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How COVID-19 Is Changing The Debate Over Health Reform

A revolution is occurring in the way medical care is being delivered in the United States. It is happening almost overnight.

People have stopped going to hospital emergency rooms. They have stopped going to doctors’ offices. Most of the nation is self-isolating. Doctors and patients are no exception.

They are communicating by means of phone, email, Skype, Zoom and other devices. Last December, Zoom was the host of 10 million video conferences a day. Last week, the company was hosting 200 million a day. Many of those were patient/doctor communications.

If you are like a great many people, you are probably wondering why it took so long.

Answer: government.

Read the full article on Forbes

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How Direct Primary Care shines a light during pandemic

In our previous piece, we discussed how the lack of price transparency in the American healthcare system has become an addictive painkiller — the “opiate of the masses.” Protection from the pain of prices that are hidden (opaque) dulls our thinking just enough so that we don’t get too worked up.

There’s a different model for the practice of medicine that is gaining increasing support among physicians and patients.

Direct Primary Care (DPC) is a timely subject because physicians using this model are among the best equipped, best prepared, and most effective on the front lines of the fight against the pandemic.

Pennsylvania is the first state to begin educating the general public, business groups, and medical schools about this model, and the first state to receive a grant from its medical society for that purpose. But DPC practices are springing up all over the country, with general practitioners leading the way, although specialists have started to follow.

Read the full article at the Courier Times

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Disney Plus — for Health Care?

Over 10 million people have signed up for Disney Plus since it launched last year. It’s easy to understand why. The service gives subscribers access to hundreds of movies and television shows for just $7 a month — no cable plan required.

Imagine if we applied that model to health care. For a flat monthly fee, subscribers could get everything from flu shots to lab tests “on demand” — no expensive, cumbersome insurance plan required.

This model already exists. It’s called direct primary care — and Americans young and old, rich and poor alike are increasingly turning to it as a means of securing affordable, high-quality health care.

Under direct primary care, a patient pays a doctor a subscription-style fee in exchange for access to an array of services. Just a decade ago, there were only a handful of direct primary care practices scattered across the country. Today, over 1,000 serve around half a million people in 49 states.

Read the full article at The Desert Review

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The Direct Primary Care Solution for America’s Health Care Woes

Austin — “the live music capital of the world” — is a lovably “weird” city and home to many musicians and artists. Willie Nelson, Stevie Ray Vaughan, Townes Van Zandt, and Janis Joplin all called it home at one time or another. Great venues like Antone’s, the Broken Spoke, and Stubb’s kept the music scene alive for years, and as it continues to evolve, they serve as storied reminders of what has always made Austin great — a vibrant arts scene.

When I was in law school at the University of Texas, I remember rushing to buy the 2-CD KHYI set each year for the best music of the day. But I also recall that the proceeds from the sale of the set went to providing health insurance for artists. This was a way people in the arts community looked after one another.

Unfortunately, while the creative community remains alive in Austin, the rising cost of housing, driven both by demand and by property taxes, and the skyrocketing cost of health care are crushing many of the artists who live gig to gig and paycheck to paycheck. Since 2013, insurance premiums have gone up more than 60 percent across the board, while private-market premiums have doubled and even tripled. While Washington “leaders” dither and waste time, some creative doctors are using a fast-growing direct-primary-care (DPC) model that may well save the day.

Read the full article at National Review

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Policy Tip Sheet: States Should Expand Direct Primary Care to Help Expand Availability of Primary Care

One of the lesser-known factors driving skyrocketing health care costs throughout the country is the lack of primary care physicians. Indeed, many states are experiencing a severe shortage of primary care physicians. According to a 2018 report from United Health Group, 13 percent of American patients live in a county with a shortage of primary care physicians.

This shortage is exacerbated by the fact that many new physicians choose to practice specialty medicine instead of primary care. Although there are many reasons for this shift, the high costs and logistical challenges inherent in primary care medicine are major contributing factors. According to the American Journal of Medicine, the percentage of American primary care physicians decreased from 50 percent in 1961 to 33 percent in 2015. The United Health study also found that only 288,000 out of 869,000 physicians conduct primary care services.

Unfortunately, this problem is likely to become worse before it becomes better. The United Health Group study estimates that by 2030 there will only be 306,000 primary care providers in the nation. Additionally, by 2032, the number of Americans over the age of 65 will increase by 48 percent, according to the U.S. Census Bureau. This, along with several other factors, will magnify the need for primary care doctors.

Read The Full Article at Heartland Institute

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The Advantage of Paying for Medical Care Directly

According to a PBS health report about a retiree on a Medicare Advantage plan, Z. Ming Ma was issued a prescription from her physician that cost $285 for a 90-day supply. “A month later,” the article says, “Ma and his wife were about to leave on another trip, and Ma needed to stock up on her medication.”

