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- เผยแพร่เมื่อ 2 มี.ค. 2021
- "Direct primary care is about as close to a free market in healthcare as you've ever seen in our country," says Dr. Lee Gross.
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The patients of doctors William Crouch and Lee Gross know exactly what services will cost before they receive them-a radical concept only in health care. They don't have to deal with benefit packages, coverage denials, hidden costs, in network vs. out of network, or any surprises whatsoever. Instead, their patients buy the medical equivalent of a Netflix subscription.
At $75 per month for adults, "We make it cheaper than a cell phone," says Dr. Gross. "If you can afford a cell phone, you can afford the most basic aspect of healthcare delivery in the United States."
Doctors Crouch and Gross are pioneers in a growing national movement called direct primary care. Tired of dealing with insurance companies when it comes to routine medical services, physicians around the country have exited the traditional system and are saying they can provide better care at a lower price by charging their patients a nominal monthly fee directly.
They're demonstrating that making American healthcare flexible and affordable requires abandoning the use of third-party insurance for routine care and adopting a market-based approach.
"Direct primary care is about as close to a free market in healthcare as you've ever seen in our country," says Dr. Gross, who also serves on the Florida Medical Association's Council on Medical Economics and Practice Innovation. "We have never tried a true marketplace in healthcare. We have competition, but we have competition in a price fixed system with very opaque prices."
When Crouch and Gross converted to direct primary care in 2010, they estimate that there were fewer than a dozen practices using this model. Today there are approximately 1,400 independent Direct Primary Care practices in 49 states. Virtually all of them charge a subscription fee that's between $50 and $100 monthly to consult with the doctor at any time in-person or from home.
Not only does this model result in lower prices, but the COVID-19 pandemic has shown that direct primary care is more flexible as well. According to a survey conducted in July, 78 percent of physicians had seen a decline in patient volume because of COVID-19. In March, the Center for Medicare and Medicaid Services issued a temporary waiver stating that Medicare would pay the same rate for certain kinds of video telemedicine visits as in-person ones. But the types of visits it would cover changed over the course of the year and are still changing.
Whether insurance companies and the government continue covering online visits after the pandemic has no bearing on Crouch and Gross. And they didn't have to wait for insurance companies and the government to OK telemedicine in the first place.
"We didn't need to wait for BlueCross to convene a committee to pay for telemedicine services," Gross says. "I didn't need to wait two months or three months for Medicare to create a new billing code in order for me to provide technology visits for a patient…Instantly from in-person practice, we were an online practice. We were a parking lot practice. We were a house call practice. We did whatever we had to do in order to get the patient the proper care at the proper time."
Gross adds that "for what Medicare pays for a single technology visit, I provide two to three months of unlimited technology visits, unlimited office visits, unlimited home visits, unlimited email visits. And so now the model is, again, pandemic tested. It's proven that it's actually a superior model because we have the built-in flexibility to do what we need at the time we need it."
Thirty-two states and D.C. have passed laws requiring insurance companies to reimburse doctors at the same rate for telemedicine visits as they do for comparable in-person visits. Dr. Gross says that shouldn't be decided by lobbyists, lawmakers, or government administrators. Prices should be set through market competition.
"The myth is that profit by its mere definition does not belong in the American healthcare system. And it's evil and creates perverse incentives…The key to making that profit work is, again, the elimination of that third party in the middle of that profit, which just drives up costs, but adds no value."
Produced by John Osterhoudt. Production support from Regan Taylor and Ian Keyser.
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Our practice has been cash pay Only for 8 years. So much better
Ditto. I always ask for the "cash price" and even I am shocked by the difference.
Glad to hear it. I'm grateful there are some doctors who are doing right by their patients' wallets in addition to their bodies.
Much easier to hide the income that way.
Pill mill?
Whatevertf a naprapathic physician is.
"Patients know exactly what services cost before using them." That this is considered a "radical concept" explains the real problem with health care in the United States.
Imagine going to a restaurant and you look at the menu and there were no prices listed. This is healthcare, in the US.
@@HVACSoldier don't forget you wouldn't be able to choose what restaurant you wanted all the time either.
@@HVACSoldier Forget the analogy of going to a restaurant with without prices on the menu. For many people paying $20,000 plus for family insurance, it's like going to a car dealer in purchasing a car without a sticker price and without negotiation. Then you get home and a month later you find out what it cost and they bill you for the rest of your life.
@@HarvardBob Add to that, the government or insurance company telling you what car you qualify for. You might qualify for an F-150 at half price, but a used Geo, you’re paying for yourself, at twice the “blue book.”
