We’re blessed to have been the thesis of Sam Jordan’s academic paper, “Medicine Shrugged.” Originally from Salina, Kansas, she’s now a freshman at George Mason University in Fairfax, Virginia and is majoring in Economics. She included email correspondences with Dr. Josh as part of her sources to build a case for free market medicine. Texts from Ayn Rand, Alan Greenspan and other intellectuals were cited alongside our personal experience.
Thanks to Sam, for letting us share her work with our supporters. We have to admit, we blushed when she compared us to Aluminum Company of America. ALCOA is known for its shining example of profit-maximization and price-minimization in Greenspan’s paper, “Trust.” It serves as a concise way of understanding our mission to cut the red tape. And yes, it’s true: we’re motivated to offer the best healthcare while making the most money possible. Sam had no hesitation in addressing that.
We’ve included the complete work below. Take a look. And if you’re interested in a digital copy of Sam’s paper, send us a line at hello[at]atlas.md …
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Medicine Shrugged
by Sam Jordan
Drs. Josh Umbehr and Doug Nunamaker “have shrugged the bureaucracy.” Considered pioneers of concierge medicine in the Wichita, Kansas area, Drs. Umbehr and Nunamaker are not only medical practitioners, they are free market businessmen. Concierge services such as Atlas MD “[guarantee] patients more personal care and services in exchange for a monthly fee.” Most of these concierge practices refuse to take health care insurance. By doing this, the doctors of Atlas MD “promise accessibility, convenience, and affordability.” These health care professionals have forgone insurance payments to not only protect themselves, but their patients from the “intrusive decisions that inevitably follow with third-party pay overs.” This both lowers cost and ultimately provides better service as the doctors are able to spend more time with patients and less time in paperwork.
Atlas MD offers their patients myriad procedures including laceration repair, biopsies, joint injections, ultrasounds, lung scans, bone scans, EKG, holter monitor, urine testing, strep throat testing, hearing testing, yearly physicals, well woman care, crotherapy, lesion removal, minor surgical procedures and more—all for an average of $50 per month. In a series of email correspondences, Dr. Umbehr compares health insurance to auto insurance. “The idea is that you don’t have insurance for the little things, like gasoline, oil changes and new tires, so why have health insurance for all the affordable things that your family doctor—or even specialist—can do. Health care isn’t innately expensive, it’s the red tape that makes it so expensive.”
This philosophy agrees with Austrian theory; that no good or service has intrinsic value. Medicine is not expensive because of a predisposed intrinsic value driving their costs upward; instead, the driving force behind high prices is insurance. If insurance is mandated to all people, what incentive does the health care industry have to lower prices? However, Atlas MD does recommend insurance for major accidents such as car wrecks, cancers, and heart attacks, in addition to their basic memberships. Through this membership-based business plan, Atlas MD is able to maximize efficiency.
Their business model is comparable to Alan Greenspan’s paper “Antitrust,” from Ayn Rand’s Capitalism: The Unknown Ideal. Greenspan argues the “capital market acts as a regulator of prices, not necessarily of profits. It leaves an individual producer free to earn as much as he can by lowering his costs and by increasing his efficiency relative to others.” Thus, the producers are able to create high incentives and increased productivity. Ultimately, this creates a higher standard of living.
To prove this, Greenspan exemplifies the Aluminum Company of America (ALCOA). The ALCOA emphases “cost cutting efficiency, rather than raising prices,” allowing the company to sustain its dominance as the single producer of primary aluminum. Greenspan furthers, profits of the ALCOA were primarily derived from increased efforts for efficiency and productivity within the company. “ Not suggesting Atlas MD is a monopoly by any definition of the term—even through the mercantilist appropriation—Atlas MD is comparable to ALCOA in that its profits are derived from efficiency. By maximizing efficiency, concierge services maximize profits and maintain a high standard for customer satisfaction, as opposed to raising prices.
Through the email correspondences, Dr. Umbehr explained, “I feel that the doctor’s profits come from always looking out for the best interest of the patient/consumer. A doctor is continually motivated to provide the best service at the best price they can OR their patients will leave.” By providing a service profitable off of the memberships, Atlas MD is able to slash overhead and percent mark up on everything in attempt to maximize their value proposition to the patients. “Sure you’re paying 50 dollars a month but look at all you get! Unlimited home/work/office/technology visits, no copays, all procedures free—very low cost to the doctor to provide and a high value for the patient—and medicine and labs at wholesale price. [This] demonstrates savings and builds trust with the patient.” Atlas MD and patients across the nation are beginning to realize concierge practices can be a better option instead of wickedly expensive health care or the unstable promises of politicians. Umbehr explains, “They [patients] can get much cheaper insurance (30-50% less) and we just saved a company 66% on their insurance down from $1800 per month to $600 per month for a family.”
As Atlas MD’s logo is literally a graphic of a man holding a globe-like sphere with the letter “A,” it is safely assumable many of their business philosophies and high standards of medical practices are heavily influenced by Ayn Rand’s Atlas Shrugged. This considered, though Atlas MD genuinely strives for excellence to provide the best medicine, it is likely their motives are largely profit based due to their inherent greed. As businessmen, Drs. Umbehr and Nunamaker appear to be in a business with lucrative implications.
