[michaelrpeskin]

That's what I do. It's called "direct primary care". In the last 10 years, I've used two DPC doctors. I loved my first doctor because we had the same philosophies towards health. Last year she started drifting too "mainstream" and I didn't like her style, so I switched and took my money elsewhere. I found a new guy who is really aligned with me and it's been great. It's almost as if having choice and market can work :)

I get the super high-deductible catastrophic with HSA plan from my work, and then I pay $135/mo for my whole family for the DPC doctor (I could pay that $135 with my HSA and have it be on pretax money, but I'd rather invest my HSA pretax right now). The total there is less than any other insurance available to me. If I ever need anything, I just call or email my doc, most of the time we just do a (secure) video chat and I'm done and I don't need to make a trip in. If it is more severe, I can easily get a same-day appointment. He knows me, knows my history, and has an incentive to keep me healthy. The healthier I am, the more I pay him and don't see him.

I love the model!

[lotsofpulp]

I pay $25 to $30 per hour to housekeepers. I question the sanity of a doctor charging $135 per month for multiple people.

[michaelrpeskin]

He’s solidly middle class. Not pulling in tons of money. But he doesn’t have crazy stress either. He doesn’t do insurance or Medicare, so his overhead and admin cost are really low.

[ivalm]

Typical panel size is ~1200 patients. So to get $300k/year that’s $20.8/person/month.

[lotsofpulp]

That’s a good point. I’ll have to ask some friends about overhead. Seems like a weirdly small number though compared to insurance premiums + deductibles, and what doctors usually get per visit when we go for run of the mill fevers for the kids (~$150+ each time).