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An antidote for Obamacare: Cash only medicine with transparent pricing and no insurance — the future of medicine?
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The price list above is from the website of Clinica Mi Pueblo, which is a chain of eight medical clinics in Southern California, serving primarily the Hispanic community. The Clinica Mi Pueblo clinics offer “general medicine services at the most affordable prices possible” and that claim is supported by the very affordable prices listed above. For example, the national average cost for an MRI is $2,611, but only $350 at the clinic. The median national cost of a colonoscopy is $1,626, but only $450 on the price list above. The US average “fair” cost of an ultrasound is $263, but only about half that amount at the Clinica Mi Pueblo.
(Related: Note that under Canada’s socialized health insurance system, “free” medical care has to be rationed by long wait times. For example, the average wait time for an MRI in Canada last year was more than 11 weeks and the wait time for a colonoscopy ranges from 3.5 to almost 22 weeks depending on the province, according to the Fraser Institute’s report “Waiting Your Turn: Wait Times for Health Care in Canada, 2016 Report.” Those services are apparently offered at Clinica Mi Pueblo with almost no wait times and are very affordable, about the same as a monthly car payment or two.)
How does Clinica Mi Pueblo offer these medial services at the “most affordable prices possible”? Here’s how: the clinic operates on a cash-only basis, with transparent prices that are listed both on the clinic’s website and on the wall at each clinic. Further, the clinic accepts no insurance, and it will not submit insurance claims on patients’ behalf. If patients have insurance, they can easily take the paperwork the clinic provides and file an insurance claim on their own. Reducing the costly, time-consuming mountain of paperwork associated with insurance, Medicare and Medicaid is one of the main reasons that cash-only medical clinics can keep their costs down and prices so low and affordable. That’s the same business model that keeps surgery costs so low/affordable at the Surgery Center of Oklahoma, the “free market-loving, price-displaying, state-of-the-art, AAAHC accredited, doctor owned, multi-specialty surgical facility in central OK” that has been featured on CD many times over the years.
So how does the cash-only, no insurance, price-displaying business model of the Clinica Mi Pueblo compare to medical coverage under Obamacare? Well, deductibles for individuals enrolled in the lowest-priced Obamacare health plans will average more than $6,000 in 2017, and families enrolled in bronze plans will have average deductibles of more than $12,000. Importantly, the deductible is the amount of money patients must personally pay out of pocket for health services before Obamacare insurance policies cover any medical costs. And what about the monthly Obamacare premiums? A 40-year-old unsubsidized bronze Obamacare plan patient will pay slightly more than $350 per month this year for their “health coverage” with a deductible of more than $6,000. And that’s supposed to somehow be “affordable” health care? In contrast, spending $350 per month out-of-pocket at Clinica Mi Pueblo, instead of going toward an Obamacare plan that provides almost no actual medical care, would actually purchase quite a lot of actual medical services.
Bottom Line: For routine medical care (annual physicals, flu shots, routine office visits, X-Rays, ultrasounds, MRIs, blood tests, etc.) most Americans, especially younger, healthier patients, would be much better off with a cash-only medical clinic like Clinica Mi Pueblo than with Obamacare, no? Under Obamacare, a 40-year-old American pays more than $4,200 per year in premiums. The out-of-pocket limit for an Obamacare plan is $7,150 this year but that doesn’t include the monthly premiums, so an individual could pay more than $11,000 out-of-pocket this year before his or her health plan would start to pay 100% of the costs of covered benefits. Only in some fantasy world of Big Government progressives and collectivists would that ever be considered an “affordable” health care system!
Prediction: We will only get medical costs under control when we move the medical system in the direction of the Clinica Mi Pueblo and the Surgery Center of Oklahoma, which are both based on the sensible, cost-controlling medical business model of: a) transparent pricing, b) out-of-pocket cash payments like almost everything else consumers purchase (food, clothing, housing, transportation, computers, travel, etc.), and c) minimizing the role of third-party payers like insurance companies, Medicare, and Medicaid. The future of affordable health care is not more government control, third-party payments, mountains of bureaucratic paperwork, Medicare/Medicaid, and opaque pricing, but rather more market-based solutions, direct out-of-pocket payments, less paperwork, less government involvement and more transparent pricing. The future of affordable medicine will instead be based on market-based solutions like the business models of Clinica Mi Pueblo and the Surgery Center of Oklahoma, along with the very promising trend in “direct primary care” which is another business model that bypasses insurance companies by charging patients a monthly membership fee ($25 to $85) that covers everything from office visits to basic lab tests.
Kudos to Clinica Mi Pueblo for its successful market-based approach to providing very affordable medical care at its eight clinics in California, it’s a business model that deserves much greater attention as an antidote to the rising health care costs that inevitably result from third party payments, government-managed health care, and Obamacare.