DCJ: Nobel-winning microeconomist wants to fix health care

Plan will extend concierge-style primary care services to Grameen microlenders

July 18, 2013

Nobel laureate Muhammad Yunus—a Bangladeshi banker who conceived the idea of microfinance—has partnered with Iora Health to offer primary care services to low-income individuals, Forbes‘s Dave Chase reports.

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Yunus, who founded Grameen Bank, has helped bring thousands of people out of poverty. In the United States alone, Grameen America microlent $93 million to more than 17,400 women at a repayment rate of 99.4%.

But Yunus says that focusing on finance isn’t enough: Access to affordable health care also is crucial to help low-income individuals to ascend the economic ranks, he says.

Yunus’ plan follows a “direct primary care” (DPC) model, which essentially brings concierge medicine to the masses for a flat, monthly fee. Iora’s primary care services will initially be offered only to Grameen borrowers for an “economically sustainable” $10 per week or $43 per month, Chase writes. After that, the model will be extended to the borrowers’ family members and eventually to the public.

Related: Would you spend $50 a month for your ‘own’ PCP?

Chase notes that many Grameen borrowers are undocumented workers who do not qualify for coverage under Medicaid or coverage options created by the Affordable Care Act, so Yunus’ plan would fill a market need. However, the Grameen-Iora partnership still faces “competition”: Its goal is to demonstrate that higher-quality, better-coordinated health care has distinct advantages over the often-disjointed care offered in EDs or through Federally Qualified Health Centers, where the uninsured typically seek treatment.

The plan also has the potential to debunk the “myth” that DPC is not applicable to the broad populous, Chase writes, adding that if there is a “two-tier health care system”—a common critique of DPC—it is that higher-income individuals get the “short end of the primary care stick.” Chase discredits the fee-for-service model, which he calls “hamster wheel primary care” that delivers suboptimal value to patients (Chase, Forbes, 7/9).


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