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America’s First Health Insurance Led Us the Wrong Way

This episode tells the story of how America’s first health insurance contract started us down the path of spiraling health care costs, closed networks, moral hazards, and “lose your job, lose your insurance.” Worth 4 minutes of your time and a share.

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Transcription:

 I’m Dr. Mike Koriwchak, Vice President of the Docs4PatientCare Foundation. As part of our continuing conversation about health care reform we need to understand the history – of health care delivery-how did we get here?  We can’t fix things unless we can answer that.

Now you would think that such a complex, mission-critical system as health care would be the product of careful consideration by really smart people. Unfortunately, it turns out that is not the case. For the past century, our healthcare system has been designed and managed by the one group of people least qualified to do it – politicians…of bot political parties.

The historical accident that is our health care system began almost a century ago. During the years leading up to The Great Depression not only were patients financially desperate for care, but hospitals were desperate for paying patients!  In 1929 Baylor Hospital in Texas, on the brink of financial ruin, tried something new.  The hospital contracted with the teachers of the Dallas Independent School District to pay a monthly premium that covered up to 21 days of hospital admission annually.  The architect of this deal was one Justin Ford Kimball, a lawyer and former Superintendent of the same Dallas School District (hence the connection with teachers).  Kimball had left the superintendent job to become the administrator of Baylor hospital sometime before. With that contract, Blue Cross Health insurance was born.

Now there is an interesting back story here.  While he was Superintendent Kimball created a “sickness fund” (as they were called) for teachers.  Financial data from that fund allowed him to measure spending for health care on the employer side.   Then when he took over Baylor Hospital he gained access to cost data on the hospital side of the equation.  With all of this information, he was able to calculate the cost of care for Dallas Independent teachers to be *15 cents* per person per month.  The price he charged the teachers was 50 cents per member per month.  That’s over a 200% markup.  Talk about surprise medical billing!!

Now think about that for a minute.  So the moment the ink was dry on this deal 4 things happened:
1.  Spending on health care more than tripled from 15 cents to 50 cents.  In all fairness, this is probably balanced by some underutilization that got corrected.
2.  The first closed provider network was created.  Baylor was the only place you could get the care and receive benefits.
3.  Health insurance was tied to your employment.  Lose your job, lose your insurance.
4.  The first moral hazard in health care was created…after taking your money the hospital was perversely incentivized to provide patients with as little care as possible.

Does any of this sound familiar???  Many of the problems in our health care system today were created right here. So on the historical timeline of America, we’re not even through the Great Depression yet and already health care costs are spiraling upward!  …why?  Because the cost of care just got hidden away!

Transparency, choice, competition, downward pressure on prices…all just went out the window. Now don’t get me wrong…we have to have health insurance of some kind.  In fact, the hospitalization coverage covered by the original Blue Cross contract is well served by a classic insurance model.  And as Americans, we have rightly committed to finding a way to pool resources to pay for care related to unexpected events, pre-existing conditions, and for folks who can’t afford to pay.

We talked about that in our last video on the right to health care.  But to solve our current health care problems we have to understand the unintended consequences of the choices we make.

From this story, we must learn that the moment you decide to pay for something with insurance, the cost goes way up. In our next video will get into what happened to health care during and after World War Two.   We’ll see that although the practice of medicine changed significantly, the way we paid for it didn’t change at all.

I’m Dr. Mike Koriwchak, Vice President of the Docs4PatientCare Foundation.  Thanks for listening.  See you again soon.

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Is Health Care a Right?

SHARE THIS FAR AND WIDE. This video simply explores the basics of rights, where they come from, and the impact on healthcare.

Help us continue shifting American healthcare back to sanity.  No matter who wins the election we will keep up the fight but we need your help.

Please donate right now and pledge just $25 a month.  Every donation brings us closer to the goal.

Your Partner in the Fight,

Michael Koriwchak, MD

Vice President, Docs 4 Patient Care Foundation

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Support Our Important Work in 2021

I want to give you a glimpse behind the scenes as I did as the former host of the Doctor’s Lounge radio show for the Docs 4 Patient Care Foundation – of which I am proud to be Vice President of the Board.

Whether you know us from

  • our conferences training up a generation of doctors in the Direct Primary Care practice model
  • the dozens of Op-Eds and white papers nationally published OR
  • Our through our victories in Washington, DC and many States

All these successes have been built over more than a decade by a core team of physicians donating thousands of hours and making dozens of trips to Washington D.C and State capitols —all through their own personal sacrifices of money and time.

Our platform has grown over three presidential administrations. We are the “go-to” health care group in crafting legislation & policy that protects the doctor-patient relationship.

