Thoughts on concierge medicine?

Magnetron
Thu, 28 Jun 2018 21:09:54 +0000

I’m curious if those totally against concierge medicine (in general - not meaning it’s simply not worth the cost to you in your situation) cut back to the pure basics on other necessities too (food, clothing, shelter) in order to keep everything fair and affordable to all.

The answer to 99% of all questions is “money.” We spend enough money on health care in this country to have concierge level service for everyone. We just have to consider it a public interest like roads and defense.

That high-level care that Sue’s husband got is the same high-level care that we get, and without a concierge fee. We just have an exceptional PCP who keeps her patient list small and is OK with the lower salary she earns. She left her old practice when they were changing to a concierge-light model, small monthly fee but $25 to answer a phone call and $35 to refill a prescription. The Dr. doesn’t become a better diagnostician just because you pay him more. A $60 injection is no better or worse than a $1600 one unless you count the mood lighting and cushier chair.

With what we have now, the PCP, the one actually doing the work, gets about 30% of collections or about 20% of billing. NPs and PAs get 2/3 of that. Just about every “reform” taken by insurance companies increases work by the PCP but decreases pay. They are also lobbying to lift the 20% limit on their profits. They have zero incentive to control costs but have 100% of the influence in health care legislation. We are told, repeatedly, this is the best system.

You can’t really compare fancy restaurants (totally optional) to basic healthcare (required in a functioning society). Like education, the way to improve it for an average person is not to funnel millions more to the Phillips Exeters of the world.