Tag Archives: direct-pay medicine

5 Ways To Protect Yourself Against Obamacare

At Forbes, Denver physician Paul Hsieh explains five ways to protect yourself against Obamacare:

  1. Get a good primary care doctor, if you haven’t already done so.
  2. Use a Health Savings Account (HSA).
  3. Consider a concierge or “direct pay” physician.
  4.  Consider medical tourism, when appropriate.
  5.  Help your doctor work on your behalf.
Dr. Hsieh explains each one here.

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What reach your doctor 24/7? Pay her directly at a new Denver care center

Economist John Goodman explains why you typically cannot reach your doctor on the phone or over the Internet: Medicare and insurers don’t pay them for this. This changes when you pay your doctor directly. The Denver Business Journal reports on a new direct-pay medical office where doctors are available at all times:

Dialysis center giant DaVita Inc. has opened its first primary-care center in Colorado, offering concierge medicine to both employees and outsiders in what it says is an effort to improve health and reduce costs by competing with traditional physicians’ practices.

Paladina Health LLC, a clinic that opened on Sept. 3 at 1783 15th St., offers two physicians and two medical assistants to treat individuals or employers who pay a monthly fee. …

Under the concierge medicine concept practiced there, patients will pay a monthly fee — $99 for adults, $59 for children and various negotiated prices for companies — and receive unlimited services from doctors rather than paying per visit, Steinfort said.

By allowing doctors to spend more time with patients, and be available to them via cellphone and web portal at all times, DaVita believes it can drive improvements to customer service and to health while cutting the cost of care if patients don’t wait until they are severely ill to see a doctor, Steinfort said.

via DaVita opens Denver health care office.

At the Center for Individual Freedom, Ashton Ellis gives more background on direct-pay medicine:

Tom Blue, Executive Director of the American Academy of Private Physicians, says that doctors are seeing revenue drop precipitously as the costs of regulations, drugs and medical liability skyrocket, while reimbursements from public and private insurance providers plunge.

In response, Blue says that a growing number of doctors are converting their practices to a new business model that cuts out the middle men, and enhances the doctor-patient relationship.

Direct-pay medical contracts require a one-time annual fee that buys 24/7 access to a primary care physician, same day appointments and a doctor-patient relationship reminiscent of an era before third party insurers and government subsidies.

More: Direct-Pay Medicine: A Free Market Approach to Healthcare Reform



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Obamacare’s doctor shortage and concierge medicine

John Goodman has a scary op-ed in the Wall Street Journal. The Journal’s summary: “The demand for health care under ObamaCare will increase dramatically. The supply of physicians won’t. Get ready for a two-tier system of medical care.”

Goodman writes:

Most provisions of the Obama health law kick in on Jan. 1, 2014. Within the decade after that, an additional 30 million people are expected to acquire health plans—and if the economic studies are correct, they will try to double their use of the health-care system. …

Here is the problem: The health-care system can’t possibly deliver on the huge increase in demand for primary-care services. The original ObamaCare bill actually had a line item for increased doctor training. But this provision was zeroed out before passage, probably to keep down the cost of health reform. The result will be gridlock. …

As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest

Read the whole article: John C. Goodman: Why the Doctor Can’t See You – WSJ.com.

See also Grace-Marie Turner at National Review: Good Luck Finding a Doctor Under ObamaCare. She summarizes recent doctor surveys.

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Filed under Policy - National

U.S. health care warning signs

At the Ayn Rand Center for Individual Rights, Rituparna Basu provides useful links about:

  • Doctors struggling to make ends meet
  • Concierge medicine becoming popular
  • ObamaCare at 2 years old: bad news
  • Commercial insurers have trouble staying in business
  • Drug companies are less ambitious,
  • Super-high health plan premiums coming soon?

Read the whole post w/ reference: Health Care Roundup — VOICES for REASON.

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Filed under Policy - National

Primary Care Can Be Comprehensive and Convenient for $2 a Day

For example of how people can get primary health care without insurance, see John Goodman’s post: Primary Care Can Be Comprehensive and Convenient for $2 a Day. Goodman notes that “all this will go away, however, if Obama Care is fully implemented.”

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Filed under physicians & medical quality

Concierge medicine: doctors tire of dealing with politically-controlled insurance

The Boston Globe reports:

Every year, thousands of people make a deal with their doctor: I’ll pay you a fixed annual fee, whether or not I need your services, and in return you’ll see me the day I call, remember who I am and what ails me, and give me your undivided attention.

