The Preventive Incentive! The best healthcare plan possible for liberty minded people!

Also, see my thread below about "boutique practices."

Overburdened doctors are shunning all types of insurance

Parija B. Kavilanz, CNNMoney.com senior writer
Monday August 17, 2009, 1:18 pm EDT

Like a lot of their patients, doctors are sick of long waits in the waiting room and dealing with insurance companies.

That's why a growing number of primary care physicians are adopting a direct fee-for-service or "retainer-based" model of care that minimizes acceptance of insurance. Except for lab tests and other special services, your insurance plan is no good with them.

In a retainer practice, doctors charge patients an annual fee ranging from $1,500 to as high as over $10,000 for round-the-clock access to physicians, sometimes including house calls.

Other services included in the membership are annual physicals, preventive care programs and hospital visits.

Doctors argue that this model cuts down their patient load, allows them to spend more time per patient and help save the system money.

However, some industry groups caution that these emerging trends are a consequence of a health care system badly in need of reform.

"I had to change the model": Dr. John Kihm, 51, an internist based in Durham, N.C., converted his solo private practice to a retainer-based model in May.

Until then, his daily schedule was jam-packed. "I was seeing patients every 15 minutes," said Kihm.

He was seeing about 80 patients a week, "many were very sick with multiple systems and complications," he said. "After 20 years, I realized that this was not doable, not sustainable."

His goal is to continue medicine for another 20 years, "but I want to practice it the right way," Kihm said. That means spending more than 15 minutes per patients and doing house calls. "I had to change the model," he said, as he adopted the retainer-based structure.

He now spends 30 minutes on average per patient. He didn't disclose his annual fees but said his fees are "less that what it could cost to smoke a pack of cigarettes a day."

His fees covers annual exams, wellness programs and other types of preventative care typically not covered by insurance. If his patients do have insurance, it would pay for things like lab tests.

"My income is about the same as before, but I have less overhead costs from half as many patients and half the amount of supplies that I need," he said.

More:

http://finance.yahoo.com/news/Overburdened-doctors-are-cnnm-...

Keep the Fed. government out of healthcare. Period.
Leave Medicare Alone. That is all the Fed. Gov. we need.
Leave it to the individual states.

Federal Government-BUTT OUT!!

people, please understand. We're so used to an old-fashioned health care system. We are thinking stone ages. We are thinking about calculators when iphone apps give you a thousand times more for 99 cents.

I've in the health care industry, and am creating a system on the internet. We don't need to pay $100 per month. I don't want to promote the site, but just want people to know our bodies were built very well, and self-correct for free. We've just tried so hard to treat the very things that are trying to fix us, spending a lot of money getting worse.

If I am understanding your idea, I don't feel that people should be penalized financially should some unforseen health or other problem negate a lower rate of payment to the doctor if they do not acheive a goal. Ideally, the patient themself should stick to a plan as guided by the doctor, but as we all know in life, attaining a specific goal does not always go as planned and having a financial reward/"punishment" would set a bad precedent in this realm I think.

A relationship solely between a doctor and patient though is definitely the right way to go and your group insurance idea seems to parallel Dr. Muney's.

Accepting only patients he wants to though with the monthly fee also poses a question.....Does he have other patients not on this plan as I think Dr. Muney has, or does he pick and choose who he wants to work with? Hope that is not the case.

Also, can you imagine the increase in number of people wanting to become doctors once more - as opposed to the number that gave up disgusted and left the profession over the past 30 years or so - becoming a reality? This would be a good thing with the healthcare mafia and government out of the picture! There would be many more doctors to go around and enough to serve the more rural areas to boot.

Lastly, the educational standards need a VAST improvement so that they can catch up with the knowledge of many patients who are way ahead of them. I can see an organization like http://www.westonaprice.org/ writing a curriculum for the medical schools so that future doctors would have a real education on how to get people well and not rely solely on big pharma.

"Bad men cannot make good citizens. It is when a people forget God that tyrants forge their chains. A vitiated state of morals, a corrupted public conscience, is incompatible with freedom." Patrick Henry

on an individual basis and got shut down by the city of new york claiming it was an unlicensed insurance plan.

*edit* http://www.vosizneias.com/28392/2009/03/04/new-york-ny-docto...

there is the link.

ANY time the word OPTION is used , it means I pay for something & agree to set a precidence for gov't to continue failed policy..
naughty, naught

The FDA and drug cartel will fight hammer and nail to NOT allow us the privelege to get well. They are in the sickcare business. I'm pretty sure that if a doctor agreed to this, he / she would quickly lose his / her license to practice.
I do like all the idea's floating around here though. I don't normally go to an AMA doctor anyway. I have gained a bit of knowledge throughout my life to treat myself when something goes wrong. I usually need a (and I'll probably spell it wrong) kneisiologist to muscle test me to let me know exactly what it is that is causing me pain, or discomfort, then I look it up in my natural healing book and fix myself. It's usually something that I am deficient in, as in my hip fracture = low bone density = Vit D by way of the sun and Carlesons Cod Liver Oil with Lemon flavor 3 Tbsp daily. All I need to do is to make myself not forget to eat/drink my nutrients that I know I need.
Of course when I fractured my hip and was taken to the ER, the doctor did the surgery, then prescribed me a Vit D pill (1 per week) that was $9.60 per pill. I went home and got online only to find out that the pill he prescribed has Propolene Glycol (something to do with anti-freeze), and a yellow dye, I didn't fill the prescription, instead I went to my book and got what I needed at the store.
With a bill of $22,000. and many many tests that I did not order and did not want, I vowed to put a DNR-H sign on my front door, and at the doctors office. It stands for, Do Not Resusatate, Do Not Hospitalize.

