These Doctors Exemplify the Virtues of Free Market Medicine
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- Опубликовано: 29 сен 2024
- "Direct primary care is about as close to a free market in healthcare as you've ever seen in our country," says Dr. Lee Gross.
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The patients of doctors William Crouch and Lee Gross know exactly what services will cost before they receive them-a radical concept only in health care. They don't have to deal with benefit packages, coverage denials, hidden costs, in network vs. out of network, or any surprises whatsoever. Instead, their patients buy the medical equivalent of a Netflix subscription.
At $75 per month for adults, "We make it cheaper than a cell phone," says Dr. Gross. "If you can afford a cell phone, you can afford the most basic aspect of healthcare delivery in the United States."
Doctors Crouch and Gross are pioneers in a growing national movement called direct primary care. Tired of dealing with insurance companies when it comes to routine medical services, physicians around the country have exited the traditional system and are saying they can provide better care at a lower price by charging their patients a nominal monthly fee directly.
They're demonstrating that making American healthcare flexible and affordable requires abandoning the use of third-party insurance for routine care and adopting a market-based approach.
"Direct primary care is about as close to a free market in healthcare as you've ever seen in our country," says Dr. Gross, who also serves on the Florida Medical Association's Council on Medical Economics and Practice Innovation. "We have never tried a true marketplace in healthcare. We have competition, but we have competition in a price fixed system with very opaque prices."
When Crouch and Gross converted to direct primary care in 2010, they estimate that there were fewer than a dozen practices using this model. Today there are approximately 1,400 independent Direct Primary Care practices in 49 states. Virtually all of them charge a subscription fee that's between $50 and $100 monthly to consult with the doctor at any time in-person or from home.
Not only does this model result in lower prices, but the COVID-19 pandemic has shown that direct primary care is more flexible as well. According to a survey conducted in July, 78 percent of physicians had seen a decline in patient volume because of COVID-19. In March, the Center for Medicare and Medicaid Services issued a temporary waiver stating that Medicare would pay the same rate for certain kinds of video telemedicine visits as in-person ones. But the types of visits it would cover changed over the course of the year and are still changing.
Whether insurance companies and the government continue covering online visits after the pandemic has no bearing on Crouch and Gross. And they didn't have to wait for insurance companies and the government to OK telemedicine in the first place.
"We didn't need to wait for BlueCross to convene a committee to pay for telemedicine services," Gross says. "I didn't need to wait two months or three months for Medicare to create a new billing code in order for me to provide technology visits for a patient…Instantly from in-person practice, we were an online practice. We were a parking lot practice. We were a house call practice. We did whatever we had to do in order to get the patient the proper care at the proper time."
Gross adds that "for what Medicare pays for a single technology visit, I provide two to three months of unlimited technology visits, unlimited office visits, unlimited home visits, unlimited email visits. And so now the model is, again, pandemic tested. It's proven that it's actually a superior model because we have the built-in flexibility to do what we need at the time we need it."
Thirty-two states and D.C. have passed laws requiring insurance companies to reimburse doctors at the same rate for telemedicine visits as they do for comparable in-person visits. Dr. Gross says that shouldn't be decided by lobbyists, lawmakers, or government administrators. Prices should be set through market competition.
"The myth is that profit by its mere definition does not belong in the American healthcare system. And it's evil and creates perverse incentives…The key to making that profit work is, again, the elimination of that third party in the middle of that profit, which just drives up costs, but adds no value."
Produced by John Osterhoudt. Production support from Regan Taylor and Ian Keyser.
I work in a ministry for physicians and about 6 months ago had an older doc call me near tears of excitement how radical and life-changing DPC was for him and his patients. He said it brought the joy back into healthcare! Imagine if you could easily and cheaply get the preventative and minor concerns taken care of immediately, a lot of the systemic health issues we have as a society would decrease.
What do you mean by “ministry for physician”? I would love to know how it works
Our practice has been cash pay Only for 8 years. So much better
Ditto. I always ask for the "cash price" and even I am shocked by the difference.
Glad to hear it. I'm grateful there are some doctors who are doing right by their patients' wallets in addition to their bodies.
Much easier to hide the income that way.
Pill mill?
Whatevertf a naprapathic physician is.
"It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medications somehow think that we can afford to pay for doctors, hospitals, medications and a government bureaucracy to administer universal health care." Thomas Sowell
and yet every other developed mnation on earth does it and it costs the government less than half as much. the numbers say M4A is cheaper.
@Refined Snack I live in Canada, and cosmetic surgery isn't included. Neither is dental care. It's only hospitals that are included.
