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Direct Primary Care: An Innovative Alternative to Conventional Health Insurance

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Uncle Siggy

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Direct Primary Care: An Innovative Alternative to Conventional Health Insurance
August 6, 2014, Daniel McCorry

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W‌ith new concerns over the effects of the Affordable Care Act (ACA)[1] on access to care and continued frustration with third-party reimbursement, innovative care models such as direct primary care may help to provide a satisfying alternative for doctors and patients. Doctors paid directly rather than through the patients’ insurance premiums typically provide patients with same-day visits for as long as an hour and offer managed, coordinated, personalized care. Direct primary care—also known as “retainer medicine” or “concierge medicine”[2]—has grown rapidly in recent years. There are roughly 4,400 direct primary care physicians nationwide,[3] up from 756 in 2010 and a mere 146 in 2005.[4]

Direct primary care could resolve many of the underlying problems facing doctors and patients in government and private-sector third-party payment arrangements. It has the potential to provide better health care for patients, create a positive work environment for physicians, and reduce the growing economic burdens on doctors and patients that are caused by the prevailing trends in health policy. With some specific policy changes at the state and federal levels, this innovative approach to primary care services could restore and revolutionize the doctor–patient relationship while improving the quality of care for patients.

In general, direct primary care practices offer greater access and more personalized care to patients in exchange for direct payments from the patient on a monthly or yearly contract. Physicians can evaluate the needs and wants of their unique patient populations and practice medicine accordingly. Patients relying on a direct primary care practice can generally expect “all primary care services covered, including care management and care coordination … seven-day-a-week, around the clock access to doctors, same-day appointments, office visits of at least 30 minutes, basic tests at no additional charge, and phone and email access to the physician.”[5] Some practices may offer more services, such as free EKGs and/or medications at wholesale cost.

This approach would enable doctors and patients to avoid the bureaucratic complexity, wasteful paperwork and costly claims processing, and growing frustrations with third-party payer systems. It can also cultivate better doctor–patient relationships and reduce the economic burden of health care on patients, doctors, and taxpayers by reducing unnecessary and costly hospital visits.

While the rapid growth in direct primary care is a relatively recent trend, policymakers could help by eliminating barriers to such innovative practices and creating a level playing field for competition. At the state level, policymakers should review and clarify existing laws and regulations, repealing those that impede these arrangements. At the federal level, policymakers should consider facilitating greater access for patients to direct primary care through the federal tax code and also within existing federal entitlement programs.

bg-direct-primary-care-chart-1.jpg


Rest of the article is at the link: http://www.heritage.org/health-care...ive-alternative-conventional-health-insurance
 
This is all fine and dandy if we want to address issues with traditional medical care, but.... how good is medical care and philosophy really? As I often quip, medical treatment is good for what I call trauma medicine (such as injuries, broken bones, and emergency crisis, etc.) but is batting zero on preventative medicine ie, keeping someone from getting some medical condition, or if something is detected even early, virtually no difference on the outcome. Yet, this is where most medical costs apply such as drugs (usually numbers-lowering drugs to "prevent" something from happening that will happen anyway, excessive tests, and additional surgeries). This improper philosophy that I find even my Christian friends duped into, is a money-making grab from pharmaceuticals especially. Just this week I'm sure we heard about the little girl who died from what their parents thought was an unnecessary dental procedure. Because the system has been twisted, it stands to reason that the fiances behind it are twisted as well, and the only solution is to foster the growth of alternative, yet scientifically based medicine. Of course I say good luck with that because big $$$ will fight that and as always the case will win out despite a majority vote. Some governmental powers that be are in bed with these money-making grabs. But as long as we ask ourselves how to "fund" this, it will only perpetuate and grow this cancer. And that's where the real cancer is-- probably not 50% of the people who are misdiagnosed and are persuaded to undergo chemo anyway. It's the system. And like many bad cancers, I fear we are too far gone.
 
I'm highly skeptical of alternative medicine.let's just say the person who I know is into it and has pointed greed in it as well.

Case in Point.chiropractic care often is over done.you dont need to be adjusted as much. And it can make it worse by doing so.
 
I agree about the greed Jason, but I'm talking about the science itself and by chance hope in people who practice that who may actually be in the field with the desire to help others instead of making money. I suppose I can dream on because that will never happen knowing the nature of man. So as Christians it may be wise to forgo all of that greed-driven philosophy in favor of something more biblical. For starters, in early Genesis we are given every herb and fruit bearing seed and later kosher meats. In short, cut the processed foods and eat only that which is natural. That's how they ate then, and for starters probably 95% of the chronic conditions we have today will be gone. As a matter of fact, some people practice health now and older ones are perfectly healthy with but may have a very normal 145/90 BP and 225 cholesterol. But in recent years they dummied those numbers down so that they "need" drugs to "stay healthier and live longer". So even aged citizens who are the picture of health are warned about the risks and badgered with fear to take these medications (in short they find something wrong even if one practices health almost as if to prove them wrong). So as long as we have this imbecilic mentality, the system will careen out of control with high costs. They are milking it and over diagnosing people with conditions they don't have.
 
Despite being kosher ashkenazi jews are at higher risks for parkinsons,chrons disease and a lot of the genetic link illness.

It's how we know who is a jew or not.the markers. Kosher eating doesn't mean you won't have heart disease.my.mil is kosher,underweight and has had a tuple by pass and has high bp.her genes.

We are stuck with some ailments that can't be prevented by diet.
 
