The One-Word Fix For Healthcare

The problems with our healthcare system seem gigantic and complex. But the truth is, the problems with healthcare all stem from one simple missing word. That one word is: ‘consumerism’.   

Big insurance companies have had the last 70 years to squeeze and wring-out every drop of ‘consumerism’. In the 80s and 90s, they ‘sealed the deal’, with $5 co-pays and ultra-low deductibles. Everyone of us has been well trained to rely completely on insurance for healthcare. In fact they are often mistaken for the same thing in conversation.

We have all been brainwashed into thinking there's no need to worry about how many specialists, procedures or diagnostic tests were ordered. Patients have no idea, nor concern about the cost of healthcare. Just hand over the insurance card and let the system decide what you need and what its going to cost.

Sadly the inverse incentives of insurance companies and the healthcare system are easy to spot. With no ‘consumers’ to push back, the price of everything in healthcare rose without restraint. No consumers meant price no longer mattered. No consumers meant medical providers and medical facilities were free to jack-up the rates with no consequence. There is no one to hold them accountable, no traditional market (consumers) forces to push for better prices, quality or access. So, with unrestrained demand and no limits on price, insurance based healthcare costs have skyrocketed and continue rising with no end in sight.

But fortunately, the Affordable Care Act slammed on the brakes. Under the ACA, premiums, co-pays and deductibles are rising at 4-6 times the annual rate of inflation. Health insurance premiums have now exceeded the average car payment, and in many cases are more than the rent, or mortgage payment in an average family budget. 

So how did this happen? Why didn’t consumers rise-up and fight for price transparency and choice in their healthcare care? The reason is simple. While big insurance and the healthcare system was busy jacking up the prices for everyday routine care, massive advancements in healthcare and technology were happening. As healthcare grew more complex, patients simply lacked the experience and knowledge to access the system as true consumers, or how to negotiate fair and reasonable prices. As long as insurance was footing the bill, there was no reason for patients to care about price. But, fast forward another 12-18 months to $1,000 monthly premiums, and $7,000 deductible plans and everyday employers are in a panic.

Patients were taught to just rely on an insurance company to take care of them. They trusted their doctor to order only the things they needed. They learned that expensive extra tests were always better ‘just to rule things out’. Nobody cared because it was all covered by insurance.

Consumers in the healthcare system are most conspicuous at the ER and urgent cares. This is where the need for trusted medical guidance shows-up, and most often with an urgency. The ER has long been regarded as the front door of the hospital, This traditional 'entry point' into the healthcare system relies on patients having no where else to turn for the episodic care needs for their family. Fortunately thanks to technology and innovation, the age of the consumer is back. Our consumer-less health system is being disrupted by something new and exciting.

Whats been missing is informed and educated consumers of healthcare. That is why membership based primary care, called Direct Primary Care is catching on like wildfire all across the US. When patients have unlimited access to a personal doctor, who is incentivized to keep them healthy, consumerism is back in the room. Patients partner with their doctor to throw 'a little daylight' on the problem and seek out the right care at the best price. So just like any other industry, transparency and an informed consumer always drives higher quality and better prices.

First Primary Care in Houston is just one example of these new consumer oriented membership-based practices, changing the way people think about personal health, finances and the need for health insurance.

https://www.firstprimarycare.com/