We even have been key in moving Direct Primary Care to becoming a National Policy goal of the executive branch.

We have succeeded beyond our financial capacity.  Personal sacrifice is no longer enough.  Our staffing and infrastructure lack the funds to go any farther.

We need you to step up and commit to monthly support. No matter any amount.

When we get the call to brief legislatures about the front lines of medicine, we want to be able to drop everything and go.

When forces against health care put a Trojan horse in pending legislation, we need to be there to sound the alarm at a moment’s notice.

Help us continue shifting American healthcare back to sanity.  No matter who wins the election we will keep up the fight but we need your help.

Please go to https://www.d4pcfoundation.org/donate/ right now and pledge just $25 a month.  Every donation brings us closer to the goal.

Your Partner in the Fight,

Michael Koriwchak, MD
Vice President, Docs 4 Patient Care Foundation

Ps. – Our team of doctors (board and advisors) have been on fire this year.  They are influencing policy and persuading the public. Here is just a sampling of our media engagement…

Florida Medical Association Interview on Direct Primary Care
Medicine, Curated Podcast: Can #DirectPrimaryCare increase access to health care, reduce costs, and improve care and outcomes? Dr. Lee Gross has done all of those things and shares his experience.
https://www.facebook.com/watch/?v=377900293562088

Dr. Chad Savage: Biden on Healthcare – History Lesson 
John Fredericks Show – October 15, 2020
https://youtu.be/PboMz1_HV9w

Debunking the ‘Trump Doesn’t Have a Health Care Plan’ Myth
Chad Savage – Oct 6, 2020 https://townhall.com/columnists/chadsavage/2020/10/06/debunking-the-trump-doesnt-have-a-health-care-plan-myth-n2577505

Dr. Josh Umbehr – Saving on Healthcare
WVMT’s The Morning Drive – Discussing Direct Primary Care and how it may save significant amounts of money for consumers, employers, and insurance companies.
https://post.futurimedia.com/wvmt/playlist/4/listen-373.html

Donate Now
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Your Doctor’s Orders are Paramount

De-Regulate Doctors and Your Healthcare Dollars

For more than a decade, the Docs 4 Patient Care Foundation’s practicing physicians have used their working knowledge of the American health care system to develop the Physician’s Prescription for Health Care Reform.

Over the past 3 1/2 years, the Trump administration has used all of its regulatory authority to improve health care quality, lower costs, and offer more choices.  

President Trump has consistently worked to eliminate regulatory red tape, remove the bureaucrats from the exam room, and free up doctors to practice medicine and care for all patients. 

In almost every instance, those changes have paralleled our recommendations.

President Trump has tirelessly worked to invigorate American health care with innovation, transparency, and choice.  We appreciate the President listening to the medical experts for what is needed to fix health care and then implementing those reforms. 

DPC Press Release 2020-10-22

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Op-Ed: Debunking the ‘Trump Doesn’t Have a Health Care Plan’ Myth

My Democrat friends foisted this refrain upon me after I attended President Trump’s announcement of his health care plan in North Carolina. I posted about it on social media, along with the transcript of his speech and the outline of his plan. How could they claim he didn’t have a health care plan? It was there in writing. Apparently, that wasn’t enough, and it wouldn’t be until the government had more control.

“It’s not a ‘plan’ because you can’t sign-up for it,” someone snidely retorted.

I realized then we held two different views of what constitutes a health care plan—and what it means for the American people.

To consider it a “plan,” my progressive friends would need President Trump to create and offer an overarching outline of how the government would run every aspect of the American health care system. In their opinion, anything less than a comprehensive takeover would constitute mere platitudes.

Read the full op-ed at Townhall.com. 

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Opinion: Disappointing Affordable Care Act

By: Brian Blase, former Special Assistant to the President

The Affordable Care Act (ACA), or Obamacare, was principally intended to improve health insurance markets for individuals and small businesses, lower health costs, and increase the number of people with insurance. It largely failed. Health insurance markets are only afloat because of massive federal subsidies and premiums and out-of-pocket obligations significantly increased for families. While the ACA has led to about 13 million more people with Medicaid, many more have been harmed. Middle-income families without employer-provided coverage and small businesses and their workers have largely fared worse from higher health care costs as did the nation’s taxpayers who are responsible for funding all of the law’s new spending. (For an in-depth review of the ACA’s performance ten years after its enactment, see this Galen Institute analysis.)

The ACA Damaged the Individual Market for Health Insurance and Harmed Middle-Income Families and Small Businesses

Prior to the ACA, the individual health insurance market—the place…

Read the full opinion at Forbes.com.

