With every week that passes, another direct primary care (DPC) practice opens its doors. There is no denying DPC is hot, not just for consumers looking for more than a brief visit with a doctor, but with primary care physicians, too, who are burning out by the day from low reimbursements and administrative headaches from the third-party payers.
DPC is a membership-based payment model that works outside insurance. Consumers pay an affordable monthly fee, usually $50 to $100 per month, in exchange for specified primary care services like doctor’s visits and medical tests. Under DPC models, many patients often have greater access to and more time with their doctor. The care is often so good, in fact, consumers find they do not have to make trips into the office as often.
DPC has been a saving grace for “self-payers” — people who no longer find value in the plans in the individual insurance market — and people with employer plans who pay high out-of-pocket fees because they never reach their deductibles.
Direct care is disrupting the health insurance and health care markets, and there is no better sign of that than the growing voice of detractors who think that when it comes to health care, they know best. These complaints demonstrate the pervasive paternalism that is built into the nation’s current health care system. Consumers can fend for themselves in many other areas — housing, food, transportation, education — but when it comes to health care, government is steamrolling our lives. And that problem might soon get much worse. Calls for single-payer, “Medicare for All” plans — or its backdoor alternative, the “public-option” — would ultimately give government total control over health care.
Those voicing opposition to DPC are in favor of more government intrusion in health care, but not based upon any objective data or reasonable argumentation.
Consider, for example, their commonly used argument “DPC promotes inequality in health care.” This notion presumes not everyone can afford to pay $50 to $100 per month in out-of-pocket fees for health care. This argument can’t possibly refer to the destitute, because currently, their health care needs are met through government programs.
It can only be presumed, then, that naysayers are referring to the middle class when they protest in the name of “health care inequality.” But many middle-class families already spend thousands upon thousands of dollars every year on health care. By cutting out the health care middlemen (insurance companies) and bloated government bureaucracies, DPC practices would help lower primary care costs, not increase them.
DPC costs families typically no more than $1,500 a year, and individuals pay much less. If that is such a large amount, why aren’t detractors speaking up about costs for a family vacation or cable and cell phone services? Why did the Obama administration sell such costs as “affordable” when they imposed Obamacare on the nation?
The primary issue here, we see, is that health care is considered by many to be a government responsibility. This isn’t about health care costs.
Detractors also warn that consumers fail to understand that DPC is not insurance, though there is no evidence that consumers are being duped. Many understand that DPC does not cover hospitalization and specialty care. DPC patients are always encouraged to buy a catastrophic health insurance plan to cover those costs.
Although it’s true that because of government regulations, some consumers have trouble finding catastrophic health insurance plans, but that problem could easily be fixed by rolling back government regulations. And even if that doesn’t occur, many consumers enrolled in DPC have found alternatives like health care sharing ministries to help cover catastrophic costs.
Additionally, DPC members are able to save more money for future costly health care expenses because they often receive discounts on prescription drugs, imaging, and lab work as a benefit of enrolling in their DPC plan. These are services that cost people who have health insurance out-of-pocket money.
Probably the most laughable complaint against DPC is that it offers “no consumer protection.” What better protection is there than simply to walk away with your money? There are no contracts with DPC. Members typically can leave any time with no financial strings attached. It is hard to find such freedom with gyms and cell phone companies!
DPC naysayers have one last assault, which is to question the need for consumers to have primary care “24 hours a day.” This presumes that members are going to be running to the doctor any hour of the day simply because they are paying for it. Yet DPC members pay month-to-month because they want an ongoing relationship with a provider. Consumers often find value in DPC because they don’t need see the doctor all the time. The kind of attention they receive keeps them from getting sick. And, of course, there are urgent care clinics and other 24/7 options available in many parts of the country for those rare occasions when a primary care visit is needed immediately.
It is time to put to rest the idea that consumers can’t figure out their own health care and pay for it as they see fit. The nation has seen the results of policies that promote growing government intrusion in health care — unaffordable premiums and limited time with a doctor. DPC reverses course, restoring the idea that when it comes to health care, the consumer, not government or insurance companies, is king.
