Rational Capitalist on Facebook

Wednesday, March 27, 2013

Concierge Medicine, The Antidote to Socialized Medicine

In 2009, I discussed an essay by Lin Zinser and Dr. Paul Hsieh in which they detailed the history of government intervention in the health care market and demonstrated how government, not the free market, is to blame for the state of health care today.  In that same post, I suggested that given the political reality of dramatic government intervention in health care, akin to the throwing of gasoline on a fire, doctors should simply refuse to contract with insurance companies or the government by setting up "concierge" practices that do not accept insurance or medicare but actually ask their patients to pay for the service (gasp).  

To follow up, I link to a current Forbes piece by Dr. Hsieh titled, Is Concierge Medicine Right For You?, in which he discusses alternative practice models being developed to respond to the phase in of Obamacare.  In the wake of an impending physician shortage due to a "silent exodus" from the profession and declining reimbursements, doctors "are establishing “concierge” or “direct pay” practices, where patients pay a monthly or annual fee for enhanced services, including same day appointments, 24/7 access to their doctor, e-mail consultations, and longer appointment times."  He goes on to discuss some key considerations and points out that you will likely face a choice:
Over the next decade, we will likely see the evolution of primary care delivery into two tracks. Some patients receive high-quality care from happy, motivated concierge doctors, whereas others will have to make do with rushed “assembly line” care from overworked providers trying to get their patients in and out the door as quickly as possible.
He concludes that "if you don’t choose, the choice will be made for you."


Abby said...

That Forbes article was good, and this whole idea of direct pay primary care is scary for alot of people. I think that many see it as a big leap forward into a further proliferation of the upper class. This movement, and I agree that it IS happening, further delineates the rich from the poor when it comes to health care. Those with money will get much better care, those without will be left to wallow in a poor heath care system.

Will said...

Actually, as noted in the article, costs often drop significantly with this approach. I first became aware of it a number of years ago when some west-coast doctors targeted this idea specifically at lower-income patients who couldn't afford decent insurance but who could pony up a lesser monthly amount to pay their doctor directly. Health care providers expend insane amounts of time and money trying to pry reimbursements out of insurance companies (and various gov't programs, but that's another story). Your doctor won't charge as much if he doesn't have to employ 2 or 3 full-time people whose sole job is dealing with insurance, and a number of doctors won't mind a reduction in revenue if it means they get to practice their profession the way they want to.