Commentary: Health care reform that’s superior to Medicare for All

Health care reform is shaping up as the defining issue of the 2020 election. According to Real Clear Politics polling, most voters say that health care is their most important issue.

For doctors, that’s no surprise. We hear complaints from our patients about the health care system every day. Chief among these is the exorbitant cost.

Average insurance premiums for employer-sponsored health insurance, which covers most Americans, have risen by more than 50 percent over the last decade. Deductibles have doubled.

How can families with median annual household incomes of around $60,000 pay $10,000 worth of combined premium and deductible costs per year?

Direct Primary Care Could Bring Savings and Quality to Missouri Medicaid

Medicaid must be reformed to ensure its long-term survival. Over the past decade, Medicaid rolls have expanded faster than many states can afford. From 2013 to 2018, the number of Medicaid enrollees increased by nearly 28 percent, to more than 67 million. In 2017, the cost of Medicaid reached $581.9 billion, representing 17 percent of total healthcare spending nationwide.

In many states, the increased cost of health care can be traced to overregulation, rising drug and medical device costs, and increased use of long-term and behavioral health services. Even worse, bloated Medicaid programs, even in states that have not expanded, face viability problems. In Missouri, Medicaid costs have risen consistently over the past decade. According to the News Tribune, Medicaid costs have grown from 17 percent of Missouri’s general revenue in 2011 to 24 percent in 2018. In 2018, the Show Me State spent a whopping $10.3 billion on Medicaid.

Unfortunately, Medicaid cost overruns will continue to grow. According to a recent report from the Centers for Medicare and Medicaid Services, Medicaid expenditures are expected to rise at an average annual rate of 5.7 percent from 2017 to 2027, a rate that far exceeds annual U.S. gross domestic product growth. The Rapid Response Review, a study of Missouri’s Medicaid system that was completed in February predicts Medicaid spending could increase to as much as 30 percent of general revenue by 2023.

Read the full article at The Heartland Institute.


How Four Pages Could Transform Health Care

Obamacare was trumpeted as a revolutionary bill when it passed into law in 2010. If a law’s impact depends on its number of pages, then the 955-page Affordable Care Act would have become one of the most impactful laws in U.S. history. But that has not been the case. That’s why Senator Ted Cruz’s innovative Personalized Care Act, weighing in at a paltry four pages but possessing powerful remedies, is desperately needed. The Personalized Care Act could transform health care by liberating Americans from employer-based health insurance, helping employers, providing new coverage options, and improving care quality.

This clever bill promises to revolutionize the U.S. employer-based health care system for the first time since its inception in 1942. Today, more than half of people under age 65 obtain insurance through their employer. That’s because employers purchase health plans with pre-tax dollars, while individuals buy their policies with post-tax dollars—substantially increasing the cost.

The Personalized Care Act, S. 3112, takes away this employer advantage by letting patients themselves buy medical coverage with pre-tax Health Savings Accounts (HSAs).

Read the full article at TownHall.


Doctors picking direct care

Dr. Emilie Scott was only a few months into her first job when she started hearing the complaint: She was spending too much time with each patient.

Like many primary care doctors working in large medical systems, Scott was encouraged to see a new patient every 20 minutes. But that was barely enough time to talk and do a physical.

She eventually quit her job to try a new approach aimed at eliminating many of the headaches of traditional health care: tight schedules, short appointments and piles of insurance paperwork.

Instead of billing insurers, Scott now charges patients a $79 monthly fee that covers office visits, phone calls, emails, texts and certain medical tests and procedures. Scott typically sees six patients a day, down from around 30, and spends more time at each appointment. She hired two assistants to help handle paperwork compared with working with a department of billing specialists.

This approach — direct primary care — aims to leverage the extra time and money from avoiding insurance into improving care for patients.

“As far as our financial success, it does not depend upon having a team of people to figure out how to get money from the insurance company,” said Scott, who co-owns a private practice in Irvine, Calif., that serves about 900 patients. Scott said the practice has grown by word-of-mouth, without advertising.

In many ways, direct primary care is a return to a simpler time when doctors charged cash for their services. Patients say they appreciate the accessibility and simplicity of the system.

Read the full article at Times Union.


