A few weeks ago, a decision by a federal district court judge stunned the healthcare community when he ruled the Affordable Care Act to be unconstitutional.
The ruling is being appealed and will not be affecting the status of the law until it is reviewed the Supreme Court. But it was interesting to observe the reaction of various parties…
The American Medical Association (AMA), which claims to speak for all doctors, tweeted that the ruling would “strip health care from tens of millions of Americans and sow chaos into the healthcare system.”
Similarly, the American Hospital Association issued a press release saying that the ruling “puts health coverage at risk for tens of millions of Americans.”
Now, I can understand a reaction of shock among patients who are dependent on health insurance subsidies without which they would be unable to afford the exorbitantly expensive care currently being provided in most healthcare venues.
But doesn’t it seem a bit disingenuous for the most powerful physician and hospital lobbying groups to lament the financial harm that the ACA rollback could have on patients? Isn’t it their institutions that are not only setting the prices for healthcare at stratospheric levels, but also obscuring them so that no one can know with any real certainty how much the care is going to cost?
The fact is, large hospital and medical groups are the primary beneficiaries of the health insurance industry, and they are very skilled at extracting payments from health plans—costs that can then be passed on by the health insurance industry to the employers or to the tax payers.
If health insurance disappeared, the same hospitals and medical groups would have to offer their services directly to the patient. And the shock would be on them! As Dr. Jane Orient put it, in reply to the alarmist tweet by the AMA: “Really? Will AMA doctors refuse to see uninsured patients?”
Dr. Orient leads an organization that supports the direct care movement, which is nothing more than a movement of doctors who have decided to put patients first and—as a result—are providing terrific care at unbeatable prices.
I have previously blogged about how Athletic Heart SF is serving patients regardless of insurance status. We serve many who are either uninsured or whose deductibles are so high that they must pay thousands of dollars out of pocket before the insurance kicks in.
With our service structure, we provide outpatient cardiology care at a fraction of the price and a fraction of the time that it would take to get it elsewhere. Our secret? We simply speak to prospective patients ahead of their visit to better understand their concerns, and we schedule the consultation or tests so that everything is done in one fell swoop for a very reasonable and transparent price.
And, 2 years ago, we also launched our direct primary care (DPC) practice.
DPC is a great model for people with chronic conditions, or for anyone who would like to have a personal, long term relationship with a physician that is not going to be subject to the ups and downs of what happens with insurance plans.
I recently had the pleasure of conducting a podcast interview with Dr. Lee Gross, who is one of the pioneers of the direct care movement. He told the story of how he and other colleagues in the movement were able to provide life-saving surgery and 6 months of follow-up treatment to a patient with thyroid cancer for less than $10,000! (You can listen to or watch the podcast episode here.)
I am very hopeful about the direct care movement. You should consider joining it, either as a patient or as a supporter. For more resources and for a direct care practice in your area, see:
- DPC Frontier Mapper (focused on primary care)
- The Wedge of Health Care Freedom Mapper (includes specialists)
- Surgery Center of Oklahoma (a pioneer in direct surgical care and price transparency—you can listen or watch our interview with its co-founder Dr. Keith Smith here)
- Free Market Medical Association, an organization that promotes the direct care movement and connects healthcare providers with buyers of healthcare, including self-insured plans and employers in small-to-medium size companies.
Indeed, if all hospitals and doctors were willing to take care of patients regardless of their insurance status, the healthcare crisis would evaporate in a minute.
Happy New Year!
–Dr. Accad
