The alleged goal of Obamacare was to increase the amount of people who have health insurance. It instead created a problem: While more people are covered (millions after the plans they had were banned), insurance is more expensive overall, and has not correlated with increased access to care.
High deductibles (the amount of money a patient has to provide out of pocket before insurance starts paying) have rendered many insurance plans essentially unusable for working and middle class Americans.
While this is a negative development – and speaks to the cronyism inherent in government and insurance companies colluding with each other – a silver lining has appeared as a market response to this chaos.
Many doctors are starting to open cash-only practices where insurance isn’t accepted. This can provide patients with a high-quality, affordable alternative for access to basic care.
As Kathleen McGrory reported for the Tampa Bay Times, many doctors are moving toward a direct primary care model, with 400 now providing basic services for cash payments since Obamacare was enacted. This allows doctors and patients to work with each other absent the nefarious government-insurance complex middleman.
McGrory highlighted the story of a doctor named Trinette Moss, whose cash-only practice in Clearwater, Florida is thriving. Wrote McGrory, “Billing at [Moss’] office works like this: Patients between 18 and 49 years old pay $60 a month. The fee covers unlimited office visits, urgent care services and an annual physical. It costs $15 a month to add a child.”
“Moss says the model, known as direct primary care, makes financial sense. She doesn’t have to hire anyone to file and track insurance claims. And she collects enough in monthly fees to keep her practice small.” Eliminating the bureaucratic barrier that so often divides doctors and patients? That sure sounds good to a lot of consumers, especially in the age of high deductibles and co-pays.
In Florida, legislators have taken notice of Moss and doctors like her, and want to accommodate this direct primary care model. As McGrory explained, “Lawmakers are considering a proposal (HB 37/SB 132) that would ensure direct primary-care providers don’t run afoul of state insurance laws, paving the way for more doctors to contract directly with patients.”
The fact that laws making it difficult for doctors and patients to contract directly exist in first place is a telling problem. Advocates of freeing the healthcare market have long noted that the regulatory maze around insurance and access to care has put consumers at a disadvantage. How can a person shop for the most cost effective services – and how can competition drive those costs down – when the government has essentially banned a market altogether?
While the direct primary care model is far from a solution to the overall corporatist mess of Obamacare, it’s an instructive innovation; a response to the fact that the government has so distorted the market that it’s time to get back to basics. When paired with a catastrophic insurance plan, direct care can make sense.
The trouble however, is that it doesn’t on its own, satisfy the requirements of Obamacare’s individual mandate, which can fine you thousands of dollars, depending on your income, if you don’t have health insurance.
Overall, direct access to a doctor without the drama of government bureaucracy and insurance is a good thing. As Dr. Moss said, “It just seems like this is the right thing to do. You can help everyone from waitresses making minimum wage to executives, and be more accessible to them all.”
If only the government would allow more direct competition rather than the crony prototype it’s relied on through Obamacare, there could be more of a market in healthcare overall. But small pockets of innovation are always welcome amid the central planning.
Hopefully, more state governments will follow Florida and work to accommodate this model.