posted on:  9/1/2006     revised: 3/8/2010

How much does my choice of health plans affect my physician?  How does the choice of a health plan affect the quality of my medical treatment?

I've noticed that my personal physician is more relaxed and chatty since I became a cash-paying patient rather than a managed care plan member. The change occurred a few yeas ago when I switched my health plan from a group Blue Cross plans to an individual Health Savings Account plan. Because of the high deductible of the HSA insurance, I am a cash-paying patient for all routine medical care. Now he treats me like a VIP.

Through our longer discussions we have discovered that we have some hobbies in common. He invited me to join his roller-blading group and even offered to fix me up on a blind date (back before I remarried). Those conversations never would have happened when I was a managed care member. Besides the immediate medical issues, we manage to squeeze in a little talk about my overall health and related issues. He used to be in an out of the examining room within minutes. A recent report on U.S. health care that said a physician now spends an average of seven minutes with each patient during an office visit. Yet the pace of my visits are always relaxed. Perhaps I even take up too much of his time now; I notice that the waiting room is always more crowded when I leave than when I arrived. 

Of course, there is no way to prove that the quality of my medical care or my overall health has improved as a result of my choice of health plans. That does not really matter to me. I simply feel better about the quality of my health care, my ability to control the care (like getting an appointment that fits my schedule, even on short notice) and I believe that my money is well spent. This is truly a self-aggrandizing position, yet one that makes me glad to be in a position that gives me this choice. 

An article in September 2006 Forbes Small Business magazine caught my attention: "Healer or Dealer" quotes one physician posing a hypothetical question to himself "For the same amount of money, would I rather operate on ten HMO patients or one private client?". The doctor considered dropping insurance plan membership altogether but was stopped only by the thought of telling long time patients that they no longer had coverage for his services.  

Turning the physician's question around to the patient's perspective: would I rather be one of the ten HMO patients or the one private client?  That makes it clear why I am grateful that I have private medical insurance.

Sure I think the idea of universal medical care is a wonderful idea. I even turned damp-eyed recently while reading the idealistic and romantic address Che Guevera gave to the group of graduating Latin-American physicians in the book "The Motorcycle Diaries". Guevera's passage on universal health care written decades ago is perhaps the most passionate and persuasive argument for socialized medicine.  Still, when it comes to my own medical care, I admit that I am a greedy capitalist.  I want my doctor well-paid and happy to see me in his office. I suspect that most Americans feel the same way.

keywords:   HMO, health insurance, medical, doctor

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Copyright 2010 by Tony Novak. Originally produced and published for the "AskTony" column syndication prior to 2007. Edited and independently republished by the author in March 2010. All rights reserved.