When I got out of the military I called around getting prices for my kids well check. Many places were really expensive, then I called the University hospital in the city. Their price, that they told me, was very reasonable so I made an appointment. We get there and I ask the front desk person if they were sure of the price, immunizations and everything. They said yes, that was the price. We go in for our appointment, everything goes fine. We go back to the front desk person after the appt and pay. Again I made sure that was the total cost. So I'm thinking okay great, that wasn't bad at all it just took a trip to the city. A couple weeks later they send me a bill for $600.
I work in a ministry for physicians and about 6 months ago had an older doc call me near tears of excitement how radical and life-changing DPC was for him and his patients. He said it brought the joy back into healthcare! Imagine if you could easily and cheaply get the preventative and minor concerns taken care of immediately, a lot of the systemic health issues we have as a society would decrease.
What do you mean by “ministry for physician”? I would love to know how it works
Moving towards decentralisation is the way.. forward.
But that will prevent politician from making 'helpful program' using taxpayers' money and further enrich themselves. Noone wants that.
@@TheSiprianus true
This is the way. -some mandilorian
@@liam3044 I don't watch mandalorian.
@@abhishekdev258 well i say both
Nothing makes me happier than seeing free market bringing the prices down and making products and services available to the poorest.
This sort of real competition -- where the customer knows the price and isn't locked into a "network" (aka limited set) of doctors that changes if you change plans -- would also lead to more diverse medical services that don't require an MD.
"Free market"
the insurance companys worst nightmare
Nothing makes me happier than talking about my lord and savior "Free Market" at any and every opportunity. Is there any cause more noble than shouting down any other economic system as demonic? It gives me such a great feeling to know my religion is best and is the only path people should accept.
@@davidanalyst671 true that mate.
The only health insurance you should have is disaster insurance(cancer, car wrecks, major surgeries). Not insurance for prescriptions and routine services.
You seemed to not have to deal with having just disaster insurance...
His point was that routine medical procedures shouldn't need insurance in the first place.
@@nukezat Why do you make up this scenario you have no information about. Catastrophic policies -- the only real insurance that exists -- work exactly the same except they cost much less. We had catastrophic plans all the time until the ACA forced me to buy a "bronze plan" that costs twice as much every month, and I still get nothing of value until I've spent $12,000 in a year (the deductible) except a "free" flu vaccine as even a short doctor's visit has a co-pay that isn't any more than what this doctor would have charged me directly. I have no dental insurance and I just pay for services; there is no catastrophic plan for teeth, which should/could be part of any medical catastrophic plan to deal with any accident that caused massive damage to my teeth.
I totally agree with you. That way, doctors have to compete with each other. The prices will be a lot lower.
If auto insurance worked the same way, could you imagine what that would do to the costs of tune-ups, oil changes, replacing tires and brakes, etc.?
ARcare in Arkansas is set up a lot like this, good program, one of docs that helped to set it up was my doc from my teens til my mid 30s, he taught me a lot about government involvement in healthcare and was the first registered libertarian I met, sadly he retired after the ACA passed, glad I get to see him occasionally as I deliver pizza to him occasionally (he always gives me a huge tip) 😁
Sounds cool
wish more doctors were like this across the country
dpcfrontier.com/mapper
@@leegross1218 Thank you for the link. I think lot more people needs know that there are other options out there other than the archaic path to receiving good care. This type of help information is not very prevalent in the current mass media.
The more people that flood into this sector, the more other doctors will see the benefit in switching. Soon the supply and demand will take over.
This only works with doctors who are in private practice and becomes much more complicated when you go outside of primary care specialities.
This is such a great way to do medicine I'm sure the gov't will step in at any moment and screw things up by "helping".
It's not bureaucrats speak out against solutions like this, it's people who usually don't learn about why practices like this work and assume medicare is a system straight from God himself. Couldn't possibly be bad, like the thought never crosses their mind.
Won't someone think of the children of the unemployed healthcare bureaucrats!
or the kids from the insurer who demands you pay him thousands every year just because you are healthy.
@@neovenom9833 Yeah! These people need jobs. They need a roof over their heads. They have to feed their children! I don't want to live in a world with unemployed bureaucrats begging on the streets with their children with a cardboard sign that reads "will overly complicated unnecessarily your life for food".
For me the idea of *not* being able to pay your doctor directly is strange.
Every place in the U.S. allows you to pay directly, but it isn't very common for people to take that option, and it's still overpriced.
