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by sparkpeasy 2816 days ago
"Direct primary care only works as a complement to insurance that pays for more catastrophic care like emergency room visits and specialists."

This is like saying: "I've found a solution to high auto insurance costs! You can save lots of money and pay directly for small fender benders! Oh, by the way, if your car is totaled, you'll need to find someone else that covers those very costly catastrophes."
2 comments
lostapathy 2815 days ago
One could also argue the current model is more like "I found a solution to routine auto maintenance costs! Our super premium insurance includes oil changes, tire replacement, and other routine service."

Part of the problem with health insurance is that it's not just "insurance" in the true sense of the word - it's involved in minor and routine care as well. I don't have to involve my auto insurance company when I run over a nail and get a flat tire - why do I need to involve my health insurance when my kid has an ear infection?

I understand why we got here - preventative care reduces costs, and people would avoid it if not included in the main package. But there isn't a doubt in my mind it hasn't distorted the market.

Get a price quote for a windshield replacement paid directly and through an insurance claim. It's a LOT more expensive, overall, when insurance is involved. Health insurance is not fundamentally different in that way.

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asn0 2815 days ago
I've negotiated direct-pay prices several times with auto-body shops, but I haven't tried with doctors.

Are most doctors set up to provide cash quotes and accept cash payment, or would I need to find specific doctors if I want to pay cash?

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killjoywashere 2815 days ago
I have never seen a private practice that couldn't handle cash payments such as credit cards and, well, cash. They may not be set up to handle Stripe or Google Wallet, but they may be and not even know it. I have a friend who's father, an internal medicine doc in North Carolina, has actually taken farm animals in payment.
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lostapathy 2815 days ago
Ironically, for businesses that operate under HIPAA regs, any doctor I've had take my credit card had paper forms that were nowhere near PCI compliant.
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killjoywashere 2813 days ago
> nowhere near PCI compliant

This I do not doubt at all...

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lostapathy 2811 days ago
My favorite - I had a routine-but-niche lab test done at a doctor I'd never been to before. They wanted a credit card "on file" in case insurance didn't pay.

They had a paper form for my name, address, SSN, credit card number, and even the CVV2 code off the card. I left the SSN and credit card info all blank, handed them the form and the card and told them I wasn't comfortable writing it all down (at least if there was a breach, it's not in my handwriting, right?). Which then got put in a pile on her desk until god knows when.

Insurance paid for the test ... at their negotiated rate of under $3. For that, I would have just paid cash and saved having personal information left laying around.

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pg_bot 2815 days ago
Very few doctors are set up to provide cash quotes. You are more likely to find this situation in primary care (general practitioner) than other specialties since you are more likely to use your primary care physician on a regular schedule.

If you are looking for a practice that is set up near you this site has a map of DPC practices across the US. https://www.dpcfrontier.com/mapper/

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