@Refined Snack actually, we do know. The most conservative estimate, done by the Mercatus Center (funded by the Koch family) found that M4A would save the government 2 trillion$ over a 10 year period. Most estimates place that number over 5 trillion. Second, according to a study by Yale epidemiologists, M4A would actually save the lives of 68000 americans who die every year du to lack of basic health care. In fact, families that make less than 60000$ a year would end up paying 14% less for healthcare each year. Basically, this shows that even though there would be a tax increase, working americans would still be nsaving money, not to mention they wouldn't have to worry about whether or not the hospital or clinic they'd be visiting would be in network, as under M4A they would all be in network. This would include dental and other non urgent services, unlike here in Canada where while hospital care is covered by medicare, Dental and prescriptions are not. however, the Canadian government regulates the prices of prescriptions and drugs, including insulin. In Canada, a vial of insulin costs less than 50$, whereas in the USA it costs, at best, over 100$, with some vials costing nearly 400$. This is what happens when you treat healthcare like a privilege rather than a human right and avoid regulating it. Dozens of thousands dead each year because they are scared of the cost. Tens of millions uninsured, even more underinsured, with insurance companies constantly nickle-and-diming customers.
there's a reason 4/5ths of Americans support medicare for all.
@Refined Snack Every other developed country on earth has done it in some way or another, so why can't America, the richest of them all, do it? Because your politicians are corrupt and bought off by corporations who don't care about them people. However, I understand that M4A is the most controversial as many see it as too centralized, and I can see why. However, a public option would end up costing more than what is currently in place. I think that dental and prescriptions, as well as non life saving surgeries (elective surgeries) shouldn't be covered. in my eyes, the most cost effectve system would involve urgent and hospital care being taken care of by the government, while surgeries that don't save the patient's life or prevent pain and suffering (cosmetic surgeries) and prescription drugs, dental, optometry, would be private to save the government even more money. Canada's system is somewhat like this except it covers unnecessary surgeries which ends up wasting colossal sums. However, the Canadian government does regulate the private sector to prevent price gouging.
This system is in India for years. No insurance to scam people.
Yes, this sort of system was always the norm everywhere. The doctor in the video said it's never been tried in the U.S., but that isn't true. It used to be much less complicated, but bad laws and ~70 years resulted in the mess we have now.
Same in Japan, as I understand it.
@@grantjohnson5785 iirc for many of those you pay nothing while ill. You're paying the doctors to keep you well-if they aren't doing their job, they aren't getting paid.
@@Shotblur Everything I've seen and read about it suggests it's pretty much pay-as-you-go... if you stay healthy, you pay nothing, and if you get sick, you pay out of pocket. You know, like everyone did for millennia? Of course, it's also expected that family visits the hospital routinely to provide much of your basic care (laundry, bathing, etc.) which is something American hospitals shun for some reason.
@@grantcivyt true
He's absolutely correct, but this is so hard to explain to the general public. All you really have to do is look at the skyscrapers downtown, many of which are owned by these insurance companies. That should tell you who is hoarding the cash.
Government run healthcare causes more problems than solutions look at the VA.
@@noahremnek3615 I don't disagree with you at all. I'm not an advocate of government run systems either.
I almost took a job working for a doctor in Charleston, SC who does this. His practice is awesome. I was really impressed by him, his staff, and their unique way of billing patients in a completely transparent and service oriented way. So good.
My PCP retired, and then came back as a DPC! He's my first DPC PCP, and I'm loving it.
I love it! How health care should be. Just like when my Great Grandpa was a Dr.
Health care should be free. End of story. There is nothing you can say that will convince me otherwise
With price transparency, suddenly that 800 dollar bag of saline at the hospital, or 25 dollar bandaid suddenly starts to reflect its actual market value.
$195 a month for a family of 4. Not quite a Netflix subscription but probably cheaper than insurance. I don't know i don't have insurance, but it still sounds expensive to me.
Pretty darn good way to change the paradigm on this topic.
Also, it's hilarious that Lord Wickiwicki wants their stupid COVID-19 prop banner on a video that only mentions the coof in relation to the changes in primary physician practices and billing for services. 😹
Are they still doing COVID banners? Hah, I had totally forgotten about those. I put a filter for them in my ad blocker, and haven't seen them in months. If you don't use uBlock Origin, you should. It's available for both Firefox and Chrome, and just installing it will nuke 99% of ads.
Removing specialty things might require some digging through HTML to find the right tags to block, but for the COVID and election pop-ups, the filter is: "www.youtube.com###clarify-box". Add that to the "My Filters" tab in the settings and enjoy telling Big Brother to shut up.
What should a person trying to live on $12,000/yr and is sick do?
YEAH! 😊 What a seed of hope. 💜
This was incredibly compelling and makes a ton of sense for primary care. What would be the libertarian/free market approach to long term chronic care? How do we make it affordable for cancer patients, people that need constant surgeries/tests, the terminally ill?
It'd be shitty, Prices would be in the hands of doctor's without control, supply would be monoplised, and basically... it'd be a lot worse than the system we have now.
Where was this video when I was in high school and my civics teacher only taught us about government run health care systems?
Why do have to pay you? Why not pay the doctorr.
Rituxin (Cancer drug)
Manufacturer price: 990 dollars
Hospital pays: 1300
Customer pays hospital: 10000
This is good, but what do you do if you have to go to the hospital or get imaging test and you can't afford it? I think direct primary care is good, but they're limited to what they can do in the office. And what happens when someone can't work anymore because they get a disease like cancer and they get so broke that they can't even afford the $75 per month anymore? The sickest people who need the most services aren't physically able to work BECAUSE of the fact that they're sick and need those services. That's the fundamental flaw of the American healthcare system. It's the reason that relying on insurance through a work place is such a stupid idea. What we really need is another hospital like St. Jude's Children's Research Hospital, but for adults.