@@Tzizenorec If you also take insurance, they can't give you a cash discount or insurance will retaliate. If you only take cash, it aint so bad.
@@m.r.p5674 I've had a few medical places give me a discount for "paying on the day of the appointment". That works out a lot like a cash discount, and I'm guessing it's hard for insurance companies to start trouble when it's phrased that way.
"I cant think of a single thing government does better than the free market" - thomas sowell
Based on the numbers, they do insurance better, but it isnt like there arent better systems we can conceive of.
Roads, sewer, water
Im thinking they do mass slaughter and suffering better than the free market. They can also fuck up the most basic things that no idiot would fuck up
It delivers mail better. It distributes power better.
@@D4PPZ456 What numbers? From what ive seen here in the UK its way cheaper for an individual to get top of the line insurance for their family, and you can get that insurance for a fraction of the price it costs the UK government to cover one person in the UK (£2200 per person spending, insurance £800)
On top of that waiting lists, treatments, etc etc is all superior in private healthcare and by a very long distance. Aint no one going private waiting up to 3 years to see a specialist for example
My family has this and its awesome! We have catastrophic insurance on top of it.
How much does a typical catastrophic insurance plan cost? Who offers them? Thanks.
I've been praying for just that. Only been to a doctor four times in my life, one hernia, broken bones twice, and pneumonia once. Who offers It? Blue Shield sure as hell does NOT !!!
@@BeingWolfy We pay $1400 per year for the direct care. One month free if you pay the year in advance.
The catastrophic will depend on the deductible you pick and provider you pick. We have 5k deductible for $4400 for a year with a 20% discount because we have direct care.
Alot cheaper and better care when compared to United, Cigna and blue shield.
Colorado...
@@MrMccurley You have to look for the Direct care in your area. Go in for a consultation and learn more. They all vary.
This is very similar to what Milton Friedman proposed where for primary care you don't have any insurance cause there is always a demand for primary care plus medical resources required are not scarce so supply side is not a problem thus there is a room for competition in a free market system.
On top of that you buy Catastrophic Care insurance plan where he proposed a voucher system which you can use to buy any plan of your choice from a private insurance company.
Simple and cost effective where economic incentives are kept right without taking away the choice of the individuals.
"It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medications somehow think that we can afford to pay for doctors, hospitals, medications and a government bureaucracy to administer universal health care." Thomas Sowell
and yet every other developed mnation on earth does it and it costs the government less than half as much. the numbers say M4A is cheaper.
@Refined Snack I live in Canada, and cosmetic surgery isn't included. Neither is dental care. It's only hospitals that are included.
@Refined Snack actually, we do know. The most conservative estimate, done by the Mercatus Center (funded by the Koch family) found that M4A would save the government 2 trillion$ over a 10 year period. Most estimates place that number over 5 trillion. Second, according to a study by Yale epidemiologists, M4A would actually save the lives of 68000 americans who die every year du to lack of basic health care. In fact, families that make less than 60000$ a year would end up paying 14% less for healthcare each year. Basically, this shows that even though there would be a tax increase, working americans would still be nsaving money, not to mention they wouldn't have to worry about whether or not the hospital or clinic they'd be visiting would be in network, as under M4A they would all be in network. This would include dental and other non urgent services, unlike here in Canada where while hospital care is covered by medicare, Dental and prescriptions are not. however, the Canadian government regulates the prices of prescriptions and drugs, including insulin. In Canada, a vial of insulin costs less than 50$, whereas in the USA it costs, at best, over 100$, with some vials costing nearly 400$. This is what happens when you treat healthcare like a privilege rather than a human right and avoid regulating it. Dozens of thousands dead each year because they are scared of the cost. Tens of millions uninsured, even more underinsured, with insurance companies constantly nickle-and-diming customers.
there's a reason 4/5ths of Americans support medicare for all.
@Refined Snack Every other developed country on earth has done it in some way or another, so why can't America, the richest of them all, do it? Because your politicians are corrupt and bought off by corporations who don't care about them people. However, I understand that M4A is the most controversial as many see it as too centralized, and I can see why. However, a public option would end up costing more than what is currently in place. I think that dental and prescriptions, as well as non life saving surgeries (elective surgeries) shouldn't be covered. in my eyes, the most cost effectve system would involve urgent and hospital care being taken care of by the government, while surgeries that don't save the patient's life or prevent pain and suffering (cosmetic surgeries) and prescription drugs, dental, optometry, would be private to save the government even more money. Canada's system is somewhat like this except it covers unnecessary surgeries which ends up wasting colossal sums. However, the Canadian government does regulate the private sector to prevent price gouging.
