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

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

    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

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Quote Originally Posted by Rocketman View Post
    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.
    “The reasonable man adapts himself to the world: the unreasonable one persists to adapt the world to himself.
    Therefore all progress depends on the unreasonable man.” ― George Bernard Shaw, Man and Superman

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Quote Originally Posted by ttwtt78640 View Post
    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.

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Quote Originally Posted by ttwtt78640 View Post
    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.......

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Quote Originally Posted by Rocketman View Post
    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?
    “The reasonable man adapts himself to the world: the unreasonable one persists to adapt the world to himself.
    Therefore all progress depends on the unreasonable man.” ― George Bernard Shaw, Man and Superman

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Quote Originally Posted by ttwtt78640 View Post
    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.

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Chickens for Check-ups - Yeah that'll work.

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Quote Originally Posted by Fisher View Post
    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.
    “The reasonable man adapts himself to the world: the unreasonable one persists to adapt the world to himself.
    Therefore all progress depends on the unreasonable man.” ― George Bernard Shaw, Man and Superman

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Quote Originally Posted by ttwtt78640 View Post
    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.

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    Re: Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health C

    Quote Originally Posted by Rocketman View Post
    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.
    Alex Carey:

    ... the 20th century has been characterized by three developments of great political importance: The growth of democracy, the growth of corporate power, and the growth of corporate propaganda as a means of protecting corporate power against democracy.

    Australian social scientist, quoted by Noam Chomsky in World Orders Old and New

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