The healthcare system is a racket — direct primary care could fix it

Everyone has a healthcare horror story.

A hidden charge on the hospital bill. A last minute test or scan that ends up costing four figures. Hours spent on the phone with insurance companies to follow up on a claim and get a reimbursement. Prescriptions costing hundreds of dollars.

And it’s getting more expensive.

Since 2007, the cost of healthcare has risen 21.6 percent, while all other prices in the economy have risen by just 17.3 percent, according to the Kaiser Family Foundation.

It’s become an unfortunate reality for many, and it’s been rightly pushed into the arena of politics.

But despite the well-intended reforms of the past two decades, including the Affordable Care Act, millions are still feeling the pinch. Why?

Too often, talk of healthcare reform is focused on insurance rather than care. It’s less about how the doctor treats your family and more about who foots the bill. Almost no one can get a straight answer about the price of procedures or medicines.

Medical insurance, once a simple way to cover higher-than-normal expenses, has become a catch-all for almost all health spending. It’s no longer about surprise injuries and illnesses. Insurance is now used to cover every ache, pain, anxiety, pill, and more. It’s like using car insurance to cover every oil change, new windshield wiper, or tire.

And in order to recoup the amount they give out, insurance companies must price their options accordingly, which leads to higher prices for consumers. That’s why healthcare expenses in 2016 amounted to 17.8 percent of GDP, higher than any other industrialized country.

At least one new doctor-patient arrangement is promising a revolution in consumer choice by bypassing insurance altogether. It’s called direct primary care, and it’s catching on across the country.

Rather than relying on insurance for ordinary health expenses, these new doctor clinics rely on monthly fees from patients, usually less than $100.

If anything more is required during doctor visits, the prices for every service and test are transparent and don’t vary depending on your plan. By not accepting insurance of any type, each clinic saves on administrative costs and overhead, prioritizing patients over costly insurers.

The results are just as intended: lower costs, more preventive care, and more face time with medical professionals.

I first learned about direct primary care when searching for a new doctor that would be flexible and affordable for my situation.

Luckily enough, I found one within driving distance in Charlotte, N.C., after consulting the mapmaintained by DPC Frontier, an online resource for direct primary care patients.

After one quick phone call, the physical was scheduled. Because the doctor wasn’t rushed to see dozens of patients, thanks to the monthly subscription model he maintains for patients, he took his time and answered every question I had. In case I needed to have anything more done, the prices for procedures, tests, and more were clearly published on his website.

Then, the bill for the simple visit was paid before I left. There was no insurance follow-up, no co-pay, and no need to file any additional paperwork. It was as if I was paying the doctor for providing the service directly, rather than the dozens of middlemen required in the current insurance racket.

But this was just a simple doctor’s visit. What would happen if I had a serious injury or disease?

Here’s what my doctor recommended: Take out a high-deductible health insurance policy intended for disasters and emergencies, and sign-up for a monthly direct primary care plan. That way, you’re covered in extreme circumstances with the high-deductible plan, but can also have preventive care with the doctor’s visits at the direct primary care clinic.

Seeing that in action was indeed refreshing. As a patient, I was empowered to own and control my own healthcare spending. And as a doctor, he was freed from bureaucracy to focus on his patients.

Whether direct primary care will be the answer to all problems remains to be seen.

Of course, chronic ailments and complicated procedures will still be of concern. Those who cannot afford the monthly fees may not be able to participate. But there is at least some momentum to open up this type of patient-doctor relationship to everyone.

For people with health savings accounts offered by employers, a bill passed by the House over the summer would allow account holders to use their health accounts on direct primary care subscriptions. It currently awaits a vote in the Senate.

A similar bill sits in the House Ways and Means Committee, presumably waiting for Congress to return from campaigning in their home districts to move it forward.

If our politicians want to try to reform healthcare, the answer may lie in empowering patients and doctors to contract on their own.

Considering there is a nationwide movement of doctors looking to free themselves from insurers, and endorsements from organizations such as the American Academy of Family Physicians, it’s worth taking another look at direct primary care.

Yaël Ossowski is an economic journalist and deputy director of the Consumer Choice Center based in Washington, D.C.

Originally published at https://www.washingtonexaminer.com/opinion/the-healthcare-system-is-a-racket-direct-primary-care-could-fix-it

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About Yaël Ossowski

Yaël Ossowski is a journalist, activist, and writer. He's currently deputy director at the Consumer Choice Center, and senior development officer for Students For Liberty. He was previously a national investigative reporter and chief Spanish translator at Watchdog.org, and worked at newspapers and television stations across the country. He received a Master’s Degree in Philosophy, Politics, Economics (PPE) at the CEVRO Institute in Prague. Born in Québec and raised in the southern United States, he currently lives in Vienna, Austria.