But what about all those poor monopolies that have their massive staffs to process insurance claims?
He's absolutely correct, but this is so hard to explain to the general public. All you really have to do is look at the skyscrapers downtown, many of which are owned by these insurance companies. That should tell you who is hoarding the cash.
Government run healthcare causes more problems than solutions look at the VA.
@@noahremnek3615 I don't disagree with you at all. I'm not an advocate of government run systems either.
This system is in India for years. No insurance to scam people.
Yes, this sort of system was always the norm everywhere. The doctor in the video said it's never been tried in the U.S., but that isn't true. It used to be much less complicated, but bad laws and ~70 years resulted in the mess we have now.
Same in Japan, as I understand it.
@@grantjohnson5785 iirc for many of those you pay nothing while ill. You're paying the doctors to keep you well-if they aren't doing their job, they aren't getting paid.
@@Shotblur Everything I've seen and read about it suggests it's pretty much pay-as-you-go... if you stay healthy, you pay nothing, and if you get sick, you pay out of pocket. You know, like everyone did for millennia? Of course, it's also expected that family visits the hospital routinely to provide much of your basic care (laundry, bathing, etc.) which is something American hospitals shun for some reason.
@@grantcivyt true
This reminds me of the school systems, where MOST of the cost is the administration personnel.
Higher ed is so bloated
Key work is “administration”. AZ voted not to give teachers more money by raising our taxes cuz we did that 8 years ago and the money never reached the classrooms or the teachers pockets.
"which drives up costs but add no value" thats the main take away i get
I almost took a job working for a doctor in Charleston, SC who does this. His practice is awesome. I was really impressed by him, his staff, and their unique way of billing patients in a completely transparent and service oriented way. So good.
How long until this is illegal? I love the concept. They do need their own ER for those injuries and illnesses that dont warrant a full hospital, but need to be handled quickly and may not happen on a week day morning.
It has been going on for year's you just do not hear about it is all. I would hope that it does not become illegal at any point!Pretty sure that the Drs offering this have done everything to protect not just their practice but the patients that they care for.
These are for simple treatments not cancer or surgeries.
I've been hearing about this kind of service for healthcare for a few years. It's how healthcare should be done. The fact that my state, SD, has 0 of these is a testament to how powerful the hospital systems are in our state.
They should be awarded a Nobel Peace Prize for their work and willingness to bring true healthcare to an affordable level.
Free markets, baby.
Here in the UK we pay for the NHS through our taxes. If you need to see a doctor, use an ambulance or go to the hospital, there's no cost for that. It's great and pretty much universally loved!
Edit: We also pay a charge of just £9.35 per prescription, although that's also free if you're over 65 or receive government benefits.
Yeah you're right but our system is not perfect, the waiting times are bad. How much do you think the average tax payer pays for the nhs? I think it is 20% of our overall spending
@@MrDanielfff777 The US spends around 15% of GDP on health care, and the UK spends less than 8% of GDP.
The US GDP per capita is 65,297 USD, while the UK GDP per capita is 42,330 USD.
So the US is both spending a larger percentage of its money on healthcare and has a significantly larger amount of money per capita to spend on that healthcare. However, the UK still ranks higher than the US on average health outcomes, with the life expectancy being almost 3 years longer in the UK.
I agree that the NHS isn't perfect, but nothing is perfect, and most people in the UK are proud of the NHS and support increasing its budget.
@@danieldancey3162 I agree that the NHS is better than what the USA have.
My question is how much does the average tax payer contribute towards the NHS each year?
The UK spends €3045 per capita per year on health services according to this report: www.oecd-ilibrary.org/docserver/health_glance_eur-2018-en.pdf?expires=1624297263&id=id&accname=guest&checksum=3A7807C79E3129B1B1801F49E75AB6D9
Averaging across taxpayers would likely be a bit nonsensical, since tax on regular incomes is only a fraction of tax income.
I used to go to a urgent care doctor that worked similarly. It was always $125 for the visit, no matter why. He had his own x-ray, lab, and pharmacy on site. My husband even had two minor surgical procedures there for construction injuries. Same price. Unfortunately I moved and now have to find a new doctor that runs his clinic in a similar way.
Seems like support for free market healthcare is directly proportional to knowledge of how the current system actually works.
Thought the AMA would revoke their licenses for this.