But this arrangement potentially poses a big threat to Medicare and to the new world of medical care envisioned under President Barack Obama’s health overhaul. …

Concierge doctors say they’re not out to exclude anyone, but are trying to recapture the personal connection shredded by modern medicine. Instead of juggling 2,000 or more patients, they can concentrate on a few hundred, stressing prevention and acting as advocates with specialists and hospitals.

MDVIP, a wholly owned subsidiary of consumer products giant Procter & Gamble …represents the largest group of concierge physicians in the country.

MDVIP marketing executive Mark Murrison says its doctors do not sell access, but a level of clinical services above what Medicare or private insurance cover.

See also:

More doctors gravitate toward boutique practice
Fed up with long hours and limits on fees, they aim to offer a more personal approach — at a price

(Via FIRM)

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A Radically Different Approach to Health Insurance

John Goodman of the National Center for Policy Analysis writes:

[B]efore the current era, the most common form of health insurance — other than Blue Cross plans — was indemnity insurance with a fee schedule. A typical benefit consisted of so many dollars a day for each day in the hospital. Since the benefit was independent of what hospitals actually charged, this type of health insurance did not interfere with the ordinary workings of the hospital marketplace.

Can we replicate that idea in a way that meets the financial and health needs in the modern era? I think we can.

In thinking about how to design a radically different type of insurance we have to come to grips with two principles that seem to invariably clash:

Principle One: Efficient, high quality health care requires that providers compete for patients on the basis of price and quality and that will not happen unless patients can unilaterally decide how their health dollars are spent.

Principle Two: Since all third-party insurance involves a pooling of resources, the more discretion individuals have to unilaterally draw from the pool, the more wasteful and costly the insurance will be. …

So how do we get around these seemingly irreconcilable principles?

Find out by reading the whole article: A Radically Different Approach to Health Insurance.

(via FIRM.)

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Filed under insurance, tax code, HSAs

Market-based alternatives to big-government health care reform

Congress to Healthcare Market: Drop Dead, economics Professor Mark J. Perry summarizes “market-based healthcare solutions have gone largely unnoticed, despite the fact that they have successfully lowered medical costs and improved both access and quality of service.” He describes the success of:

  1. Retail clinics
  2. Retail clinic-hospital partnerships
    “full range of medical services, from flu shots to major surgery”
  3. On-site workplace healthcare clinics
    References this story from Milwaukee Public Radio.
  4. Affordable $4 generic drugs
  5. Prepaid medical plans: “affordable, pre-paid healthcare plans that cover basic medical services …from a participating board-certified physician, with no deductibles, no additional premiums, and no co-payments.” $480 per year.
  6. Concierge medicine
  7. High-deductible health insurance plans along with individually owned and managed health savings accounts (HSAs).

Perry concludes that while politicians in DC are figuring out how more political intervention into medical and insurance makets can reduces costs and increase access (it won’t), the private marketplace is already doing it. Read the whole article at The American: Congress to Healthcare Market: Drop Dead.

(via State House Call)

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NY Times: “Doctors Are Opting Out of Medicare”

A headline like this makes one wonder what “Medicare for All” would look like, or what effect President Obama’s proposed “public plan” would have on physicians.  It illustrates again that having medical “coverage” is not the same as getting the medical are you want.  Some excerpts from the New York Times article:

Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle. …

In a June 2008 report, the Medicare Payment Advisory Commission, an independent federal panel that advises Congress on Medicare, said that 28 percent of the Medicare beneficiaries it surveyed who were looking for a primary care doctor had a problem finding one to treat them, up from 24 percent the year before. And a 2008 survey by the Texas Medical Association found that while 58 percent of the state’s doctors took new Medicare patients, only 38 percent of primary care doctors did. …

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Filed under coverage isn't care, Medicaid/Medicare/SCHIP

N.Y. Bureaucrats vs. Dr. John Muney & the uninsured

The case of Dr. John Muney shows the outright injustice and immoral nature of government regulations that rob us of our individual rights to associate with one another in a peaceful manner.  Next time you talk about mandated benefits on insurance, here’s a concrete example of how they violate rights.  (Whether Dr. Muney is technically providing “insurance” is irrelevant.)

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.

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.

Just who do these government bureaucrats think they are?  Here we have a physician who wants to offer his services for a price, and patients who think it’s a good deal.  But apparently this is not allowed, because government authorities forbid it.  What of individual rights?  Here’s an other section of the article:

“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.

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Filed under regulation