Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that's as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn't accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat's milk.Sounds great, right? Sidestepping the quasi-nationalization of 1/6 of the American economy, right? They underestimate the importance of the universal third-party payer concept to Communitarians in general and the present Administration in particular. All it would take would be to make accepting Medicare or Medicaid patients as a requisite of getting your medical license and presto, their revolt lays in ashes. Or at least is driven underground, to co-ops or some such scheme.
"Direct primary care," which is the industry term for Neuhofel's business model, does away with the bureaucratic hassle of insurance, which translates into much lower prices. "What people don't realize is that most doctors employ an army of people for coding, billing, and gathering payment," says Neuhofel. "That means you have to charge $200 to remove an ingrown toenail." Neuhofel charges $50.
He consults with his patients over email and Skype in exchange for a monthly membership fee of $20-30.
Obamacare, which takes full effect in 2014, will drive up costs and erode quality—and Americans will increasingly seek out alternatives. That could bring hordes of new business to practitioners like Neuhofel, potentially offering a countervailing force to Obamacare. (One example, the Surgery Center of Oklahoma's Dr. Keith Smith, profiled for Reason TV in September, is doing big business offering cash pricing for outpatient surgery at prices about 80 percent less than at traditional hospitals.)
Wednesday, December 11, 2013
Physicians Revolt Against Obamacare
These guys think they have a solution to Obamacare's continued over-bureaucratization of healthcare: jump off the third-party payer train and go "direct":