and it makes sense so that means it will fall off into the rabbit hole. LOL Let's see if we can get as many comments on this idea as that other thread that think the O plan has merit. LOL

You can have a lawyer on "retainer".
Why not a doctor?
It's amazing how little Doctors are taught on the preventative side of medicine. Very little about nutrition, exercise.
This model would force their hand. They would profit from HEALTH, rather than sickness.

HEA ,stay out of MY healthcare & any other private matter ..They forced me to pay into Medicare & SSI I didn't have a say ..THEY spent the funds...NOW they want me to be forced into something else that is none of your affair ..I was young & dumb once.
Trust them again ..I don't think so..
naughty, naught

This sounds similar to a plan I was thinking of earlier today, So Ill post it here if it's ok. It would be a co-op healthcare plan, and you would purchase it through your local co-op health food store or healthfood store, if you want to and if you shop there. The store would secure an appropate amount and type of doctors to serve the people. There should also be many natural healing type of docs on this plan. In a co-op store the people vote on who runs the store so there would also be voting / choices as to who runs it and who the drs. would be.

You miss the whole point ..If I subject myself to all this, "Preventative care", what the H--- do I need, heathcare insurance for ..I'll be healthy.. OH , now I get it....PAY in the premium and make myself well..OH!!!naughty, naught This way they can use the money to pay back my former contributions, to what should already be paid for ..Medicare & SSI.
And we said they are not smart cookies, in Washington DC...
NO BS ????

variations on this, for coops that prefer a variety of health options or philosophies. Then we'd truly have health freedom and a competitive system where we could see comparative data on success vs failure rates.
And cost comparisons, quality of life comparisons etc.

a "boutique practice." Say 100 people get together and pay a 3-5 doctors $5,000 each and for one year. These doctors take care of them including house calls for everything. There is no office, and no staff. The doc drives there, does the evaluation, prescribes any medicine or recommends a higher level of care.

'Boutique' practices expand, give doctors revenue potential of $1 million annually
Physician Compensation Report, Oct, 2003

"Boutique" practices, also called "concierge" or "retainer-based" practices, are sprouting up rapidly in metro markets around the country, satisfying patients' desires for closer relationships with physicians, and physicians' desires for higher incomes and more time to focus on patients' long-term health improvement.

Boutique physicians charge substantial annual out-of-pocket fees to provide relatively small numbers of patients with quicker access, longer visits, and more thorough preventive, wellness and diagnostic services than typically are covered by health insurance or managed care.

More:

http://findarticles.com/p/articles/mi_m0FBW/is_10_4/ai_10899...

Doctors like this are popping up all over the country. Ironically, the government is giving them a hard time because they're bypassing the insurance companies.

Check it out:
http://www.youtube.com/watch?v=qIvmOSjgGAo&feature=related

Here's an article about how the government wants to shut him down:
http://www.nypost.com/seven/03042009/news/regionalnews/state...

Here's his own website:
http://amgmedicalgroup.com/news.html

The free market is by far the only rational and logical option.

I'm pretty sure this is really happening in some places.

It's like having your own private physician, except you're sharing the costs and services with a community.

It provides some real incentives for the physician to get to know each patient and to keep them healthy.

If you were a mechanic servicing a fleet of trucks, wouldn't it be easier to keep the preventative maintenance up to date rather than deal with crisis after crisis?

the problems with the proposal...

- General Practitioners don't hardly do squat anymore... anything involving stitches? Well, we got an opening the Second Tuesday of the 7th Week... your best bet is to go to the Emergency Room.

- There is more than just the one Doctor at the Office.... $120k spread around 5 folks isn't a whole lot.

- - - - - - - - - - -

I do like the sound of it, though... imagine if you're a young Doc, and you charged even $150/ month per person or $200 per family.
The Doc could have absolutely ZERO staff to pay, and just make House Calls... that's close to $200k/year... to show up at someone's home for preventive and reactive care.

... I could see there being contracts that limit the tort of those enrolled (voluntarily, of course) - this would limit liability insurance premiums for doctors, wouldn't it?

--- WallyWorld sells prescriptions at the lowest rates I'm aware of... could there be possible programs that include Rx's? How 'bout Emergency Care?

to work, there'd have to be a whole lot more organic food available...since that's the only TRULY healthy diet...
processed foods are not good for the body, foods laden with pesticides are not good for the body, additives are not good for the body.....et cetera....

where you're forced to undergo invasive tests and procedures or your rates go up.

In this plan how would you monitor someone's diet, exercise, smoking and drinking? Invasive.

You charge people more for getting sick when they can't work as much.

Dr. Paul is right again:

http://durangoherald.com/sections/Opinion/Editorial/2009/08/...

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