The complexity and costs of Obamacare mandates regarding medical records, billing codes, and prior authorizations forced thousands of independent doctors, mostly primary care doctors, to become part of large hospital networks to help absorb the added costs. Add the complexity and lack of cost transparency for the patient, and you have a recipe for a free market solution.
Many doctors are deciding to opt out of the traditional health care system and provide fee-for-service systems, also known as direct primary care. It provides both doctors and patients more flexibility by allowing patients to pay a flat monthly fee to have access to their doctor. “[I]t’s essentially a throwback to an era before insurance companies were responsible for covering routine services like ear infections or strep cultures,” writes Mark McDaniel at Reason.
No one expects car insurance to cover routine maintenance such as oil changes, tire rotations, or tune-ups. Insurance only remains insurance so long as it covers unforeseen events, like a sudden illness. Insurance has as its purpose the facilitation to transfer the risk of a sudden, unforeseen illness to a third party at a cost that is mutually beneficial to both parties.
Obamacare also disallows the exclusion of many coverage items that are not unforeseen, making it more like a pre-prepayment plan rather than actual insurance.
With direct primary care, the individual doctors collect a flat monthly fee to allow “patients unlimited access to the physician for a full range of primary care services, including acute and urgent care, regular checkups, preventative care, chronic disease management and care coordination,” according to The Sentinel of Carlisle, Pennsylvania.
Reason also observes, “When companies like Aetna, Blue Cross, and Oxford started signing the checks for even minor health care expense, it had a destructive impact on the doctor-patient relationship.”
“We’re able to be creative in meeting their needs,” Dr. Ryan Neuhofel told Reason. ”[We are] able to give them transparency in pricing, and redesign the entire health care experience around what patients really need.”
Restoring the doctor-patient relationship also informs the patient and market of prices, acting as a check on soaring costs, and facilitating greater cost competition among doctors. LASIK eye surgery, which is considered an elective or cosmetic procedure, is not covered by insurance in most cases. For example, in 1998 LASIK eye surgery cost $2,200 per eye, but is around only $300 today.