Direct Primary Care: An Innovative Alternative to Conventional Health Insurance
August 6, 2014, Daniel McCorry

Download Report

W‌ith new concerns over the effects of the Affordable Care Act (ACA)[1] on access to care and continued frustration with third-party reimbursement, innovative care models such as direct primary care may help to provide a satisfying alternative for doctors and patients. Doctors paid directly rather than through the patients’ insurance premiums typically provide patients with same-day visits for as long as an hour and offer managed, coordinated, personalized care. Direct primary care—also known as “retainer medicine” or “concierge medicine”[2]—has grown rapidly in recent years. There are roughly 4,400 direct primary care physicians nationwide,[3] up from 756 in 2010 and a mere 146 in 2005.[4]

Direct primary care could resolve many of the underlying problems facing doctors and patients in government and private-sector third-party payment arrangements. It has the potential to provide better health care for patients, create a positive work environment for physicians, and reduce the growing economic burdens on doctors and patients that are caused by the prevailing trends in health policy. With some specific policy changes at the state and federal levels, this innovative approach to primary care services could restore and revolutionize the doctor–patient relationship while improving the quality of care for patients.

In general, direct primary care practices offer greater access and more personalized care to patients in exchange for direct payments from the patient on a monthly or yearly contract. Physicians can evaluate the needs and wants of their unique patient populations and practice medicine accordingly. Patients relying on a direct primary care practice can generally expect “all primary care services covered, including care management and care coordination … seven-day-a-week, around the clock access to doctors, same-day appointments, office visits of at least 30 minutes, basic tests at no additional charge, and phone and email access to the physician.”[5] Some practices may offer more services, such as free EKGs and/or medications at wholesale cost.

This approach would enable doctors and patients to avoid the bureaucratic complexity, wasteful paperwork and costly claims processing, and growing frustrations with third-party payer systems. It can also cultivate better doctor–patient relationships and reduce the economic burden of health care on patients, doctors, and taxpayers by reducing unnecessary and costly hospital visits.

While the rapid growth in direct primary care is a relatively recent trend, policymakers could help by eliminating barriers to such innovative practices and creating a level playing field for competition. At the state level, policymakers should review and clarify existing laws and regulations, repealing those that impede these arrangements. At the federal level, policymakers should consider facilitating greater access for patients to direct primary care through the federal tax code and also within existing federal entitlement programs.

bg-direct-primary-care-chart-1.jpg


Rest of the article is at the link: http://www.heritage.org/health-care...ive-alternative-conventional-health-insurance

Hi US

I read the above.
Did I understand it correctly?
It sounds like the socialized healthcare we have here.
The only good part of it is what sounds like the above:

Primary Care Physician

You sign up for the care of one PCP, in your area or outside your area. Your choice, although it makes little sense to have one outside your area.

He gets paid fore EACH patient he has on a yearly basis.
Here, of course, it's by the government. By the above, it sounds like it would go directly to the doctor chosen.

He gets the same amount per year, whether you ever go for a visit, or if you go every day.

Used to be that house calls were included, but things are starting to change here...

If I understood properly, then Yes, it does work well.

You could always go to another dr for a second opinion on a pay per visit basis, but why would one want to? At that point it's better just to go to a specialist.
 
As a side question, has anyone tried what they call health share ministries like Medi-Share or others like them? If so, any opinions or comments on them?
 
As a side question, has anyone tried what they call health share ministries like Medi-Share or others like them? If so, any opinions or comments on them?

I "second" that question. If we are 'forced' to have insurance now, I would at least try something that is supposedly more ethical. So along with Civilwarbuff I'd like to know, too, if anyone has experience with this. What I do know about Medi-share is that this is not an insurance, per se, but acts as one because they distribute the costs amongst brothers and sisters. So we are all paying out of pocket and sending it where it's needed, sort of like the distribution in the book of Acts. I suppose they also do some investing as well for additional returns. But yes, if anyone has experience with this,like I said, I want to know, too.
 
You sign up for the care of one PCP, in your area or outside your area. Your choice, although it makes little sense to have one outside your area.

I would think that all would depend on where you live in your area. If you live right on the border and would have to drive 30 miles to see a doctor but only live 5 miles from another doctor on the other side of the border which one would you want to see???
 
I would think that all would depend on where you live in your area. If you live right on the border and would have to drive 30 miles to see a doctor but only live 5 miles from another doctor on the other side of the border which one would you want to see???
Good question...
The one 5 miles away.
Specialists can be farther away, but the PCP should be very close.
Especially if house calls are needed...
 
Good question...
The one 5 miles away.
Specialists can be farther away, but the PCP should be very close.
Especially if house calls are needed...

If you live out in the boonies 30 miles between gas stations is nothing much less a town where a doctor might be. There are some places out west where law enforcement response time is over an hour...
 
If you live out in the boonies 30 miles between gas stations is nothing much less a town where a doctor might be. There are some places out west where law enforcement response time is over an hour...
OK Uncle Siggy
But I don't get your point...
Everyone needs a primary care physician.
I'm just saying that the system here works well.
I don't live out west and am not in the boon docks.
I still don't understand your point, however.
 
There are those christian health sharing plans that work great for many people, but they have nothing to do with covering prescription medications. It would be nice to see someone start that with medications. Like somebody I know has to pay hundreds of dollars each month for her prescription medications.
 
Interesting!

Don't know of any around my area but honestly I haven't checked cause am insured thru work and retirement from military (Can't dump the one from work because of it being collective bargaining). Would imagine though this is a good deal for young folks coupled with a catastrophic plan...
 
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