HuffPo & Public Radio praise free market health care solutions.

Two traditionally “left-wing” media outlets publish article on examples of how free market solutions can work for patients and doctors.

from Huffington Post 5/26/2011
Direct Primary Care: Skip The Insurer, Get Better Health Care?

Health insurance costs have skyrocketed, making preventative care a near-impossibility for many Americans. But a unique system has sprung up, skirting around the insurance industry entirely: direct primary care practices. And the impact, proponents say, isn’t just financial. Direct primary care clinics could dramatically increase the quality of health care, too.

The idea behind direct primary care practices (DPCPs) is that patients pay a modest, monthly fee (often adjusted according to age and existing conditions) and receive direct access to their doctor.

This means practices generate revenue directly from fees and not from billing insurance companies or ordering tests.

So what are the health implications of these plans? Proponents say they are plentiful.

Because the fee model limits the amount of time doctors have to spend filling out insurance paperwork or battling over coverage, they have more time to devote to patient appointments.



from Minnesota Public Radio 6/20/2011
Doctor as renegade — accepts cash, checks, eggs or pie, not insurance

Osakis, Minn. — Dr. Susan Rutten Wasson sits on the corner of a bed in the cramped bedroom of Alice Johnson, a 91-year-old Osakis resident everyone calls “Grandma Alice.” She’s examining Johnson’s arm, which is swollen, she’s determined, because of a tight sleeve cuff.

Also in the room are Alice’s daughter, Ione, and granddaughter, Anne, who lives downstairs in the farmhouse Johnson has occupied for decades. A Rottweiler mix as big as a Shetland licks the face of 18-month-old Sarah, Rutten Wasson’s daughter, who sits on the doctor’s lap.

It’s more a scene from the days of frontier medicine than from the modern health care system. And that’s because Rutten Wasson, 42, is a throwback to a time before HMOs, electronic health records and hospitals with fountains in their lobbies. She sees patients the same day they call if she’s not booked up, spends at least a half-hour per visit — compared to the more typical 15 minutes — and usually charges only $50 for a consultation. She takes cash or check, but no insurance — and sometimes accepts gratuities of a dozen fresh eggs or a pie.


Myth 11. There are 46 million or more Americans without “health care.”

No one, to our knowledge, has actually come up with an estimate of the number of residents in America, legal or illegal, who are denied life-saving medical care—if indeed there are any. Even accusations of violating EMTALA—the Emergency Medical Treatment and Active Labor Act, which requires screening and stabilization of any patient presenting to an emergency room—are apparently rare. Continue reading

Universal care striking out in “laboratories of democracy”

Hawaii is ending the only state universal child health-care program in the country, after just 7 months.

The Keiki (Child) Care Plan was designed to offer health care insurance to the children of parents who earn too much to qualify for Medicaid or Hawaii’s State Children’s Health Insurance Program (SCHIP), but are felt not to be able to afford private coverage.

State officials found that families were dropping private coverage in order to enroll their children in the “free” plan In fact 85 percent of the children in Keiki Care were previously in a private, nonprofit plan costing $55 per month. Facing budgetary shortfalls, Governor Linda Lingle pulled the plug on funding.

“All this is a lesson for political leaders in Washington who are drafting plans now to expand SCHIP to children in families earning up to $82,000 a year or more. That expansion would wind up doing what Keiki Care did: mainly crowd out the private coverage that millions of middle-income kids already have,” writes Grace-Marie Turner (NY Post 10/27/08).

According to MIT economist Jonathan Gruber, SCHIP crowds out private insurance 60 percent of the time. California, Pennsylvania, Illinois, and Wisconsin have turned back from major efforts to approach universal coverage because of the prohibitive cost. Massachusetts officials no longer claim that such a goal is even possible, Turner writes.

Two Massachusetts safety-net hospitals, Boston Medical Center and Cambridge Health Alliance, will be cutting programs because of state cuts of more than $200 million in payments to Medicaid providers (Boston Globe 10/17/08).

Designed to cover 3,500 children, Keiki Care was a small-scale program. Fiscal problems were evident when only 2,000 children had enrolled. Larger programs lead to fiscal disaster (Investors Business Daily 10/20/08).

Tennessee’s disastrous experiment with universal coverage “forced dozens of hospitals out of business, pushed thousands of doctors and other health care professionals out of the state, destroyed any semblance of competitive health insurance market, and nearly drove the state government into bankruptcy,” writes Patrick Poole (American Thinker 1/17/07).

The state budget was in such straits that a state income tax was proposed, precipitating the Tennessee Tax Revolt of 2000. Thousands of citizens swarmed into downtown Nashville, and traffic came to a virtual standstill, as cars blared their horns from 7:30 a.m. well into the night. Legislators abandoned the income tax proposal and fled. Poole described it as the “most exhilarating experience I have been privileged to…witness….” Democrat Gov. Phil Bredesen was forced to dismantle TennCare piecemeal.

People like Gov. Arnold Schwarzenegger, who proposed to inflict state health insurance on all residents of California, including illegal aliens, should go to Tennessee if they need a heart valve replaced, suggests Poole, to see first-hand the results of universal health care.

Additional information:

Number of uninsured fell, but government dependency rose

According to the U.S. Census Bureau, the number of Americans without health coverage has fallen for the first time in 20 years—to 45.7 million in 2007 from 47 million in 2006.

At the same time, the percentage of Americans with private health insurance fell from 67.9% in 2006 to 67.5% in 2007. An additional 1.3 million Americans went on Medicaid, 1 million were added to Medicare, and 400,000 to military health care programs.

States with budgetary problems are, however, trying to cut back on Medicaid enrollment—although the American Enterprise Institute estimates that the poverty rate now is half a percentage point higher than in June 2007 (Wall St J 8/27/08).

The way to enable more Americans to obtain private coverage is to reduce the cost. According to a new study by Stephen Parente and Roger Feldman of the University of Minnesota, Congress could boost the number of privately insured by permitting people to buy health insurance across state lines (Grace-Marie Turner, Wall St J 8/27/08).

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