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Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care

Rocketman

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Dr. Ryan Neuhofel, 31, offers a rare glimpse at what it would be like to go to the doctor without massive government interference in health care. Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that's as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn't accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat's milk.

"Direct primary care," which is the industry term for Neuhofel's business model, does away with the bureaucratic hassle of insurance, which translates into much lower prices. "What people don't realize is that most doctors employ an army of people for coding, billing, and gathering payment," says Neuhofel. "That means you have to charge $200 to remove an ingrown toenail." Neuhofel charges $50.

He consults with his patients over email and Skype in exchange for a monthly membership fee of $20-30. "I realized people would come in for visits with the simplest questions and I'd wonder, why can't they just email me?" says Neuhofel. Traditional doctors have no way to get paid when they consult with patients over the phone or by email because insurance companies only pay for office visits.

Why did he choose this course? Neuhofel’s answer: “I didn’t want to waste my career being frustrated.”

This model is growing in popularity. Leading practitioners of direct primary care include Seattle, Washington-based Qliance, which has raised venture capital funding from Jeff Bezos, Michael Dell, and comedian (and Reason Foundation Trustee) Drew Carey; MedLion, which is about to expand its business to five states; and AMG Medical Group, which operates several offices in New York City. Popular health care blogger Dr. Rob Lamberts has written at length about his decision to dump his traditional practice in favor of this model.

"Since I started my practice, I seem to hear about another doctor or clinic doing direct primary care every other week." says Neuhofel.

Direct primary care is part of a larger trend of physician-entrepreneurs all across the country fighting to bring transparent prices and market forces back to health care. This is happening just as the federal government is poised to interfere with the health care market in many new and profoundly destructive ways.

Obamacare, which takes full effect in 2014, will drive up costs and erode quality—and Americans will increasingly seek out alternatives. That could bring hordes of new business to practitioners like Neuhofel, potentially offering a countervailing force to Obamacare. (One example, the Surgery Center of Oklahoma's Dr. Keith Smith, profiled for Reason TV in September, is doing big business offering cash pricing for outpatient surgery at prices about 80 percent less than at traditional hospitals.)

The Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care - Reason.com
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Dr. Ryan Neuhofel, 31, offers a rare glimpse at what it would be like to go to the doctor without massive government interference in health care. Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that's as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn't accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat's milk.

"Direct primary care," which is the industry term for Neuhofel's business model, does away with the bureaucratic hassle of insurance, which translates into much lower prices. "What people don't realize is that most doctors employ an army of people for coding, billing, and gathering payment," says Neuhofel. "That means you have to charge $200 to remove an ingrown toenail." Neuhofel charges $50.

He consults with his patients over email and Skype in exchange for a monthly membership fee of $20-30. "I realized people would come in for visits with the simplest questions and I'd wonder, why can't they just email me?" says Neuhofel. Traditional doctors have no way to get paid when they consult with patients over the phone or by email because insurance companies only pay for office visits.

Why did he choose this course? Neuhofel’s answer: “I didn’t want to waste my career being frustrated.”

This model is growing in popularity. Leading practitioners of direct primary care include Seattle, Washington-based Qliance, which has raised venture capital funding from Jeff Bezos, Michael Dell, and comedian (and Reason Foundation Trustee) Drew Carey; MedLion, which is about to expand its business to five states; and AMG Medical Group, which operates several offices in New York City. Popular health care blogger Dr. Rob Lamberts has written at length about his decision to dump his traditional practice in favor of this model.

"Since I started my practice, I seem to hear about another doctor or clinic doing direct primary care every other week." says Neuhofel.

Direct primary care is part of a larger trend of physician-entrepreneurs all across the country fighting to bring transparent prices and market forces back to health care. This is happening just as the federal government is poised to interfere with the health care market in many new and profoundly destructive ways.

Obamacare, which takes full effect in 2014, will drive up costs and erode quality—and Americans will increasingly seek out alternatives. That could bring hordes of new business to practitioners like Neuhofel, potentially offering a countervailing force to Obamacare. (One example, the Surgery Center of Oklahoma's Dr. Keith Smith, profiled for Reason TV in September, is doing big business offering cash pricing for outpatient surgery at prices about 80 percent less than at traditional hospitals.)

The Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care - Reason.com

I question how you could possibly justify the bolded. Under PPACA you must either buy gov't approved "private" medical care insurance or pay a fine (added tax). If "opting out" was legal then you would be correct yet, after 2014, that is no longer an option.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

I question how you could possibly justify the bolded. Under PPACA you must either buy gov't approved "private" medical care insurance or pay a fine (added tax). If "opting out" was legal then you would be correct yet, after 2014, that is no longer an option.

