Direct primary care debate resurfaces

Several health care professionals and one patient urged lawmakers Wednesday morning to support a measure authorizing direct patient care agreements in Montana, reviving a debate that has surfaced in the Legislature at least twice in the past.

Sen. Cary Smith, R-Billings, introduced Senate Bill 101 to members of the Senate Business, Labor and Economic Affairs Committee, stating that the legislation would help strengthen relationships between health care providers and their patients and give Montanans access to another option for affordable health care.

“One of the really, really high costs of health care is insurance, and one of the things that adds a lot of bureaucracy and complexity to having a relationship between a physician and a patient is government regulation, state regulation,” Smith said. “This bill makes it clear that in this type of arrangement, you don’t have that problem.”

Read the full article at the Montana Free Press.


States are suspending Certificate of Need laws in the wake of COVID-19 but the damage might already be done

In the wake of the COVID-19 pandemic, 24 states that have CON laws on the books have suspended some portion of them or enabled emergency provisions.

Even though many states are reacting quickly to try to alleviate strains on their medical systems, much of the damage from these CON laws has already been done. For example, on March 20, the New York governor suspended CON laws giving providers less than a week to ramp up before capacity was reached—nowhere near enough time to effectively increase health care capacity.

This is one reason the laws should not exist in the first place. Providers know whether there is a need for services or facilities. Allowing them the flexibility to respond in a pandemic is obvious, but they should have the same flexibility year-round.

Read the full article at Pacific Legal.


Direct primary care for the vulnerable

Direct Primary Care (DPC) is not really a new model for health care in Texas. Long before employer-based insurance (with the safety nets for the elderly and disabled, Medicare and Medicaid) became the standard, patients paid doctors for their care. There were no middlemen—only the patient and the physician, and they made the decisions.

DPC seems innovative now because we have moved so far away from that model. Government regulations combined with ever-more complex insurance standards have put third-party payers in charge of the decision making.

The current system frustrates not only patients but also physicians. No health care provider wants to be second-guessed by middlemen behind a computer screen hundreds or thousands of miles from the examination room. No doctor wants to be limited to a maximum number of minutes of face time per patient, because human beings and their ailments are rarely so conveniently compartmentalized. And doctors and patients alike want the ability to follow up on treatments to ensure the best health outcomes possible.

DPC practices seek to resolve the flaws of our current health care system by providing transparent pricing and strength­ening the doctor-patient relationship. Direct care has gained momentum in primary care, surgery, pharmaceuticals, and dentistry. Direct care functions differently in each setting, but the central idea is that third-party payers are not involved, and prices are known before the patient sees the medical professional.

Read the full article at The Item.


GA is Ground Zero for American Healthcare

This is perhaps America’s greatest healthcare pivot point in history, of equal if not greater consequence that the passage of the ACA (Obamacare).

BOTH hosts of Drs Lounge, Hal Scherz, M.D. and Scott Barbour, M.D. are on deck to discuss how what happens in Georgia will determine the future of healthcare for all America.


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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 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.


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


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 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.

Dr. Chad Savage: Biden on Healthcare – History Lesson 
John Fredericks Show – October 15, 2020

Debunking the ‘Trump Doesn’t Have a Health Care Plan’ Myth
Chad Savage – Oct 6, 2020

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.

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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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