Health insurance and healthcare are two very different things.  Over the last several decades these two terms have become very confused such that most health insurance is, in reality, pre-paid health care.  Is the annual preventative exam your insurance covers at 100% really free?  Do you think the growing list of guaranteed services under the ACA has any bearing on the astronomical rise in premiums?  Where would an insurance company get the funds to pay for the covered medical services and the very large staff necessary to administrate said services?  They get them from your premiums.  It is like your bank offering to pick up the tab for your dinner using the money in your own account.  Only they hired three extra people to manage the process and you have to pay for them too.

Imagine what would it be like if you had all your premium dollars back in one lump sum sitting in a savings account?  For most people, not for all, but for most they would fully self insurance and virtually immune to medical economic catastrophe.  When these fully self-insured patients needed medical care, do you think they would have a hard time finding out the cost of care?  Hospitals and medical practices would fall all over themselves attempting to compete for the best service with the lowest prices.  We see this the retail clinic market now.  When Walgreens runs a special on the sports physicals, the Little Clinic responds by offering longer office hours.  When patients are in charge, they receive better care and a lower cost.

Direct Primary Care advocates for high quality, low cost healthcare and for true health insurance.   We would like to see patients have an economic emergency brake on healthcare expenses much like we have for car insurance.  If I have a flat tire, I pay for it.  If I’m worried a tree is going to fall on my car and total it, I might want an insurance policy that allows me to cover the cost of a replacement, but only if the replacement is expensive.  My 1987 Toyota 4Runner that sold for $1000 did not have collision coverage.

Check out this article by Jane Orient, MD.  She one of a larger than expected group of physicians that always worked directly for their patients.  She never enrolled as a physician for Medicare.  She is also uninsured.

The Case for Being Uninsured

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