JANUARY 5, 2017 – Bernie Sanders got a lot of grief yesterday for his stage prop of Donald Trump’s tweet where he used Trump’s own words, challenging him to live up to his promises to defend Social Security, Medicare, and Medicaid. Self-styled comedians converged with their own sarcastic tweets, ignoring the message that was undeniable.
Most progressive commentators fail to point out that Obamacare has provisions that increase the survivability of Medicare, and eliminate the doughnut hole of prescription coverage for seniors, as well as reducing the national deficit. CNN’s embarrassment of former senator Jim DeMint highlighted the slowing growth of health care costs due to the introduction of Obamacare.
Another aspect of the threat to our healthcare is rarely if ever discussed, and is the topic of this diary. This article, written in 2013 explains some of the issues of concierge medicine and it’s impact on the average American. Some reading this will argue that concierge service has real value, and I suppose it could if your doctor was so exceptional that paying for it makes sense, or if paying for it keeps you out of a third world clinic, but if universal healthcare is the goal, concierge medicine is the opposing team.
Many forms of concierge medicine exist in this country, and some are experiencing rapid growth as they sweep the nation with an earnest promise to improve health care by providing the personal touch. Arguments by physicians who chose to go this route most often blame the ACA for the need to increase revenue due to rising insurance costs, at least that is the latest excuse.
One company in particular, MDVIP has had a severe impact in my local area. For reference, I am privately insured through my retiree health insurance. I decided to change my PCP of over 15 years in January, 2016 when he announced, and tried to justify the new $1,800 yearly fee for remaining as a patient. This would amount to $3,600 a year for a couple, and multiples of that for dependent children. This fee isn’t covered by insurance, and all co-pays, deductibles, insurance premiums etc are not related to the fee, and thus not the concern of the doctor. He already refused to take ACA or Medicare, which I transition to in 6 months, and neither do most of the doctors in our HCOL area. It wasn’t too much of a sacrifice for me to change doctors since this one continually forgot who I was, what medication I was taking, and when I got my last physical. I saw him once or twice a year for 15 minutes each visit.
My new doctor asked me at my initial appointment why I was leaving my previous doctors care and I mentioned the MDVIP transition, the canned narrative of reducing patient load from 2,000 to 600, and the effort put into convincing me that there was value in paying about $3,600 an hour, excluding the cost of all the other things not covered by my insurance for the same basic care. He sympathized and told me the trend to concierge care was alarming. Imagine my surprise when at my routine visit last month that I was told he was transitioning to MDVIP, providing the exact same narrative as my previous doctor, as if read from a script. The fact that his waiting room was deserted ran contrary to his claim of 2,000 patients waiting impatiently in the wings.
A close friend, upon hearing of my plight suggested that I sign up with his doctor, giving me his name and address, and telling me that this doctor took Medicare and ACA as well. When I looked him up online I was greeted with his smiling face, announcing that he was a new member of MDVIP, which would vastly improve the quality of care and personal attention for a mere $1,800 a year, allowing him to reduce his patient load from 2,000 to 600. The same glowing promises of access to instant contact with the doctor through cell phone and email were highlighted.
I can’t fault a physician for his or her desire to remain profitable, and the doctor I am now forced to abandon told me during our last conversation that transitioning to MDVIP was necessary to enable his practice to survive, which made the claim of 2,000 existing patients a little less believable. But what is the true cause of this phenomena, which adds yet another layer of middleman to an already overpopulated array of those with their hand out for a share of that shrinking dollar?
One word: Health Insurance, actually I suppose that’s two words, which together send a chill up the spine of average Americans and are especially frightening for seniors. If Obama would have gotten his way, and Single Payer would have been accepted by the GOP, insurance companies who siphon off huge profits for zero value would have been simply an unpleasant memory by now. That of course was anticipated by republicans, who have been using the hammer of rising ACA premium costs to drive the nail in the coffin of Obamacare.
An organized effort should be made to add the abuses and trend of concierge medicine to the conversation over universal health care. No permanent solution will be found until the uncontrolled rise in Health Insurance premiums and the companies who engage in it are taken out of the equation. Concierge medicine simply sidesteps the issue, thus allowing it to perpetuate. Until that is done, a repeal of the ACA or any magical and self-serving replacement by the GOP is like spreading icing on a toxic cake. It doesn’t really matter what you call it, a premium is still a premium to the patient. Please call and write your representatives to make them aware of this threat to universal healthcare.
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