Great comment. Sadly, with most people having their insurance tied to their employment, they do lose their health care when they get sick and can't work. That is not the case for Direct Primary Care, as your doctor is not connected to employment. Most times, our patients that get critically sick and can't work access Medicaid, the government safety net. They still typically remain in our practice. Often, we convert those patients into charity care and provide our services at no charge. As for the imaging, in almost every situation, our cash prices are lower than a patient's copay when using their insurance. Our MRI patients pay $220.
@@leegross1218 What do you do when people need specialist to do things that you can't do in your practice? Do they ever have trouble getting insurance approval for a specialist because, even though you referred them, the insurance won't accept your referral because you're in their network. Btw, I think think insurance networks are the single worst thing about our current system. I don't know about you, but that's the number one thing I'd like to see done away with. Patients should be able to use any doctor or medical facility they want to and should expect them to all work together, as far as sharing information about test results and such.
@@Melissa0774 Thanks again for the great questions. The only time we have problems getting insurance approval for most services is if the patient has an HMO. Those referrals MUST come from an in-network PCP. We have even been able to get approvals for MRIs for Medicaid managed care patients as long as we are willing to follow their protocols. I could not agree more about the "network" issue. See our work with DeSoto Memorial Hospital's health plan where we worked with them to eliminate network restrictions and saved the hospital 54% on their health plan costs while improving access.
@@Melissa0774 We have cash prices for many specialists, specialty tests, imaging services, physical therapy, inpatient and outpatient surgeries or procedures. In most cases, those prices are less expensive than they would pay using their insurance and applying it towards their insurance deductibles, but obviously not in all cases. The biggest issue where our patients definitely want to have insurance is for emergency room visits, hospitalizations, major surgeries or needing very expensive brand name medications. As for referrals, we have referring and ordering status under Medicare, so our Medicare patients can utilized their benefits outside our office. Our traditionally insured patients who have a PPO can go anywhere we send them, as long as that specialist is in network. The only problem comes in when a patient has an HMO or a Medicaid Managed Care plan.
This is something that just boggles my mind with the US. My wife is Malaysian and when we visit our relatives I sometimes am baffled that doctors put their prices on boards for regular health care. If I go to a private hospital that is too expensive, I'll just head to the hospital next door, if that is also expensive and I'm willing to wait long hours I can head to a government hospital which is almost free. Bravo to these doctors and I wish them the best of luck in pioneering this idea
Wait, but Libertarians don't want public hospitals funded by taxpayers' money, right?
@@ab-ul1yz Of course not. Price transparency would be cool though.
@@pattybaselines But even price transparency wouldn't fix negative externalities. For example, I got Covid, I'm left to make my own choices, I don't care about Covid because I'm young so I feel invincible, and before they know some rich folks spend and lose shit tons of money, or maybe they die, because I infect them
@@ab-ul1yz There's nothing to solve. People can make whatever calculated risks they want. If I want to risk getting covid I'll go outside. Make your own decisions and be prepared to deal with the consequences.
They've done it. Let's hope this model doesn't get corrupted, or restricted by the government.
Is there a website where all these types of places are listed?
Great video and a wonderful idea. I am glad to see that we can still have a free market in medicine. Get rid of the insurance companies and their cronies in government!
Most people can’t afford cancer treatment or surgery. But regular checkups are relatively affordable
Tommy Douglas: and I took that personally
Everyone thinks the Canadian healthcare system is awesome. Various provinces are now triaging even though hospitals are operating at 80-85% (usually 110% pre-Covid). So if you have a 50% survival rate, they can deny you service in some provinces. This isn’t a Covid issue, it’s a bureaucracy and lack of food management problem. I’d rather do things this way. Our Drs no longer do yearly physicals, everything is telemedicine. My mom has a second lump after just completing cancer treatment for her first lump. The Dr said they’d look into it after Covid is over 🤬
I’m so sorry to hear of your mom’s health circumstances. I wish you both peace & healing, in time.
My only question is what happens when someone is re-referred to a specialist?
With a system like this healthcare for all Americans would be ≈270B (use pop 300M and everyone is adult). With private insurance the us population spent about 3.6T on healthcare. Personally I’d rather be taxed more, have what my employer spends on healthcare for me added to my salary, and not be charge >$300 for an aspirin at the hospital 🤷🏽♂️. I’ve always found it odd we Americans call government healthcare “socialism” and run from it, but are perfectly fine with police/military. Imagine saying: “buy your own security force I don’t want my tax dollars paying for you to not get mugged/murdered/raped” lmao
Yet another example of how government interference costs you 100x more in taxes and fees than just taking care of yourself. Small government is the answer.
Office visits for $100 a month? Typically routine office visits require two visits per year. So, what happens when you have to go to the hospital?
When I worked in the US, there were a lot of patients without health insurance, I (and many other doctors) was really friendly with the morgue staff so they'd let me use the insurance of the recently deceased for the insurance-less.