What I did and this may not be for you is I took my companies lowest offering reducing my premiums 80%. I then found a hospital and doctor in a neighboring town that reduceds cost 70-80% if payment is received day of service. I had what was a 30k operation at my local hospital for 9k at the neighboring hospital, filing with my own insurance and recovering $7200.

I admit it is not as handy as before Obamacare but it makes the most economical sense in the current market we have.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

I question how you could possibly justify the bolded. Under PPACA you must either buy gov't approved "private" medical care insurance or pay a fine (added tax). If "opting out" was legal then you would be correct yet, after 2014, that is no longer an option.

The working poor can opt out and not pay a fine. Nice loophole for those most likely to be the problem to begin with.......
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

What I did and this may not be for you is I took my companies lowest offering reducing my premiums 80%. I then found a hospital and doctor in a neighboring town that reduceds cost 70-80% if payment is received day of service. I had what was a 30k operation at my local hospital for 9k at the neighboring hospital, filing with my own insurance and recovering $7200.

I admit it is not as handy as before Obamacare but it makes the most economical sense in the current market we have.

Is that "lowest cost" company plan even still available under PPACA?
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Is that "lowest cost" company plan even still available under PPACA?

It is with my employer, they offer four types of options. I used to be on the High Gold plan now I take the bronze.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Chickens for Check-ups - Yeah that'll work.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

The working poor can opt out and not pay a fine. Nice loophole for those most likely to be the problem to begin with.......

Are you kidding me? The working poor, between 100% (133% in some states) and 400% of the federal poverty level get subdstantial tax "prebate" subsidies to buy PPACA exchange plans. Care to share that "loophole"? I see no out, except for those so poor as to fall below the PPACA mandate and not have any FIT withheld (file their W4 as exempt) from their pay.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Are you kidding me? The working poor, between 100% (133% in some states) and 400% of the federal poverty level get subdstantial tax "prebate" subsidies to buy PPACA exchange plans. Care to share that "loophole"? I see no out, except for those so poor as to fall below the PPACA mandate and not have any FIT withheld (file their W4 as exempt) from their pay.

If the poor, prisoners or illegal immigrants do not participate, they do not pay the penalty--period. Add on top of that all those exemptions Obama is handing out like candy, then the numbers add up.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Dr. Ryan Neuhofel, 31, offers a rare glimpse at what it would be like to go to the doctor without massive government interference in health care. Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that's as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn't accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat's milk.

"Direct primary care," which is the industry term for Neuhofel's business model, does away with the bureaucratic hassle of insurance, which translates into much lower prices. "What people don't realize is that most doctors employ an army of people for coding, billing, and gathering payment," says Neuhofel. "That means you have to charge $200 to remove an ingrown toenail." Neuhofel charges $50.

He consults with his patients over email and Skype in exchange for a monthly membership fee of $20-30. "I realized people would come in for visits with the simplest questions and I'd wonder, why can't they just email me?" says Neuhofel. Traditional doctors have no way to get paid when they consult with patients over the phone or by email because insurance companies only pay for office visits.

Why did he choose this course? Neuhofel’s answer: “I didn’t want to waste my career being frustrated.”

This model is growing in popularity. Leading practitioners of direct primary care include Seattle, Washington-based Qliance, which has raised venture capital funding from Jeff Bezos, Michael Dell, and comedian (and Reason Foundation Trustee) Drew Carey; MedLion, which is about to expand its business to five states; and AMG Medical Group, which operates several offices in New York City. Popular health care blogger Dr. Rob Lamberts has written at length about his decision to dump his traditional practice in favor of this model.

"Since I started my practice, I seem to hear about another doctor or clinic doing direct primary care every other week." says Neuhofel.

Direct primary care is part of a larger trend of physician-entrepreneurs all across the country fighting to bring transparent prices and market forces back to health care. This is happening just as the federal government is poised to interfere with the health care market in many new and profoundly destructive ways.

Obamacare, which takes full effect in 2014, will drive up costs and erode quality—and Americans will increasingly seek out alternatives. That could bring hordes of new business to practitioners like Neuhofel, potentially offering a countervailing force to Obamacare. (One example, the Surgery Center of Oklahoma's Dr. Keith Smith, profiled for Reason TV in September, is doing big business offering cash pricing for outpatient surgery at prices about 80 percent less than at traditional hospitals.)

The Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care - Reason.com

You really think this is a good idea? Come on.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

If the poor, prisoners or illegal immigrants do not participate, they do not pay the penalty--period. Add on top of that all those exemptions Obama is handing out like candy, then the numbers add up.

