Payment at the Time of Service

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There was a time when you finished a doctor's visit by taking out a ten or twenty dollar bill and handing it to the doc. And that was it. You get the service. The doc gets the cash. Done deal —no insurance, no paper work. Is it just wishful thinking that something like that could happen again?

Well, something like that is happening. It's called PATMOS, short for "payment at the time of service." It was started by a 45-year old doctor who got fed up with spending more time and money on insurance forms and government bureaucrats than on his patients.

Dr. Robert Berry, from Greenville, Tennessee, figured if he cut costs by just taking cash for his work, he could pass the savings on to his patients. He no longer accepts any third-party payment, not even from Medicare. But his fees, he told the Wall Street Journal, "usually cost something between an oil change and a brake job." A typical office visit to Dr. Berry now costs $35. A set of blood tests, done in his office, costs $20. And Dr. Berry carries a small pharmacy of generic medicines, so his patients don't spend as much on drugs.

He's not making as much as he used to. But, says Dr. Berry: "I don't spend all day begging Blue Cross (search) and Blue Shield (search) for money."

And that's the Asman Observer.