Business Week reported on November 29, 2012, while traditional primary-care physicians receive an average median salary of $160,000, concierge practitioners earn an average salary up to $300,000. The Business Week article continues, with an estimated 4,400 concierge practices in the U.S. currently—by following Dr. Umbehr and Nunamaker’s business model—this number is sure to rise. The American Academy of Private Physicians observes this trend with 30 percent more concierge practices in 2012 than in 2011 alone.
Dr. Umbehr believes this proliferation of no-insurance policy practices as a direct reaction to President Obama’s Affordable Care Act. The Common Wealth Fund estimates “the average American medical practice spent $82,975 per doctor dealing with insurers” in 2011. Dr. Umbehr is not alone. The Houston Chronicle on November 21, 2013 reports on Dr. Jonathan Shaffer of the Sweetwater Medical Associates in Sugar Land. Dr. Shaffer, like Dr. Umbehr, predicts concierge practices will increase in popularity due to the Affordable Care Act. As the legislation mandates all U.S. citizens to have health insurance, patients “will crowd medical offices, increasing patient loads, and reducing the time doctors spend with patients.” Concierge services offer more thorough appointments, as physician’s profits do not derive from the number of patients seen or prescriptions filled, but instead on customer satisfaction. Umbehr asserted through the emails, physicians are working in a “broken system,” beginning before even starting their practice. “Physicians are taught by med school and experience that in a nut shell, good business comes at the expense of good medicine. Where in life do we see that bad products/service/quality equals good business? Good business is ALL about finding the right quality at the right price for the customer and then improving it.”
Through policies influenced by Austrian and Randian principles and similarities to Alan Green’s efficiency and productivity model, it is clear concierge practices are not only profitable to practitioners and business men, their model is beneficial to their costumers/patients. By examining both the profits of concierge services and their exponentially increasing prevalence, concierge practices, such as Atlas MD are advantageous to medicine as a whole. Unfortunately, it is unlikely this profitable business will remain untouched by government regulation for much longer, especially with the “Affordable” Health Care Act threatening both the free market system and the health of U.S. citizens. This potential threat just might cause concierge practices such as Atlas MD to shrug.
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Footnotes
- “FAQ,” Atlas MD, accessed December 3, 2013 http://atlas.md/wichita/faq/
- Jerry Siebenmark, “Wichita doctors offer concierge medicine,” Wichita Eagle, November 10, 2011, accessed December 3, 2013 http://www.kansas.com/2011/11/10/2097088/wichita-doctors-offer-concierge.html
- Lora Hines, “Some doctors shifting to concierge practices,” Houston Chronicle, December 3, 2013, accessed December 3, 2013 http://www.chron.com/news/health/article/Some-doctors-shifting-to-concierge-practices-4998585.php
- (FAQ)
- Dr. Josh Umbehr, email message to author, November 22, 2013
- (Dr. Josh Umbehr)
- Alan Greenspan, “Antitrust,” in Microeconomics: A Free Market Approach, ed. Thomas Rustici, Carrie Milton, and Nathan Snow, (Cognella, 2009) 173
- (Alan Greenspan “Antitrust,” 173)
- (Dr. Josh Umbehr)
- Ayn Rand, “Atlas Shrugged,” New york, Random House 1957
- David Leonard, “Is Concierge Medicine the Future of Health Care?,” Business Week, November 29, 2012, accessed December3, 2013 http://www.businessweek.com/articles/2012-11-29/is-concierge-medicine-the-future-of-health-care
- (David Leonard)
- (Lora Hines)
- Dr. Josh Umbehr, email message to author, November 19, 2013
Works Cited
“FAQ.” Atlas MD. Accessed December 3, 2013. http://atlas.md/wichita/faq/
Greenspan, Alan. “Antitrust.” in Microeconomics: A Free Market Approach. ed. Thomas Rustici, Carrie Milton, and Nathan Snow. (Cognella, 2009) 173
Hines, Lora. “Some doctors shifting to concierge practices.” Houston Chronicle. December 3, 2013. Accessed December 3, 2013 http://www.chron.com/news/health/article/Some-doctors-shifting-to-concierge-practices-4998585.php
Leonard, David. “Is Concierge Medicine the Future of Health Care?,” Business Week, November 29, 2012. Accessed December3, 2013. http://www.businessweek.com/articles/2012-11-29/is-concierge-medicine-the-future-of-health-care
Rand, Ayn. “Atlas Shrugged.” New york, Random House 1957
Siebenmark, Jerry. “Wichita doctors offer concierge medicine.” Wichita Eagle. November 10, 2011. Accessed December 3, 2013 http://www.kansas.com/2011/11/10/2097088/wichita-doctors-offer-concierge.html
Umbehr, Dr. Josh. Email message to author. November 19, 2013
Umbehr, Dr. Josh. Email message to author. November 22, 2013