‘Medicare for All’ and the Free Market

Medicare for All is a single-payer, government-controlled health care system. It’s promoted as the solution to America’s high health care costs because it will eliminate competition. According to Senator Bernie Sanders’s version, all insurance-based health care plans will be eliminated and replaced by a monolithic, centrally-controlled plan that would cover the entire population. Insurance companies won’t be allowed to cover any services already covered by the government plan. Paradoxically, though, if Sanders’s plan is implemented, its shortcomings could drive patients toward free-market health care options.

If Medicare for All is implemented, wait time for testing and procedures will increase dramatically. Nurse practitioners, physician assistants, and pharmacists will help cover the deluge of demand — since there simply aren’t enough physicians to go around. That means your visit with a medical professional will be shorter than ever, not to speak of the dropoff in care quality.

It’s unlikely that patients will accept the long waits endemic in single-payer systems. They won’t wait months for an MRI or a specialist visit. Many patients will turn to the private market. That’s where they can enjoy meaningful, thorough physician visits in a short time frame — and receive reasonably priced tests and procedures.

Read the full article at the American Thinker.


VA Healthcare and the Failure of a Government Run System

In less than a year, Americans will choose a president who will chart the course for the country, with ramifications that could affect many future generations. Healthcare is one such issue. Every Democrat presidential candidate advocates for more government involvement in healthcare. Most endorse some variation of socialized medicine. The most extreme candidates, like Senators Warren and Sanders, call for an end to private healthcare insurance, meaning that 180 million Americans who receive this through work, would lose it. Some candidates want to return to failing Obamacare and prop it up by introducing a government-run health insurance option. This veiled attempt to offer greater flexibility in coverage is nothing more than a Trojan Horse which would ultimately lead to a single government-run system. This is because, over time, private insurance cannot compete against a government-sponsored competitor and will be squeezed out.

Americans have been ‘hoodwinked” already with promises that we could keep our doctors if we liked them; keep our insurance if we wanted; go wherever we wanted to receive healthcare. These guarantees were as unrealistic and disingenuous as the promises now being made by the Democratic hopefuls. Who can take seriously claims that a government-run system which will cost $52 Trillion would actually save Americans money in the long run?

Read the full op-ed at


Doctors Praise White House Rules on Price Transparency to Expand Patient Choice & Reduce Health Care Costs


November 15, 2019


Primary: Felicia Horton, Docs4PatientCare Foundation, 267-778-1170,

Secondary: Michael Hamilton, Good Comma Editing, 937-219-5366,


Two New Rules Empower Patients to Shop for Price & Quality in Health Care, as Insurers & Hospitals Disclose Negotiated Prices

Physician says ‘price transparency is the first and best form of accountability.’

[Washington, DC] [November 15, 2019] – Today the White House advanced two rules to illuminate health care prices currently hidden from patients by hospitals and insurers, drawing praise from physicians of the Docs4PatientCare Foundation (D4PCF), the only health care organization composed of practicing physicians with hands-on, practical knowledge of the American health care system.

Physicians applauded the finalization of a rule requiring hospitals to publish clear, readable prices for patient services—including “standard charges,” negotiated discounts for select payers, and discounts for cash patients.

“The rule enlists hospitals in helping patients understand the cost, quality, and value of the medical care they are purchasing,” stated Dr. Lee Gross, President of the Docs4PatientCare Foundation. “Only when patients understand what their dollars are buying them can they evaluate whether they’re making healthy purchases from quality providers.”

Hospitals must list prices of “300 common shoppable services” in a “consumer-friendly manner” once the rule takes effect in 2021, according to an email received by D4PCF from the Department of Health and Human Services (HHS) on November 15.

“Finally, patients will be able to shop for health care the same way they shop for every other service and product bought and sold in the United States,” Gross said. “The ability of patients to compare prices across providers will drive quality of care higher and prices lower.”

A second rule would clarify for patients what portions of their medical bills they must pay, versus how much their health insurance plans cover. Using an online tool, insurers would have to give patients real-time estimates of their liability for covered services. Additionally, insurers would have to post online the prices they have negotiated for in-network and out-of-network providers if the proposed rule is finalized.

“Price transparency is the first and best form of accountability,” Gross said. “Health insurers have kept patients guessing for too long. It’s time for patients to understand what — if anything — their overpriced insurance plans are doing for them, and which providers their high premiums let them access.”

The rules are a crucial step in implementing President Trump’s Executive Order on Improving Price Quality and Transparency in American Healthcare. D4PCF physicians attended the signing of the executive order at the White House in June 2019 and were recognized for their expertise and leadership.