Our hospital chief would be pissed when she found out but many time she also turned a blind eye.
HMOs and insurance really killed healthcare.
Working in the third world is so much better as I get to help people without any restrictions.
I'm seeing a lot of comments along the lines of "Well what about X?" or "What if...". Direct primary care isn't a cure all to our medical system, and nobody is claiming that it is. You still need actual insurance for catastrophes, major surgeries, etc. That's what insurance is for.
The only problem I see is that sometimes you need a hospital. Hospitals should have direct care plans too. They did in Cuba.
I live in Costa Rice where free market medicine exists. I will take free market anything over anything controlled by Government, free market is always cheaper and better.
lmao "when we took the oath" is purely metaphorical, as the hippocratic oath itself is a joke and hasn't been a requirement for centuries. the actual oath is as follows:
"I swear by Apollo the Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture.
To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the physician’s oath, but to nobody else.
I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein.
Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.
Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I transgress it and forswear myself, may the opposite befall me."
This is what Dr.Keith Smith has been talking about for years.
They will forbid this, just wait a few months
Oh yeah, yeah now this I can get behind
the best thing that could possibly happen to American health care is to eliminate the third party.
Anytime my family visits the doctor for anything other than a routine thing like a physical or minor ailment like strep throat, I have no idea if I'm going to pay $100 or $1000 once the bill comes (HDHP). It's definitely anxiety-inducing and deters me from visiting the doctor myself.
A gynecologists office should copy the concept and call their membership based practice Gold's GYN.
Too bad all of these patients will still need to pay for ObamaCare through their employers, or at least suffer the opportunity cost of lower wages due to the company having to pay the insurance company directly. Thanks, big government!
Amazing doctors
Sounds good. Sure it is way cheaper here in Sweden at €120 per year but you pay a lot in taxes so it probably gets more expensive. Not to mention that it is hard to get help. Our doctors are good but they are limited in their budget on what they can do. They might think an MRI would be good just in case but they need to hold their budget so they will only provide it if they think it is really necessary. A young doctor wanted to scan my aunt at an early stage but her superior said it was too expensive and not needed. When they finally thought it was needed it was too late. If you need psychological care you basically have to stand there with a knife saying you will kill yourself before they help you. It is not the doctors that are bad but despite massive taxes they never have enough money so they need to prioritize who gets help. There is also no incentive for them you keep you as a customer. In the private sector you need customer service but they don't need to be polite or even respond because they don't depend on your business. To be fair I've gotten great help when I've been in an emergency but for non life threatening stuff you are lucky if you get any help at all.
How are the insurance companies supposed to make money? /sarc
How do you shop around for the cheapest emergency room when the bone is through the skin?
Healthcare costs are proven to be cheaper in every country around the world when centrally organised with strong backing from the government. In terms of %of GDP, American pays about 16.1% on healthcare costs with it's ridiculous system whilst European countries who have all centralised healtcare (though to different degrees with some having minor market concessions) pay between 10-12% of GDP on healthcare which is accessible for all. The free market in health care is a problem because you cannot exactly judge competitive decisions when you're in an ambulance.
There is no free market in USA, I think you see the Vox video, such a manipulate video.
@@elsmith5977 What we see in America is the inevitable conclusion of what free market dynamics do to an essential capital-intensive sector like healthcare. Whether it's free or not does not matter if more government has proven that in literally every other country it lowers healthcare costs.
@@sebasmanders2356 the cost will be lower that the other countries if we had a free market without taxes for doctors and hospitals and a significant tax cuts for the population
@@elsmith5977 There is not a single shred of empirical evidence for that.
@@sebasmanders2356 This video is a small approach to that, besides the vast majority of people are not sick enough to pay the amount of money that is paid in European countries, where practically the state robs them almost half of their salary. Tax shifting is a concept that means that if you raise taxes to a certain economic aganet, this is transferred to their customers, the agent who pays the tax directly is not willing to bear it so it increases the price of their products.
ARcare in Arkansas is set up a lot like this, good program, one of docs that helped to set it up was my doc from my teens til my mid 30s, he taught me a lot about government involvement in healthcare and was the first registered libertarian I met, sadly he retired after the ACA passed, glad I get to see him occasionally as I deliver pizza to him occasionally (he always gives me a huge tip) 😁
Sounds cool
"Patients know exactly what services cost before using them." That this is considered a "radical concept" explains the real problem with health care in the United States.
Imagine going to a restaurant and you look at the menu and there were no prices listed. This is healthcare, in the US.
@@HVACSoldier don't forget you wouldn't be able to choose what restaurant you wanted all the time either.
@@HVACSoldier Forget the analogy of going to a restaurant with without prices on the menu. For many people paying $20,000 plus for family insurance, it's like going to a car dealer in purchasing a car without a sticker price and without negotiation. Then you get home and a month later you find out what it cost and they bill you for the rest of your life.
@@HarvardBob Add to that, the government or insurance company telling you what car you qualify for. You might qualify for an F-150 at half price, but a used Geo, you’re paying for yourself, at twice the “blue book.”