LOL, the AMA doesn't issue licenses :) That is done by each state medical board. Only about 15% of doctors are members (mostly for the Journal). The AMA actually works to make certain that certain doctors get paid, they aren't really a factor in the actually practice or delivery of healthy care in the USA.
@@Vejitasei, so no influence over any legislatures, state medical boards or the board for admissions to the medical colleges... interesting...
mises.org/library/100-years-medical-robbery
The AMA has it's own agenda and politics, I do NOT deny that. Saying they have the POWER to enforce that agenda or speak for the medical community / most doctors is NOT the same. Just as BLM does not speak for most Blacks, the AMA does not speak for most physicians.
BLM want's to destroy the nuclear family, most Blacks do not. The AMA wants to ban boxing as a sport, most physicians do not.
The OP was that the AMA would revoke a physician's licence, the AMA does NOT have the power to do that. That would be the state medical board.
I do not support the AMA (or Doctors without Borders) because of their political agendas. Neither group speaks for myself, most doctors or are they the 'official spokesman's' for the medical community.
@@Vejitasei agreed.
patient: Ill pay you for medical services
doctor: okay
lefties: reeeeeeeeee
Just imagine all the time the doctors save when they don’t have to hassle with all the paperwork. This would free up so much value in our economy.
THIS is what more doctors need to do! I REALLY admire these doctors. I'm a PA. However, I work with physicians. I've seen how administration and economic dynamics grossly effects how they are able to practice medicine. I've talked to a number of MD/DO who have had to close their practices and basically work as "staff" clinicians. I hope more graduating medical students who chose primary care, do what these doctors have done.
This is awesome! I wanna find something like this in Texas!
A lot of Hispanic doctors do this for immigrant patients that don't have health insurance. I used to visit one.
I love it! How health care should be. Just like when my Great Grandpa was a Dr.
Health care should be free. End of story. There is nothing you can say that will convince me otherwise
My PCP retired, and then came back as a DPC! He's my first DPC PCP, and I'm loving it.
There's also the Surgery Center of Oklahoma that lists prices for common surgeries and procedures on its website. The owner did a podcast where he explained that they charge a fraction of what insurance would be charged and their doctors generally make more for performing the surgeries. But drug costs are still a problem.
I need to find a doctor like this near me. I haven't had insurance in years.
Then pray you don't get a preexisting condition otherwise you are fucked
There are a lot of cheap generic drugs. The problem comes when a company takes advantage of the patent system (e.g. insulin, EpiPen, etc.)
@@MBarberfan4life as i found out myself... My wife just 2 weeks ago got diagnoses with ibs and the drugs are patented and cost over 500 a month, no generics. I'm looking to see if there is a reputable way to get them from Mexico or another country. I can get them from Canada but it's only 100 dollars cheaper. Then the doctor would have to go along with it and be willing to send the rx to them, which i can imagine many will refuse to do.
@@matthewhoover6154 I'm sorry for your situation. I didn't even know there were ibs drugs, but $500 is a total ripoff.
With price transparency, suddenly that 800 dollar bag of saline at the hospital, or 25 dollar bandaid suddenly starts to reflect its actual market value.
Imagine how much better schools would be if Central High had to compete with the other schools across the county. What if school districts bussed kids to a school of their parent's choosing? What if the government let the money follow the child? Radical!
Sweden tried the voucher system for some years. The quality fell, the reasons are inconclusive
Where I live, we have Charter schools with far more applicants to their entrance lotteries than they could ever hope to acomodate. So, with the luck of the draw, you might get the chance to choose where your kids go. I don't have to tell you what the teacher's union's response has been...
Long intro: I am a Hospitalist, for those that are not aware, we are internal medicine doctors that only work in the hospital. We take care your you while you are admitted, then you follow up / return to your PMD (primary care doctor). It's a great job and I love hospital medicine (ie hate clinic). But it is also a job that operates as a net loss to the hospital. Based on billing, they have to pay us more then we generate. So one might ask how that is, or how that could even come to exist. Well, the way the hospital is set up pretty much only doctors can generate payments, so all other services represent a cost (custodian, RN, cafe, etc). The big money makers are orthopedics, OB, HemOnc (chemotherapy is billed as a procedure for historical reasons) and GI. Hospitalists are 100% necessary to run the hospital, but we can't bill enough to cover our actually costs. HOWEVER, since we are necessary (can't have a hospital without a medicine service) we can actually compete and demand a salary / benefits package greater than our generated revenue.