Das Spiel mit Desinformation

Das österreichische Forschungsportal “Addendum” hat im Juli ein Video über die Fakten von genmanipulierten Lebensmitteln veröffentlicht. Genetisch veränderte Lebensmittel stehen weiterhin unter Kritik, besonders von Organisationen wie Greenpeace. Dass Addendum-Video zeigt die unangenehme Realität der Umweltorganisation, die mit Desinformation Spendengelder einfährt.

Wer sich der Illusion hingegeben hat, dass Organisationen wie Greenpeace echte Umweltschützer sind, die sich für die Verbesserung der menschlichen Gesundheit und der biologischen Vielfalt einsetzen, wird einen schweren Schock nach dem Anschauen dieser Dokumentation erleiden. Sebastian Theissing-Matei, Sprecher von Greenpeace in Österreich, gab folgende Antworten:

Interviewer: “Im Bioland kann ich Sorten kaufen, die mit radioaktiver Strahlung oder Chemikalien erzeugt wurden. Ist das in sich logisch, das eine zu erlauben und das andere zu verteufeln?”

Theissing-Matei: “Das ist tatsächlich eine gewisse Unschärfe und ist historisch gewachsen – muss man ganz ehrlich so sagen.”

Interviewer: “Müsste Greenpeace nicht auch gegen diverse Apfelsorten kämpfen, die es im Bioladen gibt und die radioaktiv erzeugt wurden?”

Theissing-Matei: “Wie gesagt das sind Sorten, die historisch schon viel länger existiert haben. Das ist eine gewisse Unschärfe in dem Recht, ganz sicher. Wir konzentrieren uns natürlich immer auf das, was gerade als politische Debatte ansteht, und gerade da ist. Und derzeit ist das eben die politische Debatte, ob diese neuen gentechnischen Methoden auch unter Gentechnikrecht gestellt werden sollen […].”

Interviewer: “Aber sollte sich die Argumentation von Greenpeace nicht an den realen Gegebenheiten, sprich Gefahren oder Nicht-Gefahren, möglichen Nutzen orientieren, und nicht nur an dem was gerade in den Medien diskutiert wird?”

Theissing-Matei: “Wir sind eine politische Organisation, und wir versuchen natürlich immer im besten Interesse, vor allem der Umwelt zu agieren und momentan ist die politische Debatte eben, ob diese neuen gentechnischen Methoden unter Gentechnikrecht gestellt werden oder nicht.”

In vielen Ländern könnte die Aussage dass man als politische Organisation agiert öffentliche Gelder gefährden, doch Greenpeace hat sich mehr oder weniger konsequent geweigert, Zuschüsse von Regierungen (einschließlich der Europäischen Union) anzunehmen. Es muss allerdings darauf hingewiesen werden, dass die Umweltorganisation insbesondere in Europa finanzielle Unterstützung von grünen politischen Parteien erhalten hat, die ihrerseits teilweise vom Staat finanziert werden.

Was die politische Debatte betrifft, die der österreichische Greenpeace-Sprecher anspricht, so ist es interessant, diese Aussage ausgerechnet von Greenpeace zu hören. Bereits 1996 protestierte Greenpeace gegen die Ankunft eines Transportschiffes im Hamburger Hafen, das “die erste Ladung gentechnisch veränderter Sojabohnen in Deutschland” enthielt. Der Protest zeigte damals Wirkung: Der damalige Bundesforschungsminister forderte die Hersteller auf, alle ihre genetisch veränderte Lebensmittel zu kennzeichnen. Dass überhaupt über das Thema gesprochen wird liegt an Greenpeace, und da Greenpeace nur über die Themen spricht die auch besprochen werden, sind ihnen scheinbar bei der Themenwahl die Hände gebunden. Bei Greenpeace funktionieren die selbsterfüllenden Prophezeiungen scheinbar gut.