When I got out of the military I called around getting prices for my kids well check. Many places were really expensive, then I called the University hospital in the city. Their price, that they told me, was very reasonable so I made an appointment. We get there and I ask the front desk person if they were sure of the price, immunizations and everything. They said yes, that was the price. We go in for our appointment, everything goes fine. We go back to the front desk person after the appt and pay. Again I made sure that was the total cost. So I'm thinking okay great, that wasn't bad at all it just took a trip to the city. A couple weeks later they send me a bill for $600.
Moving towards decentralisation is the way.. forward.
But that will prevent politician from making 'helpful program' using taxpayers' money and further enrich themselves. Noone wants that.
@@TheSiprianus true
This is the way. -some mandilorian
@@liam3044 I don't watch mandalorian.
@@abhishekdev258 well i say both
This is such a great way to do medicine I'm sure the gov't will step in at any moment and screw things up by "helping".
It's not bureaucrats speak out against solutions like this, it's people who usually don't learn about why practices like this work and assume medicare is a system straight from God himself. Couldn't possibly be bad, like the thought never crosses their mind.
Nothing makes me happier than seeing free market bringing the prices down and making products and services available to the poorest.
This sort of real competition -- where the customer knows the price and isn't locked into a "network" (aka limited set) of doctors that changes if you change plans -- would also lead to more diverse medical services that don't require an MD.
"Free market"
the insurance companys worst nightmare
Nothing makes me happier than talking about my lord and savior "Free Market" at any and every opportunity. Is there any cause more noble than shouting down any other economic system as demonic? It gives me such a great feeling to know my religion is best and is the only path people should accept.
@@davidanalyst671 true that mate.
wish more doctors were like this across the country
dpcfrontier.com/mapper
@@leegross1218 Thank you for the link. I think lot more people needs know that there are other options out there other than the archaic path to receiving good care. This type of help information is not very prevalent in the current mass media.
The more people that flood into this sector, the more other doctors will see the benefit in switching. Soon the supply and demand will take over.
This only works with doctors who are in private practice and becomes much more complicated when you go outside of primary care specialities.
Won't someone think of the children of the unemployed healthcare bureaucrats!
or the kids from the insurer who demands you pay him thousands every year just because you are healthy.
@@neovenom9833 Yeah! These people need jobs. They need a roof over their heads. They have to feed their children! I don't want to live in a world with unemployed bureaucrats begging on the streets with their children with a cardboard sign that reads "will overly complicated unnecessarily your life for food".
The only health insurance you should have is disaster insurance(cancer, car wrecks, major surgeries). Not insurance for prescriptions and routine services.
You seemed to not have to deal with having just disaster insurance...
His point was that routine medical procedures shouldn't need insurance in the first place.
@@nukezat Why do you make up this scenario you have no information about. Catastrophic policies -- the only real insurance that exists -- work exactly the same except they cost much less. We had catastrophic plans all the time until the ACA forced me to buy a "bronze plan" that costs twice as much every month, and I still get nothing of value until I've spent $12,000 in a year (the deductible) except a "free" flu vaccine as even a short doctor's visit has a co-pay that isn't any more than what this doctor would have charged me directly. I have no dental insurance and I just pay for services; there is no catastrophic plan for teeth, which should/could be part of any medical catastrophic plan to deal with any accident that caused massive damage to my teeth.
I totally agree with you. That way, doctors have to compete with each other. The prices will be a lot lower.
If auto insurance worked the same way, could you imagine what that would do to the costs of tune-ups, oil changes, replacing tires and brakes, etc.?
For me the idea of *not* being able to pay your doctor directly is strange.
Every place in the U.S. allows you to pay directly, but it isn't very common for people to take that option, and it's still overpriced.
@@Tzizenorec If you also take insurance, they can't give you a cash discount or insurance will retaliate. If you only take cash, it aint so bad.
@@m.r.p5674 I've had a few medical places give me a discount for "paying on the day of the appointment". That works out a lot like a cash discount, and I'm guessing it's hard for insurance companies to start trouble when it's phrased that way.
My family has this and its awesome! We have catastrophic insurance on top of it.
How much does a typical catastrophic insurance plan cost? Who offers them? Thanks.
I've been praying for just that. Only been to a doctor four times in my life, one hernia, broken bones twice, and pneumonia once. Who offers It? Blue Shield sure as hell does NOT !!!
@@BeingWolfy We pay $1400 per year for the direct care. One month free if you pay the year in advance.
The catastrophic will depend on the deductible you pick and provider you pick. We have 5k deductible for $4400 for a year with a 20% discount because we have direct care.
Alot cheaper and better care when compared to United, Cigna and blue shield.
Colorado...
@@MrMccurley You have to look for the Direct care in your area. Go in for a consultation and learn more. They all vary.
This is very similar to what Milton Friedman proposed where for primary care you don't have any insurance cause there is always a demand for primary care plus medical resources required are not scarce so supply side is not a problem thus there is a room for competition in a free market system.
On top of that you buy Catastrophic Care insurance plan where he proposed a voucher system which you can use to buy any plan of your choice from a private insurance company.