I love hospital medicine because I do not have to tell with the insurance companies. If I want a test, I order it. I want a CT/MRI, I order it. I feel the patient needs a certain intervention or treatment; I perform it or order it. I do my part and document / bill everything; but I have no real connection or concern about that aspect of things. Instead I can actually just practice medicine.
The biggest factors driving up health care costs are insurance companies / the government and lack of wellness / preventable care. I think a direct to consumer model is the way to go. But give all the above to say, I don't think that can work 100% for major emergencies / hospital care. Those costs can be reduced as well however. But no mater how you slice it: septic shock -> CVC + pressors -> intubation; is going to cost you. Hopefully, a direct market system will free up the resources to lower the costs for such services.
Getting rid of intellectual property laws would go a long way in reducing costs for those machines I would think...
No one has explained to me is why doctors can't simply bill by time and consumables, like lawyers and plumbers.
Something something “healthcare is a right!” Lol.
Because then docs don't have the incentive to see more patients and the wait times to see a doc would dramatically increase!
@@Armyguywizerdo16 If lines are very long people will simply go and visit another doctor, there is no shortage of doctors in usa. Hell doctors also immigrate to USA in large numbers.
@@abhishekdev353 That is not how it works buddy. The supply of doctors is artificially restricted by the American Medical Association, this is done so the field won't ever become saturated. It's not like lawyers and plumbers where schools are trying to churn out as many grads as possible. This is why getting into medical school is hyper-competitive where getting into a plumbing school or a law school is basically a cakewalk. There aren't enough doctors to go around for everybody, so if doctors start taking less patients the country would have a real doctor shortage. Why do you think docs routinely work +80 hours a week?
@@Armyguywizerdo16 Have you ever heard of immigration?
Moreover if AMA is artificially creating a supply demand gap then they should be kicked out.
Bureaucratization, whether trough government directly or via insurance companies responding to mandates, is always a drain on society.
I really want this to gain more traction. I am very found of this concept and a hope the government doesn't intervene with it.
FINALLY! Someone is making sense about healthcare.
HOW IS THIS SENSE? the whole video is saying "Abolish insurance, and make people pay for everything directly" DO YOU ACTUALLY KNOW HOW MUCH A HOSPITAL VISIT COSTS? THOUSANDS, UPON THOUSANDS OF DOLLARS!
@@ficsitinc.pioneer8695 go and pay a middleman for everything you buy then. Fool
This is great content. Compelling example. I will be checking out one of these direct primary care physicians myself
a subscription service for doctors? that honestly sounds amazing
I use direct primary care and it is great. Much better in terms of cost and quality than urgent care.
Thank you so much for sharing this. I didn't even know this was an option! I would love it if you could provide more videos about Health Care.
This video almost brought me to tears it’s so beautiful
We have not had insurance for 5 years. We pay cash and get a cash discount of 40% with our ped and dentist. They have payment plans when needed that are interest free and I pay for what I need. I don't throw money at pharma, instead, I eat healthy foods and supplement where needed.
Convincing examples of free market solutions working better for everyone than the current, is far better content than jokesters baselessly spewing propoganda. Please make more videos like this one. This is far more compelling and will have a better effect on public opinion than your other videos.
Don't bank on this video changing anyone's mind, people usually assume a perfect government is a fesable goal
While I like the other videos most of the time, I have to agree that videos like these will be much more impactful, because they demonstrate the point so directly and undeniably, with no hint of ideological slant. It's just an objective and meaningful look at a superior situation.
Usually I'm reluctant to show my anti-capitalist friends videos from Reason, FEE, etc because of the obvious libertarian rhetoric, even if that rhetoric is justified. It just pushes people away because they are uncomfortable with ideas they believe are deserving of ridicule. Then they have a much lower chance of actually listening. But this video immediately had me save it to a new playlist to show to these friends, because it's so unbiased and straight to the very clear and undeniable point. This is what we need if we want to change minds.
Insurance and health care in america is worse than in developing countries. I've never had to worry about going to a hospital abroad. But in america I avoid going untill I'm about to die. This direct healthcare seems like a great step in the right direction for us
Pretty darn good way to change the paradigm on this topic.
Also, it's hilarious that Lord Wickiwicki wants their stupid COVID-19 prop banner on a video that only mentions the coof in relation to the changes in primary physician practices and billing for services. 😹
Are they still doing COVID banners? Hah, I had totally forgotten about those. I put a filter for them in my ad blocker, and haven't seen them in months. If you don't use uBlock Origin, you should. It's available for both Firefox and Chrome, and just installing it will nuke 99% of ads.