Auf jeden Fall ist es eine Sache, sich 1996 gegen gentechnisch veränderte Lebensmittel zu stellen, als 20 Jahre später. Die kürzlich von vom Wissenschaftsmagazin “Nature” veröffentlichte Meta-Analyse zu gentechnisch verändertem Mais auf agronomische, ökologische und toxikologische Eigenschaften zeigt deutlich, dass Insekten, die sich nicht von Mais ernähren, nicht betroffen sind und dass gentechnisch veränderter Mais deutlich geringere Konzentrationen an krebserregenden Mykotoxinen aufweist. Aber für Greenpeace zählen wissenschaftliche Beweise nicht, sondern nur wie viele Spendengelder man mit Angstmacherei akquirieren kann. Das bestätigt auch der ehemalige Greenpeace-Aktivist Ludger Wess, der als einer der ersten Journalisten in Europa über die aufstrebende Biotechnologie- und Hightech-Industrie berichtet:

“Greenpeace war am Anfang der Gentechnik bei Pflanzen und in der Landwirtschaft durchaus aufgeschlossen, weil man gesagt hat: Wenn es stimmt dass die Pflanzen gegen die Schädlinge resistent machen kann, dann ist das eine tolle Sache da man dadurch Insektizide einspart, also sind wir dafür.

Nach der Rückkehr von einer Wissenschaftskonferenz über gentechnisch veränderten Mais im Jahr 1998 wandte sich Wess wieder an Greenpeace:

“Ich kam dann zurück, bewaffnet mit einem Koffer voller Papiere, und hatte sehr viele Gespräche geführt mit Behördenmitarbeitern und mit Wissenschaftlern, und die haben meine Befürchtungen allesamt entkräften können und ich war danach nicht mehr davon überzeugt, dass da eine Gefahr für die menschliche Gesundheit besteht.”

Ich hab dann gesagt: Also wir können diese Behauptung dass es möglicherweise gesundheitsschädlich ist, nicht aufrecht erhalten, es stimmt einfach nicht. Und dann wurde mir gesagt: Naja, wir behaupten das trotzdem weiter, weil nur wenn die Leute Angst um ihre Gesundheit haben, oder die Gesundheit ihrer Kinder haben, dann geht das Spendenportmonnaie auf. Alles andere ist nicht kampagnenfähig.”

Greenpeace hat in der Vergangenheit mehr Interesse an Öffentlichkeitsarbeit als an konstruktiven Diskussionen gezeigt. Sei es das gewaltsame Blockieren von Tankstellen in Luxemburg, die aggressive Störung der Arbeit einer Ölplattform oder gar die Lackierung des Kreisverkehrs an der Berliner Siegessäule, die Schäden an Autos und Tausende von Euros für Reinigungskosten verursacht hat: Greenpeace ist eine aufmerksamkeitssüchtige, anti-wissenschaftliche Aktivistengruppe, die die Umwelt als Vorwand benutzt, um ihre uninformierte Voreingenommenheit gegen alles zu propagieren, was der menschlichen Gesundheit und Ernährung einen Nutzen sein könnte.

Die derzeitigen Geldgeber dieser Organisation müssen sich die Frage stellen, ob sie diese (selbst-beschriebene) politische Organisation unterstützen wollen, der Fakten mehr als egal sind.

Originally published at https://www.theeuropean.de/bill-wirtz/14656-greenpeace

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About Bill Wirtz

Bill Wirtz is policy analyst for the Consumer Choice Center, based in Brussels, Belgium. Originally from Luxembourg, his articles have appeared across the world in English, French, German, and Luxembourgish. He is Editor-in-Chief of Speak Freely, the blog of European Students for Liberty, a contributing editor for the Freedom Today Network and a regular contributor for the Foundation for Economic Education (FEE). He blogs regularly on his website in four languages.

The case for defunding the WHO

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About Bill Wirtz

Bill Wirtz is policy analyst for the Consumer Choice Center, based in Brussels, Belgium. Originally from Luxembourg, his articles have appeared across the world in English, French, German, and Luxembourgish. He is Editor-in-Chief of Speak Freely, the blog of European Students for Liberty, a contributing editor for the Freedom Today Network and a regular contributor for the Foundation for Economic Education (FEE). He blogs regularly on his website in four languages.

Five reasons to rethink Britain’s public health spending

By Fred Roeder and Chloe Westley

With a combined budget of over 100 million pounds, taxpayers in the United Kingdom are some of the largest contributors to the World Health Organisation’s (WHO) budget. Britain also spends nearly 1 billion pounds on various other bilateral public health initiatives around the globe. Unfortunately, many of these projects are not improving people’s health or dealing with global pandemics. Instead, this money is wasted on inflated and decadent bureaucracies and ideological projects.

