Direct care made a local news segment in Kansas City. But Dr. Troy Burns wasn’t too happy with the title of the online article that accompanied it. It reads, “Doctor’s new orders: No more health insurance.” Thank you, Fox News, for taking notice of our model of care — one that’s affordable, practical, and is making patients and doctors happy. However, we have to point out that insurance is DEFINITELY necessary in the event of trauma or catastrophe.
Seeing the comments that sprang up on the thread made us realize how far we have to go in terms of direct care education.
Is [direct care] comparable to the ACA? Not in any way, shape, or form, no matter what variable factors you’d like to claim – your ‘membership fee’ is only going to cover things the doctor can do in the office. There’s no coverage for prescriptions, emergency room visits, hospitalizations. There won’t be coverage for the majority of medical tests, including most blood tests. In other words, unless you’re wealthy enough to be able to afford to pay for catastrophic illnesses out of pocket, this sort of plan will do you no good at all – and if you can afford that kind of expense, then you’ve been able to afford to pay for insurance premiums all along.
– AKA The BeerLady
DIRECT CARE IS THE MAJORITY OF CARE
Let’s go over what’s misguided about this commenter’s preconceptions.
CLAIM: “Your ‘membership fee’ is only going to cover things the doctor can do in the office.”
Yes and no. One of the major benefits of direct care is 24/7 access to your doctor via phone/email/social media. And this is offered at no additional cost. Compare that with Ringadoc’s Concierge Phone App that helps doctors coordinate insurance billings and get paid for every phone call they receive.
CLAIM: “There’s no coverage for prescriptions, emergency room visits, hospitalizations.”
We’ll go one by one here.
Rx coverage — This is not covered through direct care subscriptions. However, look at our list of wholesale prescription costs compared with their pharmacy price. Giving up your plan with a high premium looks more promising when you realize how cheap most pills actually are.
ER visits — 24/7 access to a physician can make visiting an ER unnecessary for a variety of incidents. Slicing open your hand, getting a concussion, dealing with food poisoning, a child breaking their arm, a painful ingrown toe, a yeast infection… these are common things that happen to us, and are so immediately painful/jeopardizing that we need help right away. These things can be handled essentially for free if you sign up for direct care, though.
Hospital stays — In the event that you need to be hospitalized, we recommend a wrap-around insurance plan. These have lower premiums and higher deductibles. In the long run, this model can SAVE you money. However, it takes discipline to hide your monthly savings from a lower insurance premium.
CLAIM: There won’t be coverage for the majority of medical tests, including most blood tests.
That same list of wholesale pill prices includes our wholesale lab prices. Seven bucks for an Hemoglobin A1C, $3 for a lipid panel… these are seriously reduced rates. So yes, the commenter is correct, the subscription fee DOES NOT cover labs and blood work. However, much like Costco or Sam’s Club, having direct care membership opens up major savings opportunities.
Why would I want to go to a Dr. where I would have to pay hefty annual premium in addition to my health ins.? I will go to a Dr. that my ins. accepts and there are many to choose from. – Joe
DIRECT CARE IS MORE VALUABLE HEALTHCARE
At Atlas MD we charge $50/month for most adults. We don’t think this is a hefty fee. We also charge less for our labs and prescriptions than some insured people pay as their copay.
Take an insured person who goes into a pharmacy and pays $15 for their levothyroxine pills (for hypothyroidism). We charge less than $15 for the same prescription (note: price per pill varies per dosage), meaning that if that same patient switched to a wrap around plan that saved them $50/month, they would be insured, break even in terms of prescription coverage, and gain 24/7 access to a physician FOR FREE.
DIRECT CARE IS AN OPTION
It’s troubling to see some of the vitriolic reactions to the work we’re doing in pioneering direct care. At the end of the day, remember that we’re trying to de-corporatize healthcare. We want doctors and patients to have more power on both ends of the examination table — by making pricing and payment more transparent. So please don’t just jump to conclusions about our business model and why we do it. If anything, be glad that we’re bringing a small business mentality to family medicine. If we’re not for you, you have every right to take your business elsewhere.
But, you might want to join our side. Because our crusade is making sure YOU have more choices in where you take your healthcare business.