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I've commented on the past on Direct Primary Care practices - it's a different model of care that is rapidly growing; you can read my previous thoughts on this model here: https://news.ycombinator.com/item?id=33682407

I largely think that doctors, especially primary care doctors, are being limited/held hostage by the insurance companies and the health care corporations that they work for.

They are not reaping the profits from the care they give, and can't focus because of patient loads being way too high. As it was explained to me by my doctor, this is because of how insurance companies pay out (per visit, no matter the duration) and the places that employ doctors usually expect that they see a certain volume of patients. Most doctors have a large amount of student loan debt, and usually feel helpless to fight against it - starting a new practice is very costly.

Once you really look into how oppressive/restrictive the system is to our doctors, the issue with our health care becomes pretty clear. People can't get timely, accurate care -- they have to wait for most prescriptions (because as long as doctors take insurance, they cannot fill medications), and they are always guessing (fearing might be more apt) how much a particular medication, test, or scan will eventually cost, causing hesitancy to seek out care. And most importantly, no longer do patients (or their doctor) have to worry if their insurance company will cover XYZ medication or treatment under this model of care.

My doctor negotiated with a local lab company, and that company offers my doctor's patients pretty much any test at-cost - this is another business dealing that is restricted by insurance companies.

DPC takes all the mystery out (I pay $45 a month for this service, all visits are free): all common procedures/lab/scan/medication costs are up on the website (they are very reasonable/wholesale/at-cost), and I don't have to fight to get that information; I don't have to fight to get an appointment, I can text/email/etc. my doctor whenever and get a prompt response. Because he limits the amount of patients he sees this is possible.

I think if primary care was overall something like this model, but perhaps a bit more accessible (more doctors practicing this way); not only would a lot of illness be treated before it is chronic, people would be less afraid to seek care out, and hospitals and specialists would be less overloaded.



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