The healthcare system is a racket — direct primary care could fix it

Everyone has a healthcare horror story.

A hidden charge on the hospital bill. A last minute test or scan that ends up costing four figures. Hours spent on the phone with insurance companies to follow up on a claim and get a reimbursement. Prescriptions costing hundreds of dollars.

And it’s getting more expensive.

Since 2007, the cost of healthcare has risen 21.6 percent, while all other prices in the economy have risen by just 17.3 percent, according to the Kaiser Family Foundation.

It’s become an unfortunate reality for many, and it’s been rightly pushed into the arena of politics.

But despite the well-intended reforms of the past two decades, including the Affordable Care Act, millions are still feeling the pinch. Why?

Too often, talk of healthcare reform is focused on insurance rather than care. It’s less about how the doctor treats your family and more about who foots the bill. Almost no one can get a straight answer about the price of procedures or medicines.

Medical insurance, once a simple way to cover higher-than-normal expenses, has become a catch-all for almost all health spending. It’s no longer about surprise injuries and illnesses. Insurance is now used to cover every ache, pain, anxiety, pill, and more. It’s like using car insurance to cover every oil change, new windshield wiper, or tire.

And in order to recoup the amount they give out, insurance companies must price their options accordingly, which leads to higher prices for consumers. That’s why healthcare expenses in 2016 amounted to 17.8 percent of GDP, higher than any other industrialized country.

At least one new doctor-patient arrangement is promising a revolution in consumer choice by bypassing insurance altogether. It’s called direct primary care, and it’s catching on across the country.

Rather than relying on insurance for ordinary health expenses, these new doctor clinics rely on monthly fees from patients, usually less than $100.

If anything more is required during doctor visits, the prices for every service and test are transparent and don’t vary depending on your plan. By not accepting insurance of any type, each clinic saves on administrative costs and overhead, prioritizing patients over costly insurers.

The results are just as intended: lower costs, more preventive care, and more face time with medical professionals.
Read the full article at the Washington Examiner.



D4PCF on Hannity National Radio

The National Briefing on Health Care Policy Begins

The frustration over health care policy at the Federal level has moved national radio host Sean Hannity to launch the national discussion with the doctor innovators on the front lines of health care.

Dr. Josh Umbehr and our own Dr. Lee Gross joined Hannity on his national radio show to kick off a regular Tuesday afternoon national briefing on the impact of free market medicine.


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.


If Amazon And Buffett Lift Veil On Health Prices, Insurers Are In Trouble

Jeff Bezos’ Amazon and Warren Buffett’s Berkshire Hathaway are forming their own healthcare company with JPMorgan Chase to increase transparency for their employees, and that could be bad news for insurers and pharmacy benefit managers.

Health insurance companies and PBMs have long said they want to bring more transparency to the U.S. healthcare system, yet consumers often don’t know the true cost of healthcare. Prices are negotiated in secret and doctors don’t often know what their own services cost or what their patients will be charged.

Details of the new company the three corporate giants want to create remain sketchy, but the idea that they want to bring more transparency is one of the disclosed goals. “Our people want transparency, knowledge and control when it comes to managing their healthcare,” said Jamie Dimon, chairman and CEO of JPMorgan Chase.

Read the full article at


Senator Pat Toomey, R-PA, On State of The Health Care Bill Negotiations

HH: Yeah, that’s what I was going to, I agree, I know that to be true. Senator, before we get to the details of where we are in the negotiations, last hour, I had a caller, Terry from Tennessee, call in. He’s a business owner. I’d like to hear you, have you hear what he had to say. This is Terry from Tennessee.

TT: I own a small business. We employ about 25 people, most of whom are women, half of whom are single mothers. And Hugh, we have two choices. That’s it. Two plans to choose from. The Blue Cross plan will go up another 16.10%, and the Humana plan, are you sitting down, 29.38%.

HH: Geez.

TT: Hugh, this is the second highest business expense next to payroll, and we made a conscious decision…

HH: You’re not going to be able to keep giving health care, right?

TT: You’ll have to excuse me…

HH: You just dropped off. Did you hit a mute button?

TT: No…

HH: Okay.

TT: It just, it breaks my heart, because we made a conscious decision, and we just can’t do it anymore.

HH: Senator Toomey, this is going on across the country. I know we’re focused on Medicaid and opioids, but the basic health care system of the country is falling apart.

Read the complete transcript. 


HHS: Arizona health insurance premiums almost tripled since 2013

WASHINGTON – Health insurance premiums nearly tripled in Arizona between 2013 and 2017, the fourth-biggest increase among the 39 states that participated in, according to new data from the Department of Health and Human Services.

Arizona’s 190 percent increase meant a monthly premium increase of about $400 to a consumer in the state, to $611, under the Affordable Care Act, or Obamacare. The average monthly increase for all marketplace states was 105 percent, or $244, according to the HHS numbers released this week.

The report does not mention the tax credits that many low-income consumers received under Obamacare, which made the coverage affordable for many.

But Republicans, whose plan to replace Obamacare took a harsh hit in a Congressional Budget Office assessment released Wednesday, quickly seized on the HHS numbers to support what they say is the urgent need to replace the Affordable Care Act.

“This is exactly why we are on a rescue mission,” said House Speaker Paul Ryan, waving a copy of the report during a news conference Thursday. “Between premiums surging up and choices going away, Obamacare is on an unsustainable path.”

Read the full article at Cronkite News.