Posted by: AtlasMD

January 3, 2014

Fox News Asks, Is This The Worst ObamaCare ‘Glitch’ Yet?


Fox News interviewed the mother of a family of five who lost their insurance. They now face “uncertainty” thanks to endless glitches on the Obamacare website. For years they elected to carry a high deductible, low cost insurance plan i.e. the type we encourage our patients to buy. According to Obama they’ve been “underinsured” though.

Their philosophy on healthcare mirrors our outlook. They’ve been paying for minor issues out of pocket for years and putting aside the the money they save on their deductible. They didn’t mention direct care, but this family would benefit greatly from an Atlas MD-style of medicine. All seven members could see Drs. Josh, Doug or Michael ANYTIME for $150/mo. Colds, flus, sprains and more could all be treated in-house, at rates much lower than average clinic costs, saving them countless dollars over the course of a year.

This new layer of ACA red tape seems problematic. Really, should the government have the right to determine HOW MUCH insurance people need? We’re not opposed to them prosecuting companies practicing unethical business; there are insurance plans on the market that willfully misrepresent their offering (Forbes wrote about these junk plans here). However, this family in question was TAKING CARE OF THEMSELVES WITH THEIR OWN MONEY. The fact our administration is willing to actually throw them under the bus in order to help those in need disappoints us. And unless the ACA starts actually helping people get healthcare this sentiment seems likely to spread.

Posted by: AtlasMD

January 3, 2014

You Won’t Believe This Reddit Tape

ABC reported on a recent Reddit post of a $55,000 appendectomy bill. Yes, 55 THOUSAND dollars. Although the 20-year-old man in question got over the pain of his appendix removal, his hospital bill probably won’t be feeling better anytime soon. Fortunately, the patient was insured, so he only had to pay $11,119.23 of the outstanding bill. The shocked man of course took to the best place on earth to document all things ridiculous.

“I never truly understood how much health care in the U.S. costs until I got appendicitis in October,” he wrote on Reddit. “I’m a 20-year-old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the U.S.” The recovery room cost $7,501.00, which surprised the man because he spent only two hours in there. The actual surgery cost $16,277.

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Posted by: AtlasMD

January 2, 2014

Study Suggests More Insurance, More ER Visits

Sabrina Tavernise writes in The New York Times about a new study that flips a steadfast assumption on its head. At first glance, you’d think that giving people more access to Medicaid would lower the frequency of ER visits. However, a study conducted in Oregon has proven the exact opposite.

The study was published in the journal Science. It compared two groups of people — a 2008 lottery randomly selected thousands of low-income people in the Portland area and provided them Medicaid coverage; a second group entered the lottery but received no insurance. Here’s the shocker. “Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts,” writes The Times. The pattern was strong, holding true across most demographics, times of day, and types of visits. These even included conditions that we could have treated here in our Atlas MD office.

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Posted by: AtlasMD

January 2, 2014

Direct Care Thought Of The Day

“A single sunbeam is enough to drive away many shadows.”

— St. Francis of Assisi

Remember, the hegemonic nature of healthcare and its associated red tape means it can’t be wished away. However, it can be untangled one cash-only clinic, one dedicated doctor, one unhurried visit at a time. In the long run, healthcare in America can mean actual care.

Posted by: AtlasMD

December 28, 2013

Free Market’s Free Reign — Company Succeeds By Making Exercise And Vacation A Priority

Okay, so we’re putting in a caveat right out of the gate — Atlas MD WILL be checking emails during vacations and probably won’t be sending our limited staff to the gym during lunch. However, we do applaud one company that does EXACTLY that.

David Morken is the sparkling Co-founder and CEO of Bandwidth, a 15-year-old tech company. It was his idea to instate these policies: the company has (and enforces) a complete embargo on email to and from the company during vacation. Oh, well how about I just stay at the office all year? Nope. He also forces employees to take their vacations. And don’t forget the 90-minute lunches. They are paid, if you workout, along with your gym membership, shuttle to and from, your personal trainer, and a comprehensive assessment of your physical condition.

So why’s this cool? Well, for starters, Bandwidth was set to make $150M in 2013 – a 20% increase from 2012 – and, get this, they expect $200M in profitable revenues in 2014. So while yes, these policies might seem Draconian, they began with the proprietor and ended up positively influencing his staff, their work, and his bottom line. And no one in the White House told him how to do his job.

READ FORBES’ COVERAGE OF BANDWIDTH CEO DAVID MORKEN

Posted by: AtlasMD

December 26, 2013

This Hurts. New ACA Fees Coming 2014.

“Here comes the ObamaCare tax bill,” writes Fox News. Unfortunately, most insurers aren’t being forthcoming about the Obamacare taxes that are to be added on to premiums. Nope. Instead these “hidden fees” will be discretely passed on to customers.

