Pre-paid health care

charging families $125 a month is a good deal. most families can afford this. if not, they probably qualify for free indigent clinics . i have been doing this for some time on some of my patients. most of them like it and it works like a charm for diabetics

AWSOM IDEA!!!! Why aren’t there more inovations,in health”Care” like this?
I say “Care” like that because I find that very few of te Dr.’s I’ve had the misfortune of dealing with actually Care about the patient, it’s all about covering their asses and collecting all the dough they can, even if it’s not exactly leagal

I am an internal medicine trained hospitalist and I see the writing on the wall with the collapse of the primary care system. It is deeply rooted in the way that primary care physicians are compensated, by medicare, in relationship to specialty medicine by way of a heavily controlled specialty committee that sets the reimbursment rates. Essentially, all private insurance follows medicare’s lead, so as primary care’s reimbursment has collapsed in the medicare system, so has private insurance rates as well.

I have polled many primary care doctors in my community and with a 10% cut threatened in 2008, (that’s right how many of you would accept a 10% cut in reimbursement) and all have expressed a desire to jump ship from the medicare program if rates continue to decline. Many internists in my community no longer accept new medicare patients. A field that specializes in “old people” can no longer afford to take care of them. That is a telling statement

I have proposed a separately funded National Primary Care Initiative for access for medicare patients to primary care physicians. I propose that primary care remove themselves from the broken reimbursment system called Medicare B. I have proposed a $300 tax credit (a dollar for dollar reimbursement by Uncle Sam) for medicare recipients be used used toward a yearly “Access Fee” for the primary care physician of their choice. The only requirement is that they are a practicing primary care physician. This would guarantee access, and using a yearly fee of $360 (the equivalent of$30, month, less than the internet access to read this), a primary care physician could make a very good quality living charging patients a cash only fee of about $25 (or what ever the market decides), for a 1/2 hour visit, 8 hours a day, 46 weeks a year. This assumes a panel of 1000 patients paying an Access fee of $360 a year. No insurance, no headaches, no rules on what level of service must to bill. Just a patient , a doctor and 30 minutes.

With 45 million medicare recipients, this program, by way of a $300 tax credit for every one of them would cost the government $14 billion dollars, but the savings would be immediate ( no more billing medicare by primary care, ever again, decreased utilization and fragmentation of specialty care, decreased hospitalizations etc, the benefits are endless, and proven.

With medicare “subsidizing” medicare recipients access to a primary care system in shambles, primary care doctors could sustainable offer low cost care to the uninsured and destitute. And feel good about doing it. The cost to a medicare recipient to see their primary care doctor (which they would be guaranteed access) would be $60/year of unreimbursable access fee, and $25 per visit, cheaper than today’s copays. PLUS they get 1/2 hour with the doctor.

It is a win, win, win, win, win situation and have yet to find anyone give me fault in the system.

I know for a fact that this would sustain a very healthy reimbursment for primary care physicians and bring a sense of rejuvination to the primary care system, which has been shown to save money for the giant beast we call health care.

A happy unrushed primary care physician means better quality care. Cheaper rates increase access to those who have never been able to in the past.

I envision access to primary care by those with employer provided health care also requiring payment of an access fee and a cash only basis. I envision the access fee potential being payed for by the employer which would decrease THEIR health care costs or partially funded by the employer and partially funded by the patient, using high deductable HSA’s.

In a cash only business, doctors offices can slash overhead costs, billing costs which routinely take 10% of reciepts, rejections, denials, precertifications and all the rest of the HOURS of unreimbursed care that happens everyday. In no other field of training are professionals EXPECTED to provide service for nothing.

In order to save primary care and all the massive benefits that come from it, primary care must remove themselves from the reimbursment system that heavily favors imaging, procedures and surgeries. Only then will medical students flock to this much needed field and will the system decompress.