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New System to Revive the Nation’s Health Care

New System to Revive the Nation’s Health Care

Direct Primary Care or DPC is sometimes associated with concierge medicine. Like concierge health care, DPC gets directly involved in a financial relationship between health care providers and patients. It typically offers the medical care given by family or general practitioners, at an affordable monthly fee.

DPC alleviates many of the financial roadblocks to health care access . It can eliminate or reduce insurance co-pays, co-insurance fees, and deductibles. Direct Primary Care is not insurance. For this reason, physicians can sidestep the overhead and the complicated process of dealing with insurers, which can cost as much as $0.40 for every dollar spent on health care.

The Benefits of Direct Primary Care Over Insurance

Texas health policy attorney Erin Gilmer has written an informative article about the benefits of Direct Primary Care in her Health as a Human Right blog site. Here’s an excerpt from her article:


“The idea behind DPC is simple: pay your doctor a monthly fee for your care. In other words, your doctor charges you say $50-$100 per month and provides your care. Usually when this model is discussed, it is in the vernacular of “concierge” medicine. The word concierge brings with it a sense that such a health care system is only available to the wealthy. However, DPC is actually a way in which we can help everyone care regardless of their socioeconomic status. It’s like a membership. You already pay (or your employer pays) insurance premiums each month and those premiums are well over $100 per month. In fact, on the individual market, insurance is easily above $400 per month per person. If employers and government invested in this model of care, the savings would be overwhelming.

The benefits of DPC are not just monetary (which seems to be the only thing anyone is concerned about these days) – it takes out the middle man, insurance. Thus the administrative burdens are gone – allowing doctors to focus on patient care instead of fighting for reimbursement. Patients in these practices often receive better care. Patients who wouldn’t have access to care because of the prohibitive cost of insurance have access to care. And the DPC model can incentivize med students to actually choose primary care over other specialties in a time where of dire need for primary care physicians (PCPs).”


Direct Primary Care Provides More Patient Care at Less Cost

In this excerpt from her article, Ms. Gilmer points out that insurance companies are after increasing their income first, and improving the patient’s health second.

“Insurance companies are for-profit companies. Make no mistake, they are not primarily interested in improving health outcomes. They are focused on increasing profits. As such, they direct your care, not your physician. The physician can recommend treatment, but this has to be approved by the insurance company. Insurance companies waste money (as I talk about in this post on Health Insurance). More than 19% of claims are incorrectly processed according to the American Medical Association (AMA) a cost of about $17 billion annually. Insurance companies deny claims which are then appealed or insist on further review for claims that could be easily processed, wasting more money and time (time being of the essence when health is at stake). That burden gets passed on to employers and individuals who see higher premiums and doctors who spend 10-14% of their operating costs on fighting insurance companies to get paid. Insurance places a burden on everyone in the system, except for themselves. Patients receive care at the whim of an insurance claims specialist and providers divert their attention from patient care to administrative matters.”


Since it is not insurance, Direct Primary Care may actually improve patient health because it will:

  • provide more access to care by reducing health care cost
  • enable employers to provide medical benefits to their workers
  • allow primary care physicians to focus more on their patients instead of being immersed in insurance payment processing.

Direct Primary Care enables patients of all ages to get the health care they deserve and need, and allows primary care physicians to apply their profession in a safe and efficient way while keeping their earnings at an acceptable level.



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