Removing specialty things might require some digging through HTML to find the right tags to block, but for the COVID and election pop-ups, the filter is: "www.youtube.com###clarify-box". Add that to the "My Filters" tab in the settings and enjoy telling Big Brother to shut up.
Yep! We used to just pay the local doc with pigs and chickens! Before big pharmaceutical bought their way into the colleges we did Not need pills for everything because we cured instead of treating! Cash pay = cash price!
Doctors don't use the word cured sooo gtfo.
Primary care is crucial. It reduces downstream costs substantially. Without doubt. However it still won't drop your health costs. There's lots of ways to run a health system. All we know is your system is the most expensive while also being disproportionately cruel and ineffective.
The part about the lab stuff is 100% correct. I called several labs regarding a test I wanted done, and they couldn’t tell me how much it would cost going through insurance. They could tell me how much the test would cost on its own, but they had to go through an entirely different reporting structure to get the final costs. Every hand a claim touches is a is a hand that must be paid.
The CPT codes decide your lab costs so the hospital doesn't lose money
Have fun trying to pay for your own chemotherapy, surgery, dialysis, or the medication that treats your rare condition. The ideas in this video are a great way for PCPs to make a living providing basic services but it is a laughably inadequate solution for our systemic healthcare problems.
Shh you might offend free market simps
I have direct primary care in spokane and it is worth the money. They have always been able to check me out immediately if I have a medical concerns.
This is the best step forward is just say "fuck it" go back to basics.
Rush Limbaugh told a story on air decades ago. He went to the doctor's office, and the receptionist asked what insurance he had. Said Rush, "None - I'll pay out of pocket", which he could afford, course. The receptionist had no idea how to respond, just saying, "We don't do that".
The problem with health insurance is health insurance.
Why wasn't this already there? In my country, this is how primary care works. You pay a fee per visit, and the relationship ends there. You can choose to go to another doctor the next time, if you are not happy for any reason. And primary care doctors are usually one level below MDs, so their rates are cheaper and really that's all the education you need for primary care.
Which country is that?
@@georgegillespie3737 India, very cheap healthcare, but of course, government is trying to solve the fictional problem of unaffordable healthcare here too.
But the logic the politicians use here is that poor people can't afford the "best" cancer treatment, so they need government help. Even though regular cancer treatment is reasonably priced, they overlook that.
No private, no public, just do it straight with your doctor. Not a CEO or a politician.
I'm going to think about moving to North Port to become one of their patients!! This model is fantastic.
It would be even better if professional organizations could offer licenses to compete directly with the AMA. It's ridiculous to intentionally constrain the supply for something as important as medical care. "For your own good" is the biggest joke in history.
people like transparency, and insurance companies are far from transparent. I'm glad this doctor discovered this market and capitalized on it, and I hope it continues to be profitable for him.
This is awesome.
This is how health insurance used to work before the government got involved.
This is great for primary care, but people still need insurance for emergencies or catastrophic illnesses. The government will likely have to help pay for this. Also, this video hasn’t addressed anything about mental health care, or physical therapy. Those are ongoing treatments that would not be covered under this model
Why do have to pay you? Why not pay the doctorr.
Rituxin (Cancer drug)
Manufacturer price: 990 dollars
Hospital pays: 1300
Customer pays hospital: 10000
In the UK, a family practitioner gets around $180 per patient on books annually. So the US is more than 5 times more expensive. But that's the true cost of medicine, no price manipulation. If prices are inherently expensive its simply a reflection of the value provided.
Is there a website where all these types of places are listed?
Excellent information- thank you for pioneering a better way. Looking forward to assisting in parenting to get this information out!
While I like the more in-your-face libertarian rhetoric most of the time (I'm an an-cap), I have to agree with a commenter below that videos like these will be much more impactful to non-libertarians, because they demonstrate the point so directly and undeniably, with no hint of ideological slant. It's just an objective and meaningful look at a superior situation.
Usually I'm reluctant to show my anti-capitalist friends videos from Reason, FEE, Free to Choose, etc because of the obvious libertarian rhetoric and criticisms, even if that rhetoric/criticism is justified. It just pushes these people away because they are uncomfortable with ideas they believe are deserving of ridicule so immediately categorize it as "opposition" and have a much lower chance of actually listening. But this video immediately had me save it to a new playlist to show to these friends, because it's so unbiased and straight to the very clear and undeniable point.
