Direct care (doctor provides value; patient/consumer pays doctor directly in return for that value) removes the middle man when he is not adding value.
I know this image doesn’t tell the whole story.
It’s just a doodle.
But it’s hard to argue with the core of it.
Like automobile insurance (required by law in the U.S.) and homeowner’s/renter’s insurance, health insurance is an important and essential tool.
But if we started using car insurance for oil changes and homeowner’s insurance to have the leaves cleaned out of the gutters, we’d get ourselves a couple more dysfunctional industries with perverse incentives.
To boot, the good folks working in the auto and home service industries would be set up for discontent and burnout, and the premiums would be unaffordable.
As health insurance has become less of an actual insurance product and more of just “the way doctors and hospitals get paid,” physicians have become dependent on a system that is incentivized to pay them less and less over time and continuously increase barriers to collecting that payment.
No wonder it’s become so much harder to own and run an independent, insurance-based medical practice.
Again, health insurance is a critically important tool, but health insurance in the U.S. these days doesn’t feel like insurance.
You know what feels like an actual insurance product?
Own occupation disability insurance. I pay handsomely for it, hope to never use it, and no one talks about it because it’s simple, boring, and it (mostly) works.
I’m grateful to the courageous physicians on the front end of what I know will be a tsunami of Direct Care adoption over the next several decades. 🙌
