Medical practice growing after refusing health insurance

[philosslayer]

Skepticism often walks through the doors to see this doctor.

"It's because we've taken out all the middle. We've taken out all the mark-up. It's wholesale medicine," said Dr. James Pinckney, founder & CEO of Diamond Physicians.

The 32-year-old is among a growing number of doctors who no longer accept health insurance.

Instead, they charge clients like Gregg Bartus monthly fees. He pays $200 for unlimited visits and procedures without any co-pay.

http://www.wfaa.com/story/news/health/health-reform/2014/12/10/medical-practice-growing-after-refusing-health-insurance/20226959/


"Concierge" medicine for the wealthy and well to do. In a perfect would this wouldn't be legal, and its certainly not ethical.

[leftofcool]

1. There will be much more of this to come.

$200.00 a month is cheaper than our insurance.

[upaloopa]

4. The problem is that the doctors limit the number

of patients they see.

[leftofcool]

18. Mine does that anyway and he takes all forms of health insurance

[Sgent]

20. Yes

but the doctor's charges are the smallest part of your health costs. Hospital, lab, radiology, etc. are much higher than your primary care physicians fees.

[upaloopa]

2. I don't know if it is illegal or unethical but

I see that a lot of people could not afford to pay $200 a month.
But as a business model it is better for the clinic than accepting everybody and what ever reimbursement you can get for the services.
I would like to know what medical professionals are paid in single payer countries compared to our system.
I was a controller of a clinic with 21 doctors.
Some actually worked all dsy and night and sometimes for free. Others worked a couple days a week. It seems those doctors had a comfortable life style and maintained it.

[dilby]

3. I would gladly pay $200 a month for unlimited doctors visits.

If you look at the cost of insurance and co-pays $200 is a deal for people on fixed budgets who need to see the doctor quite often.

[leftofcool]

19. Me too!

[The Velveteen Ocelot]

5. Considering that $200/month is less than most health insurance premiums,

maybe this doctor's practice isn't necessarily limited to the wealthy. Almost everybody who has health insurance pays at least that much, and often for shitty coverage with co-pays and deductibles, even under the ACA. Maybe it's not that bad an idea. What this doctor is doing, in a way, is being an insurer. You pay him whether you need him or not, and he treats you when you need him, without having to pay more. I don't know whether (or if) this will or should catch on, but it's an interesting idea, and it beats insurance companies at their own game.

[Orrex]

6. Probably doesn't cover lab tests, ER visits, or hospitalizations.

So although $200/month might not be unattainable for most people, they're still going to be entirely screwed if they wind up in the ER with MRIs and CAT scans followed by a four-day admission for in-patient care.

Unless they pay another $200+/month for health insurance on top of what they're paying their doctor.

[jwirr]

21. And this is primary care - does it cover a specialist?

[philosslayer]

7. Its more than that.

It doesn't constitute Health Insurance as defined by the ACA. Therefore, the users of this service will also have to pay the fines levied under the ACA for not being insured.

[The Velveteen Ocelot]

11. Well, there's that.

Still, it will be interesting to see if this concept goes anywhere.

[enough]

8. I'm not sure I see what is unethical about it. It looks like an attempt to find a sensible

way to run a practice. He does not seem to be limiting himself to the affluent. I'm not saying this is the way medicine should be structured. I think single payer is the only way. But this doesn't seem worse than what most people have under the current system.

snip from the article>

He makes money on membership fees rather than mark-ups. Those fees range from $95 to $295 a month, depending on a patient's age.

Pinckney then pays other providers cash for common tests. For example:

MRIs cost about $4,000, but his patients pay $400
CT scans are $2,000 with insurance, he said, but are $300 through his practice
X-rays are usually $500, but priced at $60 at Pinckney's clinic, the results of which he can check on his smartphone
Practicing medicine, Pinckney said, is just as important as practicing fiscal responsibility.

Most all of his patients have a catastrophic insurance policy for emergencies.

end snip>

[philosslayer]

17. It's exclusionary and elitist

Under the ACA I have to have a certain level of insurance to avoid the fine. With this doctor I have to have insurance AND pay him his monthly premium for "access". Make no mistake, this is concierge medicine for the wealthy. Under single payer, this sort of arrangement would hopefully not be allowed.

[vankuria]

9. What about hospitalization?

Not everything can be cured in a Dr.'s office. And what happens if the patient's medical needs make it necessary to refer them to someone outside this practice such as a specialist? I'd also bet that $200 doesn't include pharmacy coverage, therapies, ER visits, medical equipment, etc.

[dilby]

13. His patients can get just catostrophic insurance through the ACA and pay his monthly premium.

They will have the best of both worlds, insurance for when they need it and unlimited access to a doctor with no additional out of pocket costs.

[Hoyt]

14. Assuming doc stays in business and can honor what is essentially an insurance contract

for primary care.

Doc is banking he'll skim off healthy patients and won't take on too many.

[NaturalHigh]

10. I'm personally for universal health care.

My doctor is considering this, though, and if he goes this way I will sign up. It will actually save me money.

[zazen]

12. $2400/yr for chronic care, plus high deduct health insu for emergencies is good deal for lots of people

It just doesn't cover prescription drugs.

I won't have any coverage if ACA is overturned, so I'm hardly even middle-class, but I can certainly see how driving out wasted costs could help those in middle and upper quintiles with saner, less expensive solutions for better coverage. And anything that better demonstrates the uselessness of for-profit insurers is good by me.

[Vinca]

15. If the doctor owns a hospital and that's included, then it's a good deal.

Otherwise, it's $200 to the doctor a month and $500 to another insurance company for hospital coverage.

[B Calm]

16. What about lab tests, prescriptions, MRI's, hospital charges, etc etc etc etc etc!

[Hangingon]

22. We are without a primary care physician.

We are without a primary care physician. Our doctor closed hid clinic in mid December. He is opening a concierge practice at $150 a month per patient. He will take no insurance or Medicare. It covers office visits. We will continue to carry health insurance to cover labs, tests , specialists and medical catastrophes.

In the search for an new PCP, we found an increasing number of concierge practices. We also ran into Fee for Services practices. A set fee for simple and complex office visits, telephone and email consults. No insurance and no Medicare.

The traditional practices are closed. We are wait listed on three that will take our insurance. No one is excited about Medicare and most won't accept Medicaid patients.

Hope we hear from one of the traditional practices soon. Prescriptions are running out.

[SickOfTheOnePct]

23. I see nothing wrong with this at all

If I were younger, I would absolutely be willing to pay for this plus a catastrophic policy.