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About Fred Roeder

Fred Roder has been working in the field of grassroots activism for over eight years. He is a Health Economist from Germany and has worked in healthcare reform and market access in North America, Europe, and several former Soviet Republics. One of his passions is to analyze how disruptive industries and technologies allow consumers more choice at a lower cost. Fred is very interested in consumer choice and regulatory trends in the following industries: FMCG, Sharing Economy, Airlines. In 2014 he organized a protest in Berlin advocating for competition in the Taxi market. Fred has traveled to 100 countries and is looking forward to visiting the other half of the world’s countries. Among many op-eds and media appearances, he has been published in the Frankfurter Allgemeine Zeitung, Wirtschaftswoche, Die Welt, the BBC, SunTV, ABC Portland News, Montreal Gazette, Handelsblatt, Huffington Post Germany, CityAM. L’Agefi, and The Guardian. Since 2012 he serves as an Associated Researcher at the Montreal Economic Institute.

Germany should allow donating organs to strangers

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About Fred Roeder

Fred Roder has been working in the field of grassroots activism for over eight years. He is a Health Economist from Germany and has worked in healthcare reform and market access in North America, Europe, and several former Soviet Republics. One of his passions is to analyze how disruptive industries and technologies allow consumers more choice at a lower cost. Fred is very interested in consumer choice and regulatory trends in the following industries: FMCG, Sharing Economy, Airlines. In 2014 he organized a protest in Berlin advocating for competition in the Taxi market. Fred has traveled to 100 countries and is looking forward to visiting the other half of the world’s countries. Among many op-eds and media appearances, he has been published in the Frankfurter Allgemeine Zeitung, Wirtschaftswoche, Die Welt, the BBC, SunTV, ABC Portland News, Montreal Gazette, Handelsblatt, Huffington Post Germany, CityAM. L’Agefi, and The Guardian. Since 2012 he serves as an Associated Researcher at the Montreal Economic Institute.

Dental therapists and dental reform

ARIZONA CAPITOL TIMES: To drill or not to drill?

For the past few months, it’s a question Arizona state lawmakers have been asking themselves and various experts in the dental field.

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About Yaël Ossowski

Yaël Ossowski is a journalist, activist, and writer. He's currently deputy director at the Consumer Choice Center, and senior development officer for Students For Liberty. He was previously a national investigative reporter and chief Spanish translator at Watchdog.org, and worked at newspapers and television stations across the country. He received a Master’s Degree in Philosophy, Politics, Economics (PPE) at the CEVRO Institute in Prague. Born in Québec and raised in the southern United States, he currently lives in Vienna, Austria.

Rejection Of Right To Try Bill Is Cruel And Inhumane

FOR IMMEDIATE RELEASE:

CONTACT:

David Clement

North American Affairs Manager

Consumer Choice Center

[email protected]

 

Rejection Of Right To Try Bill Is Cruel And Inhumane

Washington DC – Yesterday, the House rejected a bill that would have given terminally ill patients the right to experimental medicines. The bill required 2/3rds support but failed to reach that mark having 259 vote in favor, and 140 vote in opposition. The majority of the opposition votes came from House Democrats, with Rep. Frank Pallone Jr stating “By defeating this bill tonight, we protected patients and supported F.D.A.’s continued role in approving experimental treatments that may help save a patient’s life”

The Consumer Choice Center condemns the rejection of “right to try” legislation and states that such prohibitions do nothing to protect terminally ill patients.

“Those who oppose the right to try, on patient protection grounds, fail to realize that we are talking about terminally ill patients. Denying those patients the right to try experimental drugs sentences them to succumb to their illness. To call that protecting patients is inhumane. Preventing a competent, consenting adult from taking a risk to save their life is both disgustingly paternalistic and incredibly cruel” David Clement, North American Affairs Manager for the Consumer Choice Center

 ***CCC North America Affairs Manager David Clement is available to speak with accredited media on consumer regulations and patient choice issues. Please send media inquiries HERE.***

The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Ottawa, Washington, Brussels, Geneva and other hotspots of regulation and inform and activate consumers to fight for #ConsumerChoice. Learn more at consumerchoicecenter.org.

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About David Clement

David Clement is the North American Affairs Manager for the Consumer Choice Center and is based out of Oakville, Ontario. David holds a BA in Political Science and a MA in International Relations from Wilfrid Laurier University. Previously, David was the Research Assistant to the Canada Research Chair in International Human Rights. David has been regularly featured on the CBC, Global News, The Toronto Star and various other major Canadian news outlets.

Dental therapist bill passes Senate health committee as latest voter poll rejects the concept

PHOENIX BUSINESS JOURNAL: A new poll released said 68 percent of Arizonans don’t want a new mid-level dental therapy profession.

