by Katherine Restrepo
Director of Health Care Policy, John Locke Foundation
There are many benefits direct primary care (DPC) brings to patients:
One of the most frequently asked questions on direct care is why would patients be willing to pay twice (monthly insurance premiums and monthly DPC membership fees) for health care – especially in a world of pricier insurance policies because of Obamacare’s price-setting on premiums.
If you think about it, people with health insurance are already “paying twice” for health care. In addition to monthly insurance premiums, patients are responsible for other out of pocket cost sharing such as co-pays and co-insurance. Direct care can help health care consumers save on the cost-sharing part. And, because most Americans do not even meet their deductible, they could potentially save more on health care costs and receive better value for care by switching from a comprehensive health plan (think gold-plated) to a major medical plan while direct care would cover preventative health services and better manage chronic conditions. Dr. Patrick Rohal, a direct care provider practicing in Pennsylvania, offers an excellent explanation:
“A friend of mine was jogging one day recently, and he cut his leg while trying to hop over a guardrail to avoid a deep puddle. He went to the ER. The ER doc did a skillful job stitching up the wound, and the insurance company, a few weeks later, did a skillful job of handing him a bill for $1800! (Alas, he had a high deductible.) My friend had no way to predict, nor to control, the costs adding up as his leg was being mended in the ER. In CovenantMD, the total bill for the procedure would have been $70 paid at the time of service, a price he would know before hand, as he would have already known that it costs $50 for me to come in after hours, and another $20 to do stitches. That is a difference of $1730. That’s $1730 saved on the “second payment” I mentioned above, which just more than paid for CovenantMD memberships for his entire family of five for a year!”