For more information or to schedule an interview with the Docs4PatientCare Foundation leadership, please contact:

Primary: Felicia Horton, Docs4PatientCare Foundation, 267-778-1170,

Secondary: Michael Hamilton, Good Comma Editing, 937-219-5366,


Why Doctors Oppose a Bill That Congress Thinks Will Help Them

“The most terrifying words in the English language are ‘I’m from the government and I’m here to help.’” Ronald Reagan uttered these words more than three decades ago, but they still ring true today. Like Reagan, 1,500 physicians are concerned about the perils of government intervention that means well but fares poorly. That’s why they have signed a petition imploring the American Academy of Family Physicians (AAFP) to oppose the bill HR 3708, which is purportedly designed to help them.

Despite the House resolution’s upbeat title and good intent, the Primary Care Enhancement Act of 2019 would hamstring the most innovative category of primary care physicians in the country — harming doctors and their patients.

Most of the doctors who have signed in opposition to HR 3708 practice under a patient-friendly model called direct primary care (DPC). These doctors practice outside of the insurance-based payment model. Instead, DPC physicians offer comprehensive primary care for an extremely low monthly fee — and offer huge discounts on more specialized care.

Liberated from the time-consuming and costly insurance industry, DPC physicians can devote more time to their patients — providing better care and cheaper prices on services, labs, imaging and medications. And if the IRS clarifies the ability to use Health Savings Accounts (HSAs) for DPC, everything could become even more affordable. HSAs use pre-tax dollars to pay for qualified medical expenses. Counting DPC monthly fees as HSA-eligible expenses would result in huge savings for patients.

Read the entire Op-Ed at



Doctors Shatter Attendance Record at Annual Direct-Pay Conference

By Michael McGrady


Registration is open for the 2019 edition of an annual conference for doctors who are turning the country’s backward health care system right-side up.


Last year’s conference, titled “Direct Primary Care 2018: Nuts and Bolts to 2.0” and hosted by the Docs 4 Patient Care Foundation, drew record numbers of physicians from across the U.S., as health care professionals from 41 states rallied at the Rosen Centre Hotel in Orlando, Florida.


Attendees were greeted with a cocktail reception before devoting the next two days to teaching and learning about direct primary care. Speakers, breakout session presenters, and regular attendees coached their fellow doctors in all aspects of how to launch and grow their own direct primary care practices.


Direct primary care is disrupting the dominant and costly insurance-based model by enabling patients to pay doctors directly for care. Patients across the U.S. are obtaining unlimited doctor visits and numerous labs and tests for flat monthly fees ranging from approximately $40 per person to $150 per family.


Doctors who attended received credit for up to 13.75 hours of continuing medical education, which most states require as a condition of licensure. The conference brochure boasts more than 20 sponsors, including the Physicians Foundation.


Movement in the Making

Roaring applause from 370 conference attendees welcomed Dr. Hal Scherz, board secretary of D4PCF, to the stage on the first full day of the conference. Scherz congratulated the crowd for shattering the previous year’s then-record of 263 attendees. Attendance grew by more than 40 percent between 2017 and 2018.


Scherz says the explosive growth of in attendance indicates the direct primary care movement is gaining momentum.


“Our conference has been a way that we have tapped into the enthusiasm and the emotion of the movement,” Sherz said.  “I think that they are almost synergistic and they both feed off of each other.”


D4PCF is connecting the current generation of direct-pay doctors with the next generation of innovative physicians, Scherz says.


“We are a vehicle to help promote this movement by bringing in people who are the experts in direct primary care who really were pioneers in this movement,” Scherz said.


D4PCF is the nation’s preeminent nonprofit organization advocating for the direct primary care model. Under this model of care, patients and doctors are able to create intimate relationships built on trust, equitability, and shared values. Supporters of the model emphasize the importance of creating a health care economy that is based on free-market principles, affordable and transparent pricing, and patient choice.


‘Mecca for DPC’

Each year the conference expands on D4PCF’s vision by exposing health care professionals to the modern challenges of running a direct primary care practice. Droves of doctors are choosing these challenges over the physician burnout and insurer- and government-induced headaches associated with the dominant model of health care.


“This is the Mecca for DPC,” Dr. Chad Savage, a Brighton, Michigan-based direct primary care physician and speaker at the conference, said. “The growing attendance shows an increase in enthusiasm amongst physicians selecting direct primary care over the broken insurance system.”