Many more will opt for the subsidy than "opt out". Wait and see. ;)
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

This "country doctor" method might work in some areas, but it's big fat pile of fail in larger, more densly populated areas, I would think.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

You really think this is a good idea? Come on.

I doubt that all healthcare can be summed down to bartering, but it isn't necessary for all health to be insured either.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

You really think this is a good idea? Come on.

I think it is a great idea, it would bring costs down for everyone and headaches
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

This "country doctor" method might work in some areas, but it's big fat pile of fail in larger, more densly populated areas, I would think.

It works in a town with 500,000 in California. It should work in larger areas.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

This may work for simple clinical procedures, but it won't work for diagnostic testing or anything beyond simple office visits.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Physicians and Surgeons Association too. Lets not forget they are going after that 15 man panel of Obamacare. Which they may have the grounds as Congress is suppose to legislate. Not some 15 man panel.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Dr. Ryan Neuhofel, 31, offers a rare glimpse at what it would be like to go to the doctor without massive government interference in health care. Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that's as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn't accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat's milk.

"Direct primary care," which is the industry term for Neuhofel's business model, does away with the bureaucratic hassle of insurance, which translates into much lower prices. "What people don't realize is that most doctors employ an army of people for coding, billing, and gathering payment," says Neuhofel. "That means you have to charge $200 to remove an ingrown toenail." Neuhofel charges $50.

He consults with his patients over email and Skype in exchange for a monthly membership fee of $20-30. "I realized people would come in for visits with the simplest questions and I'd wonder, why can't they just email me?" says Neuhofel. Traditional doctors have no way to get paid when they consult with patients over the phone or by email because insurance companies only pay for office visits.

Why did he choose this course? Neuhofel’s answer: “I didn’t want to waste my career being frustrated.”

This model is growing in popularity. Leading practitioners of direct primary care include Seattle, Washington-based Qliance, which has raised venture capital funding from Jeff Bezos, Michael Dell, and comedian (and Reason Foundation Trustee) Drew Carey; MedLion, which is about to expand its business to five states; and AMG Medical Group, which operates several offices in New York City. Popular health care blogger Dr. Rob Lamberts has written at length about his decision to dump his traditional practice in favor of this model.

"Since I started my practice, I seem to hear about another doctor or clinic doing direct primary care every other week." says Neuhofel.

Direct primary care is part of a larger trend of physician-entrepreneurs all across the country fighting to bring transparent prices and market forces back to health care. This is happening just as the federal government is poised to interfere with the health care market in many new and profoundly destructive ways.

Obamacare, which takes full effect in 2014, will drive up costs and erode quality—and Americans will increasingly seek out alternatives. That could bring hordes of new business to practitioners like Neuhofel, potentially offering a countervailing force to Obamacare. (One example, the Surgery Center of Oklahoma's Dr. Keith Smith, profiled for Reason TV in September, is doing big business offering cash pricing for outpatient surgery at prices about 80 percent less than at traditional hospitals.)

The Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care - Reason.com

So is there a problem with doctors actually competing with lower prices? Still, the reason many have health insurance is not the little stuff like you are referring to. It is the crippling costs of being hospitalized. It is a nice little kickback that during those long stretches where you don't need a hospital they toss you a few benefits like helping with a checkup or some little visit to the doctor that wouldn't cost a lot. In the end most people could afford to do those things without insurance and you sure as hell would not pay thousands every year to cover a couple of check ups. now, when he starts giving cancer treatments for 50 dollars, then you let us know.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

You really think this is a good idea? Come on.

I think it's a great idea.

Do you have any idea what a massive disaster trying to get a UTI treated is?

UTI's are common and easy to treat. Definitely GP kinda stuff. But they require speedy intervention or they can get bad quickly. As in, "laid up in the hospital" bad.

I've had UTI's before. I know what they feel like. I don't need a test. Been there, done that.

So let's say I have a UTI. What do I do?

Go to a GP? Can't. It'll take me 1-2 weeks to get an appointment. It'll be in my kidneys by then.

PP? Nope. Still waiting 3-5 days. Too long. That **** hurts. Seriously.

Just call? Nope. They won't help me. "We cannot give out medical advice without putting you through 100 unnecessary tests for this extremely obvious diagnosis that even an inbred yokel could figure out. Would you like to wait 2 weeks until we can squeeze you in?"

So what do I do?

I have to either go to urgent care or the ER, and spend between $200 and $500 just so I can walk in the door, announce I have a UTI, and leave again.

And why will it cost me $200 to $500? Because I'm 23, and every healthcare plan available to me that's even vaguely affordable doesn't cover anything short of experimental surgery -- after I pay $5,000. Even if I could go to the GP for my UTI, it would still cost me $150. I don't even know why the hell I bother having insurance at all, to tell you the truth.