Simple and cost effective where economic incentives are kept right without taking away the choice of the individuals.
But what about all those poor monopolies that have their massive staffs to process insurance claims?
"which drives up costs but add no value" thats the main take away i get
"I cant think of a single thing government does better than the free market" - thomas sowell
Based on the numbers, they do insurance better, but it isnt like there arent better systems we can conceive of.
Roads, sewer, water
Im thinking they do mass slaughter and suffering better than the free market. They can also fuck up the most basic things that no idiot would fuck up
It delivers mail better. It distributes power better.
@@D4PPZ456 What numbers? From what ive seen here in the UK its way cheaper for an individual to get top of the line insurance for their family, and you can get that insurance for a fraction of the price it costs the UK government to cover one person in the UK (£2200 per person spending, insurance £800)
On top of that waiting lists, treatments, etc etc is all superior in private healthcare and by a very long distance. Aint no one going private waiting up to 3 years to see a specialist for example
This reminds me of the school systems, where MOST of the cost is the administration personnel.
Higher ed is so bloated
Key work is “administration”. AZ voted not to give teachers more money by raising our taxes cuz we did that 8 years ago and the money never reached the classrooms or the teachers pockets.
Free markets, baby.
patient: Ill pay you for medical services
doctor: okay
lefties: reeeeeeeeee
Thought the AMA would revoke their licenses for this.
LOL, the AMA doesn't issue licenses :) That is done by each state medical board. Only about 15% of doctors are members (mostly for the Journal). The AMA actually works to make certain that certain doctors get paid, they aren't really a factor in the actually practice or delivery of healthy care in the USA.
@@Vejitasei, so no influence over any legislatures, state medical boards or the board for admissions to the medical colleges... interesting...
mises.org/library/100-years-medical-robbery
The AMA has it's own agenda and politics, I do NOT deny that. Saying they have the POWER to enforce that agenda or speak for the medical community / most doctors is NOT the same. Just as BLM does not speak for most Blacks, the AMA does not speak for most physicians.
BLM want's to destroy the nuclear family, most Blacks do not. The AMA wants to ban boxing as a sport, most physicians do not.
The OP was that the AMA would revoke a physician's licence, the AMA does NOT have the power to do that. That would be the state medical board.
I do not support the AMA (or Doctors without Borders) because of their political agendas. Neither group speaks for myself, most doctors or are they the 'official spokesman's' for the medical community.
@@Vejitasei agreed.
This is awesome! I wanna find something like this in Texas!
A lot of Hispanic doctors do this for immigrant patients that don't have health insurance. I used to visit one.
Seems like support for free market healthcare is directly proportional to knowledge of how the current system actually works.
The future
1. Both major US parties are corrupt and focus much more on their donors' interests than Americans’ needs.
2. Capitalism as a core is the best system invented by humans and has improved the lives of billions.
3. We need barely enough government and let the magic of capitalism do the rest.
4. We have for-profit healthcare in the US and that is a big reason it is terrible (i.e. far too expensive and does not cover everyone) see also 1.
5. No ‘pure’ system works well e.g. unfettered capitalism, socialism etc. We can’t leave healthcare, environmental protection, workers rights etc completely up to the free market. Government must have a role in those.
6. The for-profit healthcare system in the US has optimized itself for the following outcomes: maximize profit, keep people chronically ill and in need of healthcare, own the regulators (with lobby money), completely shun preventative healthcare (it makes no business sense)
7. We need to have hope and demand better government, more than 2 parties etc otherwise the rich and powerful will grow ever more so every cycle.
8. This video about direct pay doctors is great and all but you still need insurance (for major things). Given time, if this type of care become popular, big healthcare would ruin it somehow (force them under with predatory pricing, get the govt to pass laws to make them illegal or not profitable etc etc).
9. American insurance and healthcare is big and bloated and corrupt. We need strong government and regulations to bring them into line (yeah you laugh). Other countries do this. We can learn from them. You CAN also have competition and drive down prices at the same time. See 7. And do not believe the BS about waiting times. Also, there is no perfect system but every developed nation has a system cheaper and with better outcomes than the US.
10. This channel is funded by big polluters who want to push the narrative that the government cannot do anything right so get rid of all regulations and taxes at all costs. They want you to think: "All they do is take our money and waste it and get into our business." Well, sorry it is not that simple.
Have fun trying to pay for your own chemotherapy, surgery, dialysis, or the medication that treats your rare condition. The ideas in this video are a great way for PCPs to make a living providing basic services but it is a laughably inadequate solution for our systemic healthcare problems.
Shh you might offend free market simps
They should be awarded a Nobel Peace Prize for their work and willingness to bring true healthcare to an affordable level.
This is great content. Compelling example. I will be checking out one of these direct primary care physicians myself
No one has explained to me is why doctors can't simply bill by time and consumables, like lawyers and plumbers.
Something something “healthcare is a right!” Lol.
Because then docs don't have the incentive to see more patients and the wait times to see a doc would dramatically increase!