This is what we need if we want to change minds. This video is a quick banger that I can show somebody who's arguing against free-market healthcare, and have them immediately speechless and unable to defend their position. Please do more of these. They'll blow up if you do. They're incredibly useful tools for education and debate.
Thanks for sharing that. Means a lot to me.
$195 a month for a family of 4. Not quite a Netflix subscription but probably cheaper than insurance. I don't know i don't have insurance, but it still sounds expensive to me.
Yes! America needs this!
We were just talking about this today!
Excellent and informative video. I've heard of medical price transparency but never seen it demonstrated.
YEAH! 😊 What a seed of hope. 💜
They've done it. Let's hope this model doesn't get corrupted, or restricted by the government.
This is exactly what we need! The lack of transparency and up front pricing is intentional. I don’t know how Americans have allowed this to go on so long.
It's so weird going to the doctor and finding out up to a month later how much it cost.
Here in Brazil a private plan of R$ 400 (70 usd) offers countless specialists, hospitalization, complex surgeries, ICU. We pay directly to the hospital.
I always wonder, why this kind of system don't exist in the US?
You guys are great!
These guys should expand nation wide.
This is something that just boggles my mind with the US. My wife is Malaysian and when we visit our relatives I sometimes am baffled that doctors put their prices on boards for regular health care. If I go to a private hospital that is too expensive, I'll just head to the hospital next door, if that is also expensive and I'm willing to wait long hours I can head to a government hospital which is almost free. Bravo to these doctors and I wish them the best of luck in pioneering this idea
Wait, but Libertarians don't want public hospitals funded by taxpayers' money, right?
@@ab-ul1yz Of course not. Price transparency would be cool though.
@@pattybaselines But even price transparency wouldn't fix negative externalities. For example, I got Covid, I'm left to make my own choices, I don't care about Covid because I'm young so I feel invincible, and before they know some rich folks spend and lose shit tons of money, or maybe they die, because I infect them
@@ab-ul1yz There's nothing to solve. People can make whatever calculated risks they want. If I want to risk getting covid I'll go outside. Make your own decisions and be prepared to deal with the consequences.
thank you for this! i will be looking for a DPC near me
This was incredibly compelling and makes a ton of sense for primary care. What would be the libertarian/free market approach to long term chronic care? How do we make it affordable for cancer patients, people that need constant surgeries/tests, the terminally ill?
It'd be shitty, Prices would be in the hands of doctor's without control, supply would be monoplised, and basically... it'd be a lot worse than the system we have now.
This type of practice is what inspired me to go back to school pursuing medicine. Applying to a DO program next Spring, hoping to be like these guys someday
If we treated auto insurance like we treat health insurance, we would use insurance to buy new tires.
Worse. Think about buying gas.
This is similar to medical lodges. Who used to be a big thing back in the day.
Alex Minor, I wholeheartedly agree with your comment. My husband and I are very healthy because we believe in clean eating and taking effective supplements to maintain a healthy body so we don't need health insurance because we would never use it since we don't have any health issues. Just to get coverage for himself only would run $450 a month. $225 from each check. What we do need however is coverage in case we need to go to ER. We are never able to find such insurance covered. Do you have suggestions on how we could get coverage for ER visit if needed? Thanks so much!
all of it just makes so much sense. be it late, there’s no excuse not to immediately implement this model.
I'd gladly pay a monthly fee to know I could go to the doctor. Insurance is held over our heads, if I want to leave my job, then I'm screwed for 90 days. How can the "richest" country in the world be so poor in care.
Great video. This is how to stop the government from completely destroying the health care system.
Great video and a wonderful idea. I am glad to see that we can still have a free market in medicine. Get rid of the insurance companies and their cronies in government!
Like going to the vet! Aside from the initial examination, I always ask for an estimate before any other treatments are rendered. Good vets are always candid about cost. Always wondered why this doesn't work for people.
This is such a good service they are doing. A+ for these doctors.
Wow this is a great video. I have a pre existing condition which currently means that either I get a job that provides health insurance or I pay impossibly high personal health insurance prices. I switched my political party to libertarian last year but have been honestly a little worried about how healthcare would work. Goddamn this explains it so well, it actually kinda puts me at ease haha. Thank you for this video its awesome
A follow up on this would be great.
Direct Primary Care needs to be the standard type of primary care moving forward.
Yes.
I really do hope that this approach to healthcare grows in the future.
Very interesting idea. I will look more into it.
My health insurance is 1600$ a month.
That makes no sense.
Use cost sharing plans much cheaper than traditional insurance.