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DPC: From the Signing Ceremony

It was my honor to be invited by The White House to Charlotte, NC yesterday, and to be seated directly behind President Trump as he laid out his vision for returning health care back to American patients.

I was flanked by some of my favorite physician leaders from around the nation for the remarks. Many more made the journey and were in the crowd.

The vision rests upon 3 pillars: Better care. More choices. Lower costs.

In the press release from The White House, number 2 on the list of ENSURING BETTER CARE is “improve access to direct primary care arrangements that cut out the middleman and cut red tape to enable patients to spend more time with their doctors.”

While I acknowledge that DPC is not THE solution that solves all the problems, it is one more choice for patients to access quality affordable medical care. It checks many boxes: personalized care, price transparency, improved access, eliminating middlemen, eliminating surprise bills, no exclusion for pre-existing conditions, emphasis on longitudinal care over episodic disease care, improved access to telehealth, more affordable medications through wholesale medications, rural health access, and so much more.

I immensely appreciate the support of this administration. We have been at this for more than a decade, with mostly a headwind. I appreciate the changing winds. I look forward to seeing how far we can go to ease barriers to Direct Primary Care for doctors and patients with fair winds and following seas.

I am extremely proud of the brave physicians all across the nation that have bravely leaped from the burning building into what appeared like certain demise, only to have been saved by the relationship with their patients.

Now battle-tested by a pandemic, Direct Primary Care has proved its survival power through personalization and flexibility to serve the needs of the community.

The future is bright for primary care. Thank you!!

Lee Gross, MD
President
Docs 4 Patient Care Foundation

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Dr. Lee Gross: ‘America First Healthcare Plan’ Restores Power to Doctors and Patients, Removes Bureaucrats from the Exam Room, and Cuts Out Middlemen

D4PCF Board President Dr. Lee Gross, founder of the groundbreaking Epiphany Health Direct Primary Care clinic in North Port, Florida, thanked the administration for heeding the advice of practicing physicians who for years have prescribed patient choice as the cure.

“Today, President Trump released his plan for health care,” Gross said. “This vision achieves the three pillars of higher quality, better access and lower cost. Only two of these can be achieved with a government-centered approach. This patient-centered free-market approach can achieve all three.

“The plan restores power to doctors and patients, removes bureaucrats from the exam room and gets middlemen out of the doctor-patient relationship,” Gross continued.

“We thank the administration for steps already taken and look forward to working with the president to see this vision become reality,” he concluded.

Read the full press release.

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White House Launches Patient Freedom Initiative Flanked by Board Members of Docs4PatientCare Foundation and DPC Action

FOR IMMEDIATE RELEASE

September 24, 2020

Dr. Lee Gross: ‘America First Healthcare Plan’ Restores Power to Doctors and Patients, Removes Bureaucrats from the Exam Room, and Cuts Out Middlemen

CHARLOTTE, NC — Today President Trump, surrounded on stage by six board members of the Docs4PatientCare Foundation and DPC Action as well as approximately 95 other physicians, unveiled his “America First Healthcare Plan,” renewing the White House’s commitment to “More Choice, Lower Cost, and Better Care” and identifying patient freedom as the top priority and best solution for the American health care system.

D4PCF Board President Dr. Lee Gross, founder of the groundbreaking Epiphany Health Direct Primary Care clinic in North Port, Florida, thanked the administration for heeding the advice of practicing physicians who for years have prescribed patient choice as the cure.

“Today, President Trump released his plan for health care,” Gross said. “This vision achieves the three pillars of higher quality, better access and lower cost. Only two of these can be achieved with a government-centered approach. This patient-centered free-market approach can achieve all three.

“The plan restores power to doctors and patients, removes bureaucrats from the exam room and gets middlemen out of the doctor-patient relationship,” Gross continued.

“We thank the administration for steps already taken and look forward to working with the president to see this vision become reality,” he concluded.

Standing behind Trump during the announcement was D4PCF Board Vice President Dr. Mike Koriwchak. Koriwchak says the White House’s proven commitment to price transparency is key to Trump’s plan to liberate patients from bondage to unfair prices and confusing policies.

“Patients have an advocate in the White House,” Koriwchak said. “Today’s announcement builds on the momentum of President Trump’s executive order on price transparency, an indispensable part of any free — and fair — market.”

“Patients have a right to know the price of treatment beforehand instead of surrendering their income and savings to the black hole of government-sponsored insurance,” Koriwchak continued.

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CONTACT:

Felicia Horton, Docs4PatientCare Foundation, toll-free 1-888-788-5515, felicia@hortonlogistics.com

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