2 Key Words to Great Personal Health Care
As the adverse effects of Obamacare play out in 2014, the two key words that you will want to focus your attention on in terms of your personal health care are “quality” and “access.”
We have already witnessed the millions of health insurance cancellations for those who purchased their policies in the individual market. Now the next wave of cancellations is expected to come from employers who can no longer afford the ever-increasing costs of compliance.
These enormous changes will force hordes of people to decide what the best option is for managing their personal health care. Either enroll in the Obamacare exchange or opt out. Regardless of what they choose, it appears that premiums and deductibles are going to be higher. So this brings us back to quality and access.
If you have been following my reporting over the past several months, you will recall that I have a plan of attack. My recommendation has been to opt out of Obamacare and enjoy world-class quality and access — all while saving you money in the process.
Overall, you’ll get a greater degree of personalized care and attention [with a concierge service].
Part 1: A catastrophic high-deductible plan will cover emergencies, accidents, and life-threatening conditions like cancer, heart disease, etc. The high-deductible plan will mean much lower monthly premiums, thereby allowing you to invest those savings in…
Part 2: Your own personal tax-deferred health savings account (HSA). An added plus of the HSA is that unused funds roll over on an annual basis, so these tax-free contributions accumulate over time.
[Ed. Note: Details on Jud’s findings on high-deductible and HSA plans can be found in his full report – 4 ways to “opt-out” of Obamacare – which you can access for FREE by signing up for The Daily Reckoning, right here.]
Now that you have all costly emergencies covered, you’ll want to have regular access to a physician for physicals and prescription refills, as well as nonemergency health concerns. You don’t want to have to pay an arm and a leg and possibly wait weeks for the visit, either. This is where the medical concierge service comes in.
As you consider joining a concierge service, however, it will behoove you to understand that they come in two different flavors, each with its own pros and cons.
Part 3: Concierge Medicine Versus Direct Primary Care
Concierge medicine refers to a premium service offered to patients by their primary care physician or physician group. To become a member of a concierge service, you have to pay an annual membership fee not covered by health insurance.
The membership fee varies depending upon location and the service offering. The national average fee is approximately $1,800, but some even charge as much as $20,000 annually.
So what are the benefits of a typical concierge service?
- You get the cellphone number of your physician, giving you direct access at any time, weekends included…
- Get longer appointment times — often more than 30 minutes, instead of the typical 10…
- Receive annual physicals that can last hours (if you need it) and that focus more on preventive medicine…
- Get same-day appointments, instead of waiting weeks to get in. This is going to be really important when the current system is overwhelmed with 30 million new patients…
- More time with your doctor leads to more education about preventive care options versus a short 5-10-minute discussion…
- Overall, you’ll get a greater degree of personalized care and attention.
As you can see, medical concierge services offer tremendous individual benefits. To date, however, medical concierge services have been considered the Mercedes-Benz of premium personal health care. With the average monthly fee between $150–200 per individual, most families would find the cost prohibitive.
Fortunately, innovators in the healthcare market have established a similar type of concierge service for the masses, which is referred to as direct primary care. This service offers many of the same features as standard concierge medicine, but at much lower prices. Typically, it’s less than $100 per month, but can even go as low as $25 per month. These lower-cost options include immediate, same-day appointment times, longer office visits, and 24/7 access to a doctor via email and phone.
How are direct primary care doctors able to do this? By renouncing health insurance completely. This enables them to avoid all the administrative costs that come with working with insurers. The resultant savings can then be passed on to their patients.
According to CNN Money, “Fed up with declining payments and rising red tape, a small but growing number of doctors is opting out of the insurance system completely.” Instead, they are attempting to take back control from third parties, seeking cash-only payments.
The Wall Street Journal, citing Concierge Medicine Today, reports that “of the estimated 5,500 concierge practices nationwide, about two-thirds charge less than $135 a month on average, up from 49% three years ago.”
MedLion, an early mover into the direct primary market that’s based in Las Vegas, has seen significant growth since converting to this patient model four years ago. According to a recent article in the Sacramento Business Journal, MedLion charges a flat monthly fee of $69, plus $10 per visit. By the end of 2014, MedLion will have offices in 16 states and is planning on rapid expansion in the coming years.
The Direct Primary Care Coalition website currently lists 83 DPC physicians spread out among 19 states, with California, Washington, New York, and Florida leading the way for the highest number of doctors. If you like the idea of this lower-cost access option but find that you’re in an area without direct primary care coverage, I would suggest checking back on the coalition website on a regular basis. The chaos caused by Obamacare is going to ensure a rapid expansion of these services.
A key reason for the sudden growth of this model, according to the Direct Primary Care Coalition, is a provision in the Affordable Care Act that allows for direct primary care in the state-based insurance exchanges. Under section 1301(a) (3) of the law, “flat fee direct primary care medical home membership can be an option in the insurance exchanges when bundled with a lower-cost ‘wraparound’ insurance plan that covers unpredictable and expensive services outside the scope of primary care, such as specialist care, hospital stays, or emergency room visits.”
In plain English, this means that the law allows for direct primary care to be in compliance as long as it is bundled with a “wraparound” catastrophic high-deductible policy covering emergencies.
As you consider your health care options this year, then, I hope you will consider these alternative solutions so that you can have world-class quality and access at an affordable price.
Unfortunately, individuals that don’t take informed action may find themselves forced into state exchanges, competing for doctor visits that could potentially take weeks or months of waiting. Having to pay much higher premium and deductibles too only rubs salt in the wound.
On a closing note, I called my doctor recently to schedule my annual physical checkup. I was quite surprised when the receptionist said that she was no longer practicing with their group, where she had been for at least the past 10 years.
I asked the receptionist if she could give me her new contact information, at which point she responded abruptly that my doctor was no longer practicing medicine. I was stunned because I know this doctor was quite young and had many years left to practice her chosen field that I feel certain she enjoyed immensely.
I’ll keep you posted about my search for a new direct primary care doctor.
Wishing you a happy and healthy new year!
Ed. Note: For millions of Americans, this year is going to be a difficult year when it comes to their health care coverage. That’s why Jud is working so hard to help people “opt-out” of Obamacare altogether. Sign up for the FREE Daily Reckoning email edition, right here, to gain access to Jud’s eye-opening report.