What would it be like if insurance and government got out of the business of paying for routine and minor healthcare, and just let the free market do its thing? Here’s one man’s story about his experience in the free market healthcare system with a torn meniscus (click link below). What I find ironic about this story, is this is exactly how we’d do it if our dog needed knee surgery. This story gives us a good feel for what healthcare costs could be like if we just reserved insurance for catastrophes instead of using it for everything.
Several years ago, back in 2006, I bought the book, The New Health Insurance Revolution, by Paul Zane Pilzer, and I’m so glad I did, because I wanted to look back and see what health insurance costs were back then, vs. what they are today. It serves as a good reminder that high risk pools did work, and helped keep insurance costs low for the masses of healthy insurance buyers. It also reminds us that high risk pools, while more expensive than insurance plans offered to the healthy, can be offered on a sliding scale of income and still be affordable, even for those with pre-existing conditions. (Note: Pre-ACA, Cover Colorado, for example, was offered on a sliding scale of income. Rates shown in picture below do not display sliding scale discounts). What the ACA did was essentially turn Health insurance into a costly high risk pool for everyone. This is evident by comparing historical insurance costs to the cost of insurance today.
See the following pictures. Rates are based on a 33 year old person with similar individual deductibles.
2006-From The New Health Insurance Revolution
When I share information about Direct Primary Care with others, I’m often met with fierce resistance and disbelief. I’ve even been told that I’m full of, well, you know what! So today, when I saw this interview with Dr. Josh Umbehr of Atlas M.D. I couldn’t wait to share it! Dr. Umbehr shares with us the highlights of Direct Primary Care and how the revolutionary healthcare model is changing the way Americans receive their primary care.
“Direct primary care is the free market applied to health care. It’s medicine finally taking the best elements of other business models such as Amazon Prime, Netflix, and Hulu and applying them to an industry that’s ten or fifteen years behind the rest of the world in terms of business structure. It brings a very high-value, low-cost model to the masses.”
Here are some of the highlights of Direct Primary Care and how it saves money for the masses and fixes access to care, by far the most agregious problem in the healthcare systems of “every other developed country”, as well as in America. (Quotes below from Dr. Josh Umbehr in his interview by Tim White of the Objective Standard)
- Direct Primary Care brings a membership model to healthcare: “We charge $10 per month for kids, or $50 to $100 per month for adults, based on age.”
- Direct Primary Care lowers the cost of health insurance, because it removes the cost of basic care from insurance, saving insurance for the catastrophic claims it should be used for: “Direct primary care makes insuring the routine 80 percent of your health care unnecessary.”
- Direct Primary Care lowers the cost of procedures, prescriptions, labs and x-ray: “My best example is an EKG—it costs thirty-six cents, so we do it for free. The coffee in the waiting room costs more than that.” “Just as Amazon can use its size, technology, and resources to find the best prices for me, we can do the same for patients when it comes to medications and labs. We can get those things wholesale at giant savings, sometimes up to 95 percent off.”
- Direct Primary Care saves money for the chronically ill and those who might need high tech imaging such as CAT, PET or MRI: “A diabetic patient may have trouble getting his A1c testing covered because it’s expensive. We can do that test for $2.25. It’s $150 at most other places. A diabetic can get a thousand pills of Metformin—more than a year’s supply—for $11.” “We may not have in-house the orthopedic surgeon who does the surgery, but we can certainly do the MRI that the surgeon will need. Instead of $3,000, we do it for $300.”
- Direct Primary Care provides quality healthcare: “There’s “cost-effective” health care, which would say, “Don’t do mammograms until you’re forty-five or fifty,” depending on what guideline you use. Well, if you have a family history of breast cancer and you’re worried about it, you might start doing mammograms at forty. Some people will say you’re not cost effective, but I say, “That’s what the patient wanted, and it’s $75 for a mammogram through a direct primary care provider. She can comfortably afford it, and it buys her peace of mind—that’s quality care.”
- Direct Primary Care provides value to its patients: “The nausea medicine Zofran, prescribed to pregnant women for morning sickness, is around $120 for thirty pills. We get it wholesale for $2.65.” “Doctors can order brand-name newborn diapers wholesale for $0.02 per diaper. We can get a case of 240 diapers for even less at $3.77—it sells for $38 on Amazon.” DPCs resell wholesale items like diapers and prescriptions to their patients at cost; they do not mark them up.
- Direct Primary Care routinely saves patients thousands on emergency or urgent care. Consider this tweet from a Dr Janice M Hudson, MD.
In conclusion, we as Americans can do better than “other developed countries”, and what makes us different is freedom. If the government would allow us to buy wraparound insurance to protect us from unforeseen catastrophes, healthcare in America would once again become affordable for the masses, freeing us from waste so that we could use money saved to protect those who are truly in need.