But her 90 days weren’t up, so Anthem wouldn’t cover it. “Ma asked the pharmacist how much it would cost if she got the prescription there and paid out of pocket,” the article says.

The total cash price was about $40.

This is not uncommon. In fact, a study from USC demonstrated that nearly 25 percent of all prescriptions filled at the pharmacy cost the insurer less than what the patient paid in a copay. Yes, that means paying cash is more affordable than using your insurance card.

 

Read the Full Article at The Hill

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More Patients Turning to ‘Direct Primary Care’

Having quick access to a primary care doctor 24/7 is very appealing to Mick Lowderman, 56, who is married with two children, ages 10 and 8. He pays a monthly membership fee to AtlasMD, a direct primary care practice in Wichita, KS.

“It’s awesome that I can call or text Dr. Josh Umbehr when my children are sick and that I have a solution before they leave for school,” he says.

For example, when one child woke up coughing recently, Mick and his wife, Jennifer, contacted ‘Dr. Josh,’ who asked them to put her on the phone to hear her cough and then take a picture of her throat and text it to him.

“He prescribed an antibiotic, which we picked up at his office the same day.”

 

Read the Full Article at WebMD

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Congress has a Prescription for Health Care’s Sickly Status Quo

Despite the problems that plague American health care, innovative ideas exist to cure what ails it. But many transformative approaches are languishing in obscurity compared to insurance-based, big-government alternatives. One idea, reforming Health Savings Accounts (HSAs), is a powerful antidote to the sickly status quo. And Senator Ted Cruz’s Personalized Care Act (S. 3112) would implement this much-needed solution. S. 3112 — which has a companion bill in the House, Congressman Chip Roy’s HR 5596 — would lift unnecessary HSA restrictions, let Americans spend HSA dollars how they see fit, liberate employers, and unleash Direct Primary Care.

Created in 2003, HSAs are already powerful tools that empower patients. Individually owned, these plans allow patients to place pre-tax dollars into an account and use the funds for certain medical expenses. Frequently confused with the much less advantageous Flexible Spending Accounts (FSAs), HSAs are the ultimate tax-advantaged savings modality. That’s because they are not taxed on contribution, growth or use for an “Eligible Medical Expense.”

Currently, however, needless restrictions prevent HSAs from achieving their potential — and widespread adoption. Insurance companies, fearful of losing any power, were able to include language that prohibits Americans from owning an HSA unless it is linked to an insurance company’s High Deductible Health Plan (HDHP). This unnecessary requirement forces patients who buy HSAs to also buy overpriced traditional insurance policies, limiting the appeal of HSAs.

Read the full article at RealClear Policy

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Commentary: Health care reform that’s superior to Medicare for All

Health care reform is shaping up as the defining issue of the 2020 election. According to Real Clear Politics polling, most voters say that health care is their most important issue.

For doctors, that’s no surprise. We hear complaints from our patients about the health care system every day. Chief among these is the exorbitant cost.

Average insurance premiums for employer-sponsored health insurance, which covers most Americans, have risen by more than 50 percent over the last decade. Deductibles have doubled.

How can families with median annual household incomes of around $60,000 pay $10,000 worth of combined premium and deductible costs per year?
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Direct Primary Care Could Bring Savings and Quality to Missouri Medicaid

Medicaid must be reformed to ensure its long-term survival. Over the past decade, Medicaid rolls have expanded faster than many states can afford. From 2013 to 2018, the number of Medicaid enrollees increased by nearly 28 percent, to more than 67 million. In 2017, the cost of Medicaid reached $581.9 billion, representing 17 percent of total healthcare spending nationwide.

In many states, the increased cost of health care can be traced to overregulation, rising drug and medical device costs, and increased use of long-term and behavioral health services. Even worse, bloated Medicaid programs, even in states that have not expanded, face viability problems. In Missouri, Medicaid costs have risen consistently over the past decade. According to the News Tribune, Medicaid costs have grown from 17 percent of Missouri’s general revenue in 2011 to 24 percent in 2018. In 2018, the Show Me State spent a whopping $10.3 billion on Medicaid.

Unfortunately, Medicaid cost overruns will continue to grow. According to a recent report from the Centers for Medicare and Medicaid Services, Medicaid expenditures are expected to rise at an average annual rate of 5.7 percent from 2017 to 2027, a rate that far exceeds annual U.S. gross domestic product growth. The Rapid Response Review, a study of Missouri’s Medicaid system that was completed in February predicts Medicaid spending could increase to as much as 30 percent of general revenue by 2023.

Read the full article at The Heartland Institute.

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