Oral
Testimony
Joint
Economic Committee of Congress
Robert
S. Berry, M.D.
“Consumer-Directed
Doctoring:
The
Doctor Is In, Even If Insurance Is Out”
Mr.
Chairman and Mr. Stark:
Thank you for inviting me to testify before
this committee today.
I am grateful that our leaders want to
know what is happening at the grassroots level and that you are willing to
consider the perspective of an ordinary primary care physician like me when
deliberating healthcare policy.
I am Dr. Robert Berry and my
background is Primary Care Internal Medicine and Emergency
Medicine. As a physician in a
private practice that does not take any insurance, I believe I might be able to
offer you fresh insights on some of the seemingly insurmountable problems we
face in healthcare today.
Over three years ago, I left ER
medicine to start a clinic primarily for the uninsured of my community. I thought I might be able to help them avoid
unnecessary, expensive visits to the ER.
My motivation was simply to try and flesh out in my own life an answer
to the age-old question, “Who is my neighbor?”
Of course, I don’t refuse other
patients willing to do “Payment At The Moment
Of Service.” In
fact, because this seemed to be the unifying theme of our practice, I chose its
acronym
PATMOS is similar to charity clinics
such as Dr. Eck’s in that it serves many patients falling through the cracks of
our broken healthcare system – except we don’t receive any taxpayers’ funds
either directly as subsidies or indirectly as a tax-exempt corporation. It is similar to boutique clinics such as Dr.
Kaminetsky’s in that it contracts directly with its
patients – except that most of our patients don’t have insurance.
The prices for medical services at our
clinic are really quite reasonable. $35 for a sore throat.
$95 for a simple laceration. I can keep my fees this low – and thus affordable to the uninsured and patients with high
deductibles – because I avoid the crushing overhead and hassles of processing
relatively small medical claims – a service from which they clearly do not
benefit.
Mine is only one of many non-boutique, cash-only clinics in this country. There is a growing movement of physicians
like me who offer affordable, quality medical care by refusing to sign
insurance contracts. We are no longer
willing to tolerate anyone intruding into the once sacred doctor-patient
relationship.
And the mainstream media is catching
on.
Last November, the Wall Street Journal
featured our clinic on the center of its front page in an article entitled
“Pay-as-You-Go M.D.: The Doctor Is In, But Insurance Is Out.” Just several weeks ago, the AP News ran a
story on SimpleCare, a network of cash-only clinics,
which was picked up by CNN and many local media throughout the country. National news programs have highlighted other
cash-only clinics as well.
The media is tapping into a rich vein
of frustration and fear. Frustration with costs escalating and no end in sight while medical
care is becoming less accessible and less personal. Fear that we might end up with a single payer
system where delays for treatment can be inhumane. Clinics such as ours offer hope that there
are doctors out there today who care and who don’t cost an arm and a leg.
In
The issue before you now, it appears,
is very simple – “who will control healthcare dollars?”
The government?
No – medical decisions are much to complex and personal to entrust to
distant bureaucrats, many of whom lack basic medical knowledge.
How about patients, then? In my opinion, the most cost-effective and
humane solution to many of our healthcare problems is
to allow ordinary Americans to manage their own routine medical care by giving
them control over healthcare dollars.
They can do this now with pre-tax, tax-deferred personal and family
medical accounts within consumer driven health plans and spend them at clinics
like ours.
It is, after all, their money and
their health. They should control
both.
Ronald Reagan once said, “There are no
easy solutions. Just
simple ones.”
All they require is being a neighbor.