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March 30, 2019 by Dr. Varner in Direct Primary Care
On this National Doctors’ Day, I want to take a little trip through time.
Back before America became the land of corrupt insurance schemes, doctors used to be highly independent. We used to work alone, or in small associations, and it was a generally private business.
Most people would either directly see doctors out of their own pocket, or form unions and associations to share healthcare costs. Given the amount of knowledge and equipment we had at the time, this worked well.
But trouble was brewing…at the dawn of the 20th century, the American Medical Association (AMA) and the government started to push for organized medicine.
Then something happened that enabled the AMA to finally get their wish…
John F. Kennedy famously said that, in Chinese, “crisis” is made up of the two characters for “danger” and “opportunity.” And the concept still holds true.
World War I allowed the government to get heavily involved in medicine, as we needed more organization to cope with damage and the higher costs that came with it.
This trend continued, and slowly the dominant form of health care became an unholy cartel of bloated insurance companies, supported by state legislation.
So now we’re in a situation where the majority of people, patients and doctors are in some sort of insurance scheme. Government has increased its influence through programs like Medicare and Medicaid.
When the government is in charge, you get poor service, poor management and poor outcomes. And when that applies to health care, you play by their rules or face financial ruin.
When you subsidize a terrible system, you just get more of that terrible system…
The big problem with state-backed insurance, at least when it comes to the doctor-patient relationship, is that it incentivizes lack of care.
Think about your ideal doctor for a moment. They’re there to reassure you, inspect you thoroughly, ask you questions, and give you a solution to get better.
That simply doesn’t happen under the current insurance scheme.
It’s because you’re not the paying customer: the insurance company is. In the same way the patients play the game of the government system, doctors play the game of the insurance companies.
This means they fill out forms, tick boxes, and prescribe drugs for each individual ailment, to make bank.
Insurance companies want them to see as many of their clients as possible, and prescribe the cheapest drugs.
On the other hand, the doctors have no incentive to be efficient, so they’ll prescribe the ‘best’ i.e., the most expensive drugs.
The insurance companies foot the bill for these drugs, so they swamp them with paperwork to make this process as difficult as possible. In fact, nowadays doctors spend up to two-thirds of their day with paperwork.
So we have a system where doctors have to whiz through their clients and simply can’t afford to care about them. Add onto that the fact that the dominant form of illness in the US today is chronic conditions and you’ll see that we don’t have a healthcare system, we have a ‘sickcare’ system.
It’s just a churn of people paying each other, and nothing productive happens. We need to go back to the time when doctors could actually sit down and treat patients properly…
This is why I’m such a big fan of direct primary care (DPC): The relationship and payment between doctor and patient are both, well, direct.
It cuts out all of the obligations, overheads and nonsense that comes with insurance schemes.
My favorite form of DPC is the subscription model. Think of it as a gym membership. You pay a fee each month, often around $100, and you can get unlimited access to your doctor.
This is beneficial in so many ways. For one, you can actually spend time with your doctor, who won’t miss out on things that could be critical. It allows them to actually treat you holistically, which can cut down on the amount of unnecessary and expensive drugs you take.
Second, it’s cheaper. $1,200 a year is about a third of the average insurance plan.
Third, in addition to the time benefit, doctors won’t be overworked and burnt out. The insurance system exploits doctors and puts far too much pressure on them. How are we supposed to effectively care for people when we’re put under that amount of stress?
When you choose a direct primary care doctor, you need to maximize these benefits, so make sure you have a good look around for your ideal doctor.
Most successful business relationships are direct. They provide the best incentives for good practice and are typically more efficient. It’s just a shame that health care, one of the most important sectors, has completely forgotten this.
With direct primary care, we can pick and choose what we need and have an actual relationship with our doctors –one where they can deliver the health care they have trained so extensively to provide. On National Doctor’s Day, I can think of no better gift for both patients and doctors across the country.
This information is intended to help readers be more informed about their health options when speaking with a professional, but it should not be used alone to diagnose, treat, prevent or cure any disease or condition. Be sure to speak to a qualified doctor before taking any action to make sure that your choices reflect your actual health situation.