One insurance company, Blue Cross Blue Shield of Alabama, wasn’t hush hush about it, though. They laid out the taxes on customer bills, using a separate line item for “Affordable Care Act Fees and Taxes.” Fox News lists out all the new taxes here. Ouch. You know, when we consider our push for more direct care nationwide, it’s hard not to notice that every new patient we enroll, who opts for lower monthly insurance payments using a wrap-around plan, is actually taking money away from the Federal government. Considering all this additional revenue they plan on bringing in from these healthcare taxes, isn’t this just another power ploy? And not to harp, but where’s the actual care in any of this dialogue?

Nowhere. Which is one of the biggest problems we have with it. It doesn’t address where healthcare is failing. Instead, it becomes a bureaucratic argument over dollars and line items, not patients and doctors having healthy, meaningful interactions.

READ ABOUT NEW OBAMACARE TAXES COMING 2014

Posted by: AtlasMD

December 24, 2013

The Moral Hazard Of American Healthcare

John F. Hunt, MD writes on Kevin MD, “If you learn nothing else today, I would ask you to learn that moral hazard is the cause of medical price hyperinflation.” His is a controversial post, meant to elicit click-through with the title, “The cheapest form of health care is to let sick people die.”

Obviously, Dr. Hunt doesn’t want anyone to die. However, his argument is that so long as it’s the government’s obligation to take care of people, prices will skyrocket. This is due in part to the inherent moral hazard. He explains, “Moral hazard is when the person who bears the economic burden of a decision is not the decision maker.” In healthcare, the moral hazard is a third party payer (insurance/government) bearing the economic consequences of a patient’s decision.

Dr. Hunt makes an excellent point. When there’s moral hazard, the patient cares less about drug and procedure cost, and what doctors charge. As a result, he says, prices rise when the “buyer” doesn’t care about these costs. He compares this to teens given no-reins access to their parents’ credit card. “[Then] if everyone in America let their teenage daughters go shopping for clothes… the prices would skyrocket.”

He explains the catch-22 in play here. So long as the government/insurance are responsible for payment, the actual prices of services will be hyper-inflated. The only way to break this cycle is to make the patient the person who bears full financial responsibility. The problem is that we as a populace need to make that leap of faith. Direct care patients are doing this. Direct care docs are doing this. The question is when will everyone be doing this? Only then will we see prices return to realistic levels. Seriously, the out-of-pocket cost of an ambulance trip alone would break most Americans’ banks.

READ DR. HUNT’S BLOG POST ON KEVIN MD

Posted by: AtlasMD

December 23, 2013

Is The ACA Deadline Update A Publicity Stunt?

NPR reports that the administration has granted a one-day extension on Obamacare sign-ups. According to NPR, “The deadline that had been midnight on Dec. 23 has been pushed to Christmas Eve at midnight.” So why the update? Apparently the government realized that there were issues with time zones, and that more time should be allotted to compensate.

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It’s a good thing the federal government isn’t an actual person. We’d be concerned that their head is attached to their shoulders.

READ MORE ABOUT OBAMACARE DEADLINE UPDATE HERE

Posted by: AtlasMD

December 23, 2013

Smartphone Cholesterol Checks Could Be A Smart Tool For Direct Care Docs

Cardiovascular Business reported on a new accessory that uses a smartphone camera to measure cholesterol levels. The smartphone system is in development and uses analytical software (this would be downloaded as an app) and a smartCARD accessory that fits over a mobile phone camera. From here, a user would place a drop of blood on a commercially available test strip (similar to glucose monitoring), which fits into a smartCARD reader. The camera phone accessory measures the color change on the strip which the app then processes to display a cholesterol value on the phone’s screen.

According to Cardiovascular Business, the Cornell team found that it takes 60 seconds for the blood sample to change colors, with a 1.8 percent accuracy rate. They tested it on various smartphone platforms and found that their system had a maximum error rate of 5.8 percent, around the same rate as at-home testing kits.

So far there is one drawback: the system in question can’t discern good and bad cholesterols; only a total reading is given. However, tools like these should be introduced into the direct care practice when they hit the market. How cool is it to empower your own patients to be able to do their own cholesterol tests? If you’ve ever tried to lose weight or manage your blood sugars as a diabetic, first off, you know it’s challenging. It takes will and discipline. But tools like these are great because they enable people to track their own progress. People need that connection or lifestyle changes can wind up feeling austere. Although, we don’t have a problem if our patients want to come in every few weeks to get an A1C or cholesterol reading. We’re more than happy to oblige.

Posted by: AtlasMD

December 20, 2013

Wichita Eagle Spreads Direct Care Cheer

Thanks to reporter Kelsey Ryan who shared a touching Atlas MD story in her recent report on our model of care. She focused on one of our patients, Michael Scheidt, who’s been enrolled in our practice since around the time we opened up. His wife was extremely sick and practically bedridden when he signed them both up for Atlas MD care. Dr. Josh was able to drive to their home and check up on her, which helped them tremendously. Even after the passing of his wife, Scheidt told the Wichita paper that he keeps coming in to see us because it’s “just so darn cost effective.” This was a real tearjerker. Thanks for your kind words, Michael.

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