booking a self-pay consultation.
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jimh111
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I wish I had known that little ploy - I was well and truly ripped off at a Spire Hospital, a supposed 40 minute initial appt lasted a little over 10 minutes. On that reckoning, it cost me £22 per minute. That chap will soon be able to retire- the sooner the better if you ask me!
In a way insurance companies are doing a good job in keeping consultant fees reasonable, imagine paying USA fees.
But in the USA one of the reasons for high fees is that the insurance companies make everything such a burden to the medics. The medics have to register with, potentially, numerous schemes, and do lots of paperwork, and the delays in payment, etc.
There are quite a number of medics who refuse insurance - which ends up letting the insurance companies off the hook in some circumstances.
Helvella Thank You for your thoughtful post. Yes this is exactly how our system is working now. If you need to see a well respected Dr we need to pay out of pocket for their very high fees. Dr' don't want to bother with Insurance companies . Nor do they need to hire someone who takes care of insurance collections . Patients are losing out big times.
I think our insurance companies exert a downward pressure on consultant fees, they often operate a cartel with 'recommended' fees. It's worse in the USA although I don't know why. The important point is to watch out for consultants who automatically charge self-pay patients over the odds.
I've dug out my receipts. I received a bill from the consultant on a self-pay basis for £250, the agreed fee with the insurance company was £130. Quite a difference. Quite simply he is exploiting patients.
My consultation took less than ten minutes. I presented a neat summary which he was able to scan and so saved him a lot of time. He was quite abrupt, only interested in efficient patient processing. Very skilled and made a correct diagnosis but I would expect the focus to be on optimal patient care rather than rapid processing of patients. As you would probably guess I was more assertive and persistent than the average patient. If I get a back problem again I will choose someone else.
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