August 31, 2011

CONTRARY TO 80 YEARS OF DEMOCRATIC CANT...:

Why President Obama's Health Care Plan Missed The Mark (Todd Ganos, 8/30/11, Forbes)

Dr. Samir Qamar asked how the business model of primary care would change if compensation were a monthly subscription paid in advance and no insurance was accepted. Immediately, the costs associated with billing at both the provider and the insurance companies would drop out of the system. Dr. Qamar found that this efficiency led to other efficiencies being built into the business model. In the end, a primary care physician need only service a maximum patient base of 2000. Without the fee-for-visit compensation model driving care, there was no clock-watching and no emphasis on volume. Rather, the focus became quality of care. The average time spent with a patient more than doubled. The company is Monterey, California based MedLion, Inc.

The shocking aspect of MedLion's new approach to primary care is its cost: $59 per month for an adult, $39 per month for seniors, and $19 per month for a child. How is this possible? It seems that it is more than just primary care physicians who grasp the costs associated with insurance billing. MedLion approached other medical providers - such as labs, specialists, etc. - with a simple deal: our patients will pay you cash up front for your service instead of you billing insurance. These other providers overwhelmingly preferred this deal to billing insurance.

Major medical is not included in the MedLion model. This is where the insurance companies fit. Major medical is the true risk in health care and providing this coverage is the proper role for insurance companies. Such policies - with a high deductible - might run $150 or so per month. Thus, combining MedLion's direct primary care model with a major medical policy might run $200 to $225 per month. For employers who provide health care benefits to employees, this is a game changer.


...the reality is that you're healthy and comprehensive insurance is a waste of money for most of your life.


Posted by at August 31, 2011 6:15 AM
  

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