Direct Primary Care, or, Healthcare the Logical Way
For Brent Long and his family, this is not a rhetorical question:
Since they joined Black Bag Family Healthcare in Johnson City, Tennessee, about two years ago, the family has paid about $150 a month to belong to the practice.
What practice? That of Direct Primary Care:
Instead of accepting insurance for routine visits and drugs, these practices charge a monthly membership fee that covers most of what the average patient needs, including visits and drugs at much lower prices.
Included in this is near wholesale pricing on lab test and medications, a huge draw to this relatively new form of healthcare. Patients can also FaceTime with their doctor and also receive after-hours emergency services. There are no copays and no costs beyond the monthly fee. It almost sounds too good to be true. So why would a doctor sign up for this?
Dr. Bryan Hill decided he wanted to be self-employed, and also didn't want to deal with health insurance. He recently opened up his own Direct Primary Care pediatrics practice, Gold Standard Pediatrics in South Carolina.
There are benefits beyond money, too, although they are tied in to the savings.
When Blythe Fortin went in for a recent visit at sparkMD, a direct-primary-care practice in Boise, Idaho, Dr. Julie Gunther spent an hour chatting with her before getting to the results of her blood test, which showed elevated blood-sugar levels.
"She listened when I said I can manage with diet," rather than starting her on medication, Fortin said.
This brings to mind my own most recent visit to the doctor. I, too, luckily had a doctor willing to chat with me and we developed a plan that did not revolve around drugs. But of course I was being charged by the minute, and the visit ended up being very expensive just because we talked so long.
What about catastrophe?
To describe how (insurance) coverage functions under direct primary care, doctor's use the example of car insurance: You don't use your car insurance for small transactions like oil changes, but it's there for you if you get in a car accident. Likewise, health-insurance plans - especially those with high deductibles - can be there if you require healthcare beyond primary care.
I think this is great, because people will understand more and more exactly how much the accouterments of healthcare cost. I've understood this for a while, since I've been uninsured for the past 4 years. I've paid for lab tests, doctor's visits, and drugs out of pocket, so have a pretty good idea how much these primary care items cost.
I find this form of healthcare very fascinating, because doctor's make less at their own practices than they would at a hospital. Dr. Vance Lassey took out a loan to start his practice and refurbished and renovated his place, picking up old equipment from surplus stores and a nearby nonprofit hospital.
Keeping his costs low helped Lassey break even within four months of opening his practice. Still, he's not earning as much as he used to when he worked at a hospital and had only five to 10 minutes with a patient - a lot less time than he gets to spend with his patients now.
"I am making a profit, I have more free time, and I can practice properly," he said. "It's worth it to me."
Under the ACA, Direct Primary Care is legal. It is unclear what will happen to this burgeoning practice under ACHA. Additionally, Health Savings Accounts cannot legally be used for Direct Primary Care.
"This is a niche, but a niche that makes sense," Long said.
Photo Credit: Pixabay
Quotes taken from A new kind of doctor's office charges a monthly fee and doesn't take insurance — and it could be the future of medicine posted on the BusinessInsider.
Health care is a service. Health insurance is not health care. When government gets involved in a service through monopolization, support for corporate cartels, mandatory purchases, or other interventions, the inevitable result is chaos and higher costs. Unfortunately, this chaos and increased expense is inevitably then used as justification for more intervention in a never-ending cycle.
Freedom works. People need to be willing to see the evidence and take the leap.
You know that German state health care system is way more effective then the private one that is also here. And its from the 19th century.
And of course its way cheaper then e.g. the US system.
So when will the inevitable strike and double German costs?
I would need to know more before I could offer a reasonable opinion.For example, the US system is called "private," but it's a government-supported corporate cartel system. I can guarantee that any government program suffers from the economic calculation problem though, because this is unavoidable with any centrally planned system.
Huh? Strange.
You mean private insurances don't do their calculations centrally? Is the first tiem I have ever heard that!
And what do you mean with economic calculation problem?
The onl one I can imagine is the problem of figuring out how much interest (in the broad sense) you accumulate in half a century, and that is a problem that private systems have (thats why they are whining so much about current low interest rates). State on the opposite always can help out out of other pockets in case of emergency, and at least in Germany, does not rely on interest at all but the working force.
What? You seen to be trying to conflate central planning with the competing organizations that develop in a free market. That is disingenuous at best.
Central planning removes the possibility of rational economic calculation by market actors on both the supply and demand sides of the equation. Neither knows whether the prices charged or the service quality/quantity provided are sufficient.
But that is true for all the " rational economic calculation by market actors" because, in reality, NO ONE knows what is there in 30 years. Or 50. Or even 70 years.
And I don't even want to talk about thinks like "There is only place for a hand full of computers in the world".
You know what you are willing to spend for what you want. That is what makes you a rational market actor. You do not know what I am willing to spend for what I want.
Your comment about the failure of famous predictors is what no one should claim power to "manage" the market, because their shortsightedness, prejudice, malice, or basic mistakes inevitably create chaos. Decentralized grassroots processes minimize risk while maximizing information available to rational market actors. That is what the market process does.
Now I want to meet my first rational market actor!
Look in the mirror. You apply reason to choose actions in order to satisfy your wants. You seem to think that perfect knowledge is necessary to be a rational actor. This is false, and this false assumption seems to be the root of your objection to my arguments.
On the other hand, the limitations of individual knowledge is what guarantees chaos and destruction in any centrally-planned economy. The central planner has no access to price information to analyze supply or demand. His errors in predicting the future guarantee future shortages or gluts. His lack of systemic knowledge guarantees inability to plan or react.
Agree 100%. I think people sometimes forget healthcare is a service...
Awesome... resteemed.
I've been steaming mad about the government's approach to healthcare for a long time now. It is actually the thing the government has done in my life time that has had the most negative effect on my family.
You know what, I think it's the same for me. I've never really been harmed by the government, per se, (discounting excessive taxes and withholdings from my paycheck) except in the case of health insurance. I was luckily too poor to pay the penalty for not having insurance (irony, I know). The IRS recently did away with this penalty - we'll see if it sticks.
But I've heard horror stories of people with families and how much they pay for insurance. Besides taxes and withholdings, it seems to be the most direct way the government affects (reads, hurts) average Americans.
I made less money had had good insurance and/or no problems getting treatment for my family BEFORE the AHCA was passed.
Since then I've had insurance for myself (my wife insisted) part of the time, but none of the rest of my family has had insurance.
The premiums cost more than our mortgage, and that is before deductibles and copays... so it is so expensive we could pay it and live in a box somewhere, but we'd have no money left for the deductibles or copays so can't use it anyway.
The fines are bad, but they are way less than trying pay the crazy premiums.