Commissioned by Consumer Choice Center and conducted by OH Predictive Insights, the telephone poll was conducted Feb. 7-8 among a sample of 601 registered Arizona voters.

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About Yaël Ossowski

Yaël Ossowski is a journalist, activist, and writer. He's currently deputy director at the Consumer Choice Center, and senior development officer for Students For Liberty. He was previously a national investigative reporter and chief Spanish translator at Watchdog.org, and worked at newspapers and television stations across the country. He received a Master’s Degree in Philosophy, Politics, Economics (PPE) at the CEVRO Institute in Prague. Born in Québec and raised in the southern United States, he currently lives in Vienna, Austria.

Dental Therapists: A new dental category may not be the answer

Because so much of the U.S. healthcare system is focused on medical expenses, benefits, and insurance programs, it’s an unfortunate fact that dental care is often neglected.

An estimated 35.6 percent of U.S. adults didn’t visit a dentist last year, along with 55.3 percent of Medicaid-eligible children.

Is it mostly because people cannot find enough dentists or because costs are too high?

For consumers, it seems the single biggest reason for not visiting a dentist is cost. Knowing these facts, what can we do in order to help reduce costs for dental patients around the country? It’s a serious question which invites a good amount of discussion and recommendations.

In Florida, legislators and dental professionals have called for the state to improve the dental workforce by establishing a special loan program for dentists who practice in high-need areas.

That would at least increase the number of dentists and ease the burden for dental students who face an average amount of $287,331 in debt once they leave school.

In states like New Mexico, Arizona, and Florida, there is a movement afoot to introduce a new professional category in the field of dental care, known as dental therapists.

Dental therapists, unlike dentists, require less training and education, and could presumably offer their services at a lower cost, albeit while not fully capable of performing more complex procedures.

Such programs have already been implemented in states such as Maine, Vermont, and Minnesota, and in countries like New Zealand and Canada, but the results haven’t been clear.

New Zealand first implemented dental therapy programs early in the 20th century, and they formalized their degree program in 1999.

In the last two decades, however, the rate of child tooth decay has increased wildly, forcing thousands of children to face hospitalization or emergy surgeries. The number of children hospitalized for dental issues has skyrocketed from 4500 to 7500 in the past 15 years. So that result doesn’t seem positive.

One researcher at the School of Public Health at the University of Minnesota studying this issue is very skeptical it will work in that state.

However, the reality is that this hasn’t truly addressed the problem of that growing disparity between rural and urban oral health. As of December 2016, there were only 63 licensed dental therapists, half of whom were practicing in the Twin Cities metropolitan area.

It seems that dental therapy school graduates, once able to practice, are flocking to major cities in order to pay off their debts as well.

Organizations such as Pew Charitable Trust have crafted multi-state campaigns in order to advocate for the midlevel dental position, advocating for legislation which would allow dental therapists to become legal professions and be eligible for accepting Medicaid funding.

And that last distinction is important to note.

If we look at the state of Arizona, for example, there are 1,921,145 Arizonians on the Medicaid program, according to the  Arizona Health Care Cost Containment System. That’s 27 percent of the population eligible to have dental treatments covered as part of their public plans paid by taxpayers.

If dental therapists become a category of dental professionals and are able to perform dental services, they will also be eligible to accept Medicaid funding.

Would consumers benefit from such a scenario? Would patients be able to afford better care and have access to higher quality dental services?

That much is unclear, but the numbers from states and countries which have implemented dental therapy programs give us pause on whether they have been effective.

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About Yaël Ossowski

Yaël Ossowski is a journalist, activist, and writer. He's currently deputy director at the Consumer Choice Center, and senior development officer for Students For Liberty. He was previously a national investigative reporter and chief Spanish translator at Watchdog.org, and worked at newspapers and television stations across the country. He received a Master’s Degree in Philosophy, Politics, Economics (PPE) at the CEVRO Institute in Prague. Born in Québec and raised in the southern United States, he currently lives in Vienna, Austria.

It’s time to legalize paid plasma donations in Ontario

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About David Clement

David Clement is the North American Affairs Manager for the Consumer Choice Center and is based out of Oakville, Ontario. David holds a BA in Political Science and a MA in International Relations from Wilfrid Laurier University. Previously, David was the Research Assistant to the Canada Research Chair in International Human Rights. David has been regularly featured on the CBC, Global News, The Toronto Star and various other major Canadian news outlets.