Topics last year ranged from broad to specific. Speakers addressed current trends in health care policy and the direct primary care movement’s footing in Congress and among the states. Breakout sessions delved into marketing one’s direct primary care practice, patient acquisition, and technology.


Keynote speakers included the Trump administration’s James Parker, senior advisor to U.S. Secretary of Health and Human Services Alex M. Azar II, and Grace-Marie Turner, president of the Galen Institute, a leading think tank for free-market health care reform based in Washington, DC.


Entrepreneurial health care professionals can still register for the 2019 conference, once again at the Rosen Centre Hotel in Orlando, on November 14-16.


Michael McGrady ( is a free-market health care journalist. McGrady’s work has been published in The Wall Street Journal, Washington Examiner, Newsday, The Hill, Patient Daily, The Heartland Institute’s Health Care News, and others internationally.


Direct Primary Care Draws Convert from ‘Universal Care’ Camp

By Michael McGrady

A physician is launching a direct primary care (DPC) practice as an antidote to government-run universal health insurance model he once supported.

Dr. Adil Manzoor, a former airman from Piscataway, New Jersey, launched a DPC practice in Newark after he finishes his residency.  To prepare for launch, Manzoor attended Direct Primary Care: Nuts and Bolts to 2.0, the flagship conference of Docs 4 Patient Care Foundation (D4PCF), held in Orlando, Florida in 2018. (Register now for the 2019 conference in Orlando on November 14-16.)

D4PCF’s annual conference is a mecca for DPC advocates, including physicians considering converting their insurance-based practices to the direct-pay model. DPC practices provide a range of preventive care services, typically including unlimited doctor visits and certain labs and tests, in exchange for a flat monthly cash payment of $50 to $150 per patient.

By design, the DPC model emphasizes free-market health care delivery. Unlike a single-payer system, direct-payment models promote price transparency and simplification of the payment process.

DPC eliminates the role of third-party payers (i.e., insurance companies, Medicare, Medicaid) by allowing patients to contract directly with their health care providers. DPC is known to decrease care expenses by offering patients, as health care consumers, certain products and services at cost.

Manzoor was one of 370 attendees at this year’s D4PCF conference, which set a new attendance record.

From Newark to Norway

Manzoor says that before discovering DPC, he was long an advocate for government-sponsored universal health insurance.

“I actually went to Norway as a medical student to learn about their system in 2015,” Manzoor said. “I was reading that it was ranked 11th in the world in terms of providing care, and the U.S. at that time was 35th. So, I found a way to rotate into one of the five largest hospitals in the Scandinavian region.”

Although he enjoyed working his rotation in Norway, Manzoor started to realize the shortcomings of the single-payer system he had long admired.

“I didn’t understand the economics behind how systems work,” Manzoor said. “When I got into this residency world in this existing market, I started to burn out.”

Manzoor then noticed his quality of care decreasing due to the volume of work he was tasked with. He found the “care for all” mantra championed by universal health insurance establishment proponents was neither accurate nor effective. That’s when he grew interested in free-market economics and began studying Austrian-school economic theory in depth.

“I realized I didn’t want to be part of the system,” Manzoor said.


Like many doctors who become advocates for direct-pay models, Manzoor faced a crossroads. For Manzoor, the choice was between continuing to practice medicine or parlay his newfound interests in free markets into business school. Luckily, he discovered the DPC model.

“The more I learned about DPC, it completely opened up the whole world of free markets and the whole world of competition,” Manzoor said. “The concept of universal health care and ‘Medicare for All’ is going to drive our economy down the drain.”

Practice Makes Perfect

To Manzoor, the ideal practice is one that keeps costs low for patients while meeting their most important needs. He has lined up his first business partner: his wife, Dr. Diana Luria. Luria is also a physician, specializing in family medicine.

“We’re going to build together a holistic direct primary care practice that focuses very heavily on cost control for our patients,” Manzoor said.

The Manzoor practice serves patients in need near Manzoor’s stomping grounds, if all goes to plan.

“I grew up in a very underserved area in Newark, so, my goal is to figure out how to launch our practice in Newark,” Manzoor said.

Michael McGrady ( is a free-market health care journalist. McGrady’s work has been published in The Wall Street Journal, Washington Examiner, Newsday, The Hill, Patient Daily, The Heartland Institute’s Health Care News, and others internationally.