@@Armyguywizerdo16 If lines are very long people will simply go and visit another doctor, there is no shortage of doctors in usa. Hell doctors also immigrate to USA in large numbers.
@@abhishekdev353 That is not how it works buddy. The supply of doctors is artificially restricted by the American Medical Association, this is done so the field won't ever become saturated. It's not like lawyers and plumbers where schools are trying to churn out as many grads as possible. This is why getting into medical school is hyper-competitive where getting into a plumbing school or a law school is basically a cakewalk. There aren't enough doctors to go around for everybody, so if doctors start taking less patients the country would have a real doctor shortage. Why do you think docs routinely work +80 hours a week?
@@Armyguywizerdo16 Have you ever heard of immigration?
Moreover if AMA is artificially creating a supply demand gap then they should be kicked out.
The problem with health insurance is health insurance.
This is the best step forward is just say "fuck it" go back to basics.
I've been hearing about this kind of service for healthcare for a few years. It's how healthcare should be done. The fact that my state, SD, has 0 of these is a testament to how powerful the hospital systems are in our state.
Just imagine all the time the doctors save when they don’t have to hassle with all the paperwork. This would free up so much value in our economy.
Here in the UK we pay for the NHS through our taxes. If you need to see a doctor, use an ambulance or go to the hospital, there's no cost for that. It's great and pretty much universally loved!
Edit: We also pay a charge of just £9.35 per prescription, although that's also free if you're over 65 or receive government benefits.
Yeah you're right but our system is not perfect, the waiting times are bad. How much do you think the average tax payer pays for the nhs? I think it is 20% of our overall spending
@@MrDanielfff777 The US spends around 15% of GDP on health care, and the UK spends less than 8% of GDP.
The US GDP per capita is 65,297 USD, while the UK GDP per capita is 42,330 USD.
So the US is both spending a larger percentage of its money on healthcare and has a significantly larger amount of money per capita to spend on that healthcare. However, the UK still ranks higher than the US on average health outcomes, with the life expectancy being almost 3 years longer in the UK.
I agree that the NHS isn't perfect, but nothing is perfect, and most people in the UK are proud of the NHS and support increasing its budget.
@@danieldancey3162 I agree that the NHS is better than what the USA have.
My question is how much does the average tax payer contribute towards the NHS each year?
The UK spends €3045 per capita per year on health services according to this report: www.oecd-ilibrary.org/docserver/health_glance_eur-2018-en.pdf?expires=1624297263&id=id&accname=guest&checksum=3A7807C79E3129B1B1801F49E75AB6D9
Averaging across taxpayers would likely be a bit nonsensical, since tax on regular incomes is only a fraction of tax income.
I really want this to gain more traction. I am very found of this concept and a hope the government doesn't intervene with it.
How long until this is illegal? I love the concept. They do need their own ER for those injuries and illnesses that dont warrant a full hospital, but need to be handled quickly and may not happen on a week day morning.
It has been going on for year's you just do not hear about it is all. I would hope that it does not become illegal at any point!Pretty sure that the Drs offering this have done everything to protect not just their practice but the patients that they care for.
These are for simple treatments not cancer or surgeries.
I used to go to a urgent care doctor that worked similarly. It was always $125 for the visit, no matter why. He had his own x-ray, lab, and pharmacy on site. My husband even had two minor surgical procedures there for construction injuries. Same price. Unfortunately I moved and now have to find a new doctor that runs his clinic in a similar way.
Yep! We used to just pay the local doc with pigs and chickens! Before big pharmaceutical bought their way into the colleges we did Not need pills for everything because we cured instead of treating! Cash pay = cash price!
Doctors don't use the word cured sooo gtfo.
Primary care is crucial. It reduces downstream costs substantially. Without doubt. However it still won't drop your health costs. There's lots of ways to run a health system. All we know is your system is the most expensive while also being disproportionately cruel and ineffective.
This is awesome.
This video almost brought me to tears it’s so beautiful
Long intro: I am a Hospitalist, for those that are not aware, we are internal medicine doctors that only work in the hospital. We take care your you while you are admitted, then you follow up / return to your PMD (primary care doctor). It's a great job and I love hospital medicine (ie hate clinic). But it is also a job that operates as a net loss to the hospital. Based on billing, they have to pay us more then we generate. So one might ask how that is, or how that could even come to exist. Well, the way the hospital is set up pretty much only doctors can generate payments, so all other services represent a cost (custodian, RN, cafe, etc). The big money makers are orthopedics, OB, HemOnc (chemotherapy is billed as a procedure for historical reasons) and GI. Hospitalists are 100% necessary to run the hospital, but we can't bill enough to cover our actually costs. HOWEVER, since we are necessary (can't have a hospital without a medicine service) we can actually compete and demand a salary / benefits package greater than our generated revenue.
I love hospital medicine because I do not have to tell with the insurance companies. If I want a test, I order it. I want a CT/MRI, I order it. I feel the patient needs a certain intervention or treatment; I perform it or order it. I do my part and document / bill everything; but I have no real connection or concern about that aspect of things. Instead I can actually just practice medicine.
