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Cutting The Middle Man Out Of Health Care...For The Rich

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As the Democrats busily work on plans to make us all captive consumers of the private health insurers, the rich are cutting loose from the system. While we'll be stuck in costly Exchanges, the rich will be moving on toward their own privately reformed health system. Welcome to the world of concierge medicine.

Via Hartford Currant:

Picture this: You receive a letter from your doctor thanking you for your loyalty. But, she says, you’ll need to pay $1,500 a year if you still want to be her patient.The arrangement, one that’s gaining popularity, is called concierge medicine. In return for an annual retainer, you get extra time and 24-hour phone access to your doctor, without an insurance company butting in. Concierge medicine is a way to cut out insurance companies and reduce workload, proponents say.snipTailored primary care cuts down on costly procedures, reduces caseloads and shrinks administrative overhead. In short, it cuts out the middle man and it seems to be one way of addressing our current health care crisis.Concierge medicine didn’t begin altruistically. It arose by offering luxury services at luxury fees. But now doctors say they’re fed up with insurance companies that favor quantity over quality and whose requirements end up undermining complex issues like unhealthy lifestyles and psycho-social problems.snipConcierge medicine is a growing trend in Connecticut. Washington, D.C.’s Government Accountability Office found no such doctors in Connecticut in 2005. Now there are “several dozen,” mostly in Fairfield County, according to the Connecticut State Medical Society. snip“I had a hard time with this right from the get-go,” says Dr. Michael Bergman of Hamden. “It’s elitist.”Frustration drove Bergman to try anyway. He’s a supporter of Canada’s single-payer health care system. For him, getting out from underneath conventional insurance was in essence a vote of no-confidence for the American system. snipInstead of paying insurance providers for blanket coverage, cancer patients, say, could pay oncologists directly. Healthy people, meanwhile, could pay for routine check-ups out of pocket or simply go without. The result would be an increasingly stratified distribution of health care, Gade says, with the haves choosing preventive care and the have-nots taking their chances.

The Democratic proposals being crafted in Congress are already out of date. They are based on the failing MA model. The Massachusetts health reforms still have patients seeking care at high rates in the ER because many still lack access to primary care doctors. The Exchange is a costly bureaucracy, and insurance prices in the Connector are still unaffordable, and require high upfront costs before a patient receives covered care. The MA health reforms have siphoned money from safety net programs to pay for the reforms. As a result two state safety net hospitals have closed, and the states largest safety net hospital is suing the state. Premiums are rising here faster than the national average and are expected to increase by as much as 12% next year. Subsidies have been slashed and the rolls of public state health care recipients have been cut. And, here's what Democrats in Congress are not telling you, the real success of the MA reforms isn't the Connector, it isn't the mandate. It's the Medicaid expansion and the subsidies. It's NOT the Exchange. It's NOT competition. Via Steve Doty:

Of the 436,000 newly covered in Massachusetts, 170,000 people qualified for a subsidy and were required to purchase coverage through the exchange. Only 20,000 people purchased insurance through the exchange without a subsidy. The subsidy is the reason people enrolled, not the exchange. The exchange simply administered the subsidy.

If you don't qualify for a subsidy, good luck. If the subsidies don't rise as fast as premiums, good luck. While the rich are escaping the private insurance market failure, our Party is Washington is locking us in. While the Democrats craft reform that leaves the private insurers largely intact, the rich are voting with their wallets and moving on to a healthier care system, that emphasizes quality of quantity without interference of the middle man.

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