Do Health Care Consumers Suffer from Health Insurance Stockholm Syndrome?

During a Swedish bank robbery in 1973, police were baffled when the hostages became so irrationally attached to their captors that one of the hostages recounted to a reporter for The New Yorker“How kind I thought he was for saying it was just my leg he would shoot.” This condition of inappropriate attachment to one’s captor subsequently became known as “Stockholm syndrome.”

With all the abuse heaped onto U.S. consumers in the current health care system, reasonable people might wonder: Are American health care consumers also suffering from this bizarre condition?

Most people recognize much of the current health care system is broken, unnecessarily complex, and wildly inefficient. There are long waits to see a doctor, followed by short office visits, and conflicts of interest permeate the market. All these issues take a toll on tens of millions of people every year, both physically and financially. At an average cost of $10,739 per person, the U.S. health care system costs more than twice the average spent by other comparable countries.

With a system this dysfunctional, it’s strange more people aren’t clamoring for an entirely new, better model. Instead, similar to the hostility the Swedish hostages expressed toward the police who were trying to rescue them 45 years ago, many American health care consumers are extremely skeptical of any market-based changes to the current system—even ones that have repeatedly been proven to yield impressive results.

“What kind of scam are you pulling?” is a common refrain espoused by many disbelieving people when first they learn of much more cost-effective and patient-friendly options such as direct primary care (DPC) and health sharing organizations. DPC offers dramatically improved access to care, same-day accessibility, and telemedicine at incredibly affordable rates. How? By allowing doctors to contract directly with patients, thereby avoiding costly and intrusive health insurance middlemen. Think about it: You wouldn’t use your car insurance to pay for a new tire or oil change. Why? Because it’s much cheaper to pay for these services out of pocket than it would be to have large insurers work with your local mechanic. The same logic applies with primary care doctors.

Read the full Op-Ed at


Legislation Allowing Patients to Use HSAs for DPC at Risk

From AAPS:

Earlier this week we heard the good news that H.R. 365 was finally going to be considered by the House Committee on Ways and Means, bringing the use of Health Savings Accounts (HSAs) for Direct Patient Care (DPC) one step closer to reality.

Then we learned “a few small changes” had been made to the bill. Unfortunately the “few small changes” have greatly damaged the legislation.

You can read a copy of the latest bill here:

Under the new language, DPC practices would have to comply with several federal requirements in order to become HSA-eligible. One provision limits the care provided under the agreement to specific CPT codes.  Another would prohibit DPC arrangements priced over a certain threshold from being HSA-eligible. Others further limit how the pricing can be structured and what care can and cannot be included. Specialists would be blocked from offering innovative HSA-eligible monthly membership payment arrangements.

You can read a full summary of the legislations status at AAPS.


Thomas Jefferson Institute Handbook on Healthcare (2017)

This Handbook on Healthcare Reform is an effort by the Thomas Jefferson Institute for Public Policy to bring ideas to the table for discussion and legislative debate in order to highlight areas where Virginia and other states can take action to reduce costs, increase availability and thus broaden the number of people who can better afford, thanks to the reforms outlined in this Handbook, to see a doctor.

The Thomas Jefferson Institute worked closely with Dr. Hal Scherz of Atlanta to create this special Handbook on Healthcare Reform. We wanted to bring together the ideas of doctors and other experts in the field of Healthcare on how healthcare can be reasonably reformed so that a better system is the result.

Dr. Scherz reached out to colleagues around the country to write essays on specific areas of healthcare that they felt should be reformed in order to better serve their patients. These doctors work within the current web of regulations and they provide innovative ideas on creating a less bureaucratic system that can improve the overall healthcare delivery system. And we found a few essays from academic healthcare experts to add ideas to this Handbook.