I would KILL to have a doctor like this around. I would pay for the visit AND bring him eggs. And candy. And strippers. And build a religion around him.
 
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Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

What I did and this may not be for you is I took my companies lowest offering reducing my premiums 80%. I then found a hospital and doctor in a neighboring town that reduceds cost 70-80% if payment is received day of service. I had what was a 30k operation at my local hospital for 9k at the neighboring hospital, filing with my own insurance and recovering $7200.

I admit it is not as handy as before Obamacare but it makes the most economical sense in the current market we have.

So you paid $1800 for the operation on top of the insurance payments? That's very expensive.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

So you paid $1800 for the operation on top of the insurance payments? That's very expensive.

That was not bad at all in my opinion. I sure beats the hell out of universal health care cost in places like Canada and probably your area when you figure the whole cost
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

What I did and this may not be for you is I took my companies lowest offering reducing my premiums 80%. I then found a hospital and doctor in a neighboring town that reduceds cost 70-80% if payment is received day of service. I had what was a 30k operation at my local hospital for 9k at the neighboring hospital, filing with my own insurance and recovering $7200.

I admit it is not as handy as before Obamacare but it makes the most economical sense in the current market we have.

Good for you, Rocketman!

I think we're going to see a lot people who think as you do before too long. Americans are resilient and resourceful when necessary, and most thinking people just want to be left alone to make their own decisions about how to live their lives! "One size fits all" usually results in an unflattering garment in the retail industry, and we have certainly seen the problems in education using the same criteria. Again, Kudos! :thumbs:
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Good for you, Rocketman!

I think we're going to see a lot people who think as you do before too long. Americans are resilient and resourceful when necessary, and most thinking people just want to be left alone to make their own decisions about how to live their lives! "One size fits all" usually results in an unflattering garment in the retail industry, and we have certainly seen the problems in education using the same criteria. Again, Kudos! :thumbs:

Thanks, when i was making less money back in the 90's I carried a high deductable and paid cash for everything. Now thanks to ACA (Obamacare) I will be making the same economic decision again.
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

Dr. Ryan Neuhofel, 31, offers a rare glimpse at what it would be like to go to the doctor without massive government interference in health care. Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that's as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn't accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat's milk.

"Direct primary care," which is the industry term for Neuhofel's business model, does away with the bureaucratic hassle of insurance, which translates into much lower prices. "What people don't realize is that most doctors employ an army of people for coding, billing, and gathering payment," says Neuhofel. "That means you have to charge $200 to remove an ingrown toenail." Neuhofel charges $50.

He consults with his patients over email and Skype in exchange for a monthly membership fee of $20-30. "I realized people would come in for visits with the simplest questions and I'd wonder, why can't they just email me?" says Neuhofel. Traditional doctors have no way to get paid when they consult with patients over the phone or by email because insurance companies only pay for office visits.

Why did he choose this course? Neuhofel’s answer: “I didn’t want to waste my career being frustrated.”

This model is growing in popularity. Leading practitioners of direct primary care include Seattle, Washington-based Qliance, which has raised venture capital funding from Jeff Bezos, Michael Dell, and comedian (and Reason Foundation Trustee) Drew Carey; MedLion, which is about to expand its business to five states; and AMG Medical Group, which operates several offices in New York City. Popular health care blogger Dr. Rob Lamberts has written at length about his decision to dump his traditional practice in favor of this model.

"Since I started my practice, I seem to hear about another doctor or clinic doing direct primary care every other week." says Neuhofel.

Direct primary care is part of a larger trend of physician-entrepreneurs all across the country fighting to bring transparent prices and market forces back to health care. This is happening just as the federal government is poised to interfere with the health care market in many new and profoundly destructive ways.

Obamacare, which takes full effect in 2014, will drive up costs and erode quality—and Americans will increasingly seek out alternatives. That could bring hordes of new business to practitioners like Neuhofel, potentially offering a countervailing force to Obamacare. (One example, the Surgery Center of Oklahoma's Dr. Keith Smith, profiled for Reason TV in September, is doing big business offering cash pricing for outpatient surgery at prices about 80 percent less than at traditional hospitals.)

The Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care - Reason.com

I love this idea.
Hope it catches on here in the fort!!:cool:
 
Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

That was not bad at all in my opinion. I sure beats the hell out of universal health care cost in places like Canada and probably your area when you figure the whole cost

I would pay £0 upfront for that operation, and the average Brit pays 2-3 times less tax for healthcare than the average American for their healthcare insurance.
 
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