The biggest factors driving up health care costs are insurance companies / the government and lack of wellness / preventable care. I think a direct to consumer model is the way to go. But give all the above to say, I don't think that can work 100% for major emergencies / hospital care. Those costs can be reduced as well however. But no mater how you slice it: septic shock -> CVC + pressors -> intubation; is going to cost you. Hopefully, a direct market system will free up the resources to lower the costs for such services.
Getting rid of intellectual property laws would go a long way in reducing costs for those machines I would think...
a subscription service for doctors? that honestly sounds amazing
I use direct primary care and it is great. Much better in terms of cost and quality than urgent care.
FINALLY! Someone is making sense about healthcare.
HOW IS THIS SENSE? the whole video is saying "Abolish insurance, and make people pay for everything directly" DO YOU ACTUALLY KNOW HOW MUCH A HOSPITAL VISIT COSTS? THOUSANDS, UPON THOUSANDS OF DOLLARS!
@@ficsitinc.pioneer8695 go and pay a middleman for everything you buy then. Fool
Bureaucratization, whether trough government directly or via insurance companies responding to mandates, is always a drain on society.
It would be even better if professional organizations could offer licenses to compete directly with the AMA. It's ridiculous to intentionally constrain the supply for something as important as medical care. "For your own good" is the biggest joke in history.
Almost as though kicking and screaming when the Libs wanna get rid of insurance isn’t the best strategy... hm 🤔
Excellent information- thank you for pioneering a better way. Looking forward to assisting in parenting to get this information out!
This is how health insurance used to work before the government got involved.
Ok I applaud these guys, they're offering a good service for an affordable price. But your analysis is a misnomer, essentially these doctors are not fighting some universal health care scheme, they're competing with another free-market force: the insurance companies. The holdup with the insurance companies with the red tape is not the government's fault, it's because it's profitable for them to do so, they're a middle man, they deny what they can and allow what they must.
I'm a Canadian, I don't pay a damned thing when I see my doctor. If I had to pay a subscription fee every month for a family doctor, not only would my fellow countrymen be angry but eventually game-theory will kick in and all the doctors will set matching and constantly rising prices like every gas station in the country.
This is great for primary care, but people still need insurance for emergencies or catastrophic illnesses. The government will likely have to help pay for this. Also, this video hasn’t addressed anything about mental health care, or physical therapy. Those are ongoing treatments that would not be covered under this model
Convincing examples of free market solutions working better for everyone than the current, is far better content than jokesters baselessly spewing propoganda. Please make more videos like this one. This is far more compelling and will have a better effect on public opinion than your other videos.
Don't bank on this video changing anyone's mind, people usually assume a perfect government is a fesable goal
While I like the other videos most of the time, I have to agree that videos like these will be much more impactful, because they demonstrate the point so directly and undeniably, with no hint of ideological slant. It's just an objective and meaningful look at a superior situation.
Usually I'm reluctant to show my anti-capitalist friends videos from Reason, FEE, etc because of the obvious libertarian rhetoric, even if that rhetoric is justified. It just pushes people away because they are uncomfortable with ideas they believe are deserving of ridicule. Then they have a much lower chance of actually listening. But this video immediately had me save it to a new playlist to show to these friends, because it's so unbiased and straight to the very clear and undeniable point. This is what we need if we want to change minds.
There's also the Surgery Center of Oklahoma that lists prices for common surgeries and procedures on its website. The owner did a podcast where he explained that they charge a fraction of what insurance would be charged and their doctors generally make more for performing the surgeries. But drug costs are still a problem.
I need to find a doctor like this near me. I haven't had insurance in years.
Then pray you don't get a preexisting condition otherwise you are fucked
There are a lot of cheap generic drugs. The problem comes when a company takes advantage of the patent system (e.g. insulin, EpiPen, etc.)
@@MBarberfan4life as i found out myself... My wife just 2 weeks ago got diagnoses with ibs and the drugs are patented and cost over 500 a month, no generics. I'm looking to see if there is a reputable way to get them from Mexico or another country. I can get them from Canada but it's only 100 dollars cheaper. Then the doctor would have to go along with it and be willing to send the rx to them, which i can imagine many will refuse to do.
@@matthewhoover6154 I'm sorry for your situation. I didn't even know there were ibs drugs, but $500 is a total ripoff.
I have direct primary care in spokane and it is worth the money. They have always been able to check me out immediately if I have a medical concerns.
Insurance and health care in america is worse than in developing countries. I've never had to worry about going to a hospital abroad. But in america I avoid going untill I'm about to die. This direct healthcare seems like a great step in the right direction for us
idk if they demonstrate "the virtues of free market medicine". I think this is just an anomaly in our broken system.
i think both those who prefer free market healthcare services and those who prefer a socialized healthcare system can agree that private insurance companies are a leech and shouldn't exist.
>"Do No Harm"
>Goes on and tortures infant boys
We have not had insurance for 5 years. We pay cash and get a cash discount of 40% with our ped and dentist. They have payment plans when needed that are interest free and I pay for what I need. I don't throw money at pharma, instead, I eat healthy foods and supplement where needed.
95% reduction in lab fees, woooow