As the founder of “Docs 4 Patient Care,” Dr. Hal Scherz has a deep interest in how healthcare can be improved for all of us and he spent a good deal of time in helping us put this Handbook together. He is well-respected urologist and is deeply interested in improving the healthcare system in this country. We deeply appreciate his time and effort in this project. 5

This Handbook on Healthcare Reform brings ideas to the table for public debate and discussion. It is not an effort to support specific legislation, although it is hoped that the ideas presented herein will become public policy as is the case with Direct Primary Care (DPC) that became state policy earlier this year when Governor Terry McAuliffe signed the legislation into law. This DPC law will allow those in underserved areas to gain better healthcare access if it works as it has in other states. We are proud to have had a small role in putting some of the early pieces together which ultimately resulted in this new law here in Virginia.

Download it here.


Stop the IRS from Blocking Patients’ Use of Health Savings Accounts for Direct Primary Care, Doctors and Patients Tell Congress

The Association of American Physicians and Surgeons (AAPS) sent a letter today, signed by 1,125 doctors and patients, to the Senate Finance and House Ways and Means Committees encouraging expeditious approval of H.R. 365 and S. 1358. These bills would allow patients to spend their own Health Savings Account dollars on Direct Primary Care arrangements. The IRS currently prohibits this use.

In the letter, AAPS Executive Director, Jane M. Orient, M.D. writes:

The whole purpose of HSAs was to expand patients’ freedom to choose how to spend their own money for medical care. More and more patients, including Medicare beneficiaries, are choosing DPC, which often includes primary-care services, basic diagnostic tests, and commonly used prescription drugs at a package price. They like the up-front, affordable price and the prompt access to a doctor they know and trust. Yet the current IRS interpretation of Internal Revenue Code will not allow patients with HSAs to use their own HSA funds for DPC agreements nor permit them to make tax-deductible contributions to their HSA if they have a periodic DPC arrangement.

DPC is lowering costs for both patients and taxpayers. Prescription drugs accounted for $110 billion in Medicare spending in 2015, 17% of all Medicare spending. With DPC dispensing, the cost of pharmaceuticals can be as much as 15 times lower than pharmacy prices. And $17 billion was spent on potentially avoidable hospital readmissions. DPC patients have fewer hospital admissions because of prompt, consistent, personalized care of chronic conditions, and fewer expensive emergency department visits because of 24-hour access to a physician who knows them.

It is improper for the IRS to be picking winners and losers in medical financing and care arrangements. It is counterproductive for a tax collection entity to discourage arrangements that save federal dollars while improving medical care.

DPC also addresses the shortage of primary-care physicians by retaining physicians who would otherwise leave primary care practice or the profession altogether owing to “burn-out” from inability to serve their patients well under other practice models.

Please expedite consideration of S. 1358 / H.R. 365 and, if it cannot advance as a stand-alone measure, look for opportunities to include the language in other upcoming budget bills.

The full letter and list of signers can be viewed at: AAPS is also welcoming supporters who haven’t yet signed to add their names.

The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in virtually all specialties and every state. Founded in 1943, AAPS has the motto “omnia pro aegroto,” which means “all for the patient.”

SOURCE Association of American Physicians and Surgeons (AAPS)


DPC Debrief

Two hurricanes did not stop DPC 2017 in Orlando as more than 275 attended our conference to birth and grow direct primary care practices across the country.

Host Hal Sherz, M.D. was a part of the program and will give an insiders debrief of the event that unfolded over three days at the Rosen Centre.

Look for an exploration of new health care plans/opportunities in the final segments of the show.


Direct Primary Care

Lee Gross Joins Discussion

Lee Gross, M.D.One of the best solutions to the doctor shortage is in resurrecting the practice model that built American medicine – the direct doctor – patient relationship.

Dr. Lee Gross, President of the Docs 4 Patient Care Foundation, is one of the god-fathers of Direct Primary Care and fighting to popularize this practice model for the next generation of physicians.

No insurance, no paperwork, no bureaucrats, just doctors treating patients at an up front, low cost.

Host Michael Koriwchak will be discussing DPC with Dr. Gross and the upcoming direct primary care conference in Orlando this October.