Doctors in Texas are showing us what a medical system without comprehensive insurance might look like. The NYT profiles the rise of Texan “direct primary care” practices that don’t accept insurance. Instead, patients pay flat fees out-of-pocket. In return, doctors save both time and money that they can then pass on to patients. By not having to process reimbursements through third party payers, fill out convoluted forms, or hire administrative staff, they can charge their patients less and spend more time with them. Here’s some examples of how different practices are implementing this approach:
Concierge medicine (or dentistry) is an attempt to break away from the central control and outside influence of third party payers. I believe that new technology used well will be essential to bringing down costs and improving service.
Revolutionary technology has already transformed travel agents and film processing services and is rapidly transform publishing. When established well entrenched business systems are threatened they almost always react by trying to crush the threat. This often includes legislation or regulation to protect the